HomeMy WebLinkAbout23-13897 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 0 27c
COLLISION REP FIT 1591971
CASE 23-13897 z
INTERSTATE ❑ CITY STREET FIRE ❑RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHIl.I F ❑ LOCAL AOENC 4900 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 2 TOTAL#OF OBJECT 1 1 8 28
TRIBAL UNITS OZ RESERVATION STRUCK
z
3❑ DATE OF M M D D Y Y Y Y TIME(2400) COUNTY# MILES N E IN CITY#
CawsloN 12 - 1-- 2023 1552 17 ❑-= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
NE 4TH STREET BLOCK NO. e✓ 4700 ❑
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ �.❑ FEET e S ❑ W e DUVAL!AVE NE
0 4 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
,/NO D:2069608776 0 11
30
6� LAST NAME AHMED FIRSTNAME MOHAMED MIDDLE A 1 2 31
INITIAL
STREET ❑ 14839 MILITARY RD S APT 129 CITY TUKWILA ST WA ZIP' 981684814 z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
1/INTERLOCK YES[:]NO INTERLOCKYEs Z/NO YES �No /
LRIIVER # STATE WA SEX'M MI MIT Y
8❑ ' 09 - 29 - 1991 1 2 32
9 ON DUTY❑ STATUS' AIRBAG 2 RESTR 4 EJECT 1 HELMET U E 2 7 CLASS NAT CIOBACK PAINES 2❑
3
10 1❑ �i aE'r�S� 7T6GV sTATe UT vrN# 3KPF34AD7ME403089
TRAILER STATE TRAILER STATE
11 3 51 PLATE# PLATE# FROM TO
TRLR 7 1. TRLR 33
12 3 5 VIN#' VIN#
FROM TO
❑ VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE 3 7 34
13 3 2021 KIA FORTE 4D DAMAGE YES NO YES[:] NO✓
REGISTERED OWNER INFO OWNEDBYDRIVER VEHICLE NO. 1
SHADE IN DAMAGED AREA ❑ 35
14 LIABILITY INSURANCE INSURANCE CO GEICO 6096-45.44.64 3
IN EFFECT &POLICY# 9TOP
veFFE CHARGE 1 36
LEGALLY YES❑NO CITATION# 3A0637881 FAIL YIELD LEFT TURN MOTOR aorroM
15❑ STANDING 8 7 6
MOTOR PEDAL-:. .PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT a2 VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES 1/ NO D:4257533222
16 a
LAST NAME SYTSMA FIRST NAME KARINN MIDDLE R
INITIAL
17❑ STREET NEW ADDRESS❑' 5320 NE 22ND CT CITY RENTON ST WA ZIP 98059 37
18❑ CDL IGNITION REQUIRED IGNITION PtR-E-S1ENT MEDICAL t-T�RANSPORTED � 38
INTERLOCKYES�NO INTERLOCK YEs I I NOF YES F, NO❑
19 LDI IVER # STATE WA SEX DDY
M M .C... 11 � 000 15 _ 2 39
20❑ ON DUTY STATUS AIRBAG,3 RESTR 4 EJECT 1 HELMET 2 INJURY 5 NATURE of INJURIES ❑ 40
USE CLASS LEFT ARM FX
❑ 41
21❑ ILICENSE PLA E# BDL3916 TATE WA VIN# 2HGF62F88FH510812 1
42
22❑ PLATE# STATE PLATE# STATE
TRLR
23❑ VIN#. N#. 43
RLR
'I
VEH YEAR 2015 MAKE HOND MODEL CIVIC STYLE 4D VEHICLE TOWED TO BLIN TOWEDBY GOV HI 44
L4❑ DAMAGE YES NO YES NO
REGISTERED OWNER INFO KARINN SYTSMA 5320 NE 22ND CT RENTON WA 98059 D:4257533222 VEHICLE NO.2
SHADEDAMAGEDAREA
3 4
LIABILITY
INSURANCE &POINSURGY#E CO CONNECT A1031 2 5 6 74IN STOP 5
'E"'LE ❑ ,J� CITATION# CHARGE to BOTTOM
LEGALLY YES N J
25 e
=UGENT
PRINT) OFFICER PHONE BADGE OR ID# AGENCY26 11498 WA0171300
PAGE 01 OF
PART A
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EE26994
COLLISION REPORT III III III III III 111
1591972 CASE# 23-13897
ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY)
NAME MIDDLE INITIAL) SYTSMA VONNI D
(LAST FIRST,
ADDRESS&PHONE# D O.B. '
5320 NE 22ND CT RENTON WA 98059 4257533222 SEXi F MMDOYyry 11 - 18 - 1968
PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT ' HELMET INJURY NATURE OF INJURIES
❑ 2 POS. i 3 3 4 1 USE 1 2 CLASS 11
NAME
(LAST,FIRST,MIDDLE INITIAL)
ADDRESS&PHONE# DOB
SEX MMDDYVYV
PASSENGER ❑WITNESS❑ UNIT# SEAT AIRBAG RESTR. EJECT HELMET NJURY NATURE OF INJURIES
POS. USE CLASS
NAME
(LAST FIR57 MIDDLE INITIAL)
AppRESS R PHONE#
SEX D.Q.B. -❑
MMDDYYYY.
PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET NJURY NATURE OF INJURIES
❑ ❑ POS. USE CLASS ----�
NARRATIVE'
Please see subsequent narrative pages
I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT.
MATTHEW NUGENT 12-04-23 07:16 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
C.JACOBS 1953 1 12/5/2023 11:28:00 AM
BADGE OR ID# 11498 ORI# WA0171300 TIME POLICE DISPATCHED 3:54 PM TIME POLICE ARRIVED',3:57 PM
PART I PAGE IT]OF 5�
REPORT NO. EE26994 CASE# 23-13897 OF COLLISION
12/04/23 15:52
OF CbLLI510N
NARRATIVE
23-13897
On 12/04/2023 at approximately 1554 hours, I was dispatched to an injury and blocking vehicle
collision at the intersection of NE 4th Street and Duvall Ave NE, within the City Limits of Renton,
County of King, State of Washington. Dispatched advised that the collision involved two vehicles and
that both involved parties were complaining of pain. Dispatch advised the Renton Regional Fire
Authority (RRFA) would be responding as well.
Prior to my arrival, Officer J. Weber had arrived on scene and began evaluating those involved. Upon
my arrival, I confirmed there was a complaint of injury for back pain from the driver of Unit#1, as well
as airbag deployment and left arm pain from the driver of Unit#2. RRFA later responded and
evaluated all involved patients. The driver of Unit#2 was later transported via ambulance to Valley
Medical Center (VMC) for a suspected arm fracture.
The driver of Unit#1 said he was the sole occupant of his vehicle and was traveling eastbound on NE
4th ST approaching the intersection of Duvall Ave NE in the left-turn lane (lane 3 of 3). The driver of
Unit#1 stated he was intending to make a northbound (left) turn from the eastbound lanes of NE 4th
Street onto Duvall Ave NE. The driver of Unit#1 said he saw the traffic signal was turning yellow,
which he alleged was a solid green arrow turning to yellow light, and stated he believed he had the
right of way. The driver of Unit#1 proceeded out into the intersection to make the left turn. While
making the turn, both Unit#1 and Unit#2 collided in the intersection causing significant damage to
the rear passenger side of Unit#1.
The driver of Unit#2 stated that she and her adult passenger were traveling westbound on NE 4th
Street approaching the intersection of Duvall Ave NE in lane 3 of 4. Per Officer Weber, the Driver of
Unit#2 stated that she was approaching the intersection with the intent to continue westbound. The
driver of Unit#2 stated that once she reached the intersection, which she alleged was a solid green
light, is when Unit#1 turned out into the intersection and in front of Unit#2's direction of travel. Unit
#2 was unable to avoid the collision and collided with the passenger side of Unit#1 causing
significant damage to the front of Unit#2.
A video was provided to Officer Weber which confirmed that Unit#2 did in fact have a green light and
had the right of way while traveling westbound on NE 4th Street. A copy of the video has since been
uploaded to Evidence.com under the above-mentioned case number.
Based on the above statements, 1 determined that the driver of Unit#1 (Ahmed) did not grant the right
of way to Unit#2 traveling in the roadway which had the right of way and was already underway. The
driver of Unit#1 was turning left and traversing across traffic and must not do so until it is clear of
hazard/traffic. The driver of Unit#1 (Ahmed) violated RCW 46.61.185.1 by being the driver of a
vehicle intending to turn to the left within an intersection and shall yield the right-of-way to any vehicle
approaching from the opposite direction which is within the intersection or so close thereto as to
constitute an immediate hazard.
I cited Ahmed via mail for not granting the right of way during a left turn causing a collision.
Both Unit#1 and Unit#2 were moved off of the roadway but would require further assistance due to
significant damage. An exchange of information and case number was provided to all involved
parties.
I certify (or declare) under penalty of perjury under the laws of the State of Washington that the
foregoing is true and correct.
PAGE 3 OF 5
REPORT NO. EE26994 CASE# 23-13897 OF COLLISION
12/04/23 15:52
OF CbLLI510N
NARRATIVE
Electronically signed by Officer M. Nugent#11498 6:58 PM 12/4/2023 Renton, King County, WA.
PAGE 4 OF 5
REPORT NO. EE26994 CASE# ' 23-13897 DATE AND TIME 12/04/23 15:52
OF COLLISION
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PAGE 5 OF 5