HomeMy WebLinkAbout23-13971 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 2 27c
COLLISION REP FIT 1591971
CASE 23-13971 z
INTERSTATE ❑ CITY STREET FIRE ❑RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHIl.I F ❑ LOCAL AOENC 4Y00 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 3 TOTAL#OF OBJECT 1 1 8 28
TRIBAL UNITS OZ RESERVATION STRUCK
z
3❑ DATE dF M M D D Y Y Y Y TIME(2400) COUNTY# MILES N E IN CITY# ❑
CdwsloN 12 - 1-- 2023 1620 17 ❑.= S 8 E IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓
NE 4TH STREET BLOCK NO. e✓ 4000
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5 316 00 FEET e S ❑ E e UNION AVE NE❑
0 1 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
�/No D:4259196464 0 4 30
6� LAST NAME TOJ FIRSTNAME FAITH MIDDLE A 1 1 2 31
INITIAL
STREET ❑✓ 4311 NE 5TH ST B101 APT B101 CITY RENTON ST WA ZIP 980590000 z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
1/ I INTERLOCK YES[:]NO NTERLOCKYEs NO�/ YES R No�/
8❑ LRIIVERS STATE WA SEX'F MM DAY' 05 1- 18 - 2004 2 32
CENSE 9 ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 H U EET 2 CLASS 1 NATURE OF INJURIES z❑
3
,OF
P1 ATNES# AEV8017 sTAr WAuN# 1N4AL11D45C145346
-- TRAILER STATE TRAILER STATE
11 3 5 PLATE# PLATE# FROM To
TRLR. TRLR 3 7 33
12 0 0 VIN#j VIN#
:: FROM TO
VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE 1 3 34
13 2005 NISS ALTIMA 4D DAMAGE YES NO YES[:] No
✓
REGISTERED OWNER INFO CONNIE GARNES 4103 NE 11TH ST RENTONWA98059 D:4259196464 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
2 3 4
14 9 LIABILI INSURANCE INSURANCE CO GEICO 4068948365
IN EFFECT &POLICY# 9TOP
vErIICE CHARGE 10 BOTTOM 5 36
LEGALLY YES No clTAnoN# W23067377 OPERATION W/O HEADLIGHTS WHEN
15❑ STANDING 7 6
MOTOR PEDAL- :PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT 02 VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES 1/ NO D:2067159683
16 a
LAST NAME MERCER FIRST NAME JOHN MIDDLE I E
INITIAL
17 STREET I❑ s❑' 18906 107TH STREET CT NW CITY GIG HARBOR ST WA ZIP 983295590 4❑ 37
NEW ADOREs
18❑ CDL IGNITION REQUIRED IGNITION PR-E-1SENT MEDICAL-T�RANSPORTED � 38
INTERLOCKYES�NO� INTERLOCK YEs It I NOF YES
t l NOF,/
19 DRIVER'S STATE WA SEX M D.O.B. 03 _ 25 _ 1943 39
LICENSE# MMDDYY
20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 H U EET 2 NJAURSY 1 NATURE OF INJURIES 40
LICENSE I ❑21❑ PLA E# BXK8480 TArE 41
WA VIN# 2T2JGMDA1MC060449 1
42
22❑ PLATE# STATE PLATE# STATE
TRLR
23❑ UIN#. N#.
43
RLR
'I
VEH YEAR 2021 MAKE LEXS MODEL RX STYLE SV VEHICLETOWED TO BLIN TOWEDBY GOV HI 44
L4❑ DAMAGE YES NO YES NO
REGISTERED OWNER INFO JUNE MERCER 18906107TH STREET CT NW GIG HARBOR WA 98329 D:2067159683 VEHICLE NO.2
SHADE IN DAMAGED AREA
2 3 4
LIABILITY
INSURANCE &POINSURGY#E CO NATIONWIDE PA00162717-06IN 9TOP
'E""LE ❑ ,J� CITATION# CHARGE BOTTOM
LEGALLY YES N J
25 e
=UGENT
(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
26 11498 WA0171300
PAGE 01 OF
PART A
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EE32471
COLLISION REPORT III III III III III 111
1591972 CASE# 23-13971
ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY)
NAME MIDDLE INITIAL) HOLMBERG ANDERS B
(I.P.ST FIRST,
ADDRESS&PHONE# D O.B. '
20217 SE 157TH ST RENTON WA 980598212 4259415885 SEX M MMDOYyry 12 - 21 - 1978
PASSENGER WITNESS❑✓ UNIT# SEAT AIRBAG RESTR. EJECT ' HELMET INJURY
POS. NATURE of INJURIES
❑ USE CLASS
NAME
(LAST,FIRST,MIDDLE INITIAL)
ADDRESS&PHONE# DOB
SEX: MMDDYYYY
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.O.B.MMDD -❑
YYYY.
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 12-07-23 01:28 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
C.JACOBS 1953 12/20/2023 10:01:11 AM
BADGE OR ID# 11498 ORI# WA0171300 TIME POLICE DISPATCHED; 4:22 Pry TIME POLICE ARRIVED',4:35 PM
PART I PAGE IT]OF 5�
REPORT NO. EE32471 CASE# 23-13971 OF COLLISION
12/05/23 16:20
OF CbLLI510N
NARRATIVE
23-13971
On 12/05/2023 at approximately 1623 hours, I was dispatched to a non-injury and non-blocking
vehicle collision in the 4000 block of NE 4th Street, within the City Limits of Renton, County of King,
State of Washington.
Upon my arrival, I confirmed there were no complaints of injury requiring immediate medical response
at the time of report. While on scene, I collected each involved party's driving documents and
independent recollection of their involvement leading up to the collision.
The driver of Unit#1 said she was the sole occupant of her vehicle and was traveling westbound in
about the 4000 block of NE 4th ST (in-between Queen Ave NE and Union Ave NE) in lane 2 of 2. The
driver of Unit#1 stated she was intending to continue west. Upon reaching the location of where Unit
#2 was turning out from, the driver of Unit#1 observed Unit#2 began to enter the roadway from the
private parking lot located on the north side of the roadway. The driver of U1 stated that U2 crossed
into her lane of travel and that she was unable to avoid the collision. Both vehicles collided in the
roadway and Unit#1 suffered moderate damage to the front driver's side quarter panel, bumper, and
fender of the vehicle.
The driver of Unit#2 stated that he and his adult passenger were attempting to exit a private property
parking lot, located at 4004 NE 4th ST, and on the north side of the roadway. The driver of Unit#2
stated that he was intending to make a left turn out of the parking lot with the intent to proceed
eastbound onto NE 4th ST following the turn. The driver of Unit#2 believed all westbound traffic on
NE 4th ST was clear and therefore proceeded out into the roadway. As Unit#2 reached westbound
lane 2 of 2, Unit#2 was met by another vehicle - Unit#1. The driver of Unit#2 claimed he did not see
Unit#1 due to the vehicle not having headlights illuminated and it being a dark vehicle. The driver of
Unit#2 stated that once Unit#1 was noticed, he was unable to avoid the collision after having pulled
out into the roadway and Unit#1 struck the front driver's side of Unit#2 subsequently causing
moderate damage because of the collision.
A witness who remained at the scene, identified by pictured WADL as Anders Holmberg, stated that
he saw the collision occur. Holmberg stated that Unit#1 did not have headlights on at a time of
darkness and should have. Holmberg stated that he would not have normally stopped to be a witness
but stated that he felt that with Unit#1 having no headlights being turned on, it was a safety hazard.
It should be noted that at the time of report, it was dark outside with street lights illuminated. I had to
use my flashlight while interacting with the involved parties due to the level of darkness. This incident
was captured and recorded on Axon BodyCam and automatically uploaded to this case.
Based on the above statements, I believe that the driver of Unit#1 (Toj) was the predominant factor
for the cause of collision as Unit#1 violated RCW 46.37.020 -Every vehicle upon a highway within
this state at any time from a half hour after sunset to a half hour before sunrise and at any other time
when, due to insufficient light or unfavorable atmospheric conditions, persons and vehicles on the
highway are not clearly discernible at a distance of one thousand feet ahead shall display lighted
headlights, other lights, and illuminating devices as hereinafter respectively required for different
classes of vehicles.
I mailed the driver of Unit#1 (Toj) a written warning via mail for Improper Lighted Lamps displayed.
Both Unit#1 and Unit#2 were moved off the roadway and were unsure if they were going to have
their respective vehicles impounded or drive them home. An exchange of information was provided to
PAGE 3 OF 5
REPORT NO. EE32471 CASE# 23-13971 OF COLLISION
12/05/23 16:20
OF CbLLI510N
NARRATIVE
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.
Electronically signed by Officer M. Nugent#11498 12/7/2023 1:01 PM Renton, King County, WA.
PAGE 4 OF 5
REPORT NO. EE32471 CASE# ' 23-13971 DATE AND TIME 12/05/23 16:20
OF COLLISION
4
PAGE 5 OF 5