HomeMy WebLinkAbout23-14060 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 0 27c
COLLISION REP FIT 1591971
CASE 23-14060 z
INTERSTATE ❑ CITY STREET FIRE ❑RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHIC;I F ❑ LOCAL AOENC 4200 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 3 TOTAL#OF OBJECT 1 1 8 28
TRIBAL UNITS OZ STRUCK
RESERVATION
z
3❑ DATE of M M D D Y Y Y Y TIME(2400) COUNTY# MILES N E IN CITY# ❑
COLLISION.. 12 - 1-- 2023 1323 17 ❑.= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓
SE PETROVITSKY RD BLOCK NO. e✓ 12500
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ 250 00 FEET MILES e S ❑ W e 128THAVESE
0 1 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
✓NO D:2065109418 0 11
30
6� LAST NAME WAMBOLD FIRSTNAME GREGORY MIDDLE D 1 1 2 31
INITIAL
STREET El 5919 10TH ST NE CITY TACOMA ST WA ZIP, 984223801 z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
iNTERLOCKYEs NO INTERLOCKYEs NO YES R NO
8❑ L IIER # STATE yyq SEX'M I ELMM D Y' 12 - 09 - 1956 1 1 2 32
9 ON DUTY❑ STATUS AIRBAG 3 RESTR 4 EJECT 1 H USE CLASS
ICNLJAURY 1 NATURE OF INJURIES z❑
3
10 9❑ PI ATE 14 C17088P STATE WA VIN# 1FTEXICPXJKF83506
TRAILER STATE TRAILER STATE
11 3 5 PLATE# PLATE# FROM TO
TRLR. TRLR 7 3 33
12 3 5 VIN#' VIN#
>; FROM TO
VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TR Y GOVT.VEHICLE 7 $ 34
13 2018 FORD F150 DAMAGE YES NO �MEYER YES❑ No✓
REGISTERED OWNER INFO ORE.ORI..OLD 591910TH ST NE TACOMA WA 984223801 D:2065109418 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
14 LIABILITY INSURANCE INSURANCE CO TRAVELERS 8104T8534432243G <1�3 4
IN EFFECT &POLICY# TOPvENICLE CHARGE 36
LEGALLv YEs No clTAnoN# 3A0681748 NEGLIGENT DRIVING 2ND DEGREE orrom
15❑ ITAIN.D— 6
UNIT VE IOOR Z CYCLE ❑ PEDESTRIAN ❑ OWNER YES
❑ DYES�/ NO OLD MET PHONE
16 a
LAST NAME LAM FIRST NAME KATHY MIDDLE H
INITIAL
17❑ STREET ❑', 15400 SE 155TH PL UNIT 53 CITY' RENTON ST WA ZIP 980586352 37
NEW ADDRESS ❑
18� CDL IGNITION REQUIRED IGNITION PtR-E-S1ENT MEDICAL TRANSPORTED 38
INTERLOCKYES�NOR INTERLOCK YEs I I NOF YES t l NO❑
19 DRIVER'S STATE WA SEX F D.C.B. O6 _ 29 _ 1994 39
LICENSE# MMDDYY
WELMET INJURY1 NATURE OF INJURIES 40
20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 USE CLASS ❑
21❑ LICENSE ALM6910 TATe WA VIN# 5YFBU4EE7DP127283
❑ 41
PLATE#
42
22❑ PLATE# STATE PLATE# STATE
TRLR
23❑ UIN#. IN#.
43
RLR
'
VEH YEAR 2013 MAKE TOYT MODEL COROLL STYLE VEHICLE TOWED TO BLIN TOWEDBY GOV HI 44
24 DAMAGE YES NO GENE MEYER YES NO
REGISTERED OWNER INFO KATHY LAM 15400 SE 155TH PL UNIT 53 RENTON WA 980586352 VEHICLE NO.2
SHADE IN DAMAGEbAREA
2 3 Cd
LIABILITY
INSURANCE I PORGY#ECO ST FARM 486960000747DIN 1U
9TOP
'E""LE ❑ ,J� CITATION# CHARGE o BOTTOMLEGALYYES N`L J25 '
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
J
26
M.LEVERTON 2517 WA0171300
PART A PAGE 01 OF C7
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EE32833
COLLISION REPORT III III III III III 111
1591972 CASE# 23-14060
ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY)
NAME
(LAST FIRST,MIDDLE INITIAL)_
ADDRESS&PHONE#
SEX D.O.B. - -
MMDDYYYY.
PASSENGER❑WITNESS UNIT# SEAT AIRBAG RESTR. EJECT ' HELMET INJURY NATURE OF INJURIES
PM USE CLASS
NAME
'(LAST,FIRST MIDDLE INITIAL)
ADDRESS&PHONE# D D B
SEX MMDDYYYY
PASSENGER ❑WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET INJURY NATURE OF INJURIES
POS. USE CLASS
NAME
(LAST FIR57 MIDDLE INITIAL)
AppRESS R PHONE#
SEX D.O.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.
M.LEVERTON 12-07-23 03:13 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
CO.JOHNSON 0505 1 12/21/2023 8:08:42 AM
BADGE OR ID# 2517 ORI# WA0171300 TIME POLICE DISPATCHED; 1:24 Pry TIME POLICE ARRIVED',4:Y9 Pry
PART I PAGE IT]OF 4�
REPORT NO. EE32833 CASE# 23-14060 OF COLLISION
12/07/23 13:23
OF CbLLI510N
NARRATIVE
blue sedan/2 lane 2 eb silver truckl rear ended moving 2
CC
Within the city limits of Renton/King/Wa I responded to a 2 car blocking crash at about the 12500
block of SE Petrovitsky Rd.
When I arrived I located a truck pushed well into the back of a sedan. Both were blocking lane 2
eastbound. It looked like unit 2 had stopped for traffic and unit 1 did not stop until impact.
I contacted the driver of unit 2 who told me she was eastbound at about 35 mph when she was hit in
the back by unit 2. 1 asked her again if she was slowing, or stopped for traffic and she told me no she
was going 35 mph when she was hit from behind by the truck/unit 1. She was checked and released
by Renton Fire for being shook up. Damages were extreme and required a tow truck.
I contacted the driver of unit 1 ID'd by his picture WADL. He told me he was going with the flow of
traffic and rear-ended unit 2. When I questioned if she was moving/under way when he hit her he said
there was traffic up a ways that was turning. He did not complain of injury and damages required a
tow truck.
I contacted unit 2 again to clarify any misunderstandings of the collision. The damage to unit 2 looked
like she was stopped and was hit from behind at about 35-40 mph. Unit 2 driver said she was just
driving along, at about 35 when she was hit from behind, she was very matter of fact that her speed
was 35 when she was hit.
I asked unit 1 how fast was he going, 60, and he said he wasnt looking at this speedometer but was
going with traffic.
Negligent driving—econd degree. (1)(a) A person is guilty of negligent driving in the second degree if,
under circumstances not constituting negligent driving in the first degree, he or she operates a motor
vehicle in a manner that is both negligent and endangers or is likely to endanger any person or
property.
Unit 1 driver Wambold did operate with negligence causing a 2 car blocking crash and, without
question, totaled unit 2 vehicle. I cited unit 1 Ref RCW 46.61.525 Neg 2nd 2 car crash via complaint.
I certify (declare) under penalty of perjury under the laws of the State of Washington that the
foregoing is true and correct.
M.Leverton/2517 City of Renton/King/Wa 12/07/2023
PAGE 3 OF 4
REPORT NO. EE32833 CASE# ' 23-14060 DATE AND TIME 12/07/23 13:23
OF COLLISION
nt
12500
I blockt
Vj
PAGE 4 OF 4