HomeMy WebLinkAbout23-13245 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 5 27c
COLLISION REP FIT 1591971
CASE 23-13245 z
INTERSTATE ❑ CITY STREET FIRE ❑RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHIC;I F ❑ LOCAL AGENC 4200 3
HIT 8 RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 1 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# ❑
cowsloN 11 - 1-- 2023 1210 17 ❑.= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓
EDMONDS AVE NE BLOCK NO. e✓ 1100
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ 1001. 00 FMILES EET e S B W e NE SUNSET BLVD
0 1 29
R PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE ❑ YES ✓NO D:2066981126 0 3 30
6 LAST NAME LUCAS SUC FIRSTNAME ESTEFANY MIDDLE C 1 2 31
INITIAL
STREET ❑✓ 3715 NE 14TH ST CITY RENTON ST WA 21p 98056 z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
iNTERLOCKYEs NO 1/ INTERLOCKYEs NO�/ YES R No�/
8❑ LRIIVER #
ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 HELMET U E 2 CLASS 1 NATURE OF INJURIES z❑
3
10❑ P1 aT�S� CBK6057 sTAr� WAurN# 2T1KE40E19C016224
TRAILER STATE TRAILER STATE
11 3 0 PLATE# PLATE# FROM To
TRLR. TPILF1 1 5 33
12 3 0 VIN#' VIN#
:: FROM TO
❑ VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE 1 7 34
13 2 2009 TOYT COROL 4H DAMAGE YES NO YES[:] NO✓
REGISTERED OWNER INFO OWNEDBYDRIVER VEHICLE NO. 1
SHADE IN DAMAGED AREA ❑ 35
14 LIABILITY INSURANCE❑ INSURANCE CO 3 4
IN EFFECT &POLICY# 912P
VEHICLE CHARGE o eorrom 5 36
LEGALLY YEs No CITATION# W23067371 OP MOT VEH W/OUT INSURANCE
15❑ STANDING 8 7 6
MOTOR PEDAL PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT U2 VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES 1/ NO D:2062457037
16 a
LAST NAME CAREY FIRST NAME CORINA MIDDLE
INITIAL
17 STREET NEW ADDRESS❑', 11436 SE 208TH ST SPC 28 CITY KENT ST WA ZIP 980314129 37
18� CDL IGNITION REQUIRED IGNITION PR-E-1SENT MEDICAL TRANSPORTED 38
INTERLOCK YEs❑No� INTERLOCK YEs It I NOF YES
t l NOF,/
19 F] LICENSE# STATE WA SEX F M D.C.B. 12 _ 25 _ 1958 39
20❑ ON DUTY STATUS I
AIRBAG 2 RESTR 4 EJECT 1 H U EET 2 NJAURSY 1 NATURE OF INJURIES 40
❑ILICENSE 21❑ PLA E# BZD7389 TArE 41
WA VIN# STDBK3EH78S069822 1
42
22❑ PLATE# STATE PLATE# STATE
23❑ VIN#. 43
TRLR RLR
'IN#.
VEH YEAR 2011 MAKE TOYT MODEL HIGHLAN STYLE SI/ I VEHICLE TOWED TO BLIN TOWEDBY GOV HI 44
24= DAMAGE YES✓ NO GENE MEYERS YES NO
REGISTERED OWNER INFO CORINA CAREY 3.VUEMONT PL NE All E106 RENTON WA 98056 D:2062457037 VEHICLE NO.2
SHADE IN DAMAGED AREA
2 3 4
LIABILITY
INSURANCE INSURANCE
#E CO GEICO 6116-83-80-35IN I STOP
VE""LE ,J� CITATION# CHARGE
25 BOTTOM
LEGALLY YES❑ N`L I
$ '
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# 77P�
26MATTHEW NUGENT 11498 1300
PART A PAGE 01 OF C7
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EE22365
COLLISION REPORT III III III III III 111
1591972 CASE# 23-13245
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.
MATTHEW NUGENT 11-16-23 06:30 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY E
DAT
C.JACOBS 1953 1112212023 10:37:38 AM
BADGE OR ID# 11498 ORI# WA0171300 TIME POLICE DISPATCHED' 12:54 PM TIME POLICE ARRIVED 1:01 PM
PART I PAGE IT]OF 4�
REPORT NO. EE22365 CASE# 23-13245 OF COLLISION
11/16/23 12:10
OF CbLLI510N
NARRATIVE
23-13245
On 11/16/2023 at approximately 1254 hours, I was dispatched to a non-injury and non-blocking two-
vehicle collision at the intersection of NE Sunset Boulevard and Edmonds Ave NE, within the City
Limits of Renton, County of King, State of Washington.
Upon arrival, I contacted the involved parties and confirmed no injuries had occurred requiring
immediate medical response at the time of report. There, I collected the involved parties driving
documents and their independent recollection of events leading up to the collision.
The driver of Unit#1 said she and her juvenile passenger were traveling southbound in about the
1100 block of Edmonds Ave NE just north of the intersection of NE Sunset Blvd. The driver of Unit#1
stated she was traveling directly behind Unit#2 and saw as Unit#2 was slowing for an upcoming
turn. The driver of Unit#1 stated that the driver of Unit#2 turned slower than she was expecting and
attempted to stop her vehicle in time but was unable to and subsequently collided with the rear of Unit
#2 causing significant damage to the front of Unit#1.
The driver of Unit#2 said she was the sole occupant of her vehicle and also traveling southbound in
about the 1100 block of Edmonds Ave NE just north of the intersection of NE Sunset Blvd. The driver
of Unit#2 stated she was intending to make a west (right) turn at the upcoming intersection. While
Unit#2 was slowing down to prepare for the turn, Unit#1 collided with the rear of Unit#2 causing
moderate damage to the rear of Unit#2.
Based on the above statements, I determined that the Driver of Unit#1 (Lucas Suc) was the
predominant factor for the collision due to inattention causing a collision. Lucas Suc should have
been paying closer attention to the movement of traffic in front of her. Additionally, Lucas Suc was
unable to provide proof of motor vehicle insurance.
I issued Lucas Suc a written warning for operating a motor vehicle without insurance.
Unit#1 was able to be driven away without further incident. Unit#2 had extensive damage and had to
be impounded from the scene. An exchange of information 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.
Electronically signed by Officer M. Nugent#11498 6:25 PM 11/16/2023 Renton, King County, WA.
PAGE 3 OF 4
REPORT NO. EE22365 CASE# ' 23-13245 DATE AND TIME 11/16/23 12:10
OF COLLISION
MIL
Ate,
PAGE 4 OF 4