HomeMy WebLinkAbout24-157 a ITFFi "POLCERA II IfI) 1 IlfII ('II (Illf If( fI I . 5 27c
COLLISION REP FIT 1591971
❑ ❑ RESULTED ❑ CASE z4-157 2
INTERSTATE CITY STREET FIRE
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHICI F ❑ LOCAL AOENC 4200 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 3 TOTAL#OF OBJECT 1 1 8 28
TRIBAL UNITS 03 STRUCK
RESERVATION
2
3❑ DATE OF M M D D Y Y Y Y TIME(2400) COUNTY# MILES N E IN CITY#
COLLISION.. 01 - 1-- 2024 1455 17 ❑-= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
RENTON AVE S BLOCK NO. e✓ 100 ❑
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ ❑ FEET e S ❑ VV a HARDIEAVE SW
0 1 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
,/No D:3474883671 0 11
30
6� LAST NAME WU FIRSTNAME XIAOYUN MIDDLE N 1 1 2 31
INITIAL
STREET ❑ 7215 176TH PL NE CITY ARLINGTON ST WA 2jp, 982238189 2=
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
INTERLOCK YES[:]NO INTERLOCKYEs NO YES R NO
8❑ LRIIVER #
ON DUTY❑ STATUS AIRBAG 6 RESTR 4 EJECT 1 HELMET
2 CLASS 1 NATURE OF INJURIES 2❑
3
10❑ Pi aTES� CBV7785 sTATe WAurN# 7MUCAABGONV002254
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 TOWED BY GOVT.VEHICLE 5 1 34
13 2 2022 TOYT RAV4 UT DAMAGE YES NO YES[:] NO✓
REGISTERED OWNER INFO OWNEDBYDRIVER VEHICLE NO. 1
SHADE IN DAMAGED AREA ❑
14 LIABILITY INSURANCE INSURANCE CO STATEFARM 5045647 35
-E24.47 4
IN EFFECT &POLICY# 9TOP
VEHlcl.e 5 36
LEGALLY YES❑NO❑ CITATION# CHARGE 1 o BOTTOM
15❑ STANDING
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT VEHICLE ❑ CYCLE ❑ ❑ OWNER [:]EA.
YES NO ,/ D:2065957174
16 a
LAST NAME PRAM FIRST NAME THAN MIDDLE I V
INITIAL
17 STREET❑ NEW ADDREss❑' 304 NW 5TH ST CITY RENTON ST WA ZIP 980573413 4❑ 37
18❑ CDL IGNITION REQUIRED IGNITION PtR-E-S1ENT MEDICAL-T�RANSPORTED � 38
INTERLOCKYES�NOR INTERLOCK YEs I I NOF YEs t l NO❑
19 LDI IVEW # STATE WA SEX M M D.C.B.
12 _ 29 _ 1954 39
20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 H U EET 2 NJAU EY 1 NATURE OF INJURIES ❑ 40
❑21❑ PLATE# B23929U TATE 41
WA VIN# 3TMLU4EN3CM081123 1
42
22❑ PLATE# STATE PLATE ILER# STATE
TRLR
23❑ VIN#. IN#. 43
RLR
'
VEH YEAR 2012 MAKE TOYT MODEL TACOMA STYLE VEHICLETOWED TO BLIN TOWEDBY GOV HI 44
L4❑ DAMAGE YES NO YES NO
REGISTERED OWNER INFO THU-HUONGLE304NW5THST RENTON WA 98057 VEHICLE NO.2
SHADEDAMAGEDAREA
3 4
LIABILITY INSURANCE INSU&PORGY#E CO ECONOMY PREFERRED 411432888-0 9TOP 5
IN EFFECT
'E""LE LEGAL ❑ Nu,J CITATION# CHARGE to BOTTOM
LY YES
25 ' e
7CA
NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
J
26LAN 12007 WA0171300
PART A PAGE 01 OF
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EE44301
COLLISION REPORT III III III III III 111
1591972 CASE# 24-157
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.
C.CATALAN 01-23-24 01:59 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
C.JACOBS 1953 1/25/2024 2:06:14 PM
BADGE OR ID# 1Y007 ORI# WA0171300 TIME POLICE DISPATCHED; 2:55 PM TIME POLICE ARRIVED]2:55 PM
PART I PAGE IT]OF 5�
REPORT NO. EE44301 CASE# 24-157 OF COLLISION
01/05/24 14:55
OF CbLLI510N
NARRATIVE
On January 5, 2024, at 1300 hours dispatch requested that I respond to a collision at the intersection
of Hardie Ave SW and Renton Ave Ext. Dispatch advised that there was a three-vehicle collision that
was blocking the entire intersection.
Upon my arrival I spoke with the driver of unit 3. He stated he was facing westbound at the
intersection waiting with traffic for the light to turn green when the collision occurred. The driver stated
they did not see which vehicle ran the traffic light but one of vehicles was pushed into his tailgate.
I then spoke with the driver of unit 2 and they explained they were going northbound on Hardie Ave
SW when the collision occurred. The driver stated he had a green light going northbound, so he
proceeded through the intersection. As he crossed, unit one ran the red light going eastbound bound,
causing him to collide with their front bumper. The impact sent unit 1 into a spin which ultimately led
them to slide into unit 3.
1 then spoke with the driver unit 1 and they explained they were going eastbound on Renton Ave Ext
when the collision occurred. They could not recall what color of the traffic light was as they entered
the intersection, but they said unit 2 crossed the intersection, causing the collision.
Based on the comments I gathered the following. The driver of unit 3 had a red light while they faced
westbound on Renton Ave Ext. That means eastbound traffic was also stopped with a red light. Unit 2
had a green light, so they proceeded forward. The information above consists with the damage seen
on seen.
Only unit 1 sustained severe damage so it needed to be removed by bakers towing later.
All the drivers were medically checked by Renton Fire, and no one needed to be transported to the
hospital.
An exchange of information was given to all the drivers involved.
PAGE 3 OF 5
SUPPLEMENTAL REPORT No. EE44301
r`I POLICE TRAFFIC 1 1 8 27
COLLISION REPORT CASE# 24-157
1 COMMERCIAL MOTOR CARRIER INTERSTATE INTRASTATE G
UNIT'# USL70r !CC# VEHICLE TYPE CARGO BODY
TYPE
2 ❑ 1 28
CARRIER
NAME
3 CARRIER
ADDRESS `
CITY ST' ZIP'
4 ❑ NAME # PLACARD: :❑
GI NAME IF NO NUMBER
SOURCE AXLES +
4a ❑ ADDITIONAL UNITS
MOTOR PEDAL- PROPERTY DAMAGETHRESHOLD MET PHONE
UNIT# 3 �✓ � PEDESTRIAN YES NO
5 VEHICLE CYCLE OWNER ✓ D:2066795551
0 7 29
LAST NAME : VAO FIRST NAME : KAURIRI MIDDLE D
INITIAL
STREET 30
NEW AnDRFrtP 10757 18TH AVE SW CITY SEATTLE ST WA ZIP 981462029
6
CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TANSPORTED 1 1 2 31
INTERLOCK YEs No zERLOCK YES[:]NO[:]
YEs N
DRIVER'S
LICENSE STATE I WA SEX M MMDDYYv 07 - 28 - 1976
7
ON DUTY� STATUS AIRBAG' 2 RESTR. Q EJECT 1 HELMET 2 INJURY 1 1 NATURE OF INJURIES
USE CLASS
8 ❑ 1 32
LICENSE I C4205OW [TAT WA VIN# 1FDXF46F7YEA44247
PLATE#
9 TRAILER TRAILER
PLATE# STATE PLATE# STATE
10 ❑ TRLR TRLR
VIN.#. VIN.#.
11 O O VEH.YEAR2000 MAKE FORD MODELF4550 I STYLE TR I VEHICLE TOWS E T SABLIN TOWED BY anvi vEH1I' FROM TO
DAMAGE YES NO ✓ YES NO ✓
REGISTERED OWNER INFO.HANDY ANDY RENT 10711 AURORA AVE N SEATTLE WA 98133 J 9 33
12 � SHADE IN DAMAGED AREA
34 FROM TO
LIABILITY INSURANCE INSURANCE CO SELF INSURED GQ
IN EFFECT &POLICY# 1VEHICLE 34
13Lecnuv YES NO❑ CITATION# CHARGE
STANDING } 8 7
14 ❑ UNIT Tr Vd 1RE O CYDCLE 1:1OWNER YE
YES AGE NOHRESHOLD MET PHONE ❑ 35
PEDESTRIAN
❑
36
15 LAST NAME FIRST NAME ': NIbIAL
STR
16 STREETEETAnnR"[-] CITY ST ZIP
CDL IGNITION REdUiRED IGNITION PRESENT MEDICALTANSPORTED
INTERLOCK YES No INTERLOCK YEs NO YEs NO ❑
17 4 37
LICENSE# STATE SEX MMDDDYBYY
18 ❑ ON DUTY� STATUS AIRBAG RESTR. ; EJECT HELMET INJURY NATURE of INJURIES 38
USE CLASS
19 ❑ LICENSE TAT VIN# 39
PLATE#
20 ❑ TRAILER TRAILER El40
PLATE#< STATE PLATE# STATE
21 ❑ ❑ 41
TRLR TRLR
VIN# YIN#i
42
22 VEH.YEAR MAKE I MODEL STYLE I VEHICLE TO DUET SABLIN TOWED BY GOVT.VEHICLE
DAMAGE YES NO YES NO
23 REGISTERED OWNER INFO SHADE IN DAMAGED 3 4 4 AREA F 43
z
LIABILITY INSURANCE INSURANCE CO '
VINE
EFFECT &POLICY# i 970P - 4 E:l
44
24 VEHICLE YES❑ NO❑ CITATION# CHARGE iq 60TiOM
LECALLv
STANDING 8 7 6
1 CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT.
C.CATALAN 01-23-24 01:59 PM
25 INVESTIGATING OFFICER'S SIGNATURE OFFICER'S PHONE UNIT OR DIST DET DATED: PLACE SIGNED
APPROVED BY DATE
26 ORID# 12007 O#IL WA0171300 JACOBS 1/25/2024 PAGE F41 OFF
3000-345-013(R 11118)
REPORT NO. EE44301 CASE# ' 24-157 DATE AND TIME 01/05/24 14:55
OF COLLISION
NTS
t
I
s t '
PAGE 5 OF 5