HomeMy WebLinkAbout24-7935 a ITFFi "POLCERA II IfI) 1 IlfII ('II (Illf If( fI I . 0 27c
COLLISION REP FIT 1591971
❑ ❑ FIRE ❑ CASE$# 24-7935 2 573
INTERSTATE CITY STREET RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHIl.I F ❑ LOCAL AGENCI 4900 3
HIT 8 RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2� 1 1 8 28
TOTAL#OF OBJECT
i TRIBAL UNITS 04 STRUCK' FENCE
RESERVATION
2
3❑ DATE OF M M D D Y Y Y Y TIME(2400) COUNTY# MILES N E IN CITY# ❑
cawsloN 07 - 28 - 2024 1844 17 ❑.= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
JERICO AVE NE BLOCK NO. e
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ ❑ FEET e S ❑ W e NE 4TH ST
0 1 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
✓NO D:2532673880 0 7 30
6❑ LAST NAME CREED FIRSTNAME JENNIFER MIDDLE M 1 1 2 31
INITIAL
STREET ❑ 12600 169TH AVE SE CITY RENTON ST WA ZIP 980596521 2
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
iNTERLOCKYEs NO INTERLOCKYEs NO YES NO
8❑ LDRIVER # STATE WA SEX'F MID
.O B 04 1- 13 - 1972 2 32
9 ON DUTY❑ STATUS' AIRBAG 6 RESTR 4 . EJECT 1 H U EET CLASS 6 RIGHT ARM PAINS SCRAPES 2❑
3
10 1❑ P1 ATNES# AAE0623 sTAr WAv N# 5NIANONW5AC513291
TRAILER STATE TRAILER STATE
11 0 0 PLATE# PLATE# FR.. ro
TRLR. TRLR 3 7 33
12 0 0 VIN#' VIN#
>; FROM TO
VEH.YEAR 20I0 MAKE NISS MODEL XTERRA STYLE UT VEHICLE TOWED TO pLSSBLIN T,QVyE kkRS YOS❑ENO✓ J 9 34
DAMAGE ILJI tSA1Wl6
13 REGISTERED OWNER INFO JENNIFER CREED12600169THAVESERENTONWA980596521 D:2532673880 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
14❑ LIABILIT INSURANCE❑ INSURANCE CO
IN EFFECT &POLICY# 9TOP
VEHICLE CHARGE 5 36
LEGALLv res❑NO❑ CITATION# 4A0405356 1 o BOTTOM
15❑ NDING 7 6
MOTOR PEDAL- .PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
16
UNIT 02 VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES NO ,/ D:2532898984
a
LAST NAME MCKEAN FIRST NAME LEXIE MIDDLE R
INITIAL
17❑ STREET ❑', 16643 SE 279TH PL CITY COVINGTON ST WA ZIP 980429105 37
NEW ADDRESS ❑
18� CDL IGNITION REQUIRED IGNITION PR—E-1SENT MEDICAL TRANSPORTED 38
INTERLOCKYES�NOR INTERLOCK YEs It I NOF YES
t t— l NO❑ 11
19 DRIVER'S STATE WA SEX F D.C... 03 _ 04 1996 El 39
LICENSE# MMDDYY
WELMET INJURY1 NATURE OF INJURIES 40
20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 USE CLASS ❑
21❑ LICENSE I CMC4927 TArE WA VIN# KL8CB6SA9JC425077
❑ 41
PLATE#
42
22❑ PLATE# STATE PLATE# STATE
TRLR
23❑ VIN#. N#. 43
RLR
'I
VEH YEAR 2018 MAKE CHEV MODEL SPARK STYLE 4D VEHICLETOWED TO BLIN TOWEDBY GOV HI 44
L4❑ DAMAGE YES NO YES NO
REGISTERED OWNER INFO LEXIE MCKEAN 16643 SE 279TH PL COVINGTON WA 980429105 D:2532898984 VEHICLE NO.2
SHADE IN DAMAGEbAREA
2 3 Cd
LIABILITY
INSURANCE INSU PORGY#E CO GARRISON PROP 038548989RIN 1 9TOP
VEHICLE YES N CITATION# CHARGE i o BOTTOM
LEGALLYNC[:]25❑ s
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# JAGENCY
26
N.ODALOV/C 11628 WA0171300
PAGE 01 OF
PART A
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EF05536
COLLISION REPORT III III III III III 111
1591972 CASE# 24-7935
ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY)
NAME MIDDLE INITIAL) SINGH GURINDER
(LAST FIRST,
ADDRESS&PHONE# D O.B. '
2066790194 SEX' M MMDDYYYY O6 - 28 - 1976
PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT ' HELMET INJURY NATURE OF INJURIES
❑ ❑✓ POS. USE CLASS
NAME
(LAST,FIRST,MIDDLE INITIAL) GIBSON JOHN
ADDRESS&PHONE# D O B
2063007328 SEX: U MMDDYvvv 03 _ 25 _ 1944
PASSENGER WITNESSZ UNIT# SEAT AIRBAG RESTR. EJECT HELMET INJURY NATURE OF INJURIES
❑ POS. USE CLASS
NAME
(LAST FIRST,MIDDLE INITIAL) NGUYEN-HO MARY
AooREss&PHONE# 4254443805 _
SEX U. M -❑
MDDYYYY
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.
N.ODALOV/C 07-31-24 04:29 AM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
J.CHRISTIANSEN 10437 1 8/16/2024 2:54:28 AM
BADGE OR ID# 11628 ORI# WA0171300 TIME POLICE DISPATCHED! 6:44 PM TIME POLICE ARRIVED 6:44 PM
PART I PAGE IT]OF
REPORT NO. EF05536 CASE# 24-7935 OF COLLISION
07/28/24 18:44
OF CbLLI510N
NARRATIVE
24-7935
Unless otherwise noted, the following occurred in the City of Renton, County of King, WA.
On 07-28-2024 at approximately 1847 hours I was dispatched to an injury collision at NE 4th St/
Jericho Ave NE.
I arrived at approximately 1851 hours along with Ofc Castain. Ofc Castain assessed Unit 3
(Highlander/Jayden) as the driver was inside of the vehicle bleeding from the face. Airbags were
deployed. Other witnesses on scene told me that initially Jayden was not responsive but was starting
to speak more as time passed. Renton Fire Authority (RFA) arrived on scene and assessed Jayden.
Jayden was transported to Valley Medical Center (VMC). Ofc Castain gathered Jayden and his
parent's information. I was told by Ofc Castain that Jayden did not remember the incident. Unit 3 was
towed from the scene by Bankers Towing.
Unit 2 (Spark/Lexie) was stationary facing eastbound at the intersection. Her airbags did not deploy,
and her vehicle was drivable. Unit 2 sustained damage to the rear bumper from the force of the other
units. Unit 2 stated she wasn't paying attention while the incident happened but stated she knew she
had a red light for her direction of travel, meaning the opposite would have also had a red light.
Unit 1 (Xterra/Jennifer) was heavily damaged with airbags deployed. I observed Jennifer to be
shaken up with scrapes on her body with a little bit of blood. RFA also evaluated Jennifer and did not
believe she needed to be transported to VMC. Jennifer did not know what had happened until the
impact of the collision but stated she was traveling westbound on NE 4th St and was going to drop off
belongings at a thrift store. Jennifer told Ofc Turner that she was thinking about other errands she
needed to do while she was driving. I spoke to Jennifer several times, along with other officers, and I
do not believe Jennifer was impaired. Unit 1 was towed by Bankers Towing and Jennifer was picked
up from the scene by family. Jennifer was locked out of her phone's insurance application and was
unable to provide me her insurance information. 1 gave her my business card and asked her to email
me her insurance information later in the evening.
Nhi Tran resides at 5250 NE 3rd Pl. The fence at the north side of the residence was damaged in the
collision. Ofc Arnold gathered Nhi's information.
Witness Nguyen-Ho stated she was behind Unit 3. Both her and Unit 3 were stationary in the
southbound travel lanes. Nguyen-Ho stated they had a green light when Unit 1 came through the
intersection and hit Unit 3.
Witness Singh submitted footage from his vehicle which I reviewed. It clearly shows north and south
bound traffic having a green light and Unit 1 entering the roadway surpassing the red light for west
and east bound traffic. The significant impact spun Unit 2 around to face eastbound and caused Unit
3 to travel into the fence at 5250 NE 3rd PI.
Some witnesses told officers on scene that Unit 3 was in the southbound lanes and was going to
make a right turn to travel westbound on NE 4th St. Based on the above footage, I do not see where
Unit 3 attempted to make a right turn but was instead traveling straight in the correct lane with the
right of way.
I took photos of the scene which I uploaded to evidence.com.
I followed-up on Jayden's condition at VMC later in the evening. I was told Jayden suffered from a
PAGE 3 OF 6
REPORT NO. EF05536 CASE# 24-7935 OF COLLISION
07/28/24 18:44
OF CbLLI510N
NARRATIVE
laceration needing sutures, and a "small" head bleed. While Jayden could have been admitted to
VMC, he was transferred to Harborview Medical Center for additional CT scans due to him being a
minor.
I did not receive insurance information for Unit 1 in between the time of the incident to submitting this
report. I submitted citation 4AO405356 for Unit 1 for three infractions.
During this incident I was equipped with body-worn camera which records both audio and video.
Portions of the incident were recorded. This report is merely a summary of the incident and is not
intended to be an exact transcription of the entire investigation or what may have been captured with
the recording system.
PAGE 4 OF 6
SUPPLEMENTAL REPORT NO. EF05536
r`I POLICE TRAFFIC 1 1 8 27
COLLISION REPORT (CASE# 24-7935
1 COMMERCIAL MOTOR CARRIER INTERSTATE INTRASTATE G
UNIT'# USL70T !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 DAMAGE THRESHOLD MET PHONE
5 ❑ UNIT# 3 VEHICLE ISJ CYCLE I_) PEDESTRIAN � OWNER � YES� NO
D:4255286038
0 3 29
LAST NAME PHAM FIRST NAME : JAYDEN MIDDLE T
INITIAL
STREET 30
NFW AnnRFSP 5151 NE 1ST CT CITY RENTON ST WA ZIP 98059
6
CDL GNITIttN REQUIRED GNITION PRESENT MEDICAL TAN5PORTED 1 1 2 31
INTERLOCK YEs No zERLOCK YES[:]NO[:]
vES N
DRIVER'S
LICENSE STATE I WA SEX M MMDDYYv 07 TO]
- 2007
7
HELMET INJURY NATURE OF INJURIES
ON DUTY STATUS AIRBAG 6 RESTR. 4 EJECT 1 USE CLASS 5 SMALL HEAD BLEED,LACERATION
8 ❑ 1 32
LICENSE AKT4984 TAr WA VIN# JTEEP21A150092579
PLATE#
9 TRAILER TRAILER
PLATE# STATE PLATE# STATE
10 ❑ TRLR TRLR
VIN.#. VIN.#.
11 0 0 VEH.YEAR2005 MAKE TOYT MODELHIGHLAN STYLE UT VEHICLE TOWS E T SABLIdi' anvi vFHIG P FROM TO
DAMAGE YES NO YES NO
33
12 SHADE IN DAMAGED AREA
REGISTERED OWNER INFOMYPHAM5151 NE 1STCT RENTON WA 98059 1 ]
FROM TO
LIABILITY INSURANCE &POLICY#E CO AMERICAN FAMILY CONNECT SX05065712 TOP
N EFFECT m 34
13 ❑ LEGALLY
❑ ❑ CITATION# CHARGE BOTTOM
LEGAGALLY YES NO
STANDING
4 MOTOR PEDAL PROPERTY DAMAGE THRESHOLD MET PHONE ❑ 35
14 ❑ UNIT# VEHICLE CYCLE PEDESTRIAN OWNER YESZ NO D:2063514317
36
15 TRAN NHl MIDDLE H
LAST NAME FIRST NAME INITIAL
16 ❑ STREET ❑! 5250 NE 3RD PL CITY RENTON ST' WA ZIP 98059
NFW AnnRFS.9
CDL IGNITION REIJUIREE7 IGNITION PRESENT MEDICALTANSPORTED
17 ❑ INTERLOCK YES Nb INTERLOCK YEs NC7 YEs No ❑
DRIVER'S STATE SEX M D.O.B 37
18 ❑ LICENSE# MMDDYYY 10 - 04 - 1961
ON DUTY STATUS AIRBAG RESTR, EJECT HELMET INJURY NATURE of INJURIES ❑ 38
USE ICLASS
19 ❑ 39
LICENSE rnr VIN#
PLATE#
20 ❑ TRAILER STATE TRAILER STATE ❑ 40
PLATE#< PLATE#
21 ❑ TRLR TRLR 41
ViN# YIN#i
42
22 VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED 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 '
VE EFFECT &POLICY# i 970P - 4 E:l
44
24 LEwLLE YES❑ NO❑ CITATION# CHARGE iq 60TiOM
LEGALLY
STANDING & 7 6
I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT.
N.ODALOVIC 07-31-24 04:29 AM
25 INVESTIGATING OFFICER'S SIGNATURE OFFICER'S PHONE UNIT OR DIST DET DATED: PLACE SIGNED
26 � OR ID# 11628 O#II,WA0171300 APPROVED BY
81116/2024 PAGE�OF 6
3000-345-013(R 11118)
REPORT NO. EF05536 CASE# ' 24-7935 DATE AND TIME 07/28/24 18:44
OF COLLISION
'L N" NOT TO SCALE
Text
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PAGE 6 OF 6