HomeMy WebLinkAbout24-952 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 5 27c
COLLISION REP FIT 1591971
❑ ❑ RESULTED ❑ CASE z4-ss2 2
INTERSTATE CITY STREET FIRE
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHIr.I F ❑ LOCAL AOENC 4200 3
HIT 8 RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 2 TOTAL#OF OBJECT 1 1 8 28
TRIBAL UNITS OZ 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 1152 17 ❑-= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
SUNSET BLVD N BLOCK NO. e✓ 300 ❑
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ �.❑ FEET e S ❑ VV e N 3RD ST
0 4 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
✓NO D:2068877110 0 11
30
6� LAST NAME CHERNGSAART FIRSTNAME DANICA MIDDLE P 1 2 31
INITIAL
STREET ❑ 17012 32ND AVE S CITY SEATAC ST WA 7jp, 98188 2=
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION : PRESENT MEDICAL TRANSPORTED 3
iNTERLOCKYEs NO INTERLOCKYEs NO YES R NO
8❑ LRIIVER # STATE WA SEX'F MID
.O B 01 1— 20 — 1993 2 32
CENS [NATURE OF
9 ON DUTY❑ STATUS' AIRBAG 6 RESTR 4 EJECT 1 HELMET
2 CLASS 6 HEAD INJURY
INJURIES 2❑
3
10❑ Pi ATNES# BVM3495 sTATe WAv N# 1 C4RJFAGXCC303017
0
----� TRAILER STATE PLAT Eft STATE
11 0 PLATE# PLATE# FROM TO
TRLR. TRLR. 3 5 33
12 0 0 VIN#' VIN#
>; FROM TO
❑ VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE 7 $ 34
13 2 2012 JEEP GRAND UT DAMAGE YES NO YES[:] NO✓
REGISTERED OWNER INFO EMMA FOUST 1701232ND AVE S SEATAC WA 98188 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
14 LABILITY INSURANCE z INSURANCE CO PROGRESSIVE 940615129 3 4
IN I EFFECT POLICY# 9TOP
VEHICLE 5 36
LEGALLY res❑NO❑ CITATION# CHARGE 1 o BOTTOM
15❑ STANDING 6
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT VEHICLE ❑ CYCLE ❑ ❑ : OWNER ❑ YES 1/ NO D:2533774782
16 a
LAST NAME STRUB III FIRST NAME JAMES MIDDLE A
INITIAL
17❑ STREET ❑', 19206 91 ST AVE E CITY GRAHAM ST WA ZIP 98338 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❑
19 LDI IVER # STATE WA SEX M M D.O.B. 11 29 _ 1969 0 39
HELMET {NJURY 1 NATURE OF INJURIES 40
20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 USE 2 CLASS ❑
21❑ LICENSE I C89497U TATe I WA vIN1i 5VCACLCE9LC233000
❑ 41
PLATE#
42
22❑ PLATE# STATE PLATE# STATE
23❑ VIN#. 43
TRLR RLR
'IN#.
VEH YEAR 2020 MAKE AUTj MODEL ACX64 STYLE GG VEHICLETOWED TO BLIN TOWEDBY GOV HI 44
L4❑ DAMAGE YES NO YES NO
REGISTERED OWNER INFO WASTEMGMNTDBA WASTEMANA 81111STAVE S SEATTLE WA 98108 VEHICLE NO.2
SHADEDAMAGEDAREA
3 4
LIABILITY
INSURANCE INSU8 PORGY#E CO ACE INSURANCE MMTH10822294IN STOP 5
VE""LE ❑ ,J� CITATION# CHARGE to BOTTOM
LEGALLY YES N`LJ 6
25 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. EE46392
COLLISION REPORT III III III III III 111
1591972 CASE# 24-952
ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY)
NAME MIDDLE INITIAL) GRAY THUNDER
(LAST FIRST,
ADDRESS&PHONE#
17012 32ND AVE S SEATAC WA 98188 SEX M MMDDYyvv 05 - 04 - 2019
PASSENGER{�WITNESS UNIT# SEAT AIRBAG' RESTR. EJECT HELMET USE 2 CLASS'1 NATURE OF INJURIES
Lr 1 ❑ 1 POS, 7 6 12 1
NAME
(LAST,FIRST,MIDDLE INITIAL) BARTLETT MATTHEW N
ADDRESS&PHONE# D O B
16840 190TH AVE SE RENTON WA 98058 2062345861 SEX M MM�Dvvvv 07 _ 22 _ 1983
PASSENGER UNIT# SEAT AIRBAG RESTR. EJECT HELMET INJURY NATURE OF INJURIES
[]WITNESS POS. USE CLASS
NAME
(LAST FIR57 MIDDLE INITIAL)
AppRESS&PHONE#
SEX D.O.B.MMDD -❑
YYYY.
PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET NJURY NATURE OF INJURIES
❑ ❑ POS. USE CLASS ----�
NARRATIVE'
24-952
On January 26, 2024, at 1152 hours, dispatch requested that I respond to a collision at the
intersection of NE 3rd St and Sunset Blvd N, in the City of Renton, County of King, WA.
Upon my arrival I spoke with the driver of unit 1. They explained they were facing westbound on NE
3rd St and Sunset Blvd N when the collision occurred. Driver 1 had their child in the rear seat and
noticed that car seat was not buckled properly. She turned around and tried adjusting the seatbelt,
but failed to notice that her foot was on the accelerator. Unit 1 proceeded forward through the
intersection.
When she realized that the vehicle was moving forwards, she panicked, and pressed on the
accelerator. Unit 1 ran into the side gas tank of the garbage truck.
Unit 1 sustained severe damages that disabled the vehicle completely. The driver of unit 1, was
struck on the head by the unsecured car seat, sustaining a minor injury.
I then spoke with the driver of unit 2, and they explained they were proceeding through a green light
when unit 1 ran the red light and made an improper left turn. Unit 1 struck the drivers side of the
garbage truck.
Both vehicles were disabled and needed to be removed.
Bankers Towing took custody of unit 1, and unit 2 was removed by Waste Management.
An exchange of information was provided to both drivers.
I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT.
C.CATALAN 01-26-24 03:46 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
C.JACOBS 1953 1 21112024 2:54:37 PM
BADGE OR ID# 12007 OR]#' ' WA0171300 TIME POLICE DISPATCHED: 11:53 AM TIME POLICE ARRIVED;11:55 AM
PART I PAGE IT]OF 4�
SUPPLEMENTAL REPORT No. EE46392
r` COLLISIONOITRAFFPEA 1 27
T CASE#' 24-952
1 COMMERCIAL MOTOR CARRIER INTERSTATE INTRASTATE ✓ G
UNIT# 2 USDOr ICC# I VEHICLE TYPE 9 CARGO BODY 8
TYPE 2 ❑ 1 1 28
CARRIER
NAME. WASTE MANAGEMENT
.....
3 CARRIER
ADDRESS 8111 FIRST AVE S
CITY SEATTLE ST WA ZIP'', 98108
4 ❑ NAME # PLACARD: :❑
NAME IF NO NUMBER
SOURCE 3 AXLES 03 GWVR 54000 +
4a ❑ ADDITIONAL UNITS
MOTOR PEDAL- PROPERTY DAMAGE THRESHOLD MET PHONE
5 ❑ UNIT# VEHICLE I_J CYCLE _) PEDESTRIAN � OWNER � YES NO
i MIDDLE'... 29
LAST NAME FIRST NAME INITIAL
STREET 30
NFW AnDRFrtP. CITY ST ZIP
6 �
CDL GNITIttN REQUIRED GNITION PRESENT MEDICAL TANSPORTED 1 31
INTERLOCK YES No INTERLOCK YES❑N0� vES N
LLIICIENSE STATE I SEX M��DYRYY' 2
7 F-1
ON DUTYl STATUS AIRBAG' RESTR. EJECT HELMET INJURY NATURE OF INJURIES
USE CLASS
8 ❑ ' 1 32
LICENSE+ rar VIN.#
PLATE#
9 TRAILER TRAILER
PLATE# STATE PLATE# STATE
10 ❑ TRLR TRLR
VIN.#. VIN.#.
11 VEH.YEAR MAKE I MODEL STYLE I VEHICLE TOWS E T SABLIN TOWED BY anvi vEHII' P FROM TO
DAMAGE YES NO YES NO
REGISTERED OWNER INFO. m 33
12 � SHADE IN DAMAGED AREA
7GQl
j4 FROM TO
LIABILITY INSURANCE❑ INSURANCE CO
IN EFFECT &POLICY# t
VEHICLE 34
13 ❑ LEGALLY YES[:] NO❑ CITATION# CHARGE
❑ STANDING dRD PROPERTY PEDESTRIAN 1:1Y NOHRESHOD PHONE 8 7 6
35
VEHICLE CYCLE OWNER ESG
14 UNITr L ❑
MIDDLE
15 LAST NAME FIRST NAME ': INITIAL36
STREETIAL
❑
16 NFln+AnntxFs.� CITY'. ST SIP
CDL IGNITION REDUIRED IGNITION PRESENT MEDICALTANSPORTED
INTERLOCK YES No INTERLOCK YEs NO YEs NO El
17 37
LICENSE# STATE SEX MMDDDYBYY
18 ❑ ON DUTY� STATUS AIRBAG RESTR. ; EJECT HELMET INJURY NATURE of INJURIES 38
USE (CLASS
19 ❑ vIN 39
LICENSE #
PLATE# rnr
20 ❑ TRAILER' TRAILER ❑ 40
PLATE# STATE PLATE# STATE
21 ❑ TRLR TRLR 41
VIN# YIN#i
42
22 VEH.YEAR MAKE I MODEL STYLE VEHICLE TOWED DUE T SABLIN TOWED BY GOVT.VEHICLE
DAMAGE YES NO YES NO
23 REGISTERED OWNER INFO_ SHADE IN DAMAGED AREA 43
z s 4 F-1
LIABILITY INSURANCE INSURANCE CO '
IN EFFECT &POLICY# i BOOT - 4 E 44
24 vewcLe YES❑ NO❑ CITATION# CHARGE iq 60TiON1
LeGALIv
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 01-26-24 03:46 PM
25 INVESTIGATING OFFICER'S SIGNATURE OFFICER'S PHONE UNIT OR DIST DET DATED, PLACE SIGNED
BADGE O#I' APPROVED
1126 ORID# 12007 WA0171300 ACOBS 2112 PAGE F OF 4
3000-345-013(R 11118)
REPORT NO. EE46392 CASE# 24-952 DATE AND TIME 01/26/2411:52
OF COLLISION
Lij
Sunset Blvd N
i
3'
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