HomeMy WebLinkAbout24-1222 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 5 27c
COLLISION REP FIT 1591971
CASE 24-1222 z
INTERSTATE ❑ CITY STREET FIRE ❑RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHIr.I F ❑ LOCAL AOENC 4Y00 3
HIT&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#
COLLISION'. 02 - 1-— 2024 1448 17 ❑-= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
AIRPORT WAY BLOCK NO. e✓ 100 ❑
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ �.❑ FEET e S ❑ VV a RAINIER AVE N
0 1 29
MOTOR PEDAL- DAM THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El YEs NO ,/ D:2064128554 0 7 30
6� LAST NAME MORRIS FIRSTNAME LEONDRAE MIDDLE L 1 1 2 31
INITIAL
STREET ❑ 8025 PACIFIC HWY E CITY TACOMA ST WA ZIP 98422 z
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 2 RESTR 4 EJECT 1 HELMET
2 CLASS 1 NATURE OF INJURIES z❑
3
10❑ P1 aT�S� BFV1731 sTArI WAurN# 5TDBT48A47S278489
TRAILER STATE TRAILER STATE
11 0 0 PLATE# PLATE# FROM TO
TRLR. TRLR 7 3 33
12 0 0 VIN#' VIN#
>; FROM TO
VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE J 9 34
13 2 ZOO7 TOYT SEQUOI UT DAMAGE YES NO YES[:] NO✓
REGISTERED OWNER INFO HOLLYMAYER475015THAVENE SEATTLEWA98105 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
14 LIABILI INSURANCE❑ INSURANCE CO 3
IN EFFECT &POLICY# 9TOP
VE—LE CHARGE 5 36
LEGALLY
YES❑NO❑ CITATION# 10 BOTTOM
15❑ STANDING 8 7 6
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT U2 VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES 1/ NO D:2064553983
16 2
LAST NAME TRUONG FIRST NAME QUOC MIDDLE D
INITIAL
17❑ STREET ❑, 261 LIND AVE SW CITY' RENTON ST WA ZIP 98057 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 DRIVER'S STATE WA SEX M D.O.B. 07 01 1973 39
LICENSE# MMDDYY
HELMET {NJURY 1 NATURE OF INJURIES 40
20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 USE 2 CLASS ❑
21❑ LICENSE I CGX2383 TAre WA vIN# 7SAYGDEFXPF800967
❑ 41
PLATE#
42
22❑ PLATE# STATE PLATE ILER# STATE
23❑ UIN#. 43
TRLR RLR
'IN#.
VEH YEAR 2023 MAKE TESL MODEL X STYLE UT VEHICLE TOWED TO BLIN TOWEDBY GOV HI 44
L4❑ DAMAGE YES NO YES NO
REGISTERED OWNER INFO QUOC TRUONG 261 LIND AVE SW RENTON WA 98057 VEHICLE NO.2
SHADE IN DAMAGED AREA
2 3 4
LIABILITY
INSURANCE &POINSURGY#E CO AMERICAN FAMILYA101578050IN 1 9TOP 5
VE""LE CITATION# CHARGE
25 i o BOTTOM
LEGALLY YES Nu
❑ J s
7CA
NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY26LAN 12007 WA0171300
PART A PAGE 01 OF
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EE50250
COLLISION REPORT III III III III III 111
1591972 CASE# 24-1222
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
POS. 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'
On February 2nd, 2024, at 1616 hours dispatch requested that I respond to a collision at the
intersection of Rainier Ave S and Airport Way, in the City of Renton.
Upon my arrival I spoke with the driver of unit 2. They explained they were stopped behind traffic
facing eastbound Renton Ave Extension when the collision occurred. They stated they were in the
number 3 lane when they observed unit 1 merging into the left turn lane from the number 3 lane. As
unit 1 was behind them as they entered the turn lane. Unit 1 failed to create enough distance between
the two vehicles, making the rear right wheel catch onto unit 2 rear left wheel.
The vehicle was misaligned, and the driver believes it will be over $1000 dollars to repair.
I then spoke with the driver of unit 1 and he explained a similar story. He stated he was merging from
the number 3 lane into the left turn lane but failed to create enough distance between his vehicle and
unit 2. He caught his wheel on unit 2's wheel.
CC
I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT.
C.CATALAN 02-04-24 12:04 AM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
C.JACOBS 1953 1 2/14/2024 10:51:00 AM
BADGE OR ID# 1Y007 OR]#' ' WA0171300 TIME POLICE DISPATCHED! 2:51 PM TIME POLICE ARRIVED',3:00 PM
PART I PAGE IT]OF 3�
REPORT NO. EE50250 CASE# ' 24-1222 DATE AND TIME 02/02/24 14:48
OF COLLISION
Renton Ave ..,
Rainier Ave S
Airport Way
NTS
9.
c
c ;
n4 ,
PAGE 3 OF 3