HomeMy WebLinkAbout24-1559 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 1 27c
COLLISION REP FIT 1591971
SASE 24-1559 2
INTERSTATE ❑ CITY STREET FIRE ❑
RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHIr.I F ❑ LOCAL AOENC 4900 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 3 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 1736 17 ❑.= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓
SE PETROVITSKY RD BLOCK NO. e✓ 11500
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ 25 00 FEET MILES e S ❑ W e 116THAVESE
2 0 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
NO D:2068590163 0 11
30
6� LAST NAME BROWN FIRSTNAME ASHANTAE MIDDLE L 1 1 2 31
INITIAL
STREET ❑✓ 10710 SE 256TH ST#A-302 CITY KENT ST WA 2jp, 98030 z=
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
iNTERLOCKYEs NO 1/ INTERLOCKYEs NO�/ YES 1/ NO
8❑ LRIIVER #
ON DUTY❑ STATUS' AIRBAG 2 RESTR 4 EJECT 1 HELMETU E 2 CLASS 7 [NATURE OF
RIGHT ARM PAINS z❑
3
LICENSE CBY8691 STATE WA VIN# 1HGCP268X9A060006
10 9❑ Pr ATF�
TRAILER STATE TRAILER STATE
11 3 5 PLATE# PLATE It FROM To
TRLR. TRLR. 7 2 33
12 3 5 VIN#' VIN#
>; FROM TO
VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE 7 $ 34
13 8 2009 HOND ACCOR 4D DAMAGE YES NO YES[:] No
✓
REGISTERED OWNER INFO ASHANTAE BROWN 10710 SE 256TH ST#A-302 KENT WA 98030 D:2068590163 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
14 LIABILITY INSURANCE❑ INSURANCE CO 3 4
IN EFFECT &POLICY# 9TOP
VEHlcl.e CHARGE 5 36
LEGALLY YES❑NO❑ CITATION# 10 BOTTOM
15❑ STANDING 6
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT 02 VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES 1/ NO D:4257610137
16 a
LAST NAME MONARES GONZALEZ FIRST NAME EFREN MIDDLE
INITIAL
17 STREET❑ NEW ADDRESS❑' 15859 118TH AVE SE CITY RENTON ST WA ZIP 98058 4❑ 37
18❑ CDL IGNITION REQUIRED IGNITION PtR—E—S1ENT MEDICAL—T�RANSPORTED � 38
INTERLOCKYES�NO� INTERLOCK YEs I I NOF YES t l NOF,/
19 D STATEWSEXM .CB. _ _ 39
# M .
20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 H U EET 2 NJAURSY 1 NATURE OF INJURIES 40
LICENSE I ❑21❑ PLA E# D259226 TATE 41
WA vIN1 1D7RV1CT96S590460 1
42
22❑ PILER LATE# STATE PLATE# STATE
23❑ UIN#. 43
TRLR RLR
'IN#.
VEH YEAR 2011 MAKE DODG MODEL RAM 1500 STYLE TR VEHICLETOWED TO BLIN TOWEDBY GOV HI 44
24❑ DAMAGE YES NO YES NO
REGISTERED OWNER INFO JUAN ROBLES GONZALEZ 1455 S PUGET DR RENTON WA 98055 VEHICLE NO.2
SHADEDAMAGEDAREA
3 4
LIABILITY
INSURANCE &POINSURGY#E CO PROGRESSIVE 955215280IN STOP 5
ve
LEGALLY YESwGLE ❑ N,J�J CITATION# CHARGE to BOTTOM
25 s � a
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# JAGENCY
26
P.KORDEL 9676 WA0171300
PAGE 01 OF
PART A
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EE49721
COLLISION REPORT III III III III III 111
1591972 CASE# 24-1559
ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY)
NAME MIDDLE INITIAL) BARNES CALVIN A
(LAST FIRST,
ADDRESS&PHONE#
10710 SE 256TH ST#A-302 KENT WA 98030 2064760855 SEX i X MMDDYyry 05 - 12 - 2003
PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT ' HELMET INJURY NATURE OF INJURIES
❑✓ 1 POS. 3 2 4 1 USE 2 CLASS 1
NAME
(LAST,FIRST,MIDDLE INITIAL) BARNES DAMANI A
ADDRESS&PHONE# DOB
10710 SE 256TH ST#A-302 KENT WA 98030 SEX' MMDDYVYV 01 _ 24 _ 2024
SEAT HELMET INJURY NATURE OF INJURIES
PASSENGER WITNESS UNIT# 1 POS 3 AIRBAG 2 RESTR. 13 EJECT 1 USE 1 2 CLASS 1
NAME
(LAST FIRST,MIDDLE INITIAL) HOWIE JUSTIN L
ADDREss&PHONE# 25027 35TH PL S KENT WA 98032 2062804693 SEX MI. 26 _ 1978
MDDYYYY
PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET INJURY 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.
P.KORDEL 02-12-24 08:19 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
P.KORDEL 9676 1 2/12/2024 8:21:17 PM
BADGE OR ID# 9676 OR]# WA0171300 TIME POLICE DISPATCHED 5:39 PM TIME POLICE ARRIVED',5:47 PM
PART I PAGE IT]OF 4]
REPORT NO. EE49721 CASE# 24-1559 OF COLLISION
02/12/24 17:36
OF CbLLI510N
NARRATIVE
On 02-12-2024 at 1741 hours, I was dispatched to an injury collision in the 17400 block of 116th Ave
SE in the City of Renton, King County, WA State. Officer Kwake arrived first at 1747 hours, followed
by me at 1750 hours. Renton Fire was already on scene. The vehicles were pulled over on a side
street. This was just north of the intersection of SE Petrovitsky Rd and 116th Ave SE. It was raining
and the street was wet. Traffic was heavy. Vehicle 1, a maroon Honda Accord, had heavy damage to
the left side. Vehicle 2, a white Dodge Ram truck, had slight damage to the front right corner. Officer
Kwake assisted in getting the Ram truck driver's information as well as the Honda's front right
passenger's information (along with the infant he was carrying in a front pack when he was seated in
the Honda). I identified the driver of the Honda after she was placed in the Fire truck to be taken to
Valley Medical Center for right arm pain. Officer Kwake took photos for me. Nobody else was injured.
Honda driver A'Shantae Brown told me that she was driving eastbound on SE Petrovitsky Rd
approaching the intersection with 116th Ave SE. She was in the left straight-ahead lane, and wanted
to change lanes to the left turn lane to go north on 116th Ave SE. There was a gap in traffic in the turn
lane, with the Ram truck far enough back to allow Brown to pull into the turn lane. As she was
changing lanes, the Ram truck sped up and struck the left side of her Accord. Honda passenger
Calvin Barnes had the exact same account as Brown told me.
A witness named Justin Howie walked up to me. He told me that he was behind the Ram truck. Howie
said that there was a considerable gap in traffic ahead of the truck when the Honda changed lanes in
front of the truck. Howie said it appeared to him that the Ram truck driver intentionally was letting the
Honda change lanes in front of it, but then sped up and struck the Honda as it changed lanes.
Ram truck driver Efren Monares Gonzalez told me that he was in the left turn lane from eastbound SE
Petrovitsky Rd with the intention to turn left onto northbound 116th Ave SE. He had been stopped for
traffic with a couple vehicles ahead of him, and when he started to drive forward, the Honda turned
left directly in front of him, causing him to strike the Honda. I told Monares Gonzalez that a witness
said it appeared that he was letting the Honda change lanes in front of him. Monares Gonzalez
denied this, telling me that he did not know the Honda was going to do that when he started to drive
forward when traffic started moving for the green arrow ahead.
The driver and passenger of the Honda told me that their insurance had lapsed, so they currently did
not have any insurance. The driver of the truck did have insurance.
Brown was taken to Valley Medical Center for evaluation. Barnes secured the Honda on this private
side road. Monares Gonzalez was able to drive his truck away.
PAGE 3 OF 4
REPORT NO. EE49721 CASE# ' 24-1559 DATE AND TIME 02/12/24 17:36
OF COLLISION
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