HomeMy WebLinkAbout24-3118 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 6 27c
COLLISION REP FIT 1591971
CASE 24-3118 z
INTERSTATE ❑ CITY STREET FIRE ❑
RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHIr.I F ❑ LOCAL AGENCI 4200 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2� TOTAL#OF OBJECT 1 1 8 28
TRIBAL UNITS 1 06 STRUCK
RESERVATION
z
3❑ DATE of M M D D Y Y Y Y TIME(2400) COUNTY# MILES N E IN CITY# ❑
COLLISION.. 03 - 1-- 2024 1909 17 ❑.= S 8 IN e 1070 3
4❑ oN (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
BENSON DR S BLOCK NO. e ❑
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5 .❑ FEET ❑ S ❑ W❑ SE 172ND ST
❑ �
0 9 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
No ,/ I D:2532027374 0 11
30
6� LAST NAME WADE FIRSTNAME ROBIN MIDDLE K 1 1 2 31
INITIAL
STREET ❑ 10405 SE 172ND ST APT 10 CITy RENTON ST WA Zjp, 980555471 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❑
❑10 9❑ P1 aT�S� CLU7628 sTArI WWAvrN# 1G1ZD5STONF147965 3
TRAILER STATE TRAILER STATE
11 4 0 PLATE# PLATE# FR.. ro
TRLR. TRLR 9 9 33
12 4 0 vIN#' UIN#
FROM TO
VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE 5 1 34
13 2 2022 CHEV MAL/BU DAMAGE YES NO YES[:] No
✓
REGISTERED OWNER INFO ROBIN WADE 10405 SE 172ND ST APT 10 RENTON WA 98055 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
2 INSURANCE CO 3 4
14 LIABILITY INSURANCE PROGRESSIVE 976127303
IN EFFECT &POLICY# � 9TOP
VEF" CHARGE 36
LEGALLY re5 No CITATION# 4A0339324 FAIL TO OBEY TRAFFIC CONTROL o aorroM
15❑ STANDING 8 6
MOTOR PEDAL-: :,PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT U2 VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES,/ No D:2063347471
16 a
LAST NAME OTIENO FIRST NAME JANET MIDDLE JA
INITIAL
17❑ STREET ❑', 16965 129TH AVE SE CITY RENTON ST WA ZIP 980586145 37
NEW ADDRESS ❑
18� CDL IGNITION REQUIRED IGNITION PRESENT MEDICALTRANSPORTED ❑ 38
INTERLOCKYES�NOR INTERLOCK Y�EsI❑NOF YES
❑NoF,/
19 DRIVER'S STATE WA ]SEX IF D.C.B. O6 _ 02 _ 1987 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 BW9376 TAre WA vIN# 5TDHBRCHOLS508568
❑ 41
PLATE#
42
22❑ PLATE# STATE PLATE# STATE
TRLR
23❑ VIN#. IN#. 43
RLR
'
VEH YEAR 2020 MAKE TOYT MODEL HIGHLAN STYLE VEHICLETOWED TO BLIN TOWEDBY GOV HI 44
24❑ DAMAGE YES,/ NO BANKERS YES NO
REGISTERED OWNER INFO JANET OTIENO 16965129TH AVE SE RENTON WA 98058 VEHICLE NO.2
SHADE IN DAMAGED AREA
2 3 4
LIABILITY
INSURANCE &POLICY#E CO SAFECO H2490982IN 9TOP
VEHICLE ❑ C[ CITATION# CHARGE
25 i o BOTTOM
LEGALLY YES N
s e
7KLANE
NAME(PRINT) OFFICER PHONE BADGE OR ID# JAGENCY
26 10008 WA0171300
PAGE 01 OF
PART A
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EE62821
COLLISION REPORT III III III III III 111
1591972 CASE# 24-3118
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 FIRST 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.
K.LANE 03-23-24 02:00 AM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
CO.JOHNSON 0505 1 3/26/2024 3:53:21 PM
BADGE OR ID# 10008 OR]# WA0171300 TIME POLICE DISPATCHED 7:92 Pry TIME POLICE ARRIVED',7:14 PM
PART I PAGE IT]OF
REPORT NO. EE62821 CASE# 24-3118 OF COLLISION
03/22/24 19:09
OF CbLLI510N
NARRATIVE
This was a 6 vehicle collision in which the units are numbered in sequential order from front (north) to
back (south) as best determined by drivers statements and physical evidence. Unit 1 was in front of
all other units traveling northbound on Benson DR S approaching the 17200 blk. SE 172nd ST is
located only on the west side of Benson DR S but there are multiple signs indicating that no left turn
is authorized from southbound Benson DR S onto westbound SE 172nd ST. This is due to the high
level of traffic in a 40-mph speed zone and the need to slow and stop for a break traffic approaching
southbound to make this left turn and the high level of collisions that would result. Despite the traffic
control devices stating that this left turn is unlawful, Unit 1 slowed and stopped in the left lane of
Benson DR S to make this left turn onto westbound SE 172nd ST. Unit 2 slowed and came to a stop
behind Unit 1 as did Unit 3 slow and stop behind Unit 2.
An unknown vehicle/driver of Unit 4 did not slow and stop in time and the front end of Unit 4 struck the
rear end of Unit 3. The force of this collision sent Unit 3 forward and the front end of Unit 3 struck the
rear end of Unit 2. The force of that collision sent Unit 2 forward and the front end of Unit 2 struck the
rear end of Unit 1.
After Unit 4 struck Unit 3, the front end of Unit 5 struck the rear end of Unit 4. Unit 6 also sustained
damage but it is unknown how exactly or which other vehicle was struck as Driver 6 states she was
swerving to avoid the collision and sustained damage to the rear of her vehicle.
Multiple driver's acknowledge the presence of Unit 4 describing it as a white unknown type sedan.
Unit 4 fled the scene westbound on SE 172nd ST.
Unit 1 sustained minor rear end damage. Unit 2 sustained minor front end damage and moderate
and disabling rear end damage. Unit 3 sustained minor rear end damage and heavy and disabling
frontend damage. Unit 5 sustained heavy and disabling front end damage. Unit 6 sustained minor
rear end damage.
Unit 4 was never located or identified and it is unknown what damage it sustained.
Unit 2, Unit 3, and Unit 5 were towed by Bankers tow.
Driver 1 cited for fail to comply with a traffic control device by attempting an unlawful left turn from
Benson DR S onto westbound SE 172nd ST which was prohibited by signs and the proximate cause
of the collision.
**** AUTO-POPULATED SECTION ****
THE FOLLOWING ARE DESCRIPTIONS ENTERED FOR ITEMS SELECTED AS "OTHER":
Motor Vehicle Unit 1
Traffic Control: NO LEFT TURN SIGN
**** END OF AUTO-POPULATED SECTION ****
PAGE 3 OF 6
SUPPLEMENTAL REPORT NO. EE62821
r`) POLICE TRAFFIC 1 1 8 27
COLLISION REPORT CASE# 24-3118
1 COMMERCIAL MOTOR CARRIER INTERSTATE INTRASTATE G
UNIT'# USDOT ICC# VEHICLE TYPE CARGO BODY
;TYPE
2 ❑ 1 1 7 28
CARRIER
NAME
3 CARRIER L
ADDRESS `
—1 I
CITY ST ZIP'
4 ❑ NAME # PLACARD: :❑
GINAME IF NO NUMBER
SOURCE AXLES +
4a ❑ ADDITIONAL UNITS
MOTOR PEDAL- PROPERTY DAMAGE THRESHOLD MET PHONE
5 ❑ UNIT# 3 VEHICLE tSJ CYCLE I_) PEDESTRIAN � OWNER � YES� NO
D:2066650286
0 1 Zg
INITIAL
LAST NAME VENZANT FIRST NAME TIMMIE MIDDLE' L
: :
STREET
NFW AnDRFSP' 11444 69TH PL S CITY SEATTLE ST WA ZIP 981783001
6
CDL IGNITIttN 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 11 - 25 - 1967
7
ON DUTY� STATUS AIRBAG' $ RESTR. Q EJECT 1 HELMET 2 INJURY 1 1 NATURE OF INJURIES
USE CLASS
8 ❑ 1 1 2 32
LICENSE BWP8911 TAr WA VIN# 3FAFP06Z66R179333
PLATE#
9 9] TRAILER TRAILER
PLATE# STATE PLATE# STATE
10 TRLR TRLR 91 VIN.#. VIN.#.
11 4 0 VEH.YEAR2006 MAKE FORD MODELFUSION STYLE VEHICLE TOWE E T SABLI �d�i' anvi vEH1Ci P FROM TO
DAMAGE YES NO YES NO
33
REGISTERED OWNER INFOALICIA PIERSON PO BOX 1931 RENTON WA 98057 § 1
12 4 0 SHADE IN DAMAGED AREA
34 FROM TO
LIABILITY INSURANCE INSURANCE CO GEICO 6088827800 <�*
IN EFFECT &POLICY# 1VEHICLE 34
13Lecnuv YES❑ NO❑ CITATION# CHARGE
STANDING } 8 7 6
14 UNIT# 4 VEO IOCRLE O CYCLE � OWNER
YES AGE NOHRE3/HOLD MET PHONE ❑ 35
PEDESTRIAN
36
15 � UNKNOWN : MIDDLE'
LAST NAME FIRST NAME INITIAL
16 STREET CITY RENTON ST ZIP
N�n+AnnRFss
CDL IGNITION REOUIREE7 IGNITION PRESENT MEDICAL TANSPORTED
17 ❑ INTERLOCK YEs NO INTERLOCK YEs N. rEs No./ ElDRIVER'S STATE SEX U moo 37
D,O
18 ❑ LICENSE# MMDDYYY
ON DUTY STATUS AIRBAG 9 RESTR, 9 EJECT 1 HELMET 9 INJURY 0 NATURE OF INJURIES 38
USE CLASS
19 ❑ LICENSE ❑ 39
PLATE# DNK TAr vIN# UNK
20 ❑ TRAILER' TRAILER El40
PLATE#< STATE PLATE# STATE
21 ❑ TRLR TRLR 41
VIN# YIN#i
42
22 VEH.YEAR MAKE MODEL STYLE SD VEHICLE TOWED DUET SABLIN TOWED BY GOVT.VEHICLE 4
DAMAGE YES NO YES NO
23 REGISTERED OWNER INFO_(NEW] RENTON SHADE IN DAMAGED AREA 43
3 4 71
LIABILITY INSURANCE INSURANCE CO <�Q
VE EFFECT &POLICY# 44
24 VEHICLE LLY YES❑ NO❑ CITATION# CHARGE
L=ENSTANDING 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.
K.LANE 03-23-24 02:00 AM
25 INVESTIGATING OFFICER'S SIGNATURE OFFICER'S PHONE UNIT OR DIST DET DATED: PLACE SIGNED
APPROVED BY DATE
26 ORID# 10008 O#IL WA0171300 JOHNSON 3/26/2024 PAGE F OF 6
3000-345-013(R 11118)
SUPPLEMENTAL REPORT NO. EE62821
r`) POLICE TRAFFIC 1 1 8 27
COLLISION REPORT CASE# 24-3118
1 COMMERCIAL MOTOR CARRIER INTERSTATE INTRASTATE G
UNIT'# USDOT ICC# VEHICLE TYPE CARGO BODY
;TYPE
2 ❑ 1 1 8 28
CARRIER
NAME
3 CARRIER L
ADDRESS `❑
CITY ST ZIP—1 I '
4 ❑ NAME # PLACARD: :❑
GI PLACARD IF NO NUMBER
SOURCE AXLES +
4a ❑ ADDITIONAL UNITS
MOTOR PEDAL- �`"'j PROPERTY DAMAGE THRESHOLD MET PHONE
5 ❑ UNIT# 5 VEHICLE tSJ CYCLE I_) PEDESTRIAN � OWNER � YES� NO
D:2063912958
0 1 Zg
LAST NAME COLMENARES PAYAGUA FIRST NAME MIDDLE
RONDER INITIAL ' A
STREET
NEW AnnRnsP. 4600 DAVIS AVE S APT S103 CITY RENTON ST WA ZIP 1 980558269
6
CDL IGNITIttN REQUIRED IGNITION PRESENT MEDICAL TAN5PORTED 1 1 2 31
INTERLOCK YEs No zERLOCK YES[:]NO[:] YES N
DRIVER'S
LICENSE STATE I WA SEX M MMDDYYv 06 - 25 - 2000
7 ❑ ON DUTY� STATUS AIRBAG' 2 RESTR. Q EJECT 1 HELMET 2 INJURY 1 NATURE OF INJURIES
USE CLASS
8 ❑ 1 1 2 32
LICENSE CA TAr Wq VIN# 3N1CB51D55L466655
PLATE#
9 9] TRAILER TRAILER
PLATE# STATE PLATE# STATE
10 TRLR TRLR 91 VIN.#. VIN.#.
11 4 0 VEH.YEAR MAKE MODEL STYLE VEHICLE TOVVE E T SABLI T�y��y anvi vEH1C P FROM TO
2005 NISS SENTRA DAMAGE YES NO ,vnG� YES NO
REGISTERED OWNER INFORONDER COLMENARES PAYAGUA 4600 DAVIS AVE S APT S103 RENTON WA 980558269 D:2063912958 $ 1 33
12 4 0 SHADE IN DAMAGED AREA
3 4 FROM TO
LIABILITY INSURANCE[] INSURANCE CO R"i"Olx
IN EFFECT a Poucv# 5 1 34
o�orTUM_
13 LEGALLY
VEHICLE YES❑ NO❑ CITATION# 4A0339325,4A0339325 CHARGE OP MOT VEH W/OUT INSURANCE,NO
LEGALLY
STANDING 8 7 6
6 MdT{7R O PEDAL , ❑ ❑ PROPERTY
DAMAGETHRESHOLD MET PHONE ❑ 35
14 UNIT# VEHICLE CYCLE PEDESTRIAN OWNER YES NO D:2067954786
15 � ALVAREZ MONICA MIDDLE A
❑ 36
LAST NAME FIRST NAME INITIAL
2 STREET
16 ❑ ❑; 11217WOODLEYAVES CITY L SEATTLE ST' WA ZIP 981783153
NEn+AnntxRSS
CDL IGNITION REdUiR rD IGNITION PRESENT MEDICALTANSPORTED
17 ❑ INTERLOCK YES Nb INTERLOCK YEs NC7 YEs No�/ ❑
DRIVER'S STATE WA SEX F D.O.B 37
LICENSE# MMDDYYY` OS - 25 - 1976
18 ❑ El ON DUTY STATUS AIRBAG 2 RESTR. 4 EJECT 1 HELMET 2 INJURY 1 NATURE OF INJURIES 38
USE CLASS
19 ❑ LICENSE ❑
PLATE#
AXU4128 TAr WA v!N# 2HKRM4H71FH639956 39
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
2015 HOND CRVSD DAMAGE YES NO YES NOZI
23 ❑ REGISTERED OWNER INFO MONICA ALVAREZ 2343 YALE AVE EAPTA SEATTLEWA98102 SHADE IN DAMAGED AREA 43
2 s 4
LIABILITY INSURANCE INSURANCE CO TRAVELERS 996424945-203-1 9'1'OP
❑ VEHICLE
EFFECT &POLICY# i _'.''_ 44
24 LEMLLE YES[:] NO❑ CITATION# CHARGE iq 60TiOM
LEGALLY
STANDING & 7 6
1 CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT.
K.LANE 03-23-24 02:00 AM
25 INVESTIGATING OFFICER'S SIGNATURE OFFICER'S PHONE UNIT OR DIST DET DATED: PLACE SIGNED
APPROVED BY DATE
26 ORID# 10008 O#ILWA0171300 JOHNSON 3/26/2024 PAGE OF❑
3000-345-013(R 11118)
REPORT NO. EE62821 CASE# ' 24-3118 DATE AND TIME 03/22/24 19:09
OF COLLISION
C l
1
tt`
1 `
\ t �
}t}t
' ov
1
4
PAGE 6 OF 6