HomeMy WebLinkAbout24-3679 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 1 27c
COLLISION REP FIT 1591971
CASE 24-3679 z
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 2 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.. 04 - 1-— 2024 1606 17 ❑-= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
HARRINGTON AVE NE BLOCK NO. e✓ 700 ❑
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ ❑ FEET e S ❑ V\e NE7THST
0 1 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
NO D:2066618431 0 11
30
6� LAST NAME JAMA FIRSTNAME SARA MIDDLE A 1 1 2 31
INITIAL
STREET ❑ 871 OLYMPIA AVE NE CITY RENTON ST WA Zjp, 980563886 z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
1/ I iNTERLOCKYEs NO NTERLOCKYEs NO�/ YES R No�/
8❑ LRIIVER #
ON DUTY❑ STATUS' AIRBAG 2 RESTR 4 EJECT 1 I I [NATURE OF INJURIES
H U EET 2 1 INJURY CLASS ju POSSIBLE CONCUSSION z❑
3
LICENSE CGU6911 STATE WAa VIN# 5UXFY3C05M9G57558
10 2❑ Pr ATF�
TRAILER STATE TRAILER STATE
11 2 5 PLATE# PLATE# FROM TO
TRLR. TRLR 3 7 33
12 2 $ VIN#' VIN#
>; FROM TO
VEH.YEAR MAKE M ODEL STYLE VEHICLE
X3 SvEHICLETOWED TO BLIN T /g[ GOVT.VEHICLE 1 $ 34
13 2021 BMW X3 SV DAMAGE YES NO � '` RS YES[:] No✓
REGISTERED OWNER INFO SARA JAMA 871 OLYMPIA AVE NE RENTON WA 98056 D:2066618431 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
14 LIABILI INSURANCE INSURANCE CO STATE FARM 1406-9418.15 3 4
IN EFFECT &POLICY# 9TOP
vECALLv Hla.e 5 36
res❑NO❑ CITATION# CHARGE BOTTOM
15❑ LE STANDING 8 6
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES 1/ NO D:4252469621
16 a
LAST NAME MORIO FIRST NAME LINDSAY MIDDLE A
INITIAL
17 STREET❑ NEW ADDREss❑' 504 HARRINGTON AVE NE CITY RENTON ST WA ZIP 980563736 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 DRIVER'S STATE WA ]SEX IF D.C.B. O6 _ 15 _ 1981 39
LICENSE# MMDDYY
20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 H U EET 2 NJAURSY 1 NATURE OF INJURIES ❑ 40
❑ILICENSE 21❑ PLA E# ASK7891 TATE 41
WA VIN1 KM8JUCAG6FU987139 1
42
22❑ PILER LATE# STATE PLATE# STATE
23❑ 43
TRLR RLR
UIN#. 'IN#.
VEH YEAR 2015 MAKE HYUN MODEL TUCSON STYLE SI/ VEHICLE TOWED TO BLIN TOWEDeY GOV HI 44
24❑ DAMAGE YES NO YES NO
REGISTERED OWNER INFO LINDSAYMORIO 504 HARRINGTON AVE NERENTONWA98056 D:4252469621 VEHICLE NO.2
SHADE IN DAMAGED AREA
2 3 4
LIABILITY
INSURANCE &POLICY#E CO USAA 00693-18-47CIN 9TOP 5
'E""LE ❑ ,J� CITATION# CHARGE i o BOTTOM
LEGALLY YES N J
25 a
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
26
MATTHEW NUGENT 11498 WA0171300
PART A PAGE 01 OF
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EE69011
COLLISION REPORT III III III III III 111
1591972 CASE# 24-3679
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 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'
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.
MATTHEW NUGENT 04-04-24 08:29 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY E
DAT
C.JACOBS 1953 411712024 2:08:20 PM
BADGE OR ID# 11498 ORI# WA0171300 TIME POLICE DISPATCHED 4:08 Pry TIME POLICE ARRIVED',4:13 PM
PART I PAGE IT]OF 5�
REPORT NO. EE69011 CASE# 24-3679 OF COLLISION
04/04/24 16:06
OF CbLLI510N
NARRATIVE
24-3679
On 04/04/2024 at approximately 1608 hours, I was dispatched to a non-blocking vehicle collision with
reports of injury at the intersection of NE 7th Street and Harrington Ave NE, within the City Limits of
Renton, County of King, State of Washington.
While en route, Dispatch advised that there was a two-vehicle collision, with one of the involved
parties complaining of dizziness and head pain.
Upon arrival, I contacted all involved parties. I noticed the driver of Unit#1 was being attended to by
the Renton Regional Fire Authority (RRFA). The driver of Unit#1 was treated at the scene by RRFA
and later released. While on scene, I collected the involved parties driving documents and
independent recollection of what occurred.
The driver of Unit#1 stated that she was the sole occupant of her vehicle and was traveling
westbound on NE 7th Street approaching the intersection of Harrington Ave NE. The driver of Unit#1
stated she was intending to continue westbound on NE 7th Street. The driver of Unit#1 stated that
while traveling westbound, she stopped at the posted stop sign. The driver of Unit#1 believed it was
her turn to proceed and continued through the intersection. Upon entering the middle of the
intersection, Unit#1 was contacted by Unit#2 causing significant damage to the front passenger side
axle of Unit#1.
I contacted the driver of Unit#2 who stated she was the sole occupant of her vehicle and was
traveling southbound on Harrington Ave NE approaching the intersection of NE 7th Street. The driver
of Unit#2 stated she was intending to turn continue south on Harrington Ave NE. The driver of Unit
#2 stated that she stopped at the intersection and checked for other traffic but claimed that Unit#1
did not stop at the intersection. Upon determining that it was Unit#2's turn to proceed, Unit#2
proceeded out into the intersection. As Unit#2 entered the intersection, she observed Unit#1 also
proceed into the intersection from the east. Unit#1 and Unit#2 collided in the intersection
subsequently causing moderate damage to the front driver's side quarter panel and bumper of Unit
#2.
1 reviewed the intersection and discovered that it is a 4-way stop with posted stop signs at all 4
corners of the intersection.
Based on the above statements, I was unable to determine which vehicle was the predominant factor
for the cause of collision. Both involved parties believed it was there turn to proceed into the
intersection and both claimed to have stopped at the 4-way intersection. I told the involved parties to
contact their respective insurance companies.
While I was in my patrol vehicle and completing the exchange of information portion of my collision
investigation, the driver of Unit#1 proceeded to leave the collision scene. I had just spoken with the
driver of Unit#1 who agreed with me that the vehicle had disabling damage and should be
impounded. I had all of the driving documents for Unit#1 and decided to contact her by phone. Upon
reaching the driver of Unit#1 by phone, she had forgotten the collision occurrence and location
stating she just drove home. Fortunately, the driver of Unit#1's husband was home and was able to
return her to the scene with the husband citing, "something is not okay" in reference to his wife. I had
Dispatch contact RRFA to return to the scene. RRFA later arrived and arranged transportation for a
possible concussion.
Unit#1 had to be impounded due to extensive damage. Unit#2 was able to be driven away without
PAGE 3 OF 5
REPORT NO. EE69011 CASE# 24-3679 OF COLLISION
04/04/24 16:06
OF CbLLI510N
NARRATIVE
further incident. An exchange of information was provided to all involved parties.
I certify (or declare) under penalty of perjury under the laws of the State of Washington that the
foregoing is true and correct.
Electronically signed by Officer M. Nugent#11498 4/4/2024 8:26 PM Renton, King County, WA.
PAGE 4 OF 5
REPORT NO.! EE69011 CASE# ' 24-3679 DATE AND TIME 04/04/24 16:06
OF COLLISION
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