HomeMy WebLinkAbout24-4147 a ITFFi "POLCERA II IfI) 1 IlfII ('II (Illf If( fI I . 5 27c
COLLISION REP FIT 1591971
CASE 24-4147 z
INTERSTATE ❑ CITY STREET FIRE ❑RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHICCI F ❑ LOCAL AOENC 4900 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 1 TOTAL#OF OBJECT 1 1 8 28
TRIBAL UNITS 02 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 1008 17 ❑.❑ S 8 W e IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
PARK AVENUE NORTH BLOCK NO. e✓ 700 ❑
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ �.❑ FEET e S ❑ W e NORTH 8TH STREET
0 1 29
MOTUNIT U1 VEHICR Z PEDAL-CLE CYCLE ElYESA,G/E NHORESHOLD MET PHONE 0 8 30
6� LAST NAME AMSDILL FIRSTNAME ZACHARY MIDDLE J 1 2 31
INITIAL
STREET ❑ 3644 RANCHERO DR APT 101 CITY ANN ARBOR ST MI Zjp, 481083262 z
NEW ADDRESS
7❑ COL IGNITION REQUIRED IGNITION : PRESENT MEDICAL TRANSPORTED 3
iNTERLOCKYEs NOZINTERLOCKYEs NO�/ YES �/ NO
8❑ LRIIVER #
ON DUTY❑ STATUS' AIRBAG 6 RESTR 4 EJECT 1 1 I [NATURE OF INJURIES
H U EET 2 CLASS 5 POSSIBLE FX TO LEG/HIP. z❑
3
10 1❑ PI ATE 14 7PKP65 sTAT MI V N# 3VWDP7AJ3DM258154
- TRAILER STATE TRAILER STATE
11 3 5 PLATE# PLATE# FROM To
TRLR. TRLR 5 1 33
12 3 5 VIN#' VIN#
FROM TO
❑ VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN T Y GOVT.VEHICLE J 9 34
13 2 2013 VOLK JETTA 4D DAMAGE vE5 0NO agW�MEYERS ves❑ No
REGISTERED OWNER INFO OWNEDBYDRIVER VEHICLE NO. 1
SHADE IN DAMAGED AREA ❑ 35
14 LIABILITY INSURANCE❑ INSURANCE CO <53 4
IN EFFECT &POLICY# TOPVEHicLE CHARGE 36
LECALLvYEs❑NO CITATION# OTTOM
15❑ STANDING 6
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT 02 VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES�/ NO D:2539062757
16 a
LAST NAME GUERRERO FIRST NAME MICHAEL MIDDLE q
INITIAL
17 STREET❑ NEW ADDREss❑' 30619 124TH AVE SE CITY' AUBURN ST WA ZIP 980923129 4❑ 37
18❑ CDL ., IGNITION REQUIRED IGNITION PtR—E—S1ENT MEDICAL t—T�RANSPORTED � 38
INTERLOCKYES�NO� INTERLOCK YEs I I NOF YES
t l NOF,/
19 DRIVER'S STATE WA SEX M I D.C.B. 08 _ 03 _ 1963 39
LICENSE# MMDDYY
20❑ ON DUTY STATUS I
AIRBAG 2 RESTR 4 EJECT 1 H U EET 2 NJAURSY 1 NATURE OF INJURIES ❑ 40
LICENSE I ❑21❑ PLA E# C99301P TATE 41
WA VIN1 1NPTX4EX4GD319239 1
42
22❑ PLATE# STATE PLATE# STATE
23❑ VIN#. 43
TRLR RLR
'IN#.
VEH YEAR 2016 MAKE PTRg MODEL 367 STYLE DP VEHICLE TOWED TO BLIN TOWEDBY GOV HI 44
24❑ DAMAGE YES NO BANKERS TOWING YES NO
REGISTERED OWNER INFO GRADY EXCAVATING INC PO BOX 467 MUKILTEO WA 98275 D:2539062757 VEHICLE NO.2
SHADE IN DAMAGED AREA
2 3 4
LIABILITY
INSURANCE INSU PORGY#E CO ALASKA NATIONAL INS.CO.23JAS31957IN STOP 5
'E""LE CITATION# CHARGE
LEG
25 i o BOTTOM
ALLY YES N�
❑ s
=UGENT
(PRINT) OFFICER PHONE BADGE OR ID# 77P�1300
26 11498
PAGE 01 OF
PART A
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EE69334
COLLISION REPORT III III III III III 111
1591972 CASE# 24-4147
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 04-17-24 04:00 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
CO.JOHNSON 0505 411812024 3:46:50 PM
BADGE OR ID# 11498 ORI# WA0171300 TIME POLICE DISPATCHED! 10:08 AM TIME POLICE ARRIVED 10:13 AM
PART I PAGE IT]OF
REPORT NO. EE69334 CASE# 24-4147 OF COLLISION
04/16/24 10:08
OF CbLLI510N
NARRATIVE
24-4147
On 04/16/2024 at approximately 1008 hours, I was dispatched to a vehicle collision with reports of
injury at the intersection of North 8th Street and Park Avenue North, within the City Limits of Renton,
County of King, State of Washington.
Upon arrival, Renton Regional Fire Authority (RRFA) had just arrived on scene and began assessing
one of the involved parties for injury due to heavy vehicle mechanism of injury. This involved party
appeared to be in great discomfort from the collision and was medically attended to by RRFA and
King County Medic One. I confirmed there were no complaints of injury from the other involved party.
While on scene, I collected each of the involved driver's information and their independent
recollection of the events leading up to the collision.
The driver of Unit#1 was being medically attended to and was not able to make a formal statement
as to what occurred. The driver of Unit#1 made an excited utterance that he did not recall what
happened prior to the collision. Unit#1 did have significant front-end damage because of a recent
collision. The driver of Unit#1 was later transported to Harborview Medical Center for a possible hip
and leg fracture.
The driver of Unit#2 said he was the sole occupant of his company's commercial dump truck vehicle
and had been traveling northbound in the 700 block of Park Ave N in lane 1 of 2. The driver of Unit#2
stated he had come to a stop for a red light at the intersection of North 8th Street. While Unit#2 was
stopped, Unit#1 collided with the rear of Unit#2 causing significant mechanical damage to the rear
axle/wheel bearing of Unit#2.
A citizen remained at the scene and awaited for 911 services. The citizen did not see the collision but
heard it occur and immediately attended to the driver of Unit#1 due to the damages observed. This
interaction was captured on Axon BodyCam as I have been unable to locate the name of the citizen
who stopped.
AMSDILL violated Renton Municipal Code (RMC) 10-12-25 INATTENTIVE DRIVING: It shall be a
traffic infraction, subject to RCW 7.80.120(1)(a), for any person to drive a motor vehicle on any public
highway, street, alley, or road in an inattentive manner in the City of Renton. "Inattentive manner" in
this section means a lack of: 1) attentiveness required to safely operate the vehicle under the
prevailing conditions, including, but not limited to, the nature and condition of the roadway, the
weather conditions, the presence of pedestrians, the presence of other traffic, or by the driver
focusing or directing the driver's attention to something other than driving the motor vehicle; or 2)
attentiveness that would permit the driver of a motor vehicle to observe anything resting on, or
traveling on, or entering the roadway in time to take appropriate action as circumstances require.
(Ord. 4462, 7-25-94, eff. retroactive to 7-1-94; Ord. 5635, 11-14-11). The driver of Unit#1 was not
safely attentive to the vehicle stopped in front of his vehicle.
Based on the above statements, 1 determined that the Driver of Unit#1 (AMSDILL) was the
predominant factor for the cause of collision due to not paying attention to traffic stopped in front of
him causing a collision.
Both involved vehicles had to be impounded due to extensive damage. An exchange of information
was provided to all involved parties. I reviewed traffic camera footage of this incident which revealed
that the traffic camera was pointed to the north and did not capture this incident on camera.
I certify (or declare) under penalty of perjury under the laws of the State of Washington that the
PAGE 3 OF 6
REPORT NO. EE69334 CASE# 24-4147 OF COLLISION
04/16/24 10:08
OF CbLLI510N
NARRATIVE
foregoing is true and correct.
Electronically signed by Officer M. Nugent#11498 3:48 PM 4/17/2024 Renton, King County, WA.
PAGE 4 OF 6
SUPPLEMENTAL REPORT No. EE69334
r`) POLICE TRAFFIC 1 27
COLLISION REPORT CASE# 24-4147
1 COMMERCIAL MOTOR CARRIER INTERSTATE ✓ INTRASTATE G
UNIT# 2 USDOT 1892626 ICC# VEHICLE TYPE 3 CARGO BODY 5
TYPE
2 ❑ 1 28
CARRIER NAME GRADY EXCAVATING INC
.......
3 CARRIER
ADDRESS PO BOX 467
CITY MUKILTEO ST WA ZIP'', 98275
4 ❑ NAME # PLACARD: :❑
NAME IF NO NUMBER
SOURCE 3 AXLES 03 GI NAME
+
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 AnnRFSP CITY ST ZIP
6 �
CDL GNITIttN REQUIRED GNITION PRESENT MEDICAL TANSPORTED 1 31
INTERLOCK YES No zERLOCK 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 MODEL STYLE VEHICLE TOWS T SABLIN TOWED BY anvi vEHIC P FROM TO
DAMAGE Y EES NO YES NO
REGISTERED OWNER INFO. m 33
12 SHADE IN DAMAGED AREA
FROM TO
LIABILITY INSURANCE❑ INSURANCE CO
IN EFFECT &POLICY# tGQ
EHILLE 34
13 ❑ LEGALLY YES[:] NO❑ CITATION# CHARGE
STANDING S} MOTOR
8 7 6
14 ❑ UNIT Tr Vd 1RE O CYCLE OWNER
RTY YES AGE NOHRESHOLD MET PHONE ❑ 35
PEDESTRIAN
15 LAST NAME FIRST NAME MIDDLE': INITIAL36
STREETIAL
❑
16 NFln+AnntxFs.� CITY'. ST 21P
CDL IGNITION REdUiR rD IGNITION PRESENT MEDICALTANSPORTED
INTERLOCK YES No INTERLOCK YEs NO YEs N. El
17 37
LICENSE# STATE SEX MMDDDYSYY
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 I VEHICLE TO DUET SABLIN TOWED BY GOVT.VEHICLE
DAMAGE YES NO YES NO
23 REGISTERED OWNER INFO SHADE IN DAMAGED 3 4 4 AREA F 43
z
LIABILITY INSURANCE INSURANCE CO '
VE EFFECT &POLICY# i 970P - 4 E:l
44
24 VEHICLE YES❑ NO❑ CITATION# CHARGE iq 60TiOM
C=DLv
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.
MATTHEW NUGENT 04-17-24 04:00 PM
25 INVESTIGATING OFFICER'S SIGNATURE OFFICER'S PHONE UNIT OR DIST DET DATED: PLACE SIGNED
APPROVED BY DATE
26 ORRID# 11498 O#I,WA0171300 JOHNSON 411812024 PAGE OF 6
3000-345-013(R 11118)
REPORT NO. EE69334 CASE# ' 24-4147 DATE AND TIME 04/16/24 10:08
OF COLLISION
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