HomeMy WebLinkAbout24-8271 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 1 27c
COLLISION REP FIT 1591971
CASE 24-8271 z
INTERSTATE ❑ CITY STREET ❑ FIRE ❑
RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ HIT F ❑ LOCAL AOENC 4100 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2� 1 1 8 28
TOTAL#OF OBJECT
TRIBAL UNITS 02 STRUCK' FIRE HYDRANT
RESERVATION
z
3❑ DATE of M M D D Y Y Y Y TIME(2400) COUNTY# MILES N E IN CITY# ❑
COLLISION'. 08 - 1-— 2024 1949 17 ❑.= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓
SE PETROVITSKY RD BLOCK NO. e✓ 12210
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ ❑ FEET e S ❑ W e 1 9 29
MOTOR PEDAL- DAM THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El YES NO �/ D:2065789412 30
6� LAST NAME NJAU FIRSTNAME ERIC MIDDLE M 1 1 2 31
INITIAL
STREET ❑, 1516 65TH ST SE CITY AUBURN ST WA ZIP 98092 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 1 EJECT 1 H U EET 2 1 INJURY CLASS 6 [NATURE OF INJURIES
NECK AND BACK PAIN z❑
3
10 9❑ P1ATE14 CKC0572 sTAr WAvN#' 1FAHP35N28W18295f
IT STATE TRAILER STATE
11 0 0 PLATE# PLATE# ROM ro
TRLR. YRLR. 5 1 33
12❑ vIN#' VIN#
:: FROM TO
VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE 5 1 34
13❑9 2008 FORD FOCUS SD DAMAGE YES NO YES[:] ✓No
REGISTERED OWNER INFO OWNEDBYDRIVER VEHICLE NO. 1
SHADE IN DAMAGED AREA ❑ 35
14 UABILI INSURANCE INSURANCE CO THE GENERAL WA6004568 3 4
IN EFFECT &POLICY# 9TOP
VIC CHARGE 5 36
LECALLEHLEv res❑NO❑ CITATION# 1 o BOTTOM
15❑ STANDING 8 7 6
MOTOR PEDAL- PEDESTRIAN ✓ PROPERTY DAM THR OLD MET PHONE
UNIT VEHICLE ❑ CYCLE ❑ ❑ : OWNER ❑ YES 1/ NO D:4254172204
16 a
LAST NAME NASER FIRSTNAME RADWAN MIDDLE JA
INITIAL
17 NEW STREETREs7' 12902 SE 312TH ST,APT D202 CITY l AUBURN ST' WA ZIP 98092 37
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. 04 25 _ 1976 39
LICENSE# MMDDYY
20 ON DUTY STATUS 3 AIRBAG RESTR EJECT HELMET 2 INJURY 6 NATURE N INJURIES 40
USE CLASS NECK AND BACK PAIN
❑21❑ LICENSE TArE IN# 41
V 1
PLATE#
42
22❑ PLATE# STATE PLATE# STATE
TRLR
23❑ UIN#. IN#.
43
RLR
'
VEH YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN
TOWED BY Gov HI 44
L4 1 6 DAMAGE YES NO YES NO
REGISTERED OWNER INFO VEHICLE NO.2
SHADE IN DAMAGED AREA
2 3 4
INAEFFITY ECTNSURANCE❑ &POINSULICY#E CO IGQ
VEHICLE ❑ C[:] CITATION# CHARGE
LEGALLY YES N`LJ
25 s � e
7BEN
S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
J
26
M/N FLICK 12825 WA0171300
PART A PAGE 01 OF C7
3000-345-159 fR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EF05648
COLLISION REPORT III III III III III 111
1591972 CASE# 24-8271
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'
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.
BENJAMIN FLICK 08-06-24 09:43 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
CO.JOHNSON 0505 1 8/16/2024 11:39:19 AM
BADGE OR ID# 12825 ORI# WA0171300 TIME POLICE DISPATCHED; 7:50 PM TIME POLICE ARRIVED',7:53 PM
PART I PAGE IT]OF 4�
REPORT NO. EF05648 CASE# 24-8271 OF COLLISION
08/06/24 19:49
OF CbLLI510N
NARRATIVE
24-8271
On 08-06-2024 at approximately 1949 hours I was working a Renton Police Department patrol in full
uniform in the city of Renton, King County, Washington. I responded to a motor vehicle versus
pedestrian collision which occurred on private property at 12210 SE Petrovitsky RD.
Upon arrival I observed that the pedestrian was lying on the ground. Renton Fire was with him and
providing aid. I later learned from Renton Fire that the extent of the injuries to the pedestrian was
neck and back pain.
I spoke to the driver of unit 01. He told me that he had been attempting to deliver food (working for
Door Dash) and he exited his vehicle in the parking lot. The vehicle was not in park because it started
rolling forward. Realizing this, he attempted to put his leg into the vehicle to hit the brake, but he
accidentally hit the gas instead. Unit 01 accelerated and drug unit 01 driver with it, injuring his knee,
striking the pedestrian, and coming to rest by colliding with a Fire Department Connection standpipe.
I observed a shoe of unit 01 driver was lodged underneath the driver side front tire of unit 01. The
driver of unit 01 had his knee injury (an abrasion) treated by Renton Fire.
I determined that the proximate cause of this collision was that unit 01 driver failed to put his car in
park when he got out, then hit the gas instead of the brake when trying to stop the vehicle from rolling.
Both parties were provided with the case number. I provided the pedestrian with an exchange of
information via Sector.
This incident occurred on private property (Stonebrook Apartments) in the City of Renton.
I declare under penalty of perjury under the laws of the State of Washington that the foregoing is true
and correct.
Electronically signed by B. Flick 12825 on 08-06-2024 in Renton, WA.
PAGE 3 OF 4
REPORT NO. EF05648 CASE# ' 24-8271 DATE AND TIME 08/06/24 19:49
OF COLLISION
210 SE Petro RD
i q
destrian struck
t,
j
ui u
i
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PAGE 4 OF 4