HomeMy WebLinkAbout24-5717 24-5715 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 1 27c
COLLISION REPORT 1591971
FIRE ❑ CASE$# 24-5717 24-5715 2
INTERSTATE ❑ CITY STREET � RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHIl.I F ❑ LOCAL AGENC 4100 3
HIT 8 RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 2 TRIBAL 03 TOTAL#OF OBJECT 1 1 8 28
UNITS ! ❑
RESERVATION ' STRUCK 2
3 M M D D Y Y Y Y TIME(2400) COUNTY# MILES CITY#
CDt�usloN' 05 - 30 - 2024 1138 17 ❑.= S 8 E IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
SW GRADY WAY BLOCK NO. [: 1200 ❑
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5 MILES❑ �,❑ FEET ❑ S ❑ W❑ OAKESDALE AVE SW
OF,1 29
UNIT MOTOR ❑ PEDAL- El DAMAGE THRESHOLD MET PHONE
VEHICLE CYCLE. YES
`/No D:2532440631 0 6 30
6 LAST NAME BROWN FIRSTNAME WILLIAM MIDDLE R 1 1 2 31
INITIAL
STREET ❑ 8117 NORTH WAY SW CITY LAKEWOOD ST WA ZIP 984985811 2
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
INTERLOCK YES[:]NO INTERLOCKYEs NO YES NO
8❑ LRIENSE# STATE I WA SEX'M MMDDYY' 08 - 08 - 1975 1 1 2 32
9 ON DUTY❑ STATUS AIRBAG 1 RESTR 4 EJECT 1 H USEET CLASS 1 NATURE OF INJURIES 2❑
❑10 9❑ Pi aT�S� C68485K sTATI WWAVrN# 2NKHHJ7X7LM393814 3
TRAILER STATE TRAILER STATE
11 3 5 PLATE# PLATE# FROM TO
TRLR. YRLR. 7 3 33
12 3 5 VIN# VIN#
FROM TO
❑ VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE 7 3 34
13 2 2020 KW CONST DAMAGE YES NO YES❑ No./
REGISTERED OWNER INFO THOMPSONGAS LLC 1912238TH AVE E TACOMA WA 98446 VEHICLE NO. 1 Y ❑
SHADE IN DAMAGED AREA 35
14 rI LIABILITY INSURANCE M INSURANCE CO SAME. 4
IN EFFECT &POLICY# TOPVE—LE CHARGE36
LEGALLv YES❑NO CITATION# <1�3
OTTOM
15❑ STANDING 7 6
MOTOR PEDAL- PROPERTY DAM THR OLD MET PHONE
UNIT 02 ❑ ❑ PEDESTRIAN ❑ ❑ D:2065950988
VEHICLE CYCLE : OWNER YES�/ NO
16�
LAST NAME VORNG FIRST NAME SOMBO MIDDLE N
INITIAL
17❑ STREET ❑', 1308 SW 160TH ST CITY' BURIEN ST WA ZIP 981662842 37
NEW ADDRESS ❑
18� CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED ❑ 38
INTERLOCK YES❑No❑ INTERLOCK YEs❑No� YES❑NO❑
19 DRIVER'S STATE WA SEX M I D.C... 12 _ 18 _ 1965 39
LICENSE# MMDDYY
20❑ ON DUTY STATUS AIRBAG 6 RESTR 4 EJECT 1 HELMET INJURY 7 NATURE OF INJURIES ❑ 40
USE CLASS HEAD
21❑ LICENSE I CEU3548 TATE WA VIN1t 3CZRZ2H56PM729999
❑ 41
PLATE#
El42
22❑ PLATE# STATE PLATE# STATE
23❑ TRLR R 43
LR
VIN#. N I #.
VEH YEAR 2028 MAKE HOND MODEL HR-V STYLE VEHICLE TOWED TO BLIN TOWEDBY GOV HI 44
24❑ DAMAGE YES�/ NO BANKERS YES NO
REGISTERED OWNER INFO SOMBOVORNG1308SW160THST BURIENWA981662842 D:2065950988 VEHICLE NO.2
SHADE,IN4� �d
DAMAGE$AREA
3
LIABILITY
INSURANCE 8 POINSURGY#E CO ALLSTATE 820 47 896IN STOP
VE""Le ❑ ,J� CITATION# CHARGE toBOTTOM
LEGALLY YES N`L J
25 '
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
J
26
M.LEVERTON 2517 WA0171300
PAGE 01 OF
PART A
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EE83099
COLLISION REPORT III III III III III 111
1591972 CASE# 1 24-5717 24-5715
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 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.
M.LEVERTON 05-31-24 11:39 AM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY E
DAT
C.JACOBS 1953 6/3/2024 11:08:45 AM
BADGE OR ID# 2517 OR]#' WA0171300 TIME POLICE DISPATCHED; 11:39 AM TIME POLICE ARRIVED 11:40 AM
PART B PAGE IT]OF 5�
TIM
REPORT NO. EE83099 CASE# 24-5717 24-5715 OFC LLI ION 05/30/24 11:38
OF COLLISION
NARRATIVE
blk suv wht suv propane stopped illegal left turn and another
RTF
Within the city limits of Renton/King/WA I responded to a 3 vehicle blocking unknown if injury crash
near the intersection of SW Grady Way and Oakesdale Ave SW.
I arrived to find 2 suvs and a propane truck in lane 2 facing eastbound just beyond the intersection.
I contacted each driver to check for injuries. Unit 2 said he bumped his head. I requested fire
respond and check him.
I contacted the driver of unit 3. She told me that she was following a car with another car in front of
that one. She described that the lead vehicle made a sudden stop and was partially blocking lane 2
and the left turn lane for westbound to southbound traffic. She said the car in front of her panic
braked and so did she. She wasnt sure if unit 2 was stopped of moving but felt the impact. She did
not complain of injury was but upset. I requested Fire check her regardless. Damages did not
require a tow truck.
I contacted the driver of unit 2. He could not describe if he was moving of stopped. He complained of
bumping his head pretty hard. He did not provide too much information reference the crash. Fire
treated and released him on scene. His car required a tow truck for damages.
I contacted the driver of unit 1. He told me he was following traffic when two cars in front of unit 3
made a sudden stop to make an illegal. He said unit 3 and the car in front of her stopped. He could
not describe if unit 2 was moving or stopped but he told he panic braked and contacted unit 2 pushing
2 into unit 3. He did not complain of injury and damages did not require a tow truck. Renton Fire did
a prelim check on unit 1 for leaks with revealed nothing but a dented front bumper. Unit 1 told me he
considered swerving into lane 1 but it wasnt clear and also feared it may have cause his truck to roll
over.
Based on the very similar version of unit 3 and unit 1 describing a 4th vehicle making an
unexpected/illegal stop to make an illegal turn I dont believe any of the 3 vehicles involved in contact
during the collision were the proximate cause.
Information/Insurance only
I certify (declare) under penalty of perjury under the laws of the State of Washington that the
foregoing is true and correct.
M.Leverton/2517 City of Renton/King/Wa 5/30/2024
PAGE 3 OF 5
SUPPLEMENTAL REPORT NO. EE83099
r') POLICE TRAFFIC 1 1 8 27
COLLISION REPORT
013197 CASE#; 24-5717 24-5715 2
1 COMMERCIAL MOTOR CARRIER INTERSTATE INTRASTATE ✓
UNIT'# 1 USDOT 2812287 ICC# VEHICLE TYPE 1 2 CARGOBODY 3
2
"TYPE
❑ 1 28
CARRIER NAME. PROPANE NORTHWEST
.....
3 CARRIER L
ADDRESS 19122 38TH AVE E
CITY TACOMA ST WA ZIP'', 98446 IF NO NUM
4 ❑ SOURCE' 3 1 AXLES ,02 GI PLACARDPLACARD1075 + 2❑ NAME PROPANEBER
4a ❑ ADDITIONAL UNITS
MOTOR PEDAL- PROPERTY DAMAGETHRESHOLD MET PHONE
UNIT# 3 PEDESTRIAN YES✓ NO
5 VEHICLE CYCLE OWNER
0 7 29
LAST NAME WILLOUGHBY FIRST NAME HELEN MIDDLE' , E
INITIAL
STREET 30
NEW AnFIRFSP 410 WILLIAMS AVE N CITY RENTON ST WA ZIP 980575458
6
CDL IGNITIttN REQUIRED IGNITION PRESENT MEDICAL TAN5PORTED 1 1 2 31
INTERLOCK YEs No zERLOCK YES❑N0[ YES N
DRIVER'S D.O.B 2
LICENSE STATE I WA SEX F MMDDYYY 07 TOE]
- 1955
7
ON DUTY� STATUS AIRBAG' 2 RESTR. Q EJECT 1 HELMET I INJURY 1 NATURE OF INJURIES
USE CLASS
8 ❑ 1 32
LICENSE CFF8749 TAr Wq VIN# 5UXZV4C57CL988693
PLATE#
9 9] TRAILER TRAILER
PLATE# STATE PLATE# STATE
10 ❑ TRLR TRLR
VIN.#. VIN.#
11 U U VEH.YEAR2012 MAKE BMW I MODELX5 STYLE I VEHICLE TOVVE E T SABLIN TOWED BY anvi vEH1G E FROM TO
DAMAGE YES NO �/ YES NO
REGISTERED OWNER INFOHELEN WILLOUGHBY410 WILLIAMS AVE N RENTON WA 98057 D:4258302010 g g 33
SHADE IN DAMAGED AREA
12 7 j FROM TO
INSURANCE CO 1 _R I"01?___ S
LIABIFECT SURANCE SAME. m 34
IN EFFECT � &POLICY#
13 ❑ LEGALLY
❑ CITATION# CHARGE 1080TTOM
LEGALLY YES NO
STANDL. 8 7 Q
14 ❑ UNIT# UEO IOCRLE O : CYCLE OW ERRTY YESAGE NOHRESHOLD MET PHONE ❑ 35
PEDESTRIAN
35
15 LAST NAME FIRST NAME INITIALAL
MDDLE
❑
STREET
16 NFWAODRFS� CITY ST ZIP
CDL IGNITION REJUIRED IGNITION PRESENT MEDICAL TANSPORTED
NTERLOCK YES No NTERLOCK YEs NO YES[_]
NO ❑
17 37
LICENSE# STATE SEX MMY DDDBYY - 11
18 ❑ ON DUTY� STATUS AIRBAG RESTR. ; EJECT HELMET INJURY NATURE of 1NJURIEs 38
USE (CLASS
19 ❑ 39
LICENSE rnr VIN#
PLATE#
20 ❑ TRAILER' TRAILER El40
PLATE#< STATE PLATE# STATE
21 ❑ TRLR TRLR 41
ViN# YIN#_
42
22 VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED DUET SABLIN TOWED BY GOVT.VEHICLE
DAMAGE YES NO YES NO
23 REGISTERED OWNER INFO_ SHADE IN DAMAGED AREA 43
z 3 4
LIABILITY INSURANCE= INSURANCE CO '
VEHICLE
EFFECT &POLICY# i 970P - 4 44
24 LE
E ALE YES[:] N. CITATION CHARGE iq 60TiOM
LEGALLY
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.
M.LEVERTON 05-31-24 11:39 AM
25 INVESTIGATING OFFICER'S SIGNATURE OFFICER'S PHONE UNIT OR DIST DET DATED, PLACE SIGNED
APPROVED BY DATE
25 BADGE
R IID# 2517 O#I',WA0171300 JACOBS 6/3/2024 PAGE F41 OF F
3000-345-013(R 11118)
REPORT NO. EE83099 CASE# 24-5717 24-5715 DATE AND TIME 05/30/2411:38
OF COLLISION
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PAGE 5 OF 5