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HomeMy WebLinkAbout24-10737 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 0 27c COLLISION REP FIT 1591971 CASE 24-10737 z INTERSTATE ❑ CITY STREET FIRE ❑RESULTED 1 STOLEN STATE ROUTE ❑ OTHER ❑ VFHICI F ❑ LOCAL AGENCI 4Y00 3 HIT&RUN CODING COUNTY RD PRIVATE WAY INVOLVED 2 TOTAL#OF OBJECT 1 8 28 TRIBAL ': UNITS 04 STRUCK RESERVATION' z 3 DATE OF M M D D Y Y Y Y TIME(2400) COUNTY# MILES N E IN CITY# ❑ cawsloN 10 - 15 - 2024 0519 17 ❑.❑ S IN 1070 3 4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓ BENSON DR S BLOCK NO. e✓ 1600 4a❑ MILEPOST DISTANCE OF(REFERENCE OR CROSS STREET) 5❑ 400 00 FEET MILES e S B W e S 15TH ST OF,1 29 MOTOR ✓ PEDAL- DAMAGE THRESHOLD MET PHONE UNIT 01 VEHICLE ❑ CYCLE ❑ YES NO F D:2062515361 0 7 30 6 LAST NAME BENSON FIRSTNAME JERRY MIDDLE D 1 1 2 31 INITIAL STREET El 26404 132ND AVE SE CITY KENT ST WA ZIP, 980428017 z NEW ADDRESS 7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3 INTERLOCK YES NO�/ INTERLOCK YES NOf,/ YES R NO LRIIVERS STATE WA SEX 08I M MM DAY' — 14 — 1966 1 2 32 8❑ 9 ON DUTY❑ STATUS AIRBAG 3 RESTR 4 EJECT 1 HELMET 2 CLASS 1 NATURE OF INJURIES z❑ 3 10� P1 aT�S� C47347R sTATI WAVIN# 1 FT7X26T9KEC09613 TRAILER 59930AD STATE WA TRAILER STATE 11 4 0 PL PLATE# PLATE# Rom ro rRLR. TREK 5 1 33 12 4 0 v_N#' SFTBE2725L1003560 vIN# FROM TO ❑ VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN T Y GOVT.VEHICLE 5 9 34 13 3 2019 FORD F250 TR DAMAGE YES NO MEYERS Es[:] No REGISTERED OWNER INFO PARE MA TERIAL HANDLING INC P O BOX 987 EUGENE OR 97440 D:2067225800 VEHICLE NO. 1 ❑ SHADE IN DAMAGED AREA 35 14 r1 LIABILITY INSURANCE INSURANCE CO OLD REPUBLIC INS CO MWTB31610122 4 IN EFFECT &POLICY# TOPVEHICLE CHARGE 36 LEGALLY YES❑NO❑ CITATION# <1�3 OTTOM 15❑ STANDING 7 6 MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE UNIT VEHICLE ❑ CYCLE ❑ ❑ : OWNFR ❑ YES 1/ NO D:2537667586 16 a LAST NAME MENDEZ FERNANDEZ FIRST NAME GUILLERMO MIDDLE N INITIAL 17❑ STREET ❑', 10424 SE 200TH ST CITY KENT ST WA ZIP 980315538 37 NEW ADDRESS ❑ 18� CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 38 INTERLOCK YEs❑No� INTERLOCK YEs It I NOF YES t l NOF,/ 19 LICENSE# STATE WA SEX M M .C.B. 12 _ 23 _ 1981 0 39 WELMET INJURY1 NATURE OF INJURIES 40 20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 USE CLASS ❑ 21❑ LICENSE I C30105L TATE WA VIN# 1FTBF2A61HED18309 ❑ 41 PLATE# 42 22❑ PLATE# STATE TILER PLATE# STATE 23❑ UIN#. 43 TRLR RLR 'IN#. VEH YEAR 2017 MAKE FORD MODEL F250 STYLE TR VEHICLE TOWED TO BLIN TOWEDBY GOV HI 44 24 DAMAGE YES NO BANKERS TOWING YES NO REGISTERED OWNER INFO GREENBANK GARDENS INC 2288 W COMMODORE WAY STE 105 SEATTLE WA 98199 D:4256813130 VEHICLE NO.2 SHADE IN DAMAGE$AREA 2 3 �d LIABILITY INSURANCE INSU&PORGY#E CO CONTINENTAL WESTERN CPA605953822 IN EFFECT VEHICLE CITATION# CHARGE E,�� LEGALLY YES N� 25❑ J s OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY 26 QUINT TIBEAU 07691 WA0171300 PART A PAGE 01 OF C7 3000-345-159 OR 11/181 STATE OF POLICETRAFFICN CORRECTION REPORT NO. EF25681 COLLISION REPORT III III III III III 111 1591972 CASE# 24-10737 ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY) NAME MIDDLE INITIAL) YCAL ALVARADO ELMER E (LAST FIRST, ADDRESS&PHONE# 1111 W JAMES ST APT 21 KENT WA 980324368 2065515730 SEX i M MMDOYyry 09 - 24 - 1993 {� SEAT HELMET INJURY NATURE OF INJURIES PASSENGER ZWITNESS❑j UNIT# 2 PGS 3 AIRBAG 2 RESTR. 4 EJECT 1 USE CLASS '7 PA7N IN ABDOM/N NAME (LAST,FIRST,MIDDLE INITIAL) ADDRESS&PHONE# D O B SEXt MMDDVVYY - PASSENGER ❑WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET NJURY NATURE OF INJURIES POS. USE CLASS NAME (LAST FIR57 MIDDLE INITIAL) AppRESS&PHONE# SEX D.O.B. MMDDYVYY. 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. QUINT TIBEAU 10-15-24 09:02 AM INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED APPROVED BY DATE D.SKELTON 9139 1011812024 3:57:36 AM BADGE OR ID# 07691 OR]# ! WA0171300 TIME POLICE DISPATCHED 5:20 AM TIME POLICE ARRIVED',5:23 AM PART B PAGE IT]OF 5� REPORT NO. EF25681 CASE# 24-10737 FC LNaoy L isI©�ON O 10/15/24 05:19 F cu NARRATIVE 24-10737 Narrative The following occurred in the City of Renton, County of King, State of Washington. On 1015/2024 at about 0520 hours I was dispatched to an unknown if injury collision in the 1600 block of Benson DR S. I arrived at about 0523 hours to see it involved four vehicles and a trailer. The driver of V-1 stated that he was northbound on Benson DR S when traffic suddenly stopped in front of him. He tried to stop but the road was wet and slippery. With the added weight of the trailer and it's load behind him he was not able to stop in time and collided with V-2. The driver of V-2 stated that he stopped for traffic and about three seconds later he was struck from behind by V-1. He did not believe V-1 even attempted to stop. He was then pushed into V-3. The driver of V-3 stated that he was stopped for traffic when he heard the collision coming and tried to pull forward a little but was still struck from behind by V-2. The driver of V-4 stated that he was northbound on Benson DR S when traffic stopped in front of him. He was unable to stop and struck the back of the trailer V-1 was towing. I took digital photographs and later uploaded them to evidence.com. This incident was captured on my Axon body worn video camera. This report is a summary of events that occurred and is not an exact sequencing of events. Statements have been paraphrased and summarized. Nothing further at this time. I certify (declare) under penalty of perjury under the laws of the State of Washington that the foregoing is true and correct. Electronically signed by Q. Tibeau #07691 10/15/24 0640 hours, Renton, WA. PAGE 3 OF 5 SUPPLEMENTAL REPORT NO. EF25681 r`) POLICE TRAFFIC 1 1 8 27 COLLISION REPORT CASE# 24-10737 1 COMMERCIAL MOTOR CARRIER INTERSTATE INTRASTATE G UNIT'# USDOT ICC# VEHICLE TYPE CARGO BODY ;TYPE ❑ 1 28 2 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- PROPERTY DAMAGE THRESHOLD MET PHONE 5 ❑ UNIT# 3 VEHICLE tSJ CYCLE _) PEDESTRIAN � OWNER �I YES NO ✓ D:2534866855 0 7 29 LAST NAME FIRST NAME MIDDLE HANICH DARREL INITIAL, '' P STREET NFW AnDRFsP- 11101 SE 208TH ST APT 514 CITY KENT ST WA ZIP 980314142 6 [2 1 1 2 31 CDL IGNITIttN REQUIRED IGNITION PRESENT MEDICAL TAN5PORTED INTERLOCK YEs NO✓ zERLOCK YES❑NO❑✓ YES N ✓ DRIVER'S LICENSE STATE I WA SEX M MMDDyyv 02 - 11 - 1980 7 ❑ ON DUTY� STATUS AIRBAG' 2 RESTR. Q EJECT 1 HELMET I INJURY 1 1 NATURE OF INJURIES USE CLASS 8 ❑ 1 1 2 32 LICENSE BAC9303 TAr Wq VIN# 1FMCU9DG1AKC30564 PLATE# 9 9] TRAILER TRAILER PLATE# STATE PLATE# STATE 10 ❑ TRLR TRLR VIN.#. VIN.#. 11 4 U VEH.YEAR MAKE MODEL STYLE VEHICLE TOME E T SABLIN TOWED BY anvi vEH1C P FROM TO 2010 FORD ESCAPE UT DAMAGE YES NO ✓ YES NO ✓ REGISTERED OWNER INFODARREL HANICH 11101 SE 208TH ST APT 514 KENT WA 98031 D:2534866855 5 g 33 12 t} 0 SHADE IN DAMAGED AREA 3 4 FROM TO LIABILITY INSURANCE INSURANCE CO GEIC04464620485 q"i"Olx IN EFFECT &POLICY# 5 1 34 13 ❑ LEGAL ❑ CITATION# CHARGE 10 BOTTOM LEGALLY YES NO STANDING 8 7 6 DAMAGE THRESHOLD MET PHONE ❑ 35 14 UNIT# 4 MdT{7R ❑✓ PEDAG ❑ PEDESTRIAN ❑ PROPERTY ❑ YES NO VEHICLE CYCLE OWNER ✓ D:2065127021 15 � MILLER NATHAN MIDDLE '.J 36 ❑ LAST NAME FIRST NAME INITIAL I 2 STREET 16 ❑ ❑ 18417 127TH AVE SE CITY RENTON ST WA ZIP 980587975 NFn+AnnRFsS CDL IGNITION REdUiRED IGNITION PRESENT MEDICAL TANS PORTED 17 ❑ INTERLOCK YES NO✓ INTERLOCK YES NO✓ YEs No1 ❑ DRIVER'S STATE WA SEX M D.O.B 37 LICENSE# MMDDYYY` 09 - 10 - 1997 18 ❑ ❑ON DUTY� STATUS' AIRBAG 2 RESTR, 4 EJECT 1 H NATURE OF INJURIES 38 ELMET INJURY'1 USE CLASS 19 ❑ LICENSE PLATE# CLY2175 TAr WAvIN# 3N1C651DX5L527501 39 20 ❑ TRAILER' STATE TRAILER ST ❑ 40 PLATE#< PLATE# ATE 21 ❑ TRLR TRLR 41❑ ViN# YIN#i 42 22 VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED DUET SABLIN TOWED BY GOVT.VEHICLE 2005 NISS SENTRA DAMAGE YES NO ✓ YES NOZI El 23 [-7 REGISTEREDOWNERINFOX]MBERLYERKKILA-MILLER18417127THAVESERENTONWA98058 SHADE IN DAMAGED AREA F 43 z s 4 LIABILITY INSURANCE INSURANCE CO ALLSTATE 964398874 ❑ IN VEHICLE &POLICY# <�Q 4E:l 44 24 LEALE LLY YES❑ NO❑ CITATION# CHARGE .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. QUINT TIBEAU 10-15-24 09:02 AM 25 INVESTIGATING OFFICER'S SIGNATURE OFFICER'S PHONE UNIT OR DIST DET DATED: PLACE SIGNED 26 ORID# 07691 O#I',WA0171300 APSKELTON 10/18/202 PAGE F41 OF❑ 3000-345-013(R 11118) REPORT NO. EF25681 CASE# 24-10737 DATE AND TIME 10/15/24 05:19 OF COLLISION t R 4i v � a e } PAGE 5 OF 5