HomeMy WebLinkAbout24-9168 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 0 27c
COLLISION REP FIT 1591971
SASE 24-9168 2
INTERSTATE ❑ CITY STREET FIRE ❑
RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHIr.I F ❑ LOCAL AOENC 4Y00 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 1 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# ❑
cowsloN 08 - 1-- 2024 2338 17 ❑.= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓
NE 4TH ST BLOCK NO. e✓ 4000
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ ❑ FEET ❑ S ❑ W❑ 0 3 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
✓NO D:2063260361 0 11
30
6� LAST NAME SHEIKH FIRSTNAME NASIR MIDDLE M 1 2 31
INITIAL
STREET ❑✓ 4118 NE 2ND PL CITy RENTON ST WA ZIP' 98056 z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
iNTERLOCKYEs NO 1/ INTERLOCKYEs NO�/ YES R No�/
8❑ LRIIVER #
ON DUTY❑ STATUS AIRBAG 9 RESTR 9 EJECT 1 H USE 2 1 CLASS NATURE OF INJURIES z❑
3❑10 9❑ P1ATE14 CKF5148 STATE WA uN# 4T1BD1FK3GU200316
TRAILER STATE TRAILER STATE
11 3 5 PLATE# PLATE# FROM To
TRLR. TRLR 5 3 33
12 3 5 VIN#' VIN#
ROM TO
VEH.YEAR 2016 MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED By GOVT.VEHICLE 7 3 34
13 4 TOYT CAMRY SD DAMAGE YES NO YES[:] No
✓
REGISTERED OWNER INFO OWNEDBYDRIVER VEHICLE NO. 1
❑
SHADE IN DAMAGED AREA ❑ 35
14 LIABILI INSURANCE INSURANCE CO STATE FARM 5624313AO147001
IN EFFECT &POLICY# 9TOP
15❑ LE
vEGALLY HICLe 1 5 36
re3�No D CITATION# 4g0359615 CHARGE FAIL YIELD PRIVATE RD MOTOR I o eorrom
STANDING 8 7 6
MOTOR PEDAL- pROpERTy DAM THR OLD MET PHONE
UNIT 02 ❑ ❑ PEDESTRIAN ❑ ❑ D:2066794032
VEHICLE CYCLE OWNER YES M/ NO
16 a
LAST NAME ARIAS FIRST NAME ALEX MIDDLE E
INITIAL
17 STREET❑ NEW ADOREss❑' 5300 NE 10TH ST CITY RENTON ST WA ZIP 98059 37
18❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED � 38
INTERLOCKYES�NO� INTERLOCK yEs❑NOF YES
❑NoF,/
19 DRIVER'S STATE WA SEX M D.C.B. 02 _ 05 _ 1998 39
LICENSE# MMDDYY
20❑ ON DUTY STATUS AIRBAG 6 RESTR 9 EJECT 1 H EET 2 NJAU EY 7 COMPLAINT OF RIGHT WRIST PAIN F—NATURE OF INJURIES 40
❑21❑ PLATE# CAU5524 TATE WA VIN# 2C3CDXEJ2EH303087 41
1
42
22❑ PLATE# STATE PLATE# STATE
TRLR
23❑ VIN#. IN#. 43
RLR
'
TOWED BY Gov HI 44
VEH YEAR 2014 MAKE DODG MODEL CHARGE STYLE SD DAMAGE TOWED TOO✓
24 fj
YES BLIN YE S NO 1/
❑ REGISTERED OWNER INFO OWNED SY DRIVER VEHICLE N0.2
SHADEDAMAGEDAREA
3 4
LIABILITY
INSURANCE &POINSURGY#E CO pROGRESSIVE 953325122IN STOP 5
IEwGLE ❑ ,J� CITATION# CHARGE to BOTTOM
LEGALLY YES N`L J
25 ' e
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
J
26
C.ARNOLD 12509 WA0171300
PART A PAGE 01 OF C7
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EF10566
COLLISION REPORT III III III III III 111
1591972 CASE# 24-9168
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.
C.ARNOLD 09-01-24 01:22 AM
NVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
DESIRES SCOTT 10272 91112024 8:30:24 AM
BADGE OR ID# 12509 ORI#' WA0171300 TIME POLICE DISPATCHED 11:39 PM TIME POLICE ARRIVED',11:43 PM
PART Ei PAGE IT]OF 4�
DATE AND
TIME
REPORT NO. EF10566 CASE# 24-9168 OF COLLISION08/31/2423:38
NARRATIVE
On 8/31/2024 at 2339 hours, I was dispatched to a motor vehicle collision at around the 4000 block of
Ne 4th St.
Pre-Collision
Unit 1's driver stated that he was in the parking lot of the Pizza Hut located at around the 3900 block
of NE 4th St and preparing to perform a righthand turn to proceed East on NE 4th St.
Unit 2's driver stated that he was traveling East on NE 4th St at around the 3900 block in the number
1 lane.
Collision
Unit 1 stated that he performed a righthand turn and attempted to enter the number 2 lane from the
parking lot at around the 3900 block. Unit 1's driver stated that as he did this, he did not see Unit 2 in
the number 1 lane approaching him. Unit 2's driver stated that the front bumper of Unit 2 collided with
the rear passenger side tire and door of Unit 1 causing substantial damage.
Unit 2 stated that as he was proceeding East on NE 4th St in the number 1 lane, Unit 1 performed a
righthand turn and he did not have time to react. Unit 2's driver stated that the front bumper of Unit 2
collided with the rear passenger side tire and passenger side door of Unit 1, causing substantial
damage.
Injuries
Unit 1's driver did not complain of injuries, but the driver of Unit 2 complained of wrist pain. He was
evaluated by Renton Fire Authority (RFA) and cleared at the scene.
Vehicle dispositions
Both vehicles were inoperable and were towed from the scene.
Proximate Cause
If Unit 1 had yielded to the right of way of Unit 2, this collision would not have happened.
Final disposition
Driver 1 was cited for RCW 46.61.205.1. Driver 1 did violate RCW 46.61.205.1 because the driver of
a vehicle about to enter or cross a highway from a private road or driveway shall yield the right-of-way
to all vehicles lawfully approaching on said highway.
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 Officer C. Arnold #12509 on 9/1/2024 at 00:29 hours in the City of Renton.
PAGE 3 OF 4
REPORT NO.! EF10566 CASE# 24-9168 DATE AND TIME 08/31/24 23:38
OF COLLISION
wz„
s
4 � 2
ry
o-
a
_ ',s `,' � ��sxuarxc 1�, y,;..�> ,bps-�xSs•��" .. t, exsga ,,'
PAGE 4 OF 4