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HomeMy WebLinkAbout24-9111 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 1 27c
COLLISION REP FIT 1591971
CASE 24-9111 z
INTERSTATE ❑ CITY STREET FIRE ❑
RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHICI F ❑ LOCAL AGENCI 4100 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 TOTAL#OF OBJECT 1 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 08 - 1-- 2024 1330 17 ❑.= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓
S GRADY WAY BLOCK NO. e✓ 700
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ 400 00 FMILES EET e S ❑ E e SHATTUCKAVES
0 1 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
,/NO D:4252009788 0 11
30
6� LAST NAME PEREZ FIRSTNAME MANUELA MIDDLE I R 1 2 31
INITIAL
STREET ❑1 542 OLYMPIA AVE SE CITY RENTON ST WA ZIP 980582876 z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
1/iNTERLOCKYEs NO INTERLOCKYEs NO YES R No�/
8❑ LRIIVER #
ON DUTY❑ STATUS AIRBAG 3 RESTR 4 EJECT 1 HELMET INJURY 7 NATURE OF INJURIES 2❑
USE CLASS COMPLAINT OF PAIN LEFT KNEE,CHEST
3
10 9❑ Pl ATE 14 C55254E STATE WA ,N#' 1 GCUKREC2FF701374
TRAILER STATE TRAILER STATE
11 3 5 PLATE# PLATE# FROM TO
TRLR. TRLR 3 7 33
12 3 5 VIN#' VIN#
>; FROM TO
❑ VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN T /g[ GOVT.VEHICLE 3 7 34
13 2 2015 CHEV SILVER PK DAMAGE YES NOBS YES : No✓
REGISTERED OWNER INFO HORACIOSANTIAGO RODRIGUEZ3410 ROSEWOOD ST MOUNTVERNON WA 98273 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
14 ABILI V INSURANCE INSURANCE CO PROGRESSIVE 917275074 3 4
IN EFFECT &POLICY# 9TOP
VEHICLE CHARGE 5 36
LEGALLY YES❑NO❑ CITATION# 4AO416828 INATTENTIVE DRIVING I o eorrom
15❑ STANDING 7 6
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT 02 VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES 1/ NO DD 2067107935
16 a
LAST NAME BALDERAS FIRST NAME TRACY MIDDLE I D
INITIAL
17❑ STREET ❑', 1228 BENSON RD S APT A CITY RENTON ST WA ZIP 980553401 37
NEW ADDRESS ❑
18� CDL IGNITION REQUIRED IGNITION PtR—E�S1ENT MEDICALt—T�RANSPORTED 38
INTERLOCKYES�NOR INTERLOCK YEs W I NoF YES t l NOF,—/]
19 DRIVER'S STATE WA ]SEX IF D.C.B. 08 _ 25 _ 1970 39
LICENSE# MMDDYY
H USE COMPLAINT
NJAURSY COMPLAINT OF PAIN LEGS,CHEST,HEAD ❑ 40
20 [NATURE OF INJURE
ON DUTY STATUS AIRBAG,2 RESTR 4 EJECT 1 7
21❑ LICENSE I CGT3859 TATe I WA VIN# KMHC65LC6KU174533
❑ 41
PLATE#
42
22❑ PLATE# STATE PLATE# STATE
23❑ UIN#. 43
TRLR RLR
'IN#.
GI
VEH YEAR 2019 MAKE yyU/I/ MODEL /ON/(,� STYLE DAMAGE TO ✓WED NOO BLIN TOWED BY OV 44
Yr
H BANKERS YES No
24❑ REGISTERED OWNER INFO OWNED SY DRIVER VEHICLE N0.2
SHADEDAMAGEbAREA
s Cd
LIABILITY
INSURANCE &POINSURGY#E CO ALLSTATE 817123411IN STOP
VEHICLE I CITATION# CHARGE to BOTTOM
LEGALLY YES[:] N
,.I—
25
7.111CjEo-S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
26
HNSON 0505 WA0171300
PART A PAGE 01 OF
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EF11729
COLLISION REPORT III III III III III 111
1591972 CASE# 24-9111
ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY)
NAME MIDDLE INITIAL) DIEDER/CHS JENNY
(I.P.ST FIRST,
ADDRESS&PHONE# D O.B. '
2813 WHITWORTH AVE S RENTON WA 98055 SEXi F MMDOYyry 04 - 24 - 1986
PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT ' HELMET INJURY NATURE OF INJURIES
❑✓ ❑ 4 PC& 3 2 4 1 USE CLASS 1
NAME
(LAST,FIRST,MIDDLE INITIAL)
ADDRESS&PHONE# DOB
SEX' MMDDYYYY -
PASSENGER ❑WITNESS❑ UNIT# SEAT I AIRBAG RESTR. EJECT HELMET NJURY NATURE OF INJURIES
POS. USE CLASS
NAME
(LAST FIRST MIDDLE INITIAL)
AppRESS R PHONE#
SEX D.O.B.MMDD -❑
YYYY.
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.
CO.JOHNSON 09-03-24 11:06 AM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
CO.JOHNSON 0505 1 9/4/2024 4:02:06 PM
BADGE OR ID# 0505 OR]# WA0171300 TIME POLICE DISPATCHED 4:37 PSI TIME POLICE ARRIVED',1:38 PM
PART I PAGE ❑OF❑
REPORT NO. EF11729 CASE# 24-9111 OF COLLISION
08/30/24 13:30
OF CbLLI510N
NARRATIVE
On 08-30-2024 at about 1337 hours, I was dispatched to an Injury Collision in the 700 block of S
Grady Way in the City of Renton, County of King, Washington State. Dispatch advised four (4)
vehicles were involved and were blocking the roadway. I arrived in the area at about 1338 hours.
Renton Regional Fire department personnel happened upon the collision and stopped to render aid
prior to my arrival. The drivers of Unit 01, 02 and 03 were evaluated and released at the scene.
The front of Unit 01 was still engaged with the rear of Unit 02. The driver (sole occupant) of Unit 01
was seated in the driver seat of the vehicle. The driver spoke limited English and was identified by
WA DL as Manuela R. Perez (DOB 08-20-1951. Unit 01 was in lane #1 of westbound S Grady Way
when her vehicle collided with the rear of Unit 02. The driver of did not know what happened to
cause the collision. I asked the driver if they were on their telephone or doing anything else other
than driving during the collision and she replied no. The driver complained of pain to her left knee
and chest.
The driver of Unit 02 was outside of their vehicle and near the sidewalk. The driver was identified by
WA DL. Unit 02 was moving slowly in lane #1 when they were hit from behind by Unit 01. The force
of the collision caused the front of Unit 02 to be pushed into Unit 03. The driver of Unit 02
complained of pain in both her legs, chest and head.
The driver of Unit 03 was standing in the area of Unit 01 and 02 and his vehicle was further to the
west in lane #1 of S Grady Way. The driver was identified by WA DL. The driver said his vehicle was
moving along slowly with traffic when he noticed Unit 01 collided with Unit 02. The driver said Unit 01
continued to push Unit 02 forward and into the rear of his vehicle. The driver of Unit 03 complained of
pain in his back and neck.
The driver of Unit 04 was verbally identified and said his vehicle was in lane #2 of westbound S Grady
Way, adjacent to Unit 02 when the collision occurred. Debris from the collision impacted the
passenger side door or Unit 04 causing minor damage. Neither the driver nor passenger complained
of injury as a result of the collision.
I observed major damage to the front of Unit 01 along with major damage to the rear and front of Unit
02. A tow truck was utilized to pull the vehicles apart. Both vehicles were towed by Bankers Towing.
Based on the extensive damage to the vehicles, it appeared Unit 01 was travelling well in excess of
the posted 35 MPH speed limit. There was moderate damage to the rear of Unit 03 and minor
damage to the passenger side door of Unit 04.
During the approximate time of the collision, I observed a moderate amount of vehicle traffic in the
vicinity that caused the majority of vehicles to travel at below the posted speed limit. S Grady Way is
a major roadway in the area that has 5 to 6 lanes of travel with a minimum of two (2) lanes dedicated
in each direction.
The proximate cause of the collision was inattentive driving by the driver of Unit 01 (Perez). Renton
Municipal Code 10-12-25 Inattentive Driving states it shall be a traffic infraction 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" 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.
Notice of Infraction for Inattentive Diving sent to the Renton Municipal Court to mail to the driver of
Unit 01 (Perez).
PAGE 3 OF 5
SUPPLEMENTAL REPORT NO. EF1 1 729
r`) POLICE TRAFFIC 1 1 8 27
COLLISION REPORT CASE# 24-9111
1 COMMERCIAL MOTOR CARRIER INTERSTATE INTRASTATE G
UNIT'# USDOT ICC# VEHICLE TYPE CARGO BODY
;TYPE
2 ❑ 1 1 8 28
CARRIER
NAME
3 CARRIER
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 I_) PEDESTRIAN OWNER YES NO
D:4255248316
0 1 Zg
LAST NAME REYNOSO FIRST NAME ISRAEL MIDDLE ',, A
INITIAL
0 1 30
STREET
NEW AnDREsP 510 STEVENS AVE SW APT 0103 CITY RENTON ST WA ZIP 980572370
6
CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TANSPORTED 1 1 2 31
INTERLOCK YEs NO zERLOCK YES[:]NO[:]
YEs N
DRIVER'S
LICENSE STATE I WA SEX M MMDDYYv 04 - 29 - 1979
7 ❑ HELMET I INJURY' NATURE OF INJURIES
ON DUTY STATUS AIRBAG 2 RESTR. 4 EJECT 1 USE CLASS 7 COMPLAINT OF PAIN NECK,SACK
8 ❑ 1 1 2 32
LICENSE C20582S TAT WA VIN# 1GTN1VE06CZ288034
PLATE#
9 [9] TRAILER TRAILER
PLATE# STATE PLATE# STATE
10 TRLR TRLR 91 VIN.#. VIN.#.
11 3 5 VEH.YEAR2012 MAKE GMC I MODELSIERRA STYLE I VEHICLE TOVVE E T SABLIN TOWED BY anvi vEHICi P FROM TO
DAMAGE YES 'E YES NO
12
REGISTERED OWNER INFOISRAEL REYNOSO 510 STEVENS AVE SWAPT 0103 RENTON WA 98057 SHADE IN DAMAGED AREA 3 ] 33
3 5
7 j FROM TO
LIABILITY INSURANCE INSURANCE CO PROGRESSIVE 957304586 q"i"Olx
IN EFFECT &POLICY#
1 ------- 3 7 34
13 ❑ EL L ❑ ❑ CHARGE 0 BOTTUM
LEGAGALLY YES NO CITATION#
STANDING 8 7
DAMAGE THRESHOLD MET PHONE ❑ 35
14 UNIT# 4 MdT{7R O PEDAG ❑ PEDESTRIAN ❑ PROPERTY ❑ YES NO
VEHICLE : CYCLE OWNER �/ D:2063937094
15 � DIEDERICHS TONY MIDDLE T
❑ 36
LAST NAME FIRST NAME INITIAL
2 STREET
16 ❑ ❑ 2813 WH/TWORTH AVE S CITY RENTON ST WA ZIP 98055
NEn+AnntxESS
CDL IGNITION REdUiR rD IGNITION PRESENT MEDICALTANSPORTEII
17 ❑ INTERLOCK YES Nb INTERLOCK YEs NC7 YEs No�/ 1:1
DRIVER'S STATE WA SEX M D.O.B 37
LICENSE# MMDDYYY` 08 - 16 - 1985
18 ❑ El38
ON DUTY� STATUS' AIRBAG 2 RESTR, 4 EJECT 1 HELMET INJURY'1 NATURE OF INJURIES
USE CLASS
19 ❑ LICENSE ❑
PLATE# CFF6035 TAr WA v!N# 5YJ3E1EBXKF477683 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
2019 TESL MODEL DAMAGE YES NO YES NOZI
23 ❑ REGISTERED OWNER INFOJENNY DIEDERICHS 2813 WHITWORTH AVE SRENTONWA98055 D:2063937094 SHADE IN DAMAGED AREA 43
z 4
LIABILITY INSURANCE INSURANCE CO FTOP FARMERS i _. --` ❑
❑ EFFECT &POLICY# 1 44
VE
24 LE ALE YES❑ NO❑ CITATION# CHARGE iG BOi"TpM
LEGALLY
STANDING
I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT.
CO.JOHNSON 09-03-24 11:06 AM
25 INVESTIGATING OFFICER'S SIGNATURE OFFICER'S PHONE UNIT OR DIST DET DATED: PLACE SIGNED
APPROVED BY DATE
26 ORID# 0505 O#IL WA0171300 JOHNSON 9/4/2024 PAGE F OF❑
3000-345-013(R 11118)
REPORT NO. ER 1729 CASE# ' 24-9111 DATE AND TIME 08/30/24 13:30
OF COLLISION
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PAGE 5 OF 5