HomeMy WebLinkAbout24-11043 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 1 27c
COLLISION REP FIT 1591971
CASE 24-11043 z
INTERSTATE ❑ CITY STREET FIRE ❑RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHIr.I F ❑ LOCAL AGENC 4200 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#
COLLISION'. 10 - 1-— 2024 1432 17 ❑-= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
SW GRADY WAY BLOCK NO. e✓ ❑
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ �.❑ FEET e S ❑ VV a POWELL AVE SW
0 1 29
MOTOR PEDAL- DAM THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El YEs NO ,/ D:2063832536 0 4 30
6❑ LAST NAME MOLINA FIRSTNAME CLOTILDE MIDDLE L 1 2 31
INITIAL
STREET ❑ 14920 62ND AVE S CITY TUKWILA ST WA ZIp' 981684602 z=
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
INTERLOCK YES[:]NO INTERLOCKYEs NO YES R NO
8❑ LDRIVER # STATE WA SEX'F MID
.O B 07 1- 20 - 1944 2 32
[NATURE OF IN
9 ON DUTY❑ STATUS' AIRBAG 2 RESTR 4 EJECT 1 HELMET USE 2 6 CLASS BACK PAIN JURIES z❑
3
10 1❑ LICENS P1 ATE 14 ACR7186 sTAT WA u N# JN8AF5MVXBT008179
5 TRAILER STATE TRAILER STATE
11 3 5 PLATE# PLATE# FROM ro
TRLR. TRLR 3 7 33
12 3 5 VIN#' VIN#
>; FROM TO
VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE 1 3 34
13 2 2011 NISS JUKE UT DAMAGE YES NO YES[:] No
✓
REGISTERED OWNER INFO CLOTILDE MOLINA 1492062ND AVE S TUKWILA WA 98168 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
14 LIABILI INSURANCE❑ INSURANCE CO 3 4
IN EFFECT &POLICY# 9TOP
vErICALLv ICLE YES CHARGE 5 36
❑NO❑ CITATION# 10 BOTTOM
15❑ LE STANDING 8 7 6
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT 02 VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES 1/ NO D:9078879618
16 a
LAST NAME AUSTIN-BENNETT FIRST NAME TAELAHNA MIDDLE I T
INITIAL
17 STREET❑ NEW ADOREss❑' 2020 GRANT AVE S APT B203 CITY RENTON ST WA ZIP 980553645 37
18❑ CDL IGNITION REQUIRED IGNITION PR-E-1SENT MEDICAL-T�RANSPORTED � 38
INTERLOCKYES�NOR INTERLOCK YEs It I NOF YES
t l NO❑
19 DRIVER'S STATE WA SEX F D.C.B. 07 19 _ 1997 39
LICENSE# MMDDYY
20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 HELMET 2 INJURY 6 NATURE OF INJURIES ❑ 40
USE CLASS LEFT SHOULDER PAIN
❑21❑ PLATE# CMS0381 TATE 41
WA VIN# JTN611HK5J3023464 1
42
22❑ PLATE# STATE PLATE# STATE
23❑ VIN#. 43
TRLR RLR
'IN#.
VEH YEAR 2018 MAKE TOYT MODEL CAMRY STYLE VEHICLETOWED TO BLIN TOWEDBY GOV HI 44
24❑ DAMAGE YES NO YES NO
REGISTERED OWNER INFO TAELAHNA AUSTIN-BENNETT 2020 GRANT AVE S APT B203 RENTONWA98055 VEHICLE NO.2
SHADE IN DAMAGED AREA
2 3 4
LIABILITY
INSURANCE INSU&POLICY#E CO USAA 042544331CIN 9TOP 5
'E""LE ❑ ,J� CITATION# CHARGE i o BOTTOM
LEGALLY YES N`L J
25
CER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
26
HUNTER DEIGHAN 13030 WA0171300
PART A PAGE 01 OF
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EF28934
COLLISION REPORT III III III III III 111
1591972 CASE# 24-11043
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
PM 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.
HUNTER DEIGHAN 10-23-24 04:47 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY E
DAT
P.KORDEL 9676 1012712024 10:59:45 AM
BADGE OR ID# 13030 OR]# WA0171300 TIME POLICE DISPATCHED 2:34 PM TIME POLICE ARRIVED 2:46 PM
PART I PAGE IT]OF 4]
REPORT NO. EF28934 CASE# 24-11043 OF COLLISION
10/23/24 14:32
OF CbLLI510N
NARRATIVE
On 10/23/2024 at approximately 1434 hours, I was dispatched to an accident with injury and blocking
vehicle collision at the intersection of SW Grady Way and Powell Ave SW, within the City Limits of
Renton, County of King, State of Washington.
While en route, Officer Nugent had arrived on scene and requested Renton Regional Fire Authority
(RRFA) respond as a precaution.
Upon my arrival, I confirmed that the passenger of Unit#1 was complaining of back pain and the
driver of Unit#2 was complaining of left shoulder pain. RRFA had already responded and evaluated
the involved parties prior to my arrival. All parties were treated at the scene and released by RRFA.
While on scene, I was able to collect each involved party's information and independent summary of
the events leading up to the collision.
The driver of Unit#1 said she was the sole occupant of the vehicle traveling westbound on SW Grady
Way and had approached the traffic light controlled intersecting roadway of Powell Ave SW. The
driver of Unit#1 stated that she was intending to drive through the intersection to continue westbound
on SW Grady Way. The driver of Unit#1 stated that the traffic signal light was green when she
entered the intersection travelling approximately 30-35mph. The driver of Unit#1 said that she looked
to her right and Unit#2 then suddenly appeared. Unit#1 said she pressed on her brakes as hard as
she could but could not stop in time. Both Unit#1 and Unit#2 collided in the roadway causing
significant damage to the front driver's wheel well, hood, and fender of Unit#2. Unit#1 said that after
the collision she looked up and saw that the light for westbound travel on SW Grady Way was red.
The driver of Unit#2 said she was the sole occupant of her vehicle and was traveling southbound on
Powell Ave SW. She stopped at the red light facing southbound on Powell Ave SW in the left turn
lane. The driver of Unit#2 stated she was intending to turn eastbound onto SW Grady Way. The
driver of Unit#2 stated that upon the light changing to a green left arrow she entered the intersection
and began turning east. Unit#2 said that is when Unit#1 entered the intersection and struck Unit#2.
Unit#2 estimated she was moving around 8mph when the collision occurred.
Based on the information above I was unable to determine who committed the traffic violation. This
report is informational only.
Unit#2 had to be towed due to extensive damage by Gene Meyer's Towing. Unit#1 was able to drive
away. An exchange of information was provided to all involved parties.
I certify (or declare) under penalty of perjury under the laws of the State of Washington that the
foregoing is true and correct.
Electronically signed by Officer H. Deighan #13030 10/23/2024 4:45 PM Renton, King County, WA.
PAGE 3 OF 4
REPORT NO. EF28934 CASE# ' 24-11043 DATE AND TIME 10/23/24 14:32
OF COLLISION
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PAGE 4 OF 4
