HomeMy WebLinkAbout24-11770 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 5 27c
COLLISION REP FIT 1591971
CASE 24-11770 z
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 3 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#
cawsloN 11 - 1-- 2024 0953 17 ❑-= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
e✓ --- ----� ❑
N 3RD ST MILEPOST
4a❑
DISTANCE OF(REFERENCE OR CROSS STREET) BLOCK NO.
5❑ ❑ FEET e S ❑ W e FACTORYAVE N
0 1 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
NO D:2064029516 0 11
30
6� LAST NAME LONGAN FIRSTNAME JOCELYN MIDDLE K 1 2 31
INITIAL
STREET ❑ 20419 120TH AVE SE CITY KENT ST WA 2jp, 980311653 z=
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
iNTERLOCKYEs NO INTERLOCKYEs NO YES R NO
8❑ LRIIVER #
ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 HELMET
2 CLASS 1 NATURE OF INJURIES z❑
3
10❑ P1 aT�S� CCL8947 sTAT� WA vIN# KMHDU46DX7U133113
TRAILER STATE TRAILER STATE
11 2 5 PLATE# PLATE# FROM TO
FTRL-R TPILF1 1 5 33
12 2 5 VIN#j VIN#
FROM TO
VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE 7 $ 34
13 2 2007 HYUN ELANTR SD DAMAGE YES NO YES[:] No
✓
REGISTERED OWNER INFO JOCELYN LONGAN 20419120THAVESE KENT WA 98031 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
14 LIABILI INSURANCE INSURANCE CO NATIONAL GENERAL 2024202464
IN EFFECT &POLICY# 9TOP
VE—LE 5 36
LECALLv YES❑NO❑ CITATION# CHARGE
10 BOTTOM
15❑ STANDING 8 6
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT 02 VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES 1/ NO D:2066523978
16 a
LAST NAME ROZSON/TS FIRST NAME DONALD MIDDLE I,/
INITIAL
17❑ STREET ❑', 4000 NE 3RD LN CITY' RENTON ST WA ZIP 980568505 37
NEW ADDRESS ❑
18� CDL IGNITION REQUIRED IGNITION PtR-E-S1ENT MEDICALt-T�RANSPORTED ❑ 38
INTERLOCKYES�NOR INTERLOCK YEs I I NoF YES t l NO❑
19 LICENSE# STATE WA SEX M M D.C.B. 02 _ 17 1957 0 39
WELMET {NJURY NATURE OF INJURIES 40
20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 USE 2 CLASS 1 ❑
21❑ LICENSE I G029WSU TATe WA vIN1t 1C6RR7PT7JS118369
❑ 41
PLATE#
42
22❑ PILER LATE# STATE PLATE# STATE
23❑ 43
TRLR RLR
VIN#. IN#.
VEH YEAR 2018 MAKE RAM MODEL 1500 STYLE VEHICLETOWED TO BLIN TOWEDBY GOV HI 44
L4❑ DAMAGE YES NO YES NO
REGISTERED OWNER INFO LAURA ROZSONITS 556 RIVER DR SW QUINCY WA 98848 VEHICLE NO.2
SHADE IN DAMAGED AREA
2 3 4
LIABILITY
INSURANCE INSU&PORGY#ECO STATE FARM 0879778-FO6-47DIN 1UQI
V'""LE ❑ ,J� CITATION# CHARGELEGALLYYES N`L J25
7CA
NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
J
26LAN 12007 WA0171300
PART A PAGE 01 OF
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EF37998
COLLISION REPORT III III III III III 111
1591972 CASE# 24-11770
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.
C.CATALAN 11-14-24 01:53 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
C.JACOBS 1953 1112112024 10:05:00 AM
BADGE OR ID# 12007 ORI# WA0171300 TIME POLICE DISPATCHED; 9:55 AM TIME POLICE ARRIVED 9:57 AM
PART I PAGE IT]OF 4�
REPORT NO. EF37998 CASE# 24-11770 OF COLLISION
11/13/24 09:53
OF CbLLI510N
NARRATIVE
On November 13, 2024, at approximately 0953 hours, I was dispatched to a non-injury and non-
blocking vehicle collision at the intersection of N 3th St and Factory Ave N, within the City Limits of
Renton, County of King, State of Washington.
Upon my arrival, 1 confirmed there were no complaints of injury requiring immediate medical response
at the time of report. There, 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 traveling southbound on Factory Ave N and had approached the
controlled intersecting roadway of N 3th St. The driver of Unit 1 stated that she intended to continue
straight at the intersection so she could proceed southbound onto Factory Ave N. The driver of Unit 1
stated that she could not remember what color the traffic light was when she entered the intersection.
As she entered the intersection, both unit 1 and unit 2 collided in the roadway causing significant
damage to the rear passenger wheel well, fender, and wheel bearing of Unit 1.
The driver of Unit 2 said he was the sole occupant of his vehicle and was traveling eastbound on N
3th St approaching the intersection of Factory Ave N. The driver of Unit 2 stated he was intending to
continue straight on the one-way road through the uncontrolled intersection for his direction of travel.
The driver of Unit 2 stated that upon reaching the intersecting driveway, Unit 1 failed to yield to his
vehicle at the intersection (he had a green traffic light). The driver of Unit 2 was unable to avoid the
collision and subsequently collided into Unit 1 causing minor damage to the front of Unit 2.
Based on the above statements, 1 determined that the Driver of Unit 1 is the proximate cause for the
cause of collision as the driver did not grant the right of way to traffic already in the roadway and
underway. The driver violated RCW 46.61.190(2) as every driver of a vehicle approaching an
intersecting roadway shall stop where the driver has a view of approaching traffic on the intersecting
roadway before entering the roadway, and after having stopped shall yield the right-of-way to any
vehicle in the intersection or approaching on another roadway so closely as to constitute an
immediate hazard during the time when such driver is moving across or within the intersection or
junction of roadways.
Unit 1 had to be privately towed due to extensive damage. Unit 2 was drivable, and an exchange of
information was provided to all involved parties.
PAGE 3 OF 4
REPORT NO. EF37998 CASE# ' 24-11770 DATE AND TIME 11/13/24 09:53
OF COLLISION
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PAGE 4 OF 4
