HomeMy WebLinkAbout24-9221 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 1 27c
COLLISION REP FIT 1591971
CASE 24-9221 z
INTERSTATE ❑ CITY STREET FIRE ❑
RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHICI F ❑ LOCAL AGENCI 4900 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 TOTAL#OF OBJECT 2$
1 0
RESERVATION
TRIBAL UNITS 02 STRUCK
z
3❑ DATE OF M M D D Y Y Y Y TIME(2400) COUNTY# MILES N E IN CITY# 0 6
COLLISION'. O9 — 02 — 2024 1844 17 ❑-= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
116TH AVE SE BLOCK NO. e✓ 11600 ❑
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ ❑ FEET e S ❑ VV e PETROV/TSKYRD
0 4 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
NO F,/ I D:5416362280 30
6� LAST NAME ZHAO FIRSTNAME WOQUAN MIDDLE 1 2 31
INITIAL
STREET ❑ 17523 128TH AVE SE CITY RENTON ST WA 21p 98058 z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION : PRESENT MEDICAL TRANSPORTED 3
1/ I iNTERLOCKYEs NO NTERLOCKYEs 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� C71170D sTArI WAvIN# 5TFCY5F11FX018977
TRAILER STATE TRAILER STATE
11 0 0 PLATE# PLATE# FROM TO
TRLR. A'RLR. 1 3 33
12❑ vIN#' VIN#
:: FROM TO
VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE 1 3 34
13❑8 2015 TOYT TUNDR PK DAMAGE YES NO YES[:] NO✓
REGISTERED OWNER INFO OWNEDBYDRIVER VEHICLE NO. 1
SHADE IN DAMAGED AREA ❑ 35
14� LIABILITY INSURANCEz
INSURANCE CO STATE FARM 4922602-FO1-47 3 4
IN EFFECT &POLICY# 9TOP
vEcnLLv HICLe 5 36
res❑NO❑ CITATION# CHARGE 10 BOTTOM
15❑ LE STANDING 8 6
MOTOR PEDAL PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT VEHICLE ❑ CYCLE ❑ ❑ : OWNER ❑ YES NO ,/ D:2068505674
16 a
LAST NAME ADAM FIRST NAME (LAYS MIDDLE A
INITIAL
STREET CITY' RENTON ST' WA ZIP 4
17 NEW ADDREs� ❑ 37
18� CDL IGNITION REQUIRED IGNITION PR—E-1SENT MEDICAL TRANSPORTED 38
INTERLOCKYES�NOR INTERLOCK YEs It I NOF YES
t t— l NO❑
19 DRIVE # STATE SEX M M .C.B. 02 _ 25 _ 2008 39
ON DUTY STATUS 0 AIRBAG RESTR EJECT 1 H SE
7 LASS SCRAPES
Y 7 URE OF ION LOWER RIGHT LEG ❑NJURIES 40
❑21❑ TArE 41
IN#LICENSE V 1
PLATE#
42
22❑ PLATE# STATE PLATE# STATE
23❑ 43
TRLR 'RLR
UIN#. IN#.
VEH YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN
TOWED BY Gov HI 44
24❑ DAMAGE YES NO YES NO
REGISTERED OWNER INFO VEHICLE NO.2
SHADE IN DAMAGED AREA
2 3 4
INAEFFITY ECTNSURANCE❑ &POINSULICY#E CO I vE."LE ❑ ,J� CITATION# CHARGE
25 GQ
LEGALLY YES N J
s � e
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
26 4 7 N/CHOLAS SWAN 12965 WA0171300
PART A PAGE 01 OF C7
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EF12966
COLLISION REPORT III III III III III 111
1591972 CASE# 24-9221
ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY)
NAME MIDDLE INITIAL) ROBINSON ANALEISSIA
(IAST FIRST,
ADDRESS&PHONE# D O.B.
4750 AUBURN WAY N AUBURN WA 98002 2065309071 SEXi F MMDDYyry 05 - 10 - 1984
PASSENGER❑WITNESS UNIT# SEAT AIRBAG RESTR. EJECT ' HELMET N NATURE OF INJURIES
✓ SOS. USE INJURY LASS
NAME
(LAST,FIRST,MIDDLE INITIAL) PONCE GEORGE fill
ADDRESS&PHONE# D O B
12210 SE PETROVITSKY RD RENTON WA 98055 2065828156 SEX M MMDDYvvv 10 - 15 - 1963
PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET INJURY NATURE OF INJURIES
❑ ❑✓ POS. USE CLASS
NAME
(LAST FIRST,MIDDLE INITIAL) PONCE DAKOTA
ADDREss&PHONE# 12210 SE PETROVITSKY RD RENTON WA 98055 2064124542 SEX UM 09 _ 2004
MDDYYYY
SEAT I HELMET I INJURY N URE OF INJURIES
PASSENGER WITNESS UNIT# AIRBAG RESTR. EJECT AT
❑ Z 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.
NICHOLAS SWAN 09-02-24 11:45 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
DESIRES SCOTT 10272 1 9/8/2024 10:23:46 AM
BADGE OR ID# 12965 ORI#' WA0171300 TIME POLICE DISPATCHED 6:45 PM TIME POLICE ARRIVED i 6:47 PM
PART Ei PAGE IT]OF 4�
REPORT NO. EF12966 CASE# 24-9221 OF COLLISION
09/02/24 18:44
OF CbLLI510N
NARRATIVE
#24-9221
Unless otherwise noted, all events took place in the City of Renton, in the County of King, in the State
of Washington.
This report is a summary of events that occurred and is not an exact sequencing of events.
On 09/02/2024 at approximately 1845 hours I was dispatched to the intersection of 116th Ave SE and
Petrovitsky Rd in the city of Renton, King County, WA, for a vehicle versus pedestrian collision that
had occurred.
While enroute to the scene, dispatch advised the pedestrian was conscious and still in the roadway.
I arrived on scene and found Unit 1 a white 2015 Toyota Tundra with WA LIC: C71170D and Unit 2 a
black Sur Ron electric motorbike. Unit 1 was in the left hand turn lane of 116th Ave SE and the Unit 2
was laying under the front bumper. The rider of Unit 2 was on the ground in front of the truck being
tended to by an off duty firefighter.
Renton Fire Department arrived on scene just as I arrived and was assessing the situation.
I observed scratches on the riders right ankle. He stated other than the scratches he was fine and did
not feel any other pain.
Driver 1 of Unit 1 was the sole occupant of their vehicle. Unit 1 was traveling south on 116th Ave SE.
The driver stated he was going to turn east on to Petrovitsky Rd. He proceeded into the left hand turn
lane. He saw a group of bikes stopped in front of him in lane 1 as he made his way into the left hand
turn lane. As he proceeded towards the light to make his turn, one of the bikers immediately moved in
to the left hand turn lane and collided with the front of his vehicle. Driver 1 stated that he did not see
the rider signal to move in front of him.
Driver 2 of Unit 2 was riding a Sur Ron a-bike and stated he was in lane 1 on 116th Ave SE waiting
for the light to turn green. He decided to get in to the left hand turn lane, and failed to look for
oncoming traffic. He did not see Unit 1 coming from behind and collided with the front end, pinning
himself under it's front bumper.
Witnesses at the scene confirmed the events that took place and one, identified by her WADL as
Robinson, Analeissia DOB 05/10/1984, provided a written statement.
The driver of Unit 2 was taken to Valley Medical Center for a complete medical evaluation. He was
wearing a full face motorbike helmet. Renton Fire Department said he appeared to be okay and only
had some light scratches on his lower right leg.
Unit 1 was able to be driven away from the scene and was undamaged.
Unit 2 was damaged and towed away by friends of the rider.
Officer S. Tamaivena took pictures and uploaded them to Axon Evidence.
At the conclusion of my investigation, I determined that the proximate cause of the collision is due to
the fact that the driver of Unit 2 was riding an unlicensed electric motorcycle in traffic and failed to
yield to oncoming traffic before turning without signals into the left hand turn lane.
If Unit 2 did not proceed in to the left hand turn lane without looking and properly signaling then the
accident would not have happened.
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 N. Swan #12965 on 9/2/2024 at 2320 hours in the City of Renton.
PAGE 3 OF 4
REPORT NO.! EF12966 CASE# ' 24-9221 DATE AND TIME 09/02/24 18:44
OF COLLISION
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PAGE 4 OF 4
