No preview available
HomeMy WebLinkAbout24-9048 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 0 27c COLLISION REP FIT 1591971 SASE 24-9048 2 INTERSTATE ❑ CITY STREET FIRE ❑ RESULTED 1 STOLEN STATE ROUTE ❑ OTHER ❑ VFHICI F ❑ LOCAL AOENC 4200 3 HIT 8 RUN CODING COUNTY RD PRIVATE WAY INVOLVED 2 1 TOTAL#OF OBJECT 1 1 8 28 TRIBAL UNITS 03 STRUCK RESERVATION z 3❑ DATE OF M M D D Y Y Y Y TIME(2400) COUNTY# MILES N E IN CITY# ❑ COLLISION'. 06 - 1-- 2024 0959 17 ❑.= S 8 IN e 1070 3 4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓ LOGAN AVE NORTH BLOCK NO. e✓ 500 4a❑ MILEPOST DISTANCE OF(REFERENCE OR CROSS STREET) 5❑ 3341. 00 FMILES EET e S B W e NORTH 6TH STREET 2 0 29 R PEDAL- DAMAGE THRESHOLD MET PHONE UNIT 01 VEHICLE ❑ CYCLE ❑ YES ,/No D:2064519175 0 11 30 6� LAST NAME TERMURE FIRSTNAME MARINEL MIDDLE 0 1 31 INITIAL STREET ❑✓ 2616 196TH AVE SW CITY LAKEBAY ST WA 2jp, 98349 z NEW ADDRESS 7❑ CDL IGNITION REQUIRED IGNITION : PRESENT MEDICAL TRANSPORTED 3 INTERLOCK YES[:]NO INTERLOCKYEs NO YES R NO 8❑ LRIIVER # ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 H USEET ICNLJAURY 1 NATURE OF INJURIES 2❑ 3 10[1P1 ATNES# 503LYY sTATe OR V N# 1 GCPTEE1XK1258172 TRAILER STATE TRAILER STATE 11 3 0 PLATE# PLATE# ROM TO TRLR. TRLR. 5 1 33 12 3 0 VIN#' VIN# FROM TO ❑ VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN T GOVT.VEHICLE 5 1 34 13 3 2019 CHEV COLOR PK DAMAGE vE8 0NO f �AWkkRS-OWNER ves❑ HI REGISTERED OWNER INFO OWNEDBYDRIVER VEHICLE NO. 1 SHADE IN DAMAGED AREA ❑ 35 14 LIABILI V INSURANCE INSURANCE CO STATE FARM 449 2269-C27.47B 3 4 IN EFFECT &POLICY# STOP ve FFE CHARGE 5 36 LEGALLY YEs No clTAnoN# 4A0612118 IMPROPER LANE USAGE BOTTOM 15❑ STANDING 6 MOTOR PEDAL-: ❑ PEDESTRIAN PROPERTY DAM THR PHONE UNIT U2 VEHICLE ❑ CYCLE ❑ OWNER ❑ YES 1/ NO OLD MET D:2067157676 16 a LAST NAME AGNEW FIRST NAME PAUL MIDDLE E INITIAL 17❑ STREET ❑', 3010 CARBON RIDGE ST CITY' ENUMCLAW ST WA ZIP 980228301 37 NEW ADDRESS ❑ 18� CDL ., IGNITION REQUIRED IGNITION PtR-E-S1ENT MEDICAL TRANSPORTED 38 INTERLOCKYES�NOR INTERLOCK YEs I I NOF YES t l NO❑ 19 LDI IVER # STATE WA SEX DDY M M D.C.B. 01 28 _ 1968 El 39 HELMET INJURY1 NATURE OF INJURIES 40 20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 USE CLASS ❑ 21❑ LICENSE I D54395E TATe WA VIN1t 1GB3WREY4RF369411 ❑ 41 PLATE# ❑ 42 22❑ TRAILER 8654YJ STATE WA TRAILER STATE PLATE# PLATE# 43 23❑ uINLx 1 T9ADAED6DF833308 IN RR YEAR 2024 MAKE CHEV MODEL SILVERA STYLE PK VEHICLE TOWED TO BLIN TOWEDev GOV HI 44 VEH 24❑ DAMAGE YES NO YES NO REGISTERED OWNER INFO THE BOEING CO PO BOX 3707 SEATTLE WA 98124 VEHICLE NO.2 SHADEDAMAGEDAREA 3 4 LIABILITY INSURANCE I PORGY#E CO ACE AMERICAN INS.CO./SA H10780585 I STOP 5 IN EFFECT vE""LE YES❑ N,J�J CITATION# CHARGE to BOTTOM LEGALLY 25 s a OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# JAGENCY 26 MATTHEW NUGENT 11498 WA0171300 PAGE 01 OF PART A 3000-345-159 OR 11/181 STATE OF POLICETRAFFICN CORRECTION REPORT NO. EF10935 COLLISION REPORT III III III III III 111 1591972 CASE# 24-9048 ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY) NAME MIDDLE INITIAL) MILLER CASSIUS (LAST FIRST, ADDRESS&PHONE# D O.B. ' 6916 S 125TH ST SEATTLE WA 98178 SEX M MMDOYyry 08 - 16 - 2020 PASSENGER WITNESS UNIT# SEAT AIRBAG' RESTR. EJECT ' HELMET INJURY NATURE OF INJURIES ❑✓ 3 POS. 9 2 10 1 USE CLASS !1 NAME (LAST,FIRST,MIDDLE INITIAL) MILLER KAIA ADDRESS&PHONE# DOB 6916 S 125TH ST SEATTLE WA 98178 SEX F MMDDYv- 02 _ 05 _ 2022 SEAT HELMET I INJURY NATURE of INJURIES PASSENGER Z WITNESS UNIT# 3 pOS 7 AIRBAG 2 RESTR. 10 EJECT 1 USE CLASS 1 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. MATTHEW NUGENT 08-28-24 06:13 PM INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED APPROVED BY DATE C.JACOBS 1953 1 9/2/2024 12:20:35 PM BADGE OR ID# 11498 ORI# WA0171300 TIME POLICE DISPATCHED! 10:01 AM TIME POLICE ARRIVED]10:06 AM PART I PAGE IT]OF 5� REPORT NO. EF10935 CASE# 24-9048 OF COLLISION 08/28/24 09:59 OF CbLLI510N NARRATIVE 24-9048 On 08/28/2024 at approximately 1002 hours, I was dispatched to a non-injury and non-blocking vehicle collision at the intersection of North 6th Street and Logan Avenue North, within the City Limits of Renton, County of King, State of Washington. Upon my arrival, Officer M. Leverton and I 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 he was the sole occupant of his vehicle and was traveling northbound in about the 500 block of Logan Ave North and approaching the intersection of N 6th Street in lane 2 of 3. The driver of Unit#1 stated that he needed to get into the left lane (lane 3 of 3) to make an upcoming left turn at the intersection. The driver of Unit#1 stated that he believed traffic was clear to change lanes. The driver of Unit#1 stated that while making the lane change, Unit#1 and Unit#2 collided in lane 3 of 3 causing significant damage to the front driver's side bumper, quarter panel, and front axle of Unit#1. Due to the initial impact, Unit#1 shifted directions and collided into another vehicle (Unit#3) causing additional damage to the front passenger bumper and axle. The driver of Unit#2 said he was the sole occupant of his company's vehicle and was also traveling northbound in about the 500 block of Logan Ave N approaching the intersection of N 6th ST but in lane 3 of 3 (Left-Turn Lane). The driver of Unit#2 stated he was intending to turn left at the intersection ahead when Unit#1 changed lanes from lane 2 of 3 and into lane 3 of 3 which Unit#2 was occupying. Unit#2 was unable to avoid the collision and subsequently collided with Unit#1. Unit #2 suffered moderate damage to the front passenger side bumper and quarter panel due to the collision. The driver of Unit#3 said she and her two juvenile passengers were traveling northbound in about the 500 block of Logan Ave N approaching the intersection of N 6th ST in lane 2 of 3. The driver of Unit#3 stated that while stopped at the intersection for queued traffic, she felt a vehicle collide into her. Unit#3 suffered moderate damage to the rear driver side fender and quarter panel due to the collision. Based on the above statements, I determined that the Driver of Unit#1 (Termure) is the proximate cause for the cause of collision as Termure violated RCW 46.61.140(1) which states that a vehicle shall be driven as nearly as practicable entirely within a single lane and shall not be moved from such lane until the driver has first ascertained that such movement can be made with safety. Termure made a lane change into Unit#2's lane of travel which had the right of way and was underway. Termure did not ensure that traffic in lane 3 of 3 was clear of hazard before making the unsafe lane change. I cited Termure via for Improper Lane Usage causing a collision. Unit#1 had to be towed away from the scene due to extensive damage. Both Unit#2 and Unit#3 were able to be driven away without further incident. 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 F. LAST#11111 6:03 PM 8/28/2024 Renton, King County, WA. PAGE 3 OF 5 SUPPLEMENTAL REPORT NO. EF10935 r`) POLICE TRAFFIC 1 1 8 27 COLLISION REPORT CASE# 24-9048 1 COMMERCIAL MOTOR CARRIER INTERSTATE INTRASTATE G UNIT'# USDOT ICC# VEHICLE TYPE CARGO BODY ;TYPE 2 ❑ 1 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:2063716699 0 7 29 LAST NAME PHILLIPS FIRST NAME ZOE MIDDLE'.. A INITIAL STREET 30 NEW AnDRFrtP 6916 S 125TH ST CITY SEATTLE ST WA ZIP 981784330 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 F MMDDYYv', 04 - 08 - 1995 7 ON DUTY� STATUS AIRBAG' 2 RESTR. Q EJECT 1 HELMET I INJURY 1 1 NATURE OF INJURIES USE CLASS 8 ❑ 1 32 LICENSE BJL4985 TAr WA VIN# JTDKN3DU8F0431056 PLATE# 9 TRAILER TRAILER PLATE# STATE PLATE If STATE 10 ❑ TRLR TRLR VIN.#. VIN.#. 11 3 0 VEH.YEAR2015 MAKE TOYT I MODELPRIUS STYLE 4W VEHICLE TOWS E T SABLIN TOWED BY anvi vEH1Ci E FROM TO DAMAGE YES NO YES NO REGISTERED OWNER INFO OWNED BY DRIVER J 9 33 12 � SHADE IN DAMAGED AREA 3 4 FROM TO LIABILITY INSURANCE INSURANCE CO THE GENERAL WA6682149 q"i"Olx IN EFFECT &POLICY# 1 VEHICLE 34 13 ❑ Lecnuv YES NO❑ CITATION# CHARGE 10 BOTTUM STANDING } 8 7 14 ❑ UNIT Tr Vd 1RE O CYDCLE 1:1OWNER YE YES AGE NOHRESHOLD MET PHONE ❑ 35 PEDESTRIAN 15 LAST NAME FIRST NAME NITIAL ❑ 36 STRE 16 NEW ETETnnR"� CITY ST ZIP CDL IGNITION REdUiRED IGNITtGN PRESENT MEDICALTANSPORTED NTERLOCK YES No NTERLOCK YEs NO YES NO El 17 37 LICENSE# STATE SEX MMDDDYBYY 18 ❑ ON DUTY� STATUS AIRBAG RESTR. ; EJECT HELMET INJURY NATURE of INJURIES 38 USE (CLASS 19 ❑ 39 LICENSE rnr VIN# PLATE# 20 ❑ TRAILER' TRAILER El40 PLATE#< STATE PLATE If STATE 21 ❑ TRLR TRLR 41 VIN# YIN#i 42 22 VEH.YEAR MAKE I MODEL STYLE I VEHICLE TO DUET SABLIN TOWED BY GOVT.VEHICLE DAMAGE YES NO YES NO 23 REGISTERED OWNER INFO SHADE IN DAMAGED 3 4 4 AREA F 43 z LIABILITY INSURANCE INSURANCE CO ' VINE EFFECT &POLICY# i 970P - 4 E:l 44 24 VEHICLE YES❑ NO❑ CITATION# CHARGE iq 60TiOM LEGALLv STANDING 8 7 6 1 CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT. MATTHEW NUGENT 08-28-24 06:13 PM 25 INVESTIGATING OFFICER'S SIGNATURE OFFICER'S PHONE UNIT OR DIST DET DATED: PLACE SIGNED APPROVED BY DATE 26 ORID# 11498 O#IL WA0171300 JACOBS 9/2/2024 PAGE F OF 5 3000-345-013(R 11118) REPORT NO.! EF10935 CASE# ' 24-9048 DATE AND TIME 08/28/24 09:59 OF COLLISION �2 PAGE 5 OF 5