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Home My WebLink About23-13257 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 5 27c COLLISION REP FIT 1591971 CASE 23-13257 z INTERSTATE ❑ CITY STREET FIRE ❑RESULTED 1 STOLEN STATE ROUTE ❑ OTHER ❑ VFHIr.I F ❑ LOCAL AGENC 4100 3 HIT&RUN CODING COUNTY RD PRIVATE WAY INVOLVED 2 5 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# ❑ cowsloN 11 - 1-- 2023 2157 17 ❑.= S 8 IN e 1070 3 4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓ BENSON DR S BLOCK NO. e✓ 1500 4a❑ MILEPOST DISTANCE OF(REFERENCE OR CROSS STREET) 5❑ 1 ,❑ FEET e S B W e S 15TH ST 0 1 29 MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE UNIT 01 VEHICLE ❑ CYCLE El �/No D:2532663067 1 3 30 6❑ LAST NAME PARK FIRSTNAME YERANG MIDDLE J 1 1 2 31 INITIAL STREET ❑, 24705 132ND PL SE CITY KENT ST WA ZIP 98042 z NEW ADDRESS 7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3 1/ I INTERLOCK YES[:]NO NTERLOCKYEs NO�/ YES R No�/ 8❑ LDRIVER # STATE WA SEX'M MID -O B 09 - 29 - 1989 32 9 ON DUTY❑ STATUS AIRBAG 3 RESTR 9 EJECT 1 H U SE ICNLJAUSSY 1 NATURE OF INJURIES z❑ 3 10❑ P1 aT�S� BKF3107 sTArI WAurN# 2HGFC1E52JH705747 TRAILER STATE TRAILER STATE 11 0 0 PLATE# PLATE# FROM TO FT -R TPILF1 1 5 33 12 0 0 VIN#' VIN# FROM TO ❑ VEH.YEAR 2018 MAKE MODEL STYLE VEHICLE TOWED TO BLIN TR Y GOVT.VEHICLE 34 13 4 HOND CIVIC 4D DAMAGE YES NO �MEYER 1 5 YES❑ No✓ REGISTERED OWNER INFO .1.PARK 21711132ND PL SE KENT WA 98042 D:2532663067 VEHICLE NO. 1 ❑ SHADE IN DAMAGED AREA 35 14❑ LIABILI INSURANCE INSURANCE CO PROGRESSIVE 954382273 3 4 IN EFFECT &POLICY# 9TOP VEHCLE CHARGE 5 36 LEGALLY YES❑NO❑ CITATION# 1 o BOTTOM 15❑ STANDING 7 6 MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE UNIT U2 VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES 1/ NO D:2065958328 16❑ LAST NAME VENZANT FIRST NAME JASMINE MIDDLE S INITIAL 9 8178 37 ADORE71 CITYP 17 NEW 18� CDL IGNITION REQUIRED IGNITION PR-E-1SENT MEDICAL TRANSPORTED 38 INTERLOCKYES�NO� INTERLOCK YEs It I NOF YES t l NOF,/ 19[-] LDI IVEW # STATE WA SEX F M MD D.C.B.B. 11 14 2005 39 HELMET INJURY NATURE OF INJURIES 40 20 F1 ON DUTY STATUS AIRBAG,3 RESTR 9 EJECT 1 USE 9 6 CLASS HEAD HURT ❑ILICENSE 21❑ PLA E# ATY8378 TAre WA VIN# 41 WDBHA23G4WA556432 1 42 22❑ PLATE# STATE PLATE# STATE 23❑ 43 TRLR RLR VIN#. IN#. VEH YEAR 1998 MAKE MERZ MODEL 2304D STYLE SD VEHICLE TOWED TO BLIN TOWEDBY GOV HI �44 24 DAMAGE YES NO GENE MEYER YES NO REGISTERED OWNER INFO JASMINE VENZANT1144469THPL S SEATTLE WA 98178 D:2065958328 VEHICLE NO.2 SHADE DA GEbAREA LIABILITY INSURANCE &POINSURGY#E CO GEICO 6088827800 Cdd IN CTOP 'E""Le ❑ ,J� CITATION# CHARGE I BOTTOM LEGALLY YES N`L J 25 OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# JAGENCY 26 J RA YGOZA 12503 WA0171300 PART A PAGE 01 OF C7 3000-345-159 OR 11/181 STATE OF POLICETRAFFICN CORRECTION REPORT NO. EE23029 COLLISION REPORT III III III III III 111 1591972 CASE# 23-13257 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. J RAYGOZA 11-17-23 04:36 AM INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED APPROVED BY DATE G.BARFIELD 6476 1112412023 4:52:00 PM BADGE OR ID# 12503 OR]# WA0171300 TIME POLICE DISPATCHED 10:01 PM TIME POLICE ARRIVED',10:06 PM PART I PAGE IT]OF REPORT NO. EE23029 CASE# 23-13257 OF COLLISION 11/16/23 21:57 OF CbLLI510N NARRATIVE RPD CASE#: 23-13257 On 11/16/2023 at approximately 2201 hours, I responded to the 1500 block of Benson Dr S for an accident with injury collision, in the City of Renton, King County, Washington. Upon arrival all three vehicle were parked on the lane closest to the curb facing south on Benson Dr S. I identified Unit 1 as a blue 2018 Honda Civic, bearing WA license BKF3107 VIN#2HGFC1 E52JH705747. Unit 1 sustained major damage to the front of the vehicle. I identified the driver of Unit 1 via his WADL as Park, Yerang Joseph (DOB 09/29/1989). Park told me he in the further lane closest to the curb driving southbound on Benson Dr S. Park then looked down and collided with the rear of unit 2 which caused unit 2 to collide with unit 3. Park said he didn't see unit 1 or unit 2 on the street because he didn't see any hazard lights on. Park told me he was not injured and provided me with all the necessary documents. I identified Unit 2 as a black 1998 Mercedes 2304D, bearing WA license ATY8378 VIN#WDBHA23G4WA556432. Unit 2 sustained heavy damage to the rear and front of the vehicle. I identified the driver of Unit 2 via her WADL as Venzant, Jasmine Sierra (DOB 11/13/2005). Venzant told me she was parked behind unit 3 on the furthest lane closest to the curb filling unit 3 with gas that she got from a nearby gas station. Unit 3 ran out of gas prior to the collision and Venzant drove there to help her cousin who was the driver of unit 3. Venzant then said unit 1 collided with the rear of her vehicle causing her vehicle to hit the back of Unit 3. Venzant stated she hit her head during the collision and was transported to Valley Medical Center for a head injury. Venzant provided me with all the proper documents before being transported to Valley Medical Center. I identified Unit 3 as a blue 2004 Chevrolet Silverado bearing Washington license plate A21875U VIN#2GCEC19V041123793. The driver of unit 3 identified by her WADOL as Richardson, Mia Sole DOB (07/21/2003) was being transported to Valley Medical Center when we arrived due to hip pain. Richardson stated that she was filling her truck with gas when her vehicle was struck from behind by unit 2 who was pushed by the force of the collision caused by unit 1. Richardson provided all the proper documents before she was transported to Valley Medical Center. All three drivers were given an information exchange sheet and unit 2 and unit 1 was towed from the location. Park was advised he was the at fault driver due to his inattention. I informed Park that he would receive a citation in the mail for inattention. Once all three parties left the area, I cleared the scene. 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 J. Raygoza on 11/17/2023 at 0440 hours in the City of Renton. PAGE 3 OF 5 SUPPLEMENTAL REPORT NO. EE23029 r`) POLICE TRAFFIC 1 1 8 27 COLLISION REPORT CASE# 23-13257 1 COMMERCIAL MOTOR CARRIER INTERSTATE INTRASTATE G UNIT'# USDOT ICC# VEHICLE TYPE CARGO BODY ;TYPE 2 ❑ 1 28 CARRIER NAME 3 CARRIER L ADDRESS ` CITY ST ZIP—1 I ' 4 ❑ NAME # PLACARD: :❑ GI PLACARD IF NO NUMBER SOURCE AXLES + 4a ❑ ADDITIONAL UNITS MOTOR PEDAL- PROPERTY DAMAGETHRESHOLD MET PHONE 5 ❑ UNIT# 3 VEHICLE tSJ CYCLE I_) PEDESTRIAN � OWNER � YES NO D:2062906860 1 3 29 LAST NAME FIRST NAME MIDDLE RICHARDSON MIA INITIAL S STREET 30 NEW AnDRFSP 11416 69TH PL S CITY SEATTLE ST WA ZIP 98178 6 CDL GNITIttN REQUIRED GNITION PRESENT MEDICAL TAN5PORTED 1 31 INTERLOCK YEs NO NTERLOCK YES❑N0� vES N DRIVER'S LICENSE STATE I WA SEX F MMDDYYv 07 TV] - 2003 7 HELMET :INJURY' NATURE OF INJURIES ON DUTY STATUS AIRBAG'' 2 RESTR. 9 EJECT 1 USE 9 CLASS 7 HIP PAIN 8 ❑ 1 32 LICENSE A21875U TAT WA VIN# 2GCEC19VO41123793 PLATE# 9 TRAILER TRAILER PLATE# STATE PLATE# STATE 10 ❑ TRLR TRLR VIN.#. VIN.#. 11 0 0 VEH.YEAR2004 MAKE CHEV I MODELSIL VERA STYLE TR VEHICLE TOWS E T SABLIN TOWED BY anvi vEH1I' FROM TO DAMAGE YES NO YES NO REGISTERED OWNER INFOMIA RICHARDSON 1141669TH PL S SEATTLEWA 98178 D:2062906860 rj 1 33 12 � SHADE IN DAMAGED AREA 3 4 FROM TO LIABILITY INSURANCE INSURANCE CO GEIC04608610822 q"i"Olx IN EFFECT &POLICY# VEHICLE 1 o BarroM 34 13 ❑ LEGALLY YES❑ NO❑ CITATION# CHARGE STANDING S} 7 14 ❑ UNIT Tr Vd 1RE O CYDCLE 1:1OWNER YE YES AGE NOHRESHOLD MET PHONE ❑ 35 PEDESTRIAN 15 LAST NAME FIRST NAME INITIALMIDDLE F� ITIAL ❑ ET 16 STRETRE "F—]' CITY ST ZIP NEW CDL IGNITION REOUIREE7 IGNITION PRESENT MEDICALTANSPORTED NTERLOCK YES No NTERLOCK YES NO YEs NO ❑ 17 4 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# STATE 21 ❑ ❑ 41 TRLR TRLR 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 LEHIcLE 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. J RAYGOZA 11-17-23 04:36 AM 25 INVESTIGATING OFFICER'S SIGNATURE OFFICER'S PHONE UNIT OR DIST DET DATED: PLACE SIGNED 26 OI BADGE 12503 O#I',WA0171300 APBARFIELD 111241202 PAGE I OF F 3000-345-013(R 11118) REPORT NO. EE23029 CASE# 23-13257 DATE AND TIME 11/16/23 21:57 OF COLLISION U nit 1 N IT «' PAGE 5 OF 5