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HomeMy WebLinkAbout24-4516 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 2 27c
COLLISION REP FIT 1591971
❑ ❑ FIRE ❑ CASE# 24-4$16 z 571
INTERSTATE CITY STREET RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHIC;I F ❑ LOCAL AOENC 4200 3❑HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 3 TOTAL#OF OBJECT 1 1 8 28
TRIBAL UNITS OZ RESERVATION STRUCK
2
3❑ DATE OF M M D D Y Y Y Y TIME(2400) COUNTY# MILES N E IN CITY# ❑
COLLISION.. 04 - 1-- 2024 1934 17 ❑.= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
BENSON DRIVE S BLOCK NO. e✓ 2057 ❑
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ �,❑ FEET ❑ S ❑ W❑ 21ST ST' 0 1 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
✓NO D:2063076247 0 6 30
6� LAST NAME WU FIRSTNAME WENBIN MIDDLE 1 2 31
INITIAL
STREET ❑✓ 12940 SE 185TH ST CITY RENTON ST WA 71p 98058 2
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
iNTERLOCKYEs NO 1/ INTERLOCKYEs NO�/ YES R No�/
8❑ LRIIVER #
ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 H USE 2 1 CLASS NATURE OF INJURIES 2❑
❑10[1P1 ATNES# CGt 1025 sTAr WA N# 5YJ3E1 EA2PF477126 3
11
[ 4 0---- TRAILER STATE PLATE
STATE
PLATE# PLATE# IR.. ro
TRLR. A'RLA2 1 5 33
12 4 0 VIN#' VIN#'
:: FROM TO
❑ VEH.YEAR 2023 TESL MODEL SD MAKE MODEL STYLE VEHICLE TOWED fn TO VBLINJ TOWED BY GOVT.VEHICLE 1 $ 34
13 4 DAMAGE YES NO YES[:] NO✓
REGISTERED OWNER INFO OWNEDBYDRIVER VEHICLE NO. 1
SHADE IN DAMAGED AREA ❑ 35
14 LIABILITY INSURANCE INSURANCE CO SAFECO H2256432 �3g4
LI EFFECT I SUR N#VE"'CLE CHARGE 36
LEGALLYYES❑NO❑ CITATION# 4AO014502 INATTENTIVE DRIVINGI
15❑ STANDING 6
MOTOR PEDAL-: PROPERTY DAM THR OLD MET PHONE
UNIT ❑ ❑ PEDESTRIAN ❑ ❑ D:4252089847
VEHICLE CYCLE OWNER YES�/ NO
16 a
LAST NAME TA FIRST NAME VIET MIDDLE S
INITIAL
17❑ NEW STREETRE— 11905 SE 198TH CT CITY KENT ST WA ZIP 98031 4❑ 37
18❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED � 38
INTERLOCK YEs❑No� INTERLOCK YEs❑NOF YEs❑NOF,/
19 LICENSE# STATE WA SEX M M D.C.B. 04 27 1966 39
20❑ ON DUTY STATUS I
AIRBAG 2 RESTR 4 EJECT 1 H U EET 2 NJAURSY 1 NATURE OF INJURIES ❑ 40
LICENSE ❑21❑ PLA E# CAB 1732 TArE 41
WA VIN# 2HNYD1820$H538889 1
42
22❑ PLATE# STATE PLATE# STATE
23❑ VIN#. 43
TRLR RLR
'IN#.
VEH YEAR 2005 MAKE ACUR MODEL MDX STYLE UT VEHICLE TOWED TO BLIN TOWEDBY GOV HI 44
L4❑ DAMAGE YES NO YES NO
REGISTERED OWNER INFO VIET TA 11905 SE 198TH CT KENT WA 98031 VEHICLE NO.2
SHADE IN DAMAGEbAREA
2 3 Cd
LIABILITY
INSURANCE &POINSURGY#E CO AMERICAN FAMILY 41059-59495-91
IN STOP
VEHICLE YES N CITATION# NONE CHARGE NIA to BOTTOM
LEGALLY `LJ
25 $
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# JAGENCY
26
J.CHRISTIANSEN 10437 WA0171300
PAGE 01 OF
PART A
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EE71550
COLLISION REPORT III III III III III 111
1591972 CASE# 24-4516
ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY)
NAME MIDDLE INITIAL) TRAN KIM T
(IAST FIRST,
ADDRESS&PHONE#
17840 111TH AVE SE RENTON WA 980556539 SEXi F MMDOYyry 07 - OS - 1965
PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT ' HELMET INJURY NATURE OF INJURIES
❑✓ 2 POS. 3 2 4 1 USE 2 CLASS 1
NAME
(LAST,FIRST,MIDDLE INITIAL)
ADDRESS&PHONE# D O B
BEd MMDDYYYY
PASSENGER ❑WITNESS UNIT# SEAT I AIRBAG RESTR. EJECT HELMET NJURY NATURE OF INJURIES
POS. USE CLASS
NAME
(LAST FIR57 MIDDLE INITIAL)
AppRESS&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.CHRISTIANSEN 04-25-24 09:18 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
J.TRADER 4553 1 4/25/2024 10:58:32 PM
BADGE OR ID# 10437 OR]# WA0171300 TIME POLICE DISPATCHED! 7:39 Pry] TIME POLICE ARRIVED',7:45 PM
PART I PAGE IT]OF 4�
REPORT NO. EE71550 CASE# 24-4516 OF COLLISION
04/25/24 19:34
OF CbLLI510N
NARRATIVE
RPD CASE#: 24-4516
RECORDED ON AXON
*This incident was captured on my body worn video camera. This report is a summary of events that
occurred and is not an exact sequencing of events. Statements have been paraphrased and
summarized. *
On 04.25.2024, at approximately 1945 hours, I arrived on scene of a two-vehicle, non-injury, blocking
collision in the intersection of S. 21st ST and Benson Drive S., in the City of Renton, WA, the County
of King.
I was assigned to uniformed marked patrol in the City of Renton, WA, the County of King. I was
operating a fully marked Renton Police Tahoe #204, equipped with "POLICE" markings, overhead
exterior lights, and audible siren. I was wearing my department-issued uniform, including a fully
equipped duty belt, exterior ballistic vest with "POLICE" stenciled on the front and back and Renton
Police badge affixed to the left breast. I was also wearing my department-issued jumpsuit with
"POLICE" patches on both shoulders and across the rear shoulders. It would be immediately obvious
to any reasonable person I was a police officer. I was assigned as 3r16.
At the time of this incident, it was raining steadily, the roadway was wet with saturated water, and it
was daylight, streetlights were not illuminated.
Unit 01 was identified as a white in color Tesla Model 3 bearing WA/CGL1025. Unit 01 had moderate
damage to the front bumper and the hood was buckled but it was operable.
Unit 01's driver was identified by his WADL as WU, WENBIN (DOB: 06.23.1980). Wu matched the
photo on his DOL WADL and when asked what happened leading up to the collision, Wu stated he
was traveling southbound on Benson Drive S., occupying the left lane of travel and was directly
behind Unit 02. Unit 01 did not realize Unit 02 had stopped in front of him for a traffic signal light and
he struck the rear bumper.
A WACIC/NCIC/DOL query on Wu was clear and valid.
Unit 02 was identified as a black in color Acura MDX bearing WA/ CAB1732. Unit 02 had damage to
the rear bumper, but it was operable.
Unit 02's driver was identified by his WADL as TA, VIET SON LUU (DOB: 04.27.1966). Ta stated he
was traveling southbound on Benson Drive S. and as he approached the intersection with S. 21st ST,
he slowed for the signal light when he was struck from behind by Unit 01.
A WACIC/NCIC/DOL query on Ta revealed he was clear and valid.
Unit 01's driver, WU, WENBIN (DOB: 06.23.1980) was in violation of RMC 10.12.25: Inattentive
Driving. Wu was issued SECTOR citation 4AO014502 for the above listed violation. . I advised Wu he
would be receiving a citation in the mail.
Both vehicles were removed from the scene without incident and no injuries were reported.
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 J. Christiansen #10437, on April 25, 2024, at approximately 2116
hours, in Renton, WA.
**** AUTO-POPULATED SECTION ****
THE FOLLOWING ARE DESCRIPTIONS ENTERED FOR ITEMS SELECTED AS "OTHER":
Location Character: CITY STREET
**** END OF AUTO-POPULATED SECTION ****
PAGE 3 OF 4
REPORT NO. EE71550 CASE# ' 24-4516 DATE AND TIME 04/25/24 19:34
OF COLLISION
,..t -5
Officer J. Clu-Istiartsen #10437
INTOTT
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PAGE 4 OF 4