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HomeMy WebLinkAbout24-4674 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 0 27c
COLLISION REP FIT 1591971
SASE 24-4674 2
INTERSTATE ❑ CITY STREET FIRE ❑
RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHIr.I F ❑ LOCAL AOENC 4200 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 1 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# ❑
cowsloN 04 - 1-- 2024 1840 17 ❑.= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓
NILE AVE NE BLOCK NO. e✓ 558
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ ❑ FEET e S ❑ W e 0 1 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
�/No D:4255164408 0 3 30
6� LAST NAME PAHL FIRSTNAME TABITHA MIDDLE P 1 1 2 31
INITIAL
STREET 01 716 MT BAKER AVE NE CITY RENTON ST WA ZIP 980594835 z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
1/ I INTERLOCK YES[:]NO NTERLOCKYEs NO�/ YES R No�/
8❑ LRIIVERS STATE WA SEX'F MM DAY' 08 1- 31 - 2007 2 32
CENSE 9 ON DUTY❑ STATUS AIRBAG 2 RESTR 9 EJECT 1 HELMET U E 2 1 CLASS NATURE OF INJURIES z❑
3
10 9� Pi AT 14 CFP4392 STATE WA VIN# 5UXWX5C5XBL709089
- TRAILER STATE PLAT Eft STATE
11 3 5 PLATE# PLATE# FROM ro
TRLR. TRLR 5 1 33
12 3 5 VIN#' VIN#
>; FROM TO
VEH.YEAR 2011 MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE 5 3 34
13 4 BMW X3 SV DAMAGE YES NO YES[:] No
✓
REGISTERED OWNER WFO LESLEYPAHL901 EVERGREEN VALLEY LOOP RD RONALD WA 98940 VEHICLE NO. 1
❑
SHADE IN DAMAGED AREA 35
4 INSURANCE CO 3 4
14 LIABILITY INSURANCE STATE FARM 4941925F17478
IN EFFECT &POLICY# 9TOP
vewcLE CHARGE � to BOTTOM 5 36
LEGALLY YES❑NOD CITATION# 4A0359584 FOLLOW VEHICLE TOO CLOSELY 5
15❑ NDING 8 6
MOTOR PEDAL-: PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT VEHICLE ❑ CYCLE' El ❑ OWNER ❑ YES NO ,/ D:8082217806
16 a
LAST NAME PUAZA FIRST NAME MARK-ANTHONY MIDDLE H
INITIAL
17 STREET I❑ s❑' 501 SW 5TH PL CITY RENTON ST WA ZIP 980572339 4❑ 37
NEW ADDREs
18❑ CDL IGNITION REQUIRED IGNITION PR-E-1SENT MEDICAL-T�RANSPORTED � 38
INTERLOCK YEs❑No� INTERLOCK YEs It I NOF YES
t l NOF,/
19� LDI IVERS STATE 'WA SEX M MMDDW 04 25 _ 1987 39
20❑ ON DUTY STATUS I
AIRBAG 2 RESTR 9 EJECT 1 H U EET 2 NJAURSY 1 NATURE OF INJURIES 40
❑21❑ 41
PLA E# CDW5472 TATE WA VIN 1 2T3MWRFV7KW033390 1
42
22❑ PILER LATE# STATE pLATE# STATE
23❑ VIN#. 43
TRLR RLR
'IN#.
VEH YEAR 2019 MAKE TOYT MODEL RAV4 STYLE SV VEHICLE TOWED TO BLIN TOWEDBY GOV HI 44
L4❑ DAMAGE YES NO YES NO
REGISTERED OWNER INFO MARK-ANTHONYPUAZA501SW5THPL RENTONWA98057 VEHICLE NO.2
SHADE IN DAMAGED AREA
2 3 4
LIABILITY
INSURANCE &POLICY#E CO GEICO 6141969912IN 1 9TOP 5
'E""LE ❑ Nu,J CITATION# CHARGE
LEG
25 i o BOTTOM
ALLY YES $ '
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
J
26
C.ARNOLD 12509 WA0171300
PAGE 01 OF
PART A
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EE74264
COLLISION REPORT III III III III III 111
1591972 CASE# 24-4674
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.ARNOLD 04-30-24 07:44 PM
NVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
D.MOYNIHAN 1128E 1 51512024 6:53:21 PM
BADGE OR ID# 112509 ORI#' WA0171300 TIME POLICE DISPATCHED! 6:43 PM TIME POLICE ARRIVED',7:07 pry
PART I PAGE IT]OF 4�
REPORT NO. EE74264 CASE# 24-4674 OF COLLISION
04/30/24 18:40
OF CbLLI510N
NARRATIVE
On 04/30/2024 at 1843 hours I was dispatched to a non-injury collision at 558 Nile Ave NE. I arrived
and spoke with the drivers of Unit's 1 and 2.
Unit 1 was traveling North on Nile Ave NE at around the 500 block going straight ahead.
Unit 2 was traveling North on Nile Ave NE at around the 500 block and was preparing to perform a
righthand turn into a driveway at 558 Nile Ave NE.
Unit 1's driver stated that she did not see that Unit 2 was slowing down and performing a righthand
turn into a driveway. Unit 1's driver stated that she attempted to slow down by hitting her brakes and
maneuvering her vehicle left to avoid a collision. Unit 1's driver stated that she was unable to avoid
the collision and the front passenger side bumper of Unit 1 collided with the rear driver side bumper of
Unit 2.
Unit 2's driver stated that he was performing a righthand tun from Nile Ave NE into the driveway at
558 Nile Ave NE and noticed that Unit 1 was behind him. Unit 2's driver stated that he saw that Unit 1
was not slowing down and began to maneuver faster into the driveway, however he was unable to get
out of the way and the front passenger side bumper of Unit 1 collided with the rear driver side bumper
of Unit 2.
1 noticed ABS skid marks on the roadway leading to the collision location where Unit 1 had attempted
to slow down. Given that the skid marks were present, a vehicle following at an appropriate distance
would have had time and space to stop.
Both vehicles were operational and were driven away from the scene.
Proximate Cause:
If Unit 1's driver had been at an appropriate following distance, she would have had time to slow to
avoid the collision. Unit 1's driver was cited for following too closely.
PAGE 3 OF 4
REPORT NO. EE74264 CASE# ' 24-4674 DATE AND TIME 04/30/24 18:40
OF COLLISION
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PAGE 4 OF 4