HomeMy WebLinkAbout24-4844 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 1 27c
COLLISION REP FIT 1591971
SASE 24-4844 2
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 1 TOTAL#OF OBJECT 1 1 7 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#
COLLISION'. 05 - 1-- 2024 0925 17 ❑-= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
SUNSET BLVD NORTH BLOCK NO. e✓ 300 ❑
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ �.❑ FEET e S ❑ VV e NORTH 3RD STREET
0 1 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
,/No D:4252282294 0 11
30
6� LAST NAME WALMSLEY FIRSTNAME JEANNETTE MIDDLE P 1 1 2 31
INITIAL
STREET ❑ 2308 NE 27TH ST CITY RENTON ST WA 2jp, 980562233 z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
INTERLOCK YES[:]NO 1/ INTERLOCKYEs 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❑ PI aT�S1t DP29820 sTArI WAurN# KNDJN2A24J7559447
TRAILER STATE TRAILER STATE
11 3 5 PLATE# PLATE# FROM To
TRLR. TRLR 3 7 33
12 3 0 VIN#' VIN#'
>; FROM TO
❑ VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN T GOVT.VEHICLE 1 $ 34
13 2 2018 KIA SOUL UT DAMAGE vEs 0NO f �AWkkRS vEs❑ No
REGISTERED OWNER INFO LEE WALMSLEY 2308 NE 27TH ST RENTON WA 98056 D:4252282294 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
14 ABILI V INSURANCE INSURANCE CO USAA 03913 32 69G 71019 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 VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES 1/ NO D:2064320768
16 a
LAST NAME VENTURA FIRST NAME DULCE MIDDLE G
INITIAL
17❑ NEW STREETR 659 DA
7 YTON AVE NE CITY RENTON ST WA ZIP 980563643 4❑ 37
18❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL—T�RANSPORTED � 38
INTERLOCK YEs❑No� INTERLOCK YEs I I NOF YEs t l NOF,/
19[—] DRIVER'S STATE WA ]SEX IF D.O.B. 01 30 _ 2000 39
LICENSE# MMDDYY
20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 H U EET 2 NJAU EY 6 C/O HEAD PAIN. BY RRFA ❑ 40
❑ 41
21❑ PLATE# CGU6575 TArE WA VIN# 5N1ED28T5YC523265 1
42
22❑ PLATE# STATE PLATE# STATE
23❑ VIN#. 43
TRLR RLR
'IN#.
VEH YEAR 2000 MAKE NISS MODEL XTERRA STYLE UT VEHICLE TOWED TO BLIN TOWEDBY GOV HI 44
24❑ DAMAGE YES NO BANKERS YES NO
REGISTERED OWNER INFO DULCE VENTURA 659 DAYTON AVE NE RENTON WA 98056 D:2064320768 VEHICLE NO.2
SHADE IN DAMAGED AREA
2 3 4
LIABILITY
INSURANCE &POINSURGY#E CO PROGRESSIVE 938635977IN U�D
g
'E""LE LEG ❑ N,J� CITATION# CHARGE
ALLY YES
25 =UGENT
(PRINT) OFFICER PHONE BADGE OR ID# 77P�1300
26 11498
PART A PAGE 01 OF C7
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EE75528
COLLISION REPORT III III III III III 111
1591972 CASE# 24-4844
ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY)
NAME
(/AST FIRST,MIDDLE INITIAL)_
ADDRESS&PHONE#
SEX D.O.B. - -
MMDDYYYY.
PASSENGER❑WITNESS UNIT# SEAT AIRBAG RESTR. EJECT ' HELMET INJURY NATURE OF INJURIES
POS. 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.
MATTHEW NUGENT 05-07-24 03:26 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
CO.JOHNSON 0505 1 51912024 1:53:38 PM
BADGE OR ID# 11498 ORI# WA0171300 TIME POLICE DISPATCHED 9:27 AM TIME POLICE ARRIVED',9:30 AM
PART I PAGE IT]OF 4�
REPORT NO. EE75528 CASE# 24-4844 OF COLLISION
05/06/24 09:25
OF CbLLI510N
NARRATIVE
24-4844
On 05/06/2024 at approximately 0928 hours, I was dispatched to a non-injury and blocking vehicle
collision at the intersection of Sunset Boulevard North and North 3rd Street, within the City Limits of
Renton, County of King, State of Washington.
Upon my arrival, I confirmed there was a complaint of injury for head pain from one of the involved
parties therefore the Renton Regional Fire Authority (RRFA) responded and treated the involved
party for injury. RRFA treated the involved party at the scene where they were later released. Both
involved vehicles had suffered significant damage because of the collision but were able to be moved
from the roadway and into the Burger King Parking Lot. There, I collected the involved parties driving
documents and their independent summary of the collision.
The driver of Unit#1 stated that she was the sole occupant of her vehicle and was traveling
westbound on North 3rd Street approaching the intersection of Sunset Blvd N in lane 2 of 4. The
driver of Unit#1 stated that she was intending to continue straight (west) through the intersection.
The driver of Unit#1 stated that her traffic light was green therefore Unit#1 proceeded forward
through the intersection when she observed Unit#2 approach the same intersection but from the
north. Unit#1 stated that Unit#2 appeared "out of nowhere" and was the only vehicle to have moved
forward from the stopped line traffic. The driver of Unit#1 noticed Unit#2 move forward into her path
of travel but was unable to avoid the collision. Both vehicles collided in the intersection. Unit#1
suffered moderate damage to the front bumper.
The driver of Unit#2 stated that she was the sole occupant of her vehicle and was traveling
southbound on Sunset Blvd N approaching the intersection of North 3rd Street. The driver of Unit#2
stated that she had a red light for her direction of travel and had come to a stop. Upon the traffic-
controlled light changing to green, Unit#2 proceeded forward with the intent to continue south
through the intersection. The driver of Unit#2 stated that she initially entered the intersection but saw
Unit#1 still traveling through the intersection. The driver of Unit#2 said she stopped her vehicle
again but that suddenly both vehicles had subsequently collided in the roadway. Unit#2 suffered
significant damage to the front drivers side wheel bearing/bumper/quarter panel.
I reviewed the traffic camera which was unfortunately down at the time of incident and had not been
recording since 5/1/2024 at 1030 hours when it lost connection to the server. This was verified by a
City of Renton Traffic Engineer.
Based on the above statements, I was not able to determine the predominant factor for the cause of
collision and no witnesses had contacted 911 nor come forward at the scene. It should be noted that
during my investigation of the above-mentioned collision, the driver of Unit#1 caused a secondary
collision which was documented under Renton Police Case #24-4845.
Both Unit#1 and Unit#2 had to impounded due to extensive damage. 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 M. Nugent#11498 2:54 PM 5/7/2024 Renton, King County, WA.
PAGE 3 OF 4
REPORT NO. EE75528 CASE# 24-4844 DATE AND TIME 05/06/24 09:25
OF COLLISION
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PAGE 4 OF 4
