Press Alt + R to read the document text or Alt + P to download or print.
This document contains no pages.
HomeMy WebLinkAbout24-4972 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 1 27c
COLLISION REP FIT 1591971
SASE 24-4972 2
INTERSTATE ❑ CITY STREET FIRE ❑
RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHICI F ❑ LOCAL AOENC 4Y00 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 CITY# ❑
COLLISION'. 05 — 09 — 2024 1435 17 ❑.❑ N E IN S 8 W H OF e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓
KIRKLAND AVE NE BLOCK NO. e✓ 1200
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ 270 00 FEET MILES e S B W e NE 12TH ST
0 1 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
�/No D:4255298758 1 3 30
6� LAST NAME LY FIRSTNAME VI MIDDLE L 1 1 2 31
INITIAL
STREET ❑ 1508 KIRKLAND AVE NE APT F CITy RENTON ST WA 2jp, 980563294 z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
iNTERLOCKYEs NO 1/ INTERLOCKYEs NO�/ YEs No�/
8❑ D
RI
VER # STATE WA SEX'F MMDDYY' 12 — 19 — 2000 32
9 ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 HELMETU SE CLASS 1 NATURE OF INJURIES z❑
3
10❑ PI ATNE 14 BCX3323 sTAr WAu N# 1 NXBU4EE3A2290197
TRAILER STATE TRAILER STATE
11 2 5 PLATE# PLATE# FROM TO
TRLR. YRLR $ 1 33
12 0 0 VIN#' VIN#
>; FROM TO
VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE 1 $ 34
13 2 2010 TOYT COROL 4D DAMAGE YES NO YES[:] NO✓
REGISTERED OWNER INFO OWNEDBYDRIVER VEHICLE NO. 1
SHADE IN DAMAGED AREA ❑
14❑ LIABILITY INSURANCE INSURANCE CO STATE FARM 531 7468.616.47A 35
IN EFFECT &POLICY# 9TOP
vewCLE 5 36
LECALLv res❑NO❑ CITATION# CHARGE 1 o BOTTOM
15❑ STANDING 8 6
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT a2 VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES 1/ NO D:2068566547
16❑
LAST NAME TABASONDRA FIRST NAME JOHN MIDDLE I C
INITIAL
17❑ STREET - 1222 KIRKLAND AVE NE CITY' RENTON ST WA ZIP 98056 37
NEW ADDRESS ❑
18� CDL IGNITION REQUIRED IGNITION PR—E-1SENT MEDICAL—T�RANSPORTED 38
INTERLOCKYES�NO� INTERLOCK YEs It I NOF YES
t l NOF,/
19[—] LICENSE# STATE WA SEX M MMDDW 07 25 _ 1997 0 39
HELMET INJURY NATURE OF INJURIES 40
20❑ ON DUTY STATUS AIRBAG 2 RESTR 9 EJECT 1 USE 9 1
CLASS ❑
21❑ LICENSE I CFX4502 TAre WA vIN# WDBUF76J04A550368
❑ 41
PLATE#
42
22❑ PLATE# STATE PLATE# STATE
23❑ VIN#. 43
TRLR RLR
'IN#.
VEH YEAR 2004 MAKE MERZ MODEL E STYLE QD VEHICLETOWED TO BLIN TOWEDBY GOV HI 44
L4❑ DAMAGE YES NO YES NO
REGISTERED OWNER INFO JOHN TABASONDRA 1222 KIRKLAND AVE NE RENTON WA 98056 VEHICLE NO.2
SHADE IN DAMAGED AREA
2 3 4
INAEFFIECTTY NSURANCE❑ &POINSULICY#E CO 1 9TOP 5
VEHICLE ES[:] N,.I—I CITATION# CHARGE i o BOTTOM
LEGALLY Y
25 s a
7.FF1CJEO-S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
26
HNSON 0505 WA0171300
PART A PAGE 01 OF
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EE76813
COLLISION REPORT III III III III III 111
1591972 CASE# 24-4972
ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY)
NAME MIDDLE INITIAL) TABASONDRA LEONIDAS C
(LAST FIRST,
ADDRESS&PHONE#
1222 K/RKLAND AVE NE RENTON WA 98058 SEX M MMDOYyry -�-
PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT ' HELMET INJURY NATURE OF INJURIES
❑✓ ❑' 2 POS, 7 1 10 1 USE CLASS 11
NAME
(LAST,FIRST,MIDDLE INITIAL) HERNANDEZ MARLENE
ADDRESS&PHONE# D O B
1222 KIRKLAND AVE NE RENTON WA 98058 SEX F MMDDYYYv 05 _ 09 _ 1999
PASSENGER [:]WITNESS POS. USE CLASS UNIT# SEAT AIRBAG RESTR. EJECT HELMET NJURY NATURE OF INJURIES
NAME
(LAST FIR57 MIDDLE INITIAL)
AppRESS&PHONE#
SEX D.O.B.MMDD -❑
YYYY.
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.
CO.JOHNSON 05-10-24 12:02 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
CO.JOHNSON 0505 1 511412024 8:09:33 AM
BADGE OR ID# 0505 OR]# WA0171300 TIME POLICE DISPATCHED; 2:42 PM TIME POLICE ARRIVED:2:52 PM
PART I PAGE IT]OF 4�
REPORT NO. EE76813 CASE# 24-4972 OF COLLISION
05/09/24 14:35
OF CbLLI510N
NARRATIVE
U1 NB 1200 Kirkland, U2 parked east side of roadway; passenger side of U1 into rear driver door
(open) of U2
On 05-09-2024 at about 1442 hours, I was dispatched to a collision at 1222 Kirkland Ave NE in the
City of Renton, County of King, Washington State. Dispatch advised a vehicle hit a parked car in
front of the location and there were no injuries. I arrived at about 1452 hours.
The driver of Unit 01 was identified by WA DL and seated in the driver seat of the vehicle. The driver
said she was wearing a seatbelt at the time of the collision. Unit 01 was northbound in the 1200 block
of Kirkland Ave NE. Another vehicle was southbound and approaching Unit 01 at a point in the
roadway where vehicles were parked on the east and west sides of the roadway. Unit 01 slowed and
continued northbound. The passenger side of Unit 01 collided with the open driver side rear door of
Unit 02.
Unit 02 was parked and occupied on the east side of the roadway, pointing to the north. The
registered owner was seated in the driver seat and waiting for passengers to load into the vehicle. A
2 year old child had just been placed into a forward facing child seat in the left rear passenger seat.
The witness was standing at the open door after having just placed the child into the seat. Unit 01
collided with the open door as the witness was standing next to the door.
The proximate cause of the collision was the driver of Unit 01 driving in a inattentive manner by failing
to sufficiently recognize the open door of Unit 02 and drive in a manner to avoid colliding with the
open door. Renton Municipal Code 10-12-25, Inattentive Driving, defines "Inattentive manner" as a
lack of: 1) attentiveness required to safely operate the vehicle under the prevailing conditions,
including, but not limited to, the nature and condition of the roadway, the weather conditions, the
presence of pedestrians, the presence of other traffic, or by the driver focusing or directing the
driver's attention to something other than driving the motor vehicle; or 2) attentiveness that would
permit the driver of a motor vehicle to observe anything resting on, or traveling on, or entering the
roadway in time to take appropriate action as circumstances require. Were it not for the actions of the
driver of Unit 01, the collision would not have occurred.
No citations or infractions issued. Report for information and insurance.
PAGE 3 OF 4
REPORT NO. EE76813 CASE# ' 24-4972 DATE AND TIME 05/09/24 14:35
OF COLLISION
i+
Y' t i,
i
n
u
PAGE 4 OF 4