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HomeMy WebLinkAbout24-5366 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 0 27c COLLISION REP FIT 1591971 CASE 24-5366 z INTERSTATE ❑ CITY STREET FIRE ❑RESULTED 1 STOLEN STATE ROUTE ❑ OTHER ❑ VFHIC;I F ❑ LOCAL AOENC 4Y00 3 HIT&RUN CODING COUNTY RD PRIVATE WAY INVOLVED 2 3 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# ❑ COLLISION.. 05 — 21 — 2024 0820 17 ❑.= S 8 IN e 1070 3 4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓ 152ND AVE SE BLOCK NO. e✓ 15500 4a❑ MILEPOST DISTANCE OF(REFERENCE OR CROSS STREET) 5❑ 190 00 FMILES EET e S B W e MAPLE VALLEYHWY 0 8 29 MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE UNIT 01 VEHICLE ❑ CYCLE El ,/NO D:2069195127 0 11 30 6� LAST NAME WELLS FIRSTNAME MARIA MIDDLE I T 1 2 31 INITIAL STREET ❑1 28621 227TH AVE SE CITY MAPLE VALLEY ST WA 2jp, 980383347 z NEW ADDRESS 7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3 iNTERLOCKYEs NO INTERLOCKYEs NO YES R No�/ 8❑ LRIIVER # ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 HELMETU E ICNLJAUSSY 1 NATURE OF INJURIES z❑ 3 10 PI ATE B 4 BMV7899 JBTATIJ WAv N If SHHFK7H95JU425716 TRAILER STATE TRAILER STATE 11 2 5 PLATE# PLATE# FROM TO TRLR. YRLR. 3 1 33 12 2 5 VIN#' VIN# >; FROM TO VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE 5 1 34 13 2 2018 HOND CIVIC 4H DAMAGE YES NO YES[:] No✓ REGISTERED OWNER INFO JASON WELLS 28621227THAVE SE MAPLE VALLEYWA 98038 VEHICLE NO. 1 ❑ SHADE IN DAMAGED AREA 35 14 LIABILITY INSURANCE INSURANCE CO STATE FARM 035 1200-CO6.471 3 4 IN EFFECT &POLICY# 9TOP VEHICLE CHARGE 5 36 LEGALLY YES❑NO❑ CITATION# 10 BOTTOM 15❑ STANDING MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE UNIT 02 VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES NO ,/ D:2537379151 16 a LAST NAME MELLA FIRST NAME KARINA MIDDLE M INITIAL 17❑ STREET ❑', 15400 SE 155TH PL UNIT 37 CITY' RENTON ST WA ZIP 980586350 37 NEW ADDRESS ❑ 18� CDL IGNITION REQUIRED IGNITION PtR—E—S1ENT MEDICAL TRANSPORTED 38 INTERLOCKYES�NOR INTERLOCK YEs I I NOF YES t l NOF,/ 19 DRIVER # INJURY1 NATURE OF INJURIES 40 20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 USE CLASS ❑ 21❑ LICENSE I CDL2093 TATe WA vIN# JTEDC3EH8D2018373 ❑ 41 PLATE# 42 22❑ PLATE# STATE PLATE# STATE TRLR 23❑ UIN#. IN#. 43 RLR ' VEH YEAR 2013 MAKE TOYT MODEL HIGHLAN STYLE 4H VEHICLE TOWED TO BLIN TOWEDBY GOV HI 44 L4❑ DAMAGE YESfj NO,/ YES NO REGISTERED OWNER INFO MISAEL MELLA LIZAMA 15400 SE 155TH PL UNIT 37 RENTON WA 98058 VEHICLE NO.2 SHADEDAMAGEDAREA 3 4 LIABILITY INSURANCE INSU&PORGY#E CO PROGRESSIVE 915976633IN IGQl VEHICLe ❑ ,.I—I CITATION# CHARGE LEGALLY YES N`LJ 25 s � a 7.111CjEo-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. EE78999 COLLISION REPORT III III III III III 111 1591972 CASE# 24-5366 ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY) NAME MIDDLE INITIAL) MELLA KATHERINE (LAST FIRST, ADDRESS&PHONE# 15400 SE 155TH PL UNIT 37 RENTON WA 98058 SEXi F MMDOYyvv - - PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT ' HELMET INJURY NATURE OF INJURIES ❑✓ 2 POS, 4 2 10 1 USE CLASS 1 NAME (LAST,FIRST,MIDDLE INITIAL) ` MELLA EVANGELINE ADDRESS&PHONE# DOB - 15400 SE 155TH PL UNIT 37 RENTON WA 98058 SEX F M .0 B v SEAT HELMET INJURY NATURE OF INJURIES PASSENGER WITNESS UNIT# 2 POS 7 AIRBAG 2 RESTR. 10 EJECT 1 USE CLASS 1 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. CO.JOHNSON 05-21-24 10:59 AM INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED APPROVED BY DATE CO.JOHNSON 0505 1 512112024 11:06:34 AM BADGE OR ID# 0505 OR]# WA0171300 TIME POLICE DISPATCHED; 8:30 AM TIME POLICE ARRIVED',9:09 AM PART I PAGE IT]OF 4� DATE AND REPORT NO. EE78999 CASE# 24-5366 OFCOLISION 05/21/2408:20 OF COLLISION NARRATIVE U2 NB 152nd Ave SE In #2; U1 exit private drive onto 152nd On 05-21-2024 at about 0831 hours, I was dispatched to a Collision in the vicinity of 152nd Ave SE and Maple Valley Highway in the City of Renton, County of King, Washington State. Two (2) vehicles were involved and both were pulled into a nearby bus lane. I arrived at about 0909 hours. The driver of Unit 02 was identified by WA DL and admitted to driving the listed vehicle. The driver said she was not injured as a result of the collision and verbally identified the two juvenile passengers. Unit 02 was northbound in lane #2 of 152nd Ave SE after having just left her nearby residence. Unit 02 was moving towards Maple Valley Highway when Unit 01 entered the roadway from the area of Starbucks. The driver side of Unit 01 collided with the passenger side fender of Unit 02. The driver of Unit 01 was identified by WA DL and admitted to driving the listed vehicle. The driver said she was wearing a seatbelt and not injured as a result of the collision. Unit 01 was entering 152nd Ave SE from the area of the Starbucks drive through. The driver of Unit 01 said her vehicle was side swiped once she entered the roadway. I observed moderate damage to the driver side of Unit 01 and minor damage to the passenger fender of Unit 02. The damage was consistent with the information provided by both drivers. Neither vehicle required a tow truck and both departed the location under their own power. RCW 46.61.205 states the driver of a vehicle about to enter or cross a highway from a private road or driveway shall yield the right-of-way to all vehicles lawfully approaching on said highway. Unit 02 was established on the roadway prior to Unit 01 exiting the driveway. The proximate cause of the collision was the driver of Unit 01 failing to yield the right-of-way when entering the roadway from a private driveway. 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. EE78999 CASE# 24-5366 DATE AND TIME 05/21/24 08:20 OF COLLISION n , v " el raX:rb to,„ tuq spy F 9 I �r i6 z } x PAGE 4 OF 4