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HomeMy WebLinkAbout24-5407 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 1 27c COLLISION REP FIT 1591971 CASE 24-5407 z INTERSTATE ❑ CITY STREET FIRE ❑ RESULTED 1 STOLEN STATE ROUTE ❑ OTHER ❑ VFHIr.I F ❑ LOCAL AGENCI 4900 3 HIT&RUN CODING COUNTY RD PRIVATE WAY INVOLVED 2� 1 1 8 28 TOTAL#OF OBJECT TRIBAL UNITS 03 STRUCK' RETAINING WALL 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 1826 17 ❑-= S 8 IN e 1070 3 4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑ SE 144TH ST BLOCK NO. e✓ 16000 ❑ 4a❑ MILEPOST DISTANCE OF(REFERENCE OR CROSS STREET) 5❑ ❑ FEET e S ❑ W e 160THAVESE 0 1 29 MOTOR PEDAL- DAMAGE THRESHOLDHONE UNIT 01 VEHICLE ❑ CYCLE El MET P YES �/No D:4259023873 0 11 30 6� LAST NAME BAKER FIRSTNAME ADRIAN MIDDLE M 1 1 2 31 INITIAL STREET ❑, 16500 SE 149TH ST CITY RENTON ST WA ZIP' 98059 z NEW ADDRESS 7❑ CDL IGNITION REQUIRED I IGNITION PRESENT MEDICAL TRANSPORTED 3 iNTERLOCKYEs 1/ I NO NTERLOCKYEs NO Z YEs No�/ 8❑ LRIIVER # ON DUTY❑ STATUS AIRBAG 6 RESTR 4 EJECT 1 HELMET 2 CLASS 1 NATURE OF INJURIES z❑ 3 LICENSE CHD1407 sTArI WAurN# 4S3GKAC69K3622967 10 F91 PI ATE# TRAILER STATE TRAILER STATE 11 2 5 PLATE# PLATE# ROM ro FT -R TPILF1 1 5 33 12 2 5 VIN#j VIN# FROM TO ❑ VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN 7 3 TOWED BY GOVT.VEHICLE 34 4 2019 SUBA IMPREZ P4 DAMAGE YES NO YES[:] No ✓ 13 REGISTERED OWNER INFO AD/?.BAKER 16500 SE 149TH ST RENTON WA 98059 D:4259023873 VEHICLE NO. 1 ❑ SHADE IN DAMAGED AREA 35 14 LIABILITY INSURANCE INSURANCE CO PEMCO CA1906516 IN EFFECT &POLICY# 9TOP VE—L' 15❑ EC 1 5 36 LALLv YES❑NO❑ CITATION# CHARGE 1 o BOTTOM STANDING 8 7 6 MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OL PHONE UNIT VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES 1/ D MET NO D:9169174078 16 a LAST NAME BUI FIRST NAME DUONG MIDDLE H INITIAL 17 STREET I❑ 14527 178TH AVE SE CITY RENTON ST WA ZIP 98059 37 NEW ADDRESS❑' 18❑ CDL IGNITION REQUIRED IGNITION PtR-E-S1ENT MEDICAL-T�RANSPORTED � 38 INTERLOCK YEs❑No� INTERLOCK YEs I I NOF YEs t l NOF,/ 19 LDI IVER # STATE WA SEX M M D.C.B. 08 _ 04 1995 39 20❑ ON DUTY STATUS AIRBAG,6 RESTR 4 EJECT 1 HELMET 2 INJURY 6 NATURE of INJURIES ❑ 40 USE CLASS PAIN TO LEFT KNEE ❑21❑ PLATE# CGV0282 TArE WA VIN# 41 JTDKBRFU4G3016213 1 42 22❑ PLATE# STATE PLATE# STATE TRLR 23❑ VIN#. IN#. 43 RLR ' VEH YEAR 2016 MAKE TOYT MODEL PRIUS STYLE P4 VEHICLE TOWED TO BLIN TOWEDBY GES HI 44 24❑ DAMAGE vES�/ NO GENE MEYERS TOWING ves No�/ REGISTERED OWNER INFO ADEBAYO BAKARE 150 FERNDALE AVE SERENTONWA98056 VEHICLE NO.2 SHADEDAMAGEDAREA 3 4 LIABILITY INSURANCE INSU&PORGY#E CO POLICY THROUGH TURO RENTALIN STOP 5 VE""LE ❑ N,J� CITATION# CHARGE LEGAL io BOTTOM LY YES 6 25 OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY J 26 D.NELSON 12421 WA0171300 PART A PAGE 01 OF 3000-345-159 OR 11/181 STATE OF POLICETRAFFICN CORRECTION REPORT NO. EE79670 COLLISION REPORT III III III III III 111 1591972 CASE# 24-5407 ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY) NAME MIDDLE INITIAL) KHUU NGUYEN (LAST FIRST, ADDRESS&PHONE# D O.B. ' 14527 178TH AVE SE RENTON WA 98059 9169174078 SEXi F MMDOYyry 11 - 10 - 2001 SEAT HELMET INJURY NATURE OF INJURIES PASSENGER ZWITNESS� UNIT# 2 POS. 3 AIRBAG 6 RESTR. q EJECT 1 USE 2 CLASS ',6 BACK PAIN NAME (LAST,FIRST,MIDDLE INITIAL) BUl HARLEY ADDRESS&PHONE# D D B 14527 178TH AVE SE RENTON WA 98059 SEX MM F DD ; O6 _ O6 _ 2021 SEAT HELMET NJURY NATURE OF INJURIES PASSENGER Z WITNESS UNIT# 2 PDS 9 AIRBAG 6 RESTR. 11 EJECT 1 USE 2 CLASS 1 NAME (LAST FIRST,MIDDLE INITIAL) WEST TALON AooREss PHONE# UNK RENTON 7167180053 M _ SEX D.D.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. D.NELSON 05-21-24 09:18 PM INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED APPROVED BY DATE P.SUMMERS 888 1 5/23/2024 8:43:51 AM BADGE OR ID# ! 12421 ORI#' WA0171300 TIME POLICE DISPATCHED 6:29 Pry TIME POLICE ARRIVED]6:36 PM PART I PAGE IT]OF 5� TIME REPORT NO. EE79670 CASE# 24-5407 OF COLLISION05/21/24 18:26 NARRATIVE 24-5407 COLL On 5/21/2024 1 was working as a uniformed patrol officer and driving a marked patrol vehicle for the City of Renton. I was dispatched to a report of a collision in the intersection of 160th Ave SE and SE 144th St Renton/King/WA. The involved parties were calling in to advise there was a vehicle off the roadway and reports of minor injuries. I arrived on scene and located a 2019 Subaru Impreza WA/CHD1407 stopped on the southeast curb with damage to the front and passenger side. The driver, identified as Adrian M Baker DOB: 3/30/2007, advised he was not injured but was evaluated by RRFA personnel and cleared at the scene. Adrian said that he was turning off 160th Ave SE to go east on SE 144th St when he was struck by the Prius on his passenger side. I spoked with the driver of the 2016 Toyota Prius WA/CGV0282, he was identified as Duong H Bui DOB: 8/4/1995. Duong said that he was driving east on SE 144th St when the Impreza turned in front of him causing him to hit them, Duong then lost control of the Prius and drove through a flower bed, over a retaining wall, and struck the side of an RRV R-Pod WA/34552AG camper trailer that was parked in the driveway of 16004 SE 144th St. There was damage to the front bumper of the Prius. Duong had a complaint of pain to his left knee and his wife, Nguyen Khuu DOB: 11/10/2001, had complaint of pain to her back. Their daughter, Harley Bui DOB: 6/6/2021, was not injured. All three were evaluated by RRFA on scene and cleared. The owner of the camper trailer, Richard E Rinehart DOB: 4/29/1972, advised the trailer was unoccupied at the time of the collision. The trailer had been hit on the passenger side. Gene Meyers Towing removed the Prius from the scene. The Impreza was able to move from the flower bed and be parked on the street. Nothing further. **** AUTO-POPULATED SECTION **** THE FOLLOWING ARE DESCRIPTIONS ENTERED FOR ITEMS SELECTED AS "OTHER": Motor Vehicle Unit 3 Seat Position (Driver RICHARD RINEHART): NOT INSIDE TRAVEL TRAILER/TRAILER PARKED **** END OF AUTO-POPULATED SECTION **** PAGE 3 OF 5 SUPPLEMENTAL REPORT NO. EE79670 r`) POLICE TRAFFIC 1 1 8 27 COLLISION REPORT CASE# 24-5407 1 COMMERCIAL MOTOR CARRIER INTERSTATE INTRASTATE G UNIT'# USDOT ICC# VEHICLE TYPE CARGO BODY ;TYPE 2 ❑ 1 28 CARRIER NAME 3 CARRIER ADDRESS ` CITY ST ZIP—1 I ' 4 ❑ NAME # PLACARD: :❑ GI PLACARD IF NO NUMBER SOURCE AXLES + 4a ❑ ADDITIONAL UNITS MOTOR PEDAL- PROPERTY DAMAGE THRESHOLD MET PHONE 5 ❑ UNIT# 3 VEHICLE t_"J CYCLE _) PEDESTRIAN � OWNER � YES� NO D:7738447953 4 29 LAST NAME RINEHART FIRST NAME RICHARD MIDDLE 1E INITIAL STREET 30 NEW AnDRFSP' 16005 SE 144TH ST CITY RENTON ST WA ZIP 98059 6 CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TANSPORTED 1 31 INTERLOCK YEs NO NTERLOCK YES❑N0� YEs N L DRIVER'S STATE I SEX M M�DDYBYv 04 - 29 - 1972 LICENSE 7 F-1 ON DUTY STATUS AIRBAG g RESTR. g EJECT g HELMET I, INJURY 0 NATURE OF INJURIES USE CLASS 8 ❑ 1 32 LICENSE 34552AG TAr WA VIN# 4X4TRPV13MR205434 PLATE# 9 TRAILER TRAILER PLATE# STATE PLATE# STATE 10 ❑ TRLR TRLR VIN.#. VIN.#. 11 O O VEH.YEAR MAKE MODEL STYLE VEHICLE TOWS E T SABLIN TOWED BY anvi vEH1Ci P FROM TO 2021 OTH R-POD CT DAMAGE YES NO YES NO 33 SHADE IN DAMAGED AREA REGISTERED OWNER INFORICHARD RINEHART 16005 SE 144TH ST RENTON WA 98059 D:7738447953 m 12 7 j 4 FROM TO LIABILITY INSURANCE INSURANCE CO PROGRESSIVE 949257145 gTOp IN EFFECT &POLICY# EHICLE o BarroM 34 13 ❑ LEGALLY YES❑ NO❑ CITATION# CHARGE STANDING ❑ PROPERTY YE AGNOHRESHOLD MET ❑ 35 UNIT� V O CYCLE OWNER S PHONE 14 D MDDLE F� I 15 LAST NAME FIRST NAME INITIAL36 ITIAL ❑ STREET"[-] 16 NEW nnR CITY ST ZIP CDL IGNITION REdUiRED IGNITtGN PRESENT MEDICALTANSPORTED NTERLOCK YES No INTERLOCK YEs NO YES NO El 17 37 LICENSE# STATE SEX MMDDDYBYY 18 ❑ ON DUTY� STATUS AIRBAG RESTR. ; EJECT HELMET INJURY NATURE of INJURIES 38 USE (CLASS 19 ❑ 39 LICENSE rnr VIN# PLATE# 20 ❑ TRAILER' TRAILER El40 PLATE#< STATE PLATE# STATE 21 ❑ TRLR TRLR 41 VIN# YIN#i 42 22 VEH.YEAR MAKE I MODEL STYLE I VEHICLE TO DUET SABLIN TOWED BY GOVT.VEHICLE DAMAGE YES NO YES NO 23 REGISTERED OWNER INFO SHADE IN DAMAGED 3 4 4 AREA F 43 z LIABILITY INSURANCE INSURANCE CO ' VEHICLE EFFECT &POLICY# I 970P - 4 44 24 LEwcLE YES❑ NO❑ CITATION# CHARGE iq 60TiOM LeGALLv E:l STANDING 8 7 6 1 CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT. D.NELSON 05-21-24 09:18 PM 25 INVESTIGATING OFFICER'S SIGNATURE OFFICER'S PHONE UNIT OR DIST DET DATED: PLACE SIGNED 26 OI BADGE 12421 O#I',WA0171300 APPROVED 512312024 PAGE�OF F 3000-345-013(R 11118) REPORT NO. EE79670 CASE# ' 24-5407 DATE AND TIME 05/21/24 18:26 OF COLLISION 4k a PAGE 5 OF 5