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HomeMy WebLinkAbout24-5399 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 0 27c
COLLISION REP FIT 1591971
CASE 24-5399 z
INTERSTATE ❑ CITY STREET FIRE ❑RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHIr.I F ❑ LOCAL AOENC 4Y00 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 2 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 - 1-- 2024 1533 17 ❑.= S 8 IN e 1070 3
4❑ oN (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
NE 4TH STREET BLOCK NO. e✓ 4600 ❑
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ �.❑ FEET e S ❑ VV e DUVAL!AVE NE
0 4 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
,/No D:4258372075 0 11
30
6� LAST NAME LAW FIRSTNAME NAOMI MIDDLE F 1 2 31
INITIAL
STREET ❑ 225 MT OLYMPUS DR SW CITY ISSAQUAH ST WA Zjp, 980273513 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 HELMETU E 2 CLASS 1 NATURE OF INJURIES z❑
3
10 9❑ Pi aT�S� BUB7170 sTArI WA urN# JHtRE38357CO26503
TRAILER STATE TRAILED STATE
11 0 0 PLATE# PLATE# IRM ro
TRLR. TRLR 5 7 33
12 3 5 VIN#' VIN#
>;. FROM TO
VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED By GOVT.VEHICLE 3 ] 34
13Fal 2007 HOND CR-V SV DAMAGE YES NO YES[:] NO✓
REGISTERED OWNER INFO JESSICA FORMOSA 225 MT OLYMPUS DR SW ISSAQUAH WA 98027 D:4258372075 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
14 LIABILI INSURANCE INSURANCE CO AMICA 94084623SG 3 4
IN EFFECT &POLICY# 9TOP
15❑ LE
vECALLv HICLe 1 5 36
res❑NO❑ CITATION# 4g0344169 CHARGE FAIL STOP AT STOP )o BOTTOM
STANDING 8 7 6
MOTOR PEDAL- ,PEDESTRIAN PROPERTY DAM NO OLD MET PHONE
UNIT VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES 1/ No D:2063552259
16 a
LAST NAME COOPER FIRST NAME CHRISTINA MIDDLE I J
INITIAL
17 STREET NEW ADDREs7 120 MONTEREY PL NE CITY RENTON ST WA ZIP 980564031 4❑ 37
18� CDL IGNITION REQUIRED IGNITION PRESENT MEDICALTRANSPORTED 38
INTERLOCK YES❑NO� INTERLOCK yEs❑NOF YEs❑NOF,/
19 RRS LDI IVE STATE WA ]SEX IF M .C.B. 02 _ 18 _ 1968 39
20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 H U EET 2 NJAURSY 1 NATURE OF INJURIES ❑ 40
LICENSE I ❑21❑ PLA E# CGJ5999 TArE WA VIN# 41
JTJBK16A6D2456431 1
42
22❑ PLATE# STATE PLATE# STATE
23❑ UIN#. 43
TRLR RLR
'IN#.
GI
VEH YEAR 2013 MAKE !EX$ MODEL RX 350 STYLE $V DAMAGE TOWED NOO✓ BLIN TOWED BY ov HyES NO 1/ 44
24❑ ES
REGISTERED OWNER INFO OWNED BY DRIVER VEHICLE N0.2
SHADEDAMAGED AREA
3 4
LIABILITY
INSURANCE &POINSURGY#E CO STATE FARM 1463132-A15-47IIN STOP
g
VE""LE ❑ ,J� CITATION# CHARGE I BOTTOM
LEGALLY YES N 6
25 =UGENT
(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
26 11498 WA0171300
PAGE 01 OF
PART A
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EE79849
COLLISION REPORT III III III III III 111
1591972 CASE# 24-5399
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.
MATTHEW NUGENT 05-22-24 02:38 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
CO.JOHNSON 0505 1 5/23/2024 3:54:38 PM
BADGE OR ID# 11498 ORI# WA0171300 TIME POLICE DISPATCHED! 3:45 PM TIME POLICE ARRIVED 3:46 PM
PART I PAGE IT]OF 4�
TIME
REPORT NO. EE79849 CASE# 24-5399 OF COLLISION05/21/24 15:33
NARRATIVE
24-5399
On 05/21/2024 at approximately 1545 hours, I was dispatched to a non-injury and non-blocking
vehicle collision at the intersection of NE 4th Street and Duvall Ave NE, within the City Limits of
Renton, County of King, State of Washington.
Upon my arrival, I confirmed there were no complaints of injury requiring immediate medical response
at the time of report. While on scene, I was able to collect each involved party's information and
independent summary of the events leading up to the collision.
The driver of Unit#1 stated she was the sole occupant of her vehicle and was attempting to exit a
private property parking lot, located in the 300 block of Duvall Ave NE, on the west side of the
roadway. The driver of Unit#1 stated that she was intending to make a left turn out of the parking lot
with the intent to proceed westbound onto NE 4th ST following the turn. The driver of Unit#1 said she
was following her GPS guidance and believed all traffic on NE 4th ST was clear and therefore
proceeded out into the roadway. As Unit#1 pulled out in the roadway, Unit#1 was met by another
vehicle - Unit#2. The driver of Unit#1 stated that she was unable to avoid the collision after having
pulled out into the roadway and that both vehicles collided causing moderate damage to the front
passenger side fender of Unit#1.
The driver of Unit#2 said she and one other occupant were traveling westbound in about the 4700
block of NE 4th ST in lane 1 of 2. The driver of Unit#2 stated she was intending to continue west.
Upon reaching the location where Unit#1 was turning out from, Unit#2 observed Unit#1 pull out into
her lane of travel. The driver of Unit#2 stated that she attempted to swerve to the right to avoid the
collision but was ultimately unable to avoid the collision. Both vehicles collided in the roadway and
Unit#2 suffered moderate damage to the driver's side door and front fender of the vehicle. The driver
of Unit#2 stated there was additional damage caused by swerving into the curb.
Based on the above statements, I believe that the driver of Unit#1 (Law) was the predominant factor
for the cause of collision as Law is required to comply with RCW 46.61.190(2) which states that every
driver of a vehicle approaching the point nearest the intersecting roadway where the driver has a view
of approaching traffic of the intersecting roadway must stop before entering the roadway, and after
having stopped shall yield the right-of-way to any vehicle in the intersection or approaching on
another roadway so closely as to constitute an immediate hazard during the time when such driver is
moving across or within the intersection or junction of roadways. Unit#2 was already underway in the
roadway and had right of way.
I cited the driver of Unit#1 (Law) by mail for failure to comply with RCW 46.61.190(2).
Both Unit#1 and Unit#2 were able to be driven away without further incident. 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 2:36 PM 5/22/2024 Renton, King County, WA.
PAGE 3 OF 4
REPORT NO. EE79849 CASE# ' 24-5399 DATE AND TIME 05/21/24 15:33
OF COLLISION
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