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HomeMy WebLinkAbout24-5985 a ITFFi "POLCERA II IfI) 1 IlfII ('II (Illf If( fI I . 0 27c COLLISION REP FIT 1591971 CASE 24-5985 z INTERSTATE ❑ CITY STREET FIRE ❑RESULTED 1 STATE ROUTE OTHER STOLEN ❑ ❑ HFHIC;I F ❑ LOCAL AOENC 3 HIT 8 RUN CODING COUNTY RD PRIVATE WAY INVOLVED 2 1 TOTAL#OF OBJECT 1 1 8 28 TRIBAL UNITS 03 STRUCK RESERVATION z 3❑ DATE OF M M D D Y Y Y Y TIME(2400) COUNTY# MILES N E IN CITY# ❑ COLLISION: 06 - 1-- 2024 0945 17 ❑. S 8 W Li OF e 1070 3 4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑ TALBOT RD S BLOCK NO. e✓ 1200 4a❑ MILEPOST DISTANCE OF(REFERENCE OR CROSS STREET) 5❑ �,❑ FEET e S ❑ W e I405 ON RAMP 0 1 29 MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE UNIT 01 VEHICLE ❑ CYCLE El ,/No D:2532898441 0 11 30 6� LAST NAME MCCOY FIRSTNAME DEMETRIUS MIDDLE C 1 1 2 31 INITIAL STREET ❑, 10408 SE 174TH ST APT D204 CITY RENTON ST WA 2jp, 980555805 z NEW ADDRESS 7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3 INTERLOCK YES[:]NO 1/ INTERLOCKYEs NO Z/ YES R No�/ 8❑ LRIIVER # ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 H U EET ICNLJAURY 1 NATURE OF INJURIES 2❑ 3 10 1❑ PI ATE 14 CJD0217 STATE WA u N# 2C3CA6CT8BH549533 11[-jTRAILER STATE TRAILER STATE 11 0 0 PLATE# PLATE# IR.. ro TRLR. TRLR. 5 1 33 12 0 0 VIN#' VIN# :: FROM TO ❑ VEH.YEAR 2011 CHRY 300C MAKE MODEL STYLE VEHICLE TOWED TO BLIN Tg YMEYERS GOVT.VEHICLE 5 1 34 13 4 DAMAGE YES No YES[:] No REGISTERED OWNER INFO DEMETRIUS MCCOY 4211 SW 314TH PL FEDERAL WAY WA 98023 D:2532898441 VEHICLE NO. 1 ❑ SHADE IN DAMAGED AREA 35 4 14 LIABILITY INSURANCE❑ INSURANCE CO 3 IN EFFECT &POLICY# 9TOP VEHICLE CHARGE 5 36 LEGALLY res❑NO❑ CITATION# 1 o BOTTOM 15❑ NDING 6 MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE UNIT 02 VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES 1/ NO D:8083863057 16 a LAST NAME WU FIRST NAME ZHOU ER CHARLES MIDDLE INITIAL 17 STREET❑ NEW ADOREss❑' 1128 ALOHI WAYAPT B CITY l HONOLULU ST HI ZIP 96814 4❑ 37 18❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED � 38 INTERLOCK YES❑No� INTERLOCK YEs❑NOF YEs❑NOF,/ 19 DRIVE # STATE SEX M M .C.B. 10 _ 27 1995 39 ❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 HEJ EET INCLASSJURY1 NATURE OF INJURIES 40 LICENSE I ❑21❑ PLA E# CWR9790 TATE 41 WA VIN# WAUEAAF40PA031771 1 42 22❑ PLATE# STATE PLATE# STATE 23❑ UIN#. 43 TRLR RLR 'IN#. VEH YEAR 2023 MAKE AUDI MODEL FAQ STYLE SO VEHICLE TOWED TO BLIN TOWEDBY GOV HI 44 24 DAMAGE YES�/ NO (,ENE MEYER YES NO REGISTERED OWNER INFO EAN HOLDINGS 4100 W GALVESTON ST STE I CHANDLERAZ85226 VEHICLE NO.2 SHADE IN DAMAGEbAREA 2 3 Cd LIABILITY INSURANCE INSU POLICY#E CO UNKNOWN UNKNOWNIN VE"LE ❑ ,J� CITATION# CHARGE E,�� LEGALYYES N`L J25 $ =SLINKMAN AME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY26 11618 WA0171300 PART A PAGE 01 OF C7 3000-345-159 OR 11/181 STATE OF POLICETRAFFICN CORRECTION REPORT No. EE95943 COLLISION REPORT III III III III III 111 1591972 CASE# 24-5985 ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY) NAME MIDDLE INITIAL) TRINH TRINH T (LAST FIRST, ADDRESS&PHONE# D O.B. 1128 ALOH1 WAYAPT B HONOLULU H196814 SEXi F MMDDYyry 12 - 25 - 1995 PASSENGER WITNESS UNIT# SEAT ' AIRBAG RESTR. EJECT ' HELMET INJURY NATURE OF INJURIES ❑✓ O, 2 POS. 3 2 4 1 USE CLASS 1 NAME (LAST,FIRST,MIDDLE INITIAL) LEE ELIJAH ADDRESS&PHONE# D O 8 14243 SE 157TH PL RENTON WA 98058 SEX M MMDDYvvY 01 _ 05 _ 2022 SEAT HELMET I INJURY NATURE OF INJURIES PASSENGER �WITNESS� UNIT# 3 pOS 9 AIRBAG'2 RESTR. 11 EJECT 1 USE CLASS 6 BLOODY LIP NAME (LAST FIR57 MIDDLE INITIAL) AppRESS&PHONE# SEX D.O.B. MMDDYYYY. - PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET NJURY NATURE OF INJURIES ❑ ❑ POS. USE CLASS ----� NARRATIVE' All three vehicles were traveling northbound on Talbot Rd S. They approached an "intersection" where there is an on ramp for 1405 Northbound. The light was a steady green. Unit 1 was in lane 3 (closest to the median) when the vehicle in front of unit 1 slammed on thier brakes for no reason. Unit 2 and unit 3 were in lane 2 (middle lane) slightly further north than unit 1. When the vehicle in front of unit 1 slammed on its brakes, unit 1 swerved into lane 2 to avoid hitting the vehicle. That was the lane that unit 2 and 3 were in and therefore, unit 1 collided with unit 2 who then collided with unit 3. I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT. ROBERT SLINKMAN 06-06-24 11:13 AM INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED APPROVED BY DATE P.KORDEL 9676 1 711512024 2:48:51 PM BADGE OR ID# 11618 ORI# WA0171300 TIME POLICE DISPATCHED; 9:45 AM TIME POLICE ARRIVED]9:45 AM PART I PAGE IT]OF 4� SUPPLEMENTAL REPORT No. EE95943 r`) POLICE TRAFFIC 1 1 8 27 COLLISION REPORT CASE# 24-5985 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 tSJ CYCLE I_) PEDESTRIAN OWNER YES NO D:2066696527 ] OF 1 29 LAST NAME :. LEE FIRST NAME ANDY MIDDLE ,.. K r:j INITIAL STREET 30 NEW AnDRFSP' 14243 SE 157TH PL CITY RENTON ST WA ZIP 98058 6 [2 1 1 2 31 CDL IGNITIttN REQUIRED IGNITION PRESENT MEDICAL TANSPORTED INTERLOCK YEs NO NTERLOCK YES❑N0� YES N DRIVER'S LICENSE STATE I WA SEX M MMDDYYv 06 - 12 - 1989 7 ON DUTY� STATUS AIRBAG' 2 RESTR. Q EJECT 1 HELMET I INJURY 1 1 NATURE OF INJURIES USE CLASS 8 ❑ 1 32 LICENSE AWK0960 TAr WA VIN# JTHCF1D29F5027706 PLATE# 9 TRAILER TRAILER PLATE# STATE PLATE# STATE 10 ❑ TRLR TRLR VIN.#. VIN.#. 11 0 0 VEH.YEAR2015 MAKE LEXS MODELS STYLE VEHICLE TOVVE E T SABLIN TOWED BY anvi vEH1I' P FROM TO DAMAGE YES 'E YES NO REGISTERED OWNER INFOOU SAELEE 14243 SE 157TH PL RENTON WA 98058 rj 1 33 12 � SHADE IN DAMAGED AREA 7 j FROM TO LIABILITY INSURANCE INSURANCE CO STATE FARM 0142135C16471 q"i"Olx IN EFFECT &POLICY# 1 EHICLE 34 13 4 LEGALLY YES❑ NO❑ CITATION# CHARGE 0 BOTTUM STANDING } 8 7 14 ❑ UNIT Tr Vd 1RE O CYDCLE OWNERRTY YES AGE NOHRESHOLD MET PHONE ❑ 35 PEDESTRIAN 15 LAST NAME FIRST NAME MIDDLE INITIAL TIAL ❑ ET 16 STRETRE "F ' CITY ST ZIP NEW CDL IGNITION REdUiRED IGNITION PRESENT MEDICALTANSPORTED NTERLOCK YES No NTERLOCK YES NO YES NO ❑ 17 4 37 LICENSE# STATE SEX MMDDDYBYY 18 ❑ ON DUTY� STATUS AIRBAG RESTR. ; EJECT HELMET INJURY NATURE of INJURIES 38 USE CLASS 19 ❑ LICENSE TAr VIN# 39 PLATE# 20 ❑ TRAILER' TRAILER El40 PLATE#< STATE PLATE# STATE 21 ❑ ❑ 41 TRLR TRLR 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 AREA 43 3 4 71 LIABILITY INSURANCE INSURANCE CO ' VINE EFFECT &POLICY# i 970P - 4 E:l 44 24 LEwcLE YES❑ NO❑ CITATION# CHARGE iq 60TiOM LECALLv 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. ROBERT SLINKMAN 06-06-24 11:13 AM 25 INVESTIGATING OFFICER'S SIGNATURE OFFICER'S PHONE UNIT OR DIST DET DATED: PLACE SIGNED 26 ORID# 11618 O#II,WA0171300 APPROVED BY 7/115/2024 PAGE F OF 4 3000-345-013(R 11118) REPORT NO. EE95943 CASE# 24-5985 DATE AND TIME 06/06/24 09:45 OF COLLISION 4 of to Scale a k , a t ' rn, , r r� r « bv� z ce 'W' 'm PAGE 4 OF 4