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HomeMy WebLinkAbout24-6786 IT si " II IIIII III IIIII II IIII IIIII I . 27c REPORT NO EE92379OLCERA
COLLISION REPORT 1591971
CASE# 24-6786 2
INTERSTATE CITY STREET FIRE I
RESULTEDSTOLENSTATE ROUTE OTHER VEHICLE LdCCOAGENCY 4200 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 TOTAL#OF OBJECT 1 1 8 28
TRIBAL UNITS 02 STRUCK
RESERVATION : 2
3� M M D D Y Y Y Y TIME(2400) COUNTY# MILES CITY#
DATE OF N E
cDLLISION' 06 - 27 - 2024 1113 17 =.�� S W e OF 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
BLOCK e 200 SUNSET BLVD NORTH .�
4a❑ MILE POST
❑ DISTANCE OF(REFERENCE OR CROSS STREET)
5 �.� FEET e S 8 W e MAPLEVALLEYHWY
0 1 29
MOTOR PEDAL- DAM AG THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE ❑ YEs Vl No D:2064376559 0 4 30
5 LAST NAME YUMBIA FIRST NAME ESTHER MIDDLE I W 1 1 2 31
INITIAL
STREET ❑ 985 RILEY DR E CITY; ENUMCLAW ST WA ZIP; 980225067 2
NEW ADDRESS
7 CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED' 3
INTERLOCKYES No�/ INTERLt)CKYES NO�/ YES NO
8❑ DRIVER' # STATE WA SEXI F MMDDYY' 11 - 10 - 1982 1 2 32
-NJUR
9 ON DUTY STATUS' AIRBAG 2 RESTR 4 EJECT 1 HELMET
2 CLASSY 1 [NATURE of INJURIES 2
10 PI ENSttEI BON9299 STATE WA VIN# 5FNYF4H53AB027589 3
TRAILER
11 3 0 STATE TRAILER STATE ROM To
PLATE# PLATE#
TRLR zRLR. 1 1 5 33
12 3 0 VIN#' vIN#
FROM TO
VEH.YEAR 2010 MAKE yOND MODEL PILOT STYLE SV VEHICLE TOWED[n TO ZBLIN TOWEDBY GOVT VEHICLE 1 3 34
13� DAMAGE YES II_II NO YESII_I) NO
REGISTERED OWNER INFO OWNEDBYDRIVER VEHICLE NO. 1
SHADE IN DAMAGED AREA 35
14 LIABILITY INSURANCE NSURANCE CO AMERICAN FAMILY 41053-44451-61
IN EFFECT &POLICY# 9TOP _
sVEHICLE
rgNo NG ❑NO❑ CITATION# 4A0344201 CHARGE IMPROPER LANE USAGE s I o¢orrofi 36
Yes
15
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT VEHICLE CYCLE nWNFR D:2064599525
16�
LAST NAME MEANS FIRST NAME DENNIS MIDDLE'
INITIAL
17 F1 STREET ❑❑ 709 143RD PL SE CITY BELLEVUE ST, WA ZIP 980076761 4 37
NEW ADDRESS
18❑ CDL ; IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED: 38
INTERLOCKYES NO INTERLOCK YES NO YES NO'✓
19 DRIVERS ' STATE WA SEX M D.o.a. 01 24 1979 � 39
LICENSE# MMDDYY —
20❑ ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 H U ET 2 INJURY 1 NATURE OF INJURIES 40
21 LICENSEPATE# CLASS
C14245T rare WA vIN# 1H9AAGAC3K1674264 41
22❑ PLATE# STATE PLATE# STATE E 42
23 TRLR RLR 43
UIN#. 'IN#
VEH.YEAR 2019 MAKE �.`�.`C MODEL LET2 STYLE GG VEHICLE TOWED TO BLIN
TOWED BY GOV HI 44
24 DAMAGE YES NO VES NO
REGISTERED OWNER INFO CGOR LLC 7343 E MARGINAL WAY S SEATTLE WA 98108 D:2064599525 VEHICLE NO.2
SHADE IN DAMAGED AREA
2 3 4
LIABILITY INSURANCE INSURANCE CO EVEREST DENALMALLIANT INS.SERVICES CF1CA00333-241
IN EFFECT &POLICY# I STOP
vewaE ❑ ,.I—I CITATION11 CHARGE to BOTTOM
EEGnEEY YES N
25 e
OFFICER'S NAME(PRINT)
26 OFFICER PHONE BADGE OR ID# JAGENCY
MATTHEW NUGENT 11498 WA0171300
PART A PAGE 01 OF
3000-348-189(R 11/18)
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EE92379
COLLISION REPORT III III III III III 111
1591972 CASE# 24-6786
E NA ADDITIONAL PERSONS INVOLVED(PASSENGERS AND/OR WITNESSES ONLY)
M
(LAST,FIRST,MIDDLE INITIAL) KIMILE MARYW
ADDRESS&PHONE N, D�
2646 NE 131ST AVE VANCOUVER WA 986846431 2064376559 SEXi F M D,O B.Y 09 - 27 - 1988
PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET INJURY NATURE OF INJURIES
1 POS. 3 2 4 1 USE 2 CLASS 1 ----�
:NAME
Lnsr EIRST,MIDDLE INITIAL) TODD MICHAEL S
ADDRESS R PHONE* D O B
12429 14TH AVE S BURIEN WA 981682244 2064599525 SEX M MMDDYYvr 10 - 17 _ 1967
SEAT HELMET INJURY NATURE OF INJURIES
PASSENGER a WITNESS UNIT# 2 POS. ' 3 AIRBAG 2 RESTR. 4 EJECT 1 USE 2 CLASS 1 ----�
:NAME
(LOST,FIRST,MIDDLE INITIAL)
ADDRESS&PHONE#
SEX MMDDYY D.O.B.
YY
PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET NJURY NATURE OF INJURIES
POS. I 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 07-01-24 02:55 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST.DET DATED PLACE SIGNED
APPROVED BY DATE
M.LEVERTON 2517 7/3/2024 8:23;04 AM
BADGE OR ID# j 11498 ORI# WA0171300 TIME POLICE DISPATCHED 11:15 AM TIME POLICE ARRIVED i 11:17 AM
PAST B 3 Do-3mx-attar gt 1Mffp PAGE 2�OF
REPORT NO. EE92379 CASE# 24-6786 DATE OF COLLI r�510NN + 06/27/24 11:13
L1
NARRATIVE
24-6786
On 06/27/2024 at approximately 1115 hours, I was dispatched to a non-injury and blocking vehicle
collision at the intersection of Sunset Boulevard North and Maple Valley Highway, within the City
Limits of Renton, County of King, State of Washington.
While en route, Dispatch advised that both involved parties were blocking the intersection. Dispatch
advised that the involved vehicles were a front loader garbage truck and a Honda SUV.
Upon arrival, I confirmed there were no complaints of injury from either of the involved parties at the
time of report. While on scene, I was able to collect each involved party's information and
independent summary of their involvement.
The driver of Unit#1 said that prior to the collision, she and her 6 passengers (1 adult, 5 juveniles)
were traveling southbound in about the 200 block of Sunset Boulevard North approaching the
intersection of Maple Valley Highway in what she believed to be was lane 4 of 5. The driver of Unit#1
stated that she had intended to continue south towards the on-ramp to 1-405 southbound. The driver
of Unit#1 stated that upon receiving a green light, Unit#1 proceeded straight forward. As Unit#1
entered the intersection, Unit#1 was met by Unit#2 which was traveling in the adjacent lane.
According to the driver of Unit#1, Unit#2 had turn into her vehicle causing moderate damage to the
passenger doors of
The driver of Unit#2 said that prior to the collision, he and his adult passenger (co-worker) were
operating a Commercial Garbage truck and were also traveling southbound in about the 200 block of
Sunset Boulevard North in what he believed to be lane 4 of 5. The driver of Unit#2 stated he was
intending to make an eastbound (left) turn onto Maple Valley Highway. The driver of Unit#2 stated
that Unit#1 was not in lane 4 of 5 but actually in lane 5 of 5 which is a left-turn lane only. When the
light changed to green, Unit#2 proceeded forward to make a left turn. According to the driver of Unit
#2, Unit #1 proceeded straight ahead which would have been an illegal movement within the
intersection as the traffic control legend indicated left-turn only for lane 5 of 5. Both vehicles made
contact in the intersection causing minor damage to the front diver's side quarter panel and door of
Unit#2.
The occupants of Unit#2 stated that their company has several dash cameras installed on their
Commercial Garbage truck vehicles. At the time of this writing, the footage has not been provided
therefore I am not able to determine who the predominant factor for this collision was without knowing
which lane each vehicle was in. Each driver claims they were in the proper lane (lane 4 of 5) and
believes the other involved vehicle turned into them.
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 11:45 AM 7/1/2024 Renton, King County, WA.
PAGE 3 OF 5
SUPPLEMENTAL REPORT No. EE92379POLICE TRAFFIC
1 27
... ^'� COLLISION REPORT CASE#i 24-6786
t113197
1 COMMERCIAL MOTOR CARRIER INTERSTATE INTRASTATE ✓
UNIT# 2 USDOT 2067700 ICC# VEHICLE TYPE 1 3 1 CARGO BODY 8 3
TYPE
2 ❑ 1 28
CARRIER NAME. CGOR LLC
..:
3 ❑ CARRIER ADDRESS 7343 E MARGINAL WAYS L
CITY SEATTLE I
ST, WA 71P', 98108
4 ❑ NAME I # PLACARD
NAME IF NO NUMBER
SOURCE 4 AXLES 03 GWVR 70000 +
4a ❑ ADDITIONAL UNITS
UNIT MOTOR PEDAL- PROPERTY DAMAGE THRESHOLD MET PHONE
5 ❑ lJ VEHICLE CI ( CYCLE C) PEDESTRIAN C OWNER I_]ID
FsF—1 NO
MIDDLE; 29
LAST NAME FIRST NAME INITIAL
STREET 30
NEW AnnRFSJ—jl CITY ST ZiP
6 1 CDL GNITION REQUIRED 1{iNi7iON PRESENT MEDICALTANSPORTED'. 1 31
I ::
INTERLOCK YES NO INTERLOCK YES No YES N
LICENSE STATE I SEX MMDDY Y' -C-
7
ON DUTY STATUS AIRBAG RESTR. EJECT HELMET INJURY NAruREofINJURIES
USE CLASS
8 ❑ 1 32
LICENSE TAT UIN.
PLATE#
9 TRAILER I I TRAILER L
PLATE# STATE PLATE# STATE
0
10 ❑ TRLR TRLR
VIN.#. VIN#.
11 VEH.YEAR MAKE MODEL STYLE VEHICLE TOWE E T ABLIN TOWED BY GOVr.VFHIOI F FROM TO
DAMAGE YES NO YES NO
REGISTERED OWNER INFO. m 33
12 � SHADE IN DAMAGED AREA
4 FROM TO
LIABILITY INSURANCE❑ INSURANCE CO TOP
IN EFFECT &POLICY# _..__`-'_.S m 34
13 vewc�e YES NO[jI CITATION# CHARGE
1080TTOM
ecauv
sTANoiNc
MOTOR PEDAL_ ' PROPER' DAMAGE THRESHOLD MET PHONE 35
14 ❑ UNIT# VEHICLE CYCLE PEDESTRIAN OWNER YES NO
36
15 LAST NAME FIRST NAME IN L
16 ❑ STREET �' CITY ST ZIP
NFW AODREsa
CDL IGNITION REQUIRED IGNITION PRESENT MEDICALTANSPORTED.
INTERLOCK YES NO INTERLOCK YES No :YES NO ❑
17 37
LLIICENSE# STATE SEX MMID g - C-----�
18 ❑ ❑
HELMET INJURY NATURE OF INJURIES 38
ON DUTY STATUS AIRBAG RESTR. EJECT USE CLASS.
19 ❑ ❑ 39
LICENSE TAT vIN#
PLATE#
20 TRAILER TRAILER 40
PLATE#. STATE PLATE# STATE ❑
21 ❑ TRLR TRLR 41
VIN#�, VIN#::
42
22 VEH.YEAR MAKE I MODEL I STYLE VEHICLE TOWED DUET ABLIN TOWED BY GOVT.VEHICLE
DAMAGE YES NO YES NO
23 REGISTERED OWNER INFO. SHADE IN DAMAC ED AREA 43
2 3 4
LIABILITY INSURANCE INSURANCE CO
IN EFFECT I &POLICY# 7c;Q
S. 44
vewc�e ❑ ❑ CITATION# CHARGE
24 I..EGALLY YES NO
STIWDING 8 3 G
1 CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT.
MATTHEW NUGENT 07-01-24 02:55 PM
25 INVESTIGATING OFFICER'S SIGNATURE OFFICER'S PHONE UNIT OR DIST DET DATED: PLACE SIGNED
26 OR ID# 11498 O#RI WA0171300 APPROVED BY
713312024
PAGE�OF
3000-345-013(R 11/18)
REPORT NO. EE92379 CASE# 24-6786 DATE AND TIME 06/27/2411:13
OF COLLISION
M'.
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PAGE 5 OF 5