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HomeMy WebLinkAbout24-7519 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 1 27c
COLLISION REP FIT 1591971
CASE 24-7519 z
INTERSTATE ❑ CITY STREET FIRE ❑RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHIC;I F ❑ LOCAL AOENC 4900 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 TOTAL#TRIBAL OF OZ OBJECT 1 1 8 28
UNITS
RESERVATION I I
STRUCK
z
3❑ DATE OF M M D D Y Y Y Y TIME(2400) COUNTY# MILES N E IN CITY# ❑
cawsloN 07 - 18 - 2024 1540 17 ❑.= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓
MAPLE VALLEY HWY BLOCK NO. e✓ 12900
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ 550 00 FEET e S B W e 131STAVESE
0 1 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
,/NO D:2532220890 0 6 30
6� LAST NAME PARKINS FIRSTNAME JUDITH MIDDLE L 1 1 2 31
INITIAL
STREET ❑, 24504 148TH LN SE CITY KENT ST WA 2jp, 980424139 z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
1/ I iNTERLOCKYEs NO NTERLOCKYEs NO YES R No�/
8❑ LRIIVER #
ON DUTY❑ STATUS AIRBAG 3 RESTR 4 EJECT 1 HELMET INJURY 7 NATURE OF INJURIES z❑
USE CLASS COMPLAINT OF NECK AND BACK PAIN
3
10 9❑ Pi ATE 14 BZE6421 STATE WA VIN#' 1GKEK63UO3J333397
TRAILER STATE TRAILER STATE
11 4 0 PLATE# PLATE# Rom ro
TRLR. TRLR 8 4 33
12 4 0 VIN#' VIN#
>;.F oFROM TO
❑ VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN T GOVT.VEHICLE $ 4 34
13 2 2003 GMC YUKON DAMAGE vES 0NO f �AWkkRS vEs❑ No
REGISTERED OWNER INFO CHARLES PARKINS...148TH LN SE KENT WA 98042 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
14 ABILI V INSURANCE INSURANCE CO STATE FARM 200 0378-D22.47A 4
IN EFFECT &POLICY# TOP'E"CLE CHARGE36
LABILLv res❑NO❑ CITATION# <1�3
OTTOM
15❑ STANDING 7 6
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT 02 VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES 1/ NO D:2067698533
16 a
LAST NAME MAGNO FIRST NAME REYNALDO MIDDLE O
INITIAL
17❑ STREET ❑', 155 GLEN PL SE CITY' RENTON ST WA ZIP 980568888 37
NEW ADDRESS ❑
18� CDL IGNITION REQUIRED IGNITION PtR—E—S1ENT MEDICAL TRANSPORTED 38
INTERLOCKYES�NO� INTERLOCK YEs I I NOF YES F% NO❑
19[—] DRIVER'S STATE WA SEX M D.O.B. 02 _ 17 1971 El 39
LICENSE# MMDDYY
—NATURE OF INJURIES
W USE
LASS 7
Y COMPLAINT OF HEAD PAIN ❑ 40
20 ON DUTY STATUS AIRBAG,2 RESTR 4 EJECT 1
21❑ LICENSE I CBM2099 TATe WA VIN# 7SAXCBE51NF332935
❑ 41
PLATE#
42
22❑ PLATE# STATE PLATE# STATE
TRLR
23❑ UIN#. N#.
43
RLR
'I
VEH YEAR 2022 MAKE TESL MODEL MODEL X STYLE VEHICLE TOWED TO BLIN TOWED By GOV HI 44
24❑ DAMAGE YES" NO BANKERS YES NO
REGISTERED OWNER INFO REYNALDO MAGNO 720 N 10TH STREET RENTON WA 98057 VEHICLE NO.2
SHADE IN DAMAGEbAREA
2 3 Cd
LIABILITY
INSURANCE &POLICY#E CO SAFECO H2514893IN 1 9TOP
VEHICLE ES[:] C[:] CITATION# CHARGE i o BOTTOM
LEGALLY YN
25 $ '
7.FF1CJEO-S NAME(PRINT) OFFICER PHONE BADGE OR ID# ��A
NCY
26
HNSON 0505 0171300
PART A PAGE 01 OF
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EE99213
COLLISION REPORT III III III III III 111
1591972 CASE# 24-7519
ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY)
NAME MIDDLE INITIAL) MAGNO ROCHELLE G
(LAST FIRST,
ADDRESS&PHONE# D O.B. '
155 GLENNWOOD PL SE RENTON WA 980568888 2063904255 SEXi F MMDOYyry 10 - 03 - 1980
SEAT HELMET INJURY NATURE OF INJURIES
PASSENGERWITNESS❑'UNIT# 2 POS. 3 AIRBAG 2 RESTR. q EJECT 1 USE CLASS 17 COMPLAINT OFSTOMACHPAIN
NAME
(LAST,FIRST,MIDDLE INITIAL)
ADDRESS&PHONE# D 0.8
SEX MMDDYVYY
PASSENGER ❑WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET NJURY NATURE OF INJURIES
POS. USE CLASS
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'
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 07-19-24 12:56 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
CO.JOHNSON 0505 1 7/25/2024 3:36:30 PM
BADGE OR ID# 0505 OR]# WA0171300 TIME POLICE DISPATCHED 3:45 PM TIME POLICE ARRIVED 3:45 PM
PART I PAGE IT]OF 4�
REPORT NO. EE99213 CASE# 24-7519 OF COLLISION
07/18/24 15:40
OF CbLLI510N
NARRATIVE
On 07-18-2024 at about 1543 hours, I was northbound in the 12900 block of Maple Valley Highway
(SR 169) in the City of Renton, County of King, Washington State. I observed traffic stopped in the
southbound lanes and what appeared to be a 2-vehicle collision in lane #1 (of 2). 1 activated my
overhead emergency lights and conducted a U-turn in order to get behind the vehicles.
The driver of Unit 02 was identified by WADL and seated in the driver seat of the vehicle. The driver
said he was wearing a seatbelt and complained of head pain as a result of the collision. Unit 02 was
southbound in lane #1 when he observed traffic ahead slowing and backing up due to a signal light.
The driver applied his brakes and began slowing when his vehicle was struck from behind by Unit 01.
The front passenger of Unit 02 was outside the vehicle and talking to dispatch when I approached the
vehicle. The passenger said she was wearing her seatbelt and complained of stomach pain as a
result of the collision.
Both occupants of Unit 02 were evaluated by RRFD personnel at the scene and later transported by
ambulance for additional medical treatment.
The driver of Unit 01 was identified by WADL and seated in the driver seat of the vehicle. The front
airbag of Unit 01 was deployed. The driver said she was wearing a seatbelt and complained of neck
and back pain as a result of the collision. Unit 01 was southbound in lane #1 and following behind
Unit 02. The driver of Unit 01 was unable to articulate what lead up to the collision. The driver of Unit
01 said she works near the collision location, regularly drives along Maple Valley Highway and knows
that traffic can back up in the area.
I observed extensive damage to the rear of Unit 02 and front of Unit 01. The vehicles were engaged
with each other when I arrived and later separated after the tow trucks arrived. The damage to both
vehicles was consistent with the information provided by both drivers. Both vehicles were towed by
Bankers Towing.
The proximate cause of the collision was the driver of Unit 01 failing to recognize traffic to the front
slowing to a stop. The driver of Unit 01 drove in an inattentive manner with a lack of attentiveness
that would permit the driver of a motor vehicle to observe anything resting on, or traveling on, or
entering the roadway in time to take appropriate action as circumstances require. Were it not for the
actions of the driver of Unit 01, the collision would not have occurred.
During this incident I was wearing a body camera and my patrol vehicle was equipped with an in-car
video system with forward-facing camera and camera in the rear passenger compartment. Portions
of this incident were recorded. This report is a summary of the incident and not intended to be an
exact transcription of the investigation or what may have been captured with the recording systems.
No citations or infractions issued. Report for information and insurance.
PAGE 3 OF 4
REPORT NO. EE99213 CASE# ' 24-7519 DATE AND TIME 07/18/24 15:40
OF COLLISION
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