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HomeMy WebLinkAbout24-8000 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 6 27c
COLLISION REP FIT 1591971
SASE 24-8000 2
INTERSTATE ❑ CITY STREET FIRE ❑
RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHICI F ❑ LOCAL AOENC 4200 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#
cowsloN 07 - 1-- 2024 1311 17 ❑-= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
RENTON AVE EXT
BLOCK NO. e✓ --- ----� ❑
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ ❑ FEET e S ❑ VV a HARDIEAVE SW
0 1 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
,/No D:2069458478 0 11
30
6 LAST NAME GUZMAN FLORES FIRST NAME CARLOS MIDDLE S 0 1 31
INITIAL
STREET ❑, 429 SW 155TH ST APT H CITY BURIEN ST WA ZIP 981664416 z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNIT{ON PRESENT MEDICAL TRANSPORTED 3
:NTERLOCKYEs NO INTERLOCK YES NO YES No
8❑ DRIVERS
# STATE WA SEXI M I D-MIDI Y' 04 — 17 — 2003 1 2 32
9 ON DUTY❑ STATUS AIRBAG 3 RESTR 4 EJECT 1 H USE CLASS 2 CLASS 1 NATURE OF INJURIES 2❑
3
10[1PI ATNE 14 CGU4776 sTAr WAu N# 1HGCR2F8XDA192055
0 TRAILER STATE TRAILER STATE
11 4 0 PLATE# PLATE# FROM TO
TRLR. TRLR 7 3 33
12 3 0 VIN#' VIN#
>; FROM TO
VEH.YEAR MAKE I MODEL STYLE VEHICLE TOWED TO BLIN T Y GOVT.VEHICLE 1 $ 34
13 2013 HOND ACCOR DAMAGE YES NO 14I� /�TE TOW 'Es❑ NO
REGISTERED OWNER INFO CARLOS GUZMAN FLORES 429 SW 155TH STAPTH BURIEN WA 98166 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
14 ABILI V INSURANCE INSURANCE CO PACIFIC STAR 5550813 3 4
IN EFFECT &POLICY# 9TOP
VEHICLE CHARGE 5 36
LEGALLY YES❑NO❑ CITATION# 1 o BOTTOM
15❑ STANDING 7 6
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT VEHICLE ❑ CYCLE ❑ ❑ : OWNER ❑ YES 1/ NO D:2069534462
16 2
LAST NAME MUCKERHEIDE FIRST NAME WILLIAM MIDDLE M
INITIAL
17❑ STREET ❑', 406 TAYLOR AVE NW#B CITY RENTON ST WA ZIP 980573420 37
NEW ADDRESS ❑
18� CDL IGNITION REQUIRED IGNITION PR—E-1SENT MEDICAL—T�RANSPORTED ❑ 38
INTERLOCKYES�NOR INTERLOCK YEs It I NOF YES t l NO❑
19 LDI IVER # STATE WA SEX M M D.C.B. 04 29 _ 1945 0 39
HELMET {NJURY 1 NATURE OF INJURIES 40
20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT '1 USE 2 CLASS 41
❑
21❑ LICENSE AOM1236 TAre WA VINIi 1GHDT13W4Y2270731
❑
PLATE#
42
22❑ PILER LATE# STATE PLATE# STATE
23❑ UIN#. 43
TRLR RLR
'IN#.
VEH YEAR 2000 MAKE OLDS MODEL BRAVADA STYLE VEHICLETOWED TO BLIN TOWEDBY GOV HI 44
L4❑ DAMAGE YES NO YES NO
REGISTERED OWNER INFO WILLIAM MUCKERHEIDE PO BOX 450 RENTONWA98057 VEHICLE NO.2
SHADE IN DAGED AREA
4
LIABILITY INSURANCE INSU&PORGY#E CO FARMERS INSURANCE 188656568 IGQ
5
IN EFFECT
VE""LE ❑ ,J� CITATION# CHARGE
LEGALLY YES N`L J
25 s � e
7CA
NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
J
26LAN 12007 WA0171300
PART A PAGE 01 OF
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EF03712
COLLISION REPORT III III III III III 111
1591972 CASE# 24-8000
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
POS. 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'
On July 30, 2024, at 1311 hours Officer Nelson came across a collision at Renton Ave Ext and Hardie
Ave SW, in Renton.
Upon my arrival I spoke with the driver of unit 1, a Honda Accord. The driver explained he was driving
eastbound in the number 1 lane on Renton Ave Extension and approaching Hardie Ave SW when the
traffic signal turned yellow. He applied his brakes, but they became defective and failed to work. He
continued through light but struck unit 2 which had just crossed the intersection going southbound.
Unit 1 struck unit 2's passenger doors, causing moderate damage to unit 2.
The driver stated that he recently replaced his front brakes.
Unit 1 sustained severe damage to the front of the vehicle and needed to be towed away from the
intersection. Unit 1 was removed by a private tow.
I then spoke with the driver of unit 2, an Oldsmobile Bravada. The driver explained he was going
southbound on Hardie Ave SW and crossing Renton Ave Extension when he was struck by unit 1.
The driver stated he had a green light and does not know why unit 1 struck his passenger doors.
Although unit 2 sustained moderate damage to his passenger doors, his vehicle was drivable.
I believe that unit 1 had an equipment issue which was the predominate cause of the collision.
An exchange of information was given to both drivers.
I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT.
C.CATALAN 07-30-24 02:31 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
CO.JOHNSON 0505 1 8/9/2024 10:04:35 AM
BADGE OR ID# 1Y007 OR]# WA0171300 TIME POLICE DISPATCHED 1:11 PM TIME POLICE ARRIVEDf 1:11 PM
PART I PAGE IT]OF
REPORT NO. EF03712 CASE# ' 24-8000 DATE AND TIME 07/30/24 13:11
OF COLLISION
as
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