HomeMy WebLinkAbout24-8900 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 6 27c
COLLISION REP FIT 1591971
INTERSTATE ❑ CITY STIR FIRE CASE
EET ❑
24-ssoo 2
RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHICI F ❑ LOCAL AGENCI 4Y00 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2� 1 1 8 28
TOTAL#OF OBJECT
TRIBAL UNITS 03 STRUCK EARTH BANK OR LEDGE
RESERVATION
z
3❑ DATE of M M D D Y Y Y Y TIME(2400) COUNTY# MILES N E IN CITY# ❑
COLLISION.. O8 - 1-- 2024 1848 17 ❑.= S 8 IN e 1070 3
4❑ oN (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
DUVALL AVE NE BLOCK NO. e✓ 4700 ❑
4a❑ MILE POST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ �.❑ FEET ❑ S ❑ VV❑ NE SUNSET BLVD
0 1 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
,/No D:4255189299 0 11
30
6� LAST NAMEj FRENCH FIRSTNAME DAVID MIDDLE A 1 2 31
INITIAL
STREET ❑ 24257 229TH AVE SE CITY MAPLE VALLEY ST WA 21p 98038 1 z
'NEW ADDRESS
7❑ CDL I 1/ IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
iNTERLOCKYEs NO NTERLOCKYEs NO Z YES No�/
8❑ LRIIVER #
ON DUTY❑ STATUS AIRBAG 6 RESTR 9 EJECT 1 H USE 2 1 CLASS NATURE OF INJURIES z❑
3❑
10 1❑ P1 ATE 14 CAX6568 STATE WA VN# 5TDYK3DC3GS754035
11[-j- TRAILER STATE TRAILER STATE
11 3 5 PLATE# PLATE# IR.. ro
TRLR. A'RLR. 1 5 33
12 3 5 VIN#j VIN#
:: FROM TO
VEH.YEAR 2016 MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED By GOVT.VEHICLE 7 3 34
13 4 TOYT SIENNA VN DAMAGE YES NO YES[:] No
✓
REGISTERED OWNER INFO OWNEDBYDRIVER VEHICLE NO. 1
❑
SHADE IN DAMAGED AREA ❑ 35
4
14 4 LIABILITY INSURANCE INSURANCE CO STATE FARM 3819531CO247A
IN EFFECT &POLICY# 9TOP
VEHCLE CHARGE to BOTTOM 5 36
LEGALLY YES❑NO❑ CITATION# 4A0359607 VEH ENTER INTERSEC STEADY RED
15❑ STANDING 7 6
MOTOR PEDAL- ❑ PEDESTRIAN PROPERTY DAM THR OLD M PHONE
UNIT 02 VEHICLE ❑ CYCLE ❑ OWNER ❑ YES 1/ ET No D:4
16 a 253956176
LAST NAME BERG FIRST NAME REBECCA MIDDLE M
INITIAL
17 STREET❑ NEW ADDREss❑' 580 8TH AVE NE UNIT 505 CITY ISSAQUAH ST WA ZIP 98029 37
18❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED � 38
INTERLOCK YEs❑No� INTERLOCK yEs❑NOF YES
❑NOF,/
19 LDIIVER # STATE WA ]SEX IF M .C.B. 08 _ 01 1975 39
20❑ ON DUTY STATUS AIRBAG 6 RESTR 9 EJECT 1 H U EET 2 NJAU EY 1 NATURE OF INJURIES ❑ 40
❑21❑ PLATE# C94391U TATE 41
WA VIN# 1C6JJTEGSLL209446 1
42
22❑ PLATE# STATE PLATE# STATE
23❑ VIN#. 43
TRLR RLR
'IN#.
GI
VEH YEAR 2020 MAKE JEEPMODEL GLADIAT STYLE PK DAMAGE TO WED NOO✓ BLIN TOWED BY 44
Yr
ov H yES NO 1/
24❑ REGISTERED OWNER INFO OWNED SY DRIVER VEHICLE N0.2
SHADEDAMAGEDAREA
3 4
LIABILITY INSURANCE INSU&PORGY#E CO STATE FARM 4266697F2347AO01 STOP 5
IN EFFECT
'E""LE ❑ ,J� CITATION# CHARGE to BOTTOM
LEGALLY YES N`L J
25 ' a
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
J
26
C.ARNOLD 12509 WA0171300
PAGE 01 OF
PART A
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EF07937
COLLISION REPORT III III III III III 111
1591972 CASE# 24-8900
ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY)
NAME MIDDLE INITIAL) FRENCH KATHLEEN L
(LAST FIRST,
ADDRESS&PHONE# D O.B. '
24257 229TH AVE SE MAPLE VALLEY WA 98038 2532051431 SEXi F MMDDYyry 07 - 07 - 1991
PASSENGER Z WITNESS UNIT# 1 I SEA 3 AIRBAG 6 RESTR. 9 EJECT ? 1 HELMET INJURY NATURE OF INJURIES
POS, USE 1 2 CLASS '1
NAME
(LAST,FIRST,MIDDLE INITIAL) FRENCH ASHER A
ADDRESS&PHONE# D O B
24257 229TH AVE SE MAPLE VALLEY WA 98038 SEX M MMDD Bv,, O6 _ 09 _ 2019
SEAT HELMET INJURY NATURE OF INJURIES
PASSENGER WITNESS UNIT# 1 POS 11 AIRBAG 2 RESTR. 9 EJECT 1 USE 1 2 CLASS 1
NAME
(LAST FIRST,MIDDLE INITIAL) FRENCH EMMELINE E
ADDREss&PHONE# 24257 229TH AVE SE MAPLE VALLEY WA 98038 SEX F D.O.B. 11 -F
06 _ 2021
MMDDYYYY
PASSENGER WITNESS UNIT# ! 1 SEAT 11 AIRBAG 6 RESTR. 9 EJECT 1 HELMET 2 NJURY 1 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.
C.ARNOLD 08-23-24 09:21 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
J.CHRISTIANSEN 10437 1 8/23/2024 11:20:35 PM
BADGE OR ID# 12509 ORI# WA0171300 TIME POLICE DISPATCHED 6:50 PM TIME POLICE ARRIVED',6:55 PM
PART I PAGE IT]OF
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EF07937
COLLISION REPORT III III III III III 111
1591972 CASE# 24-8900
ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY)
NAME MIDDLE INITIAL) FRENCH ROMAN
(LAST FIRST,
ADDRESS&PHONE#
24257 229TH AVE SE MAPLE VALLEY WA 98038 SEX M MMDOYyry 07 - 11 - 2023
PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT ' HELMET LASS NATURE OF INJURIES
❑✓ ❑ 1 POS, i 11 6 9 1 USE 2 CLA59 1
NAME
(LAST,FIRST,MIDDLE INITIAL)
ADDRESS&PHONE# DOB
SEX' MMDDYYYY
PASSENGER ❑WITNESS❑ UNIT# SEAT I AIRBAG RESTR. EJECT HELMET NJURY NATURE OF INJURIES
POS. USE CLASS
NAME
(LAST FIR57 MIDDLE INITIAL)
AppRESS&PHONE#
SEX D.O.B.MMDD -❑
YYYY.
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.
C.ARNOLD 08-23-24 09:21 PM
NVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
J.CHRISTIANSEN 10437 1 8/23/2024 11:20:35 PM
BADGE OR ID# 12509 ORI# WA0171300 TIME POLICE DISPATCHED 6:50 PM TIME POLICE ARRIVED',6:55 PM
PART I PAGE IT]OF
REPORT NO. EF07937 CASE# 24-8900 OF COLLISION
08/23/24 18:48
OF CbLLI510N
NARRATIVE
On 8/23/2024 at 1850 hours, I was dispatched to a motor vehicle collision at Duvall Ave NE and NE
Sunset Blvd.
Pre-Collision
Unit 1's driver stated that he was traveling South on Duvall Ave NE approaching NE Sunset Blvd in
the #2 lane.
Unit 2's driver stated that she was traveling East on NE Sunset Blvd, proceeding through a green light
to continue East on NE Sunset Blvd past Duvall Ave NE in the #2 lane.
Unit 3's driver stated that she was facing East at the light on NE Sunset Blvd and preparing to
perform a lefthand turn to proceed North on Duvall Ave NE.
Collision
Unit 1's driver stated that he drove through the red light while still in the #2 lane because he was
unable to see that the light was red due to the vehicle in front of him. Unit 1's driver stated that the
front bumper of Unit 1 made contact with Unit 2. Unit 1 proceeded through the intersection, over the
Southwest curb at the intersection of Duvall Ave NE and NE Sunset Blvd, and over bushes where it
came to rest in the parking lot of the gas station located at 4715 NE Sunset Blvd.
Unit 2's driver stated that as she was proceeding through a green light, Unit 1 failed to stop at the red
light and proceeded into the intersection. Unit 2's driver stated that the front bumper of Unit 1 made
contact with an unknown area on Unit 2. Based on the damage present, it appears that the front
bumper of Unit 1 made contact with the front driver's side bumper of Unit 2, causing significant
damage.
Unit 3's driver stated that she was in the #3 lane and proceeded to perform a lefthand turn with a
green arrow to proceed North on Duvall Ave NE from NE Sunset Blvd. Unit 3's driver stated that she
was unsure which Unit hit Unit 3. Based on the damage present, it appears to me that the front
bumper of Unit 3 made contact with the middle passenger side of Unit 1 when it entered the
intersection through a red light.
Injuries
Unit 2's driver, as well as all children in Unit 1 were seen by Renton Fire Authority (RFA). Nobody
was medically transported from the scene.
Vehicle dispositions
Unit's 1, 2, and 3 were all towed from the scene as they had complex airbag deployments and a
variety of damage that rendered them unsafe or inoperable.
Proximate Cause
If Unit 1 had not entered the intersection against a red light, this collision would not have happened.
Final disposition
Driver 1 did violate RCW 46.61.055.3A because vehicle operators facing a steady circular red signal
alone shall stop at a clearly marked stop line. Driver 1 was issued a citation by mail which was
forwarded to the Renton Prosecuting Attorneys queue.
I certify (declare) under penalty of perjury under the laws of the State of Washington that the
foregoing is true and correct.
Electronically signed by Officer C. Arnold #12509 on 8/23/2024 at 21:20 hours in the City of Renton.
PAGE 4 OF 6
SUPPLEMENTAL REPORT NO. EF07937
r`) POLICE TRAFFIC 1 1 8 27
COLLISION REPORT CASE# 24-8900
1 COMMERCIAL MOTOR CARRIER INTERSTATE INTRASTATE G
UNIT'# USDOT ICC# VEHICLE TYPE CARGO BODY
;TYPE
2 ❑ 1 28
CARRIER
NAME
3 CARRIER L
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:8054336880
0 4 29
LAST NAME HAWKINS FIRST NAME NATALIE MIDDLE' ',, J
INITIAL
30
STREET
NEW Ann2F.g; 31183 W LAKE SMMAMISH PKWY SW B204 CITY BELLEVUE ST WA ZIP 98008
6 ❑ 1 1 2 31
CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TANSPORTED
INTERLOCK YEs NO zERLOCK YES❑N0� YEs N
DRIVER'S
LICENSE STATE I WA SEX F MMDDYYv', 11 - 30 - 1998
7
ON DUTY� STATUS AIRBAG' g RESTR. g EJECT 1 HELMET 2 INJURY 1 1 NATURE OF INJURIES
USE CLASS
8 ❑ 1 32
LICENSE I CBN1411 [TAT WA VIN# KM8J33A49HU400797
PLATE#
9 TRAILER TRAILER
PLATE# STATE PLATE# STATE
10 ❑ TRLR TRLR
VIN It VIN.#.
11 3 5 VEH.YEAR2017 MAKE HYUN I MODEL TUCSON STYLE UT I VEHICLE TOME E T SABLIN TOWED BY anvi vFH1C P FROM TO
DAMAGE YES NO YES NO
REGISTERED OWNER INFO OWNED BY DRIVER ] 1 33
12 � SHADE IN DAMAGED AREA
4 FROM TO
LIABILITY INSURANCE INSURANCE CO GEIC04631031624 q"i"Olx
IN EFFECT &POLICY#
vEHICLE 1 t7 6QTTOM 34
13 ❑ LEGALLY YES[:] NO❑ CITATION# CHARGE gg�@
STANDING S} l:9 7 6
14 ❑ UNIT Tr Vd IRE O CYDCLE OWNER
RTY YES[-]AGE NOHRESHOLD MET PHONE ❑ 35
PEDESTRIAN
15 LAST NAME FIRST NAME I MIDDLE 36
STREET"[-]
❑
16Fl NEW AnnREs� CITY ST ZIP
CDL IGNITION REdUiRED IGNITtGN PRESENT MEDICALTANSPORTED
INTERLOCK YES No INTERLOCK YEs NO YES NO ❑
17 4 37
LICENSE# STATE SEX MMDDDYBYY -� II
18 ❑ ON DUTY� STATUS AIRBAG RESTR. ; EJECT HELMET INJURY NATURE of 1NJURIEs 38
USE CLASS
19 ❑ LICENSE TAr VIN# 39
PLATE#
20 ❑ TRAILER' STATE TRAILER STATE ❑ 40
PLATE#< PLATE#
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 3 4 4 AREA F 43
z
LIABILITY INSURANCE INSURANCE CO '
VINE
EFFECT &POLICY# i 970P - 4 E:l
44
24 VEHICLE YES❑ NO❑ CITATION# CHARGE iq 60TiOM
LEGALLv
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.
C.ARNOLD 08-23-24 09:21 PM
25 INVESTIGATING OFFICER'S SIGNATURE OFFICER'S PHONE UNIT OR DIST DET DATED: PLACE SIGNED
APPROVED BY DATE
26 OR ID# 12509 O#I',WA0171300 CHRISTIANSEN 8/23/2024 PAGE OF 6
3000-345-013(R 11118)
REPORT NO. EF07937 CASE# ' 24-8900 DATE AND TIME 08/23/24 18:48
OF COLLISION
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PAGE 6 OF 6
