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HomeMy WebLinkAbout24-9166 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 6 27c
COLLISION REP FIT 1591971
INTERSTATE ❑ CITY STREET FIRE ❑
CASE 24-slss z
RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHIC;I F ❑ LOCAL AOENC 4900 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 1 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#
cawsloN 08 - 1-- 2024 2312 17 ❑-= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
SE PETROVITSKY BLOCK NO. e✓ 11600 ❑
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ ❑ FEET e S ❑ VV e 116THAVE SE
0 1 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
✓NO D:2068527656 0 11
30
6� LAST NAME PROCTOR-MILLS FIRSTNAME RAY MIDDLE D 1 1 2 31
INITIAL
STREET ❑ 19319 114TH PL SE CITY KENT ST WA ZIP 98031 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 2 RESTR 4 EJECT 1 H USE 2 1 CLASS NATURE OF INJURIES z❑
3
LICENSE CMR0762 sTATe WA vN# 19UUA56962A047968
10 1❑ PI ATE�
11
C 3 5.... TRAILER STATE TRAILED STATE
PLATE# PLATE# IR.. ro
TRLR. A'RLR. 1 5 33
12 3 5 VIN#j VIN#
:: FROM TO
VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN T /g[AWk GOVT.VEHICLE 34
13 4 2002 ACUR TL SD DAMAG 7 3 E YES NO YYES[:] ✓No
REGISTERED OWNER INFO KIZZIE WRIGHT 19319114TH PL SE.KENT WA 98031 VEHICLE NO. 1
❑ ❑
SHADE IN DAMAGED AREA 35
14 LIABILITY INSURANCE❑ INSURANCE CO 4
IN EFFECT &POLICY# 9TOP
VEHICLE 5 36
LEGALLv res❑NO❑ CITATION# CHARGE 1 o BOTTOM
15❑ STANDING 8 6
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT 02 VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES 1/ NO D:2065795302
16 a
LAST NAME SINGLETON FIRST NAME FALON MIDDLE M
INITIAL
17 STREET❑ NEW ADOREss❑' 8836 9TH AVE SW,APT 1 CITY SEATTLE ST WA ZIP 98106 37
18❑ CDL IGNITION REQUIRED IGNITION PtR-E-S1ENT MEDICAL t-T�RANSPORTED � 38
INTERLOCKYES�NO INTERLOCK Y�EsI I I NOF YES
t l NO�
19 D IVEW # STATE WA ]SEX IF M D.C.B. 10 _ 14 1983 39
20❑ ON DUTY STATUS AIRBAG,3 RESTR 2 EJECT 1 WEB SET 2 NJAU SY 6 LEFT ARM PAIN AND TINGLING ❑F—NATURE OF INJURIES 40
LICENSE I ❑21❑ PLA E# BLT7302 TATE 41
WA VIN# 1N4AL3AP8EC112629 1
42
22❑ PLATE# STATE PLATE# STATE
TRLR
23❑ UIN#. IN#.
43
RLR
'
I
VEH YEAR 2014 MAKE j1//$$ MODEL SQL)'/Nj�Q STYLE $D DAMAGE TO ✓WED NOO BLIN TOWED BY GOV 44
Yr
H BANKERS YES NO
24❑ REGISTERED OWNER INFO OWNED SY DRIVER VEHICLE N0.2
SHADEDAMAGEDAREA
3 4
LIABILITY
INSURANCE I POLICY#E CO SAFECO H2502264IN STOP 5
'E""LE ❑ ,J� CITATION# CHARGE io BOTTOM
LEGALLY YES N J
25 e
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# T AGENCY
26
JAMAAL KEARSE 12994 WA0171300
PART A PAGE 01 OF
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EF10565
COLLISION REPORT III III III III III 111
1591972 CASE# 24-9166
ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY)
NAME MIDDLE INITIAL) ASHLEY TYLER K
(LAST FIRST,
ADDRESS&PHONE# D O.B. '
2701 SE 10TH ST UNIT 1095 RENTON WA 98058 2062500621 SEX M MMDovyry 05 - 08 - 2002
PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT ' HELMET INJURY NATURE OF INJURIES
❑ ❑✓ POS. USE CLASS
NAME
(LAST,FIRST,MIDDLE INITIAL) KEKIC ISABELLE M
ADDRESS&PHONE# D O B
10930 SE 172ND ST APT J206 RENTON WA 98055 3313020031 SEX' F MMopvvvv 03 _ 03 _ 2003
PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET INJURY 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.
JAMAAL KEARSE 09-01-24 03:13 AM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
DESIRES SCOTT 10272 1 91112024 8:30:20 AM
BADGE OR ID# 12994 OR]# WA0171300 TIME POLICE DISPATCHED 11:12 PM TIME POLICE ARRIVED',11:13 PM
PART Ei PAGE IT]OF 4�
DATE AND
TIME
REPORT NO. EF10565 CASE# 24-9166 OF COLLISION08/31/2423:12
NARRATIVE
Unless otherwise noted, all events took place in the City of Renton, in the County of King, in the State
of Washington.
This incident was captured on my body worn video camera and in-car cameras. This report is a
summary of events that occurred and is not an exact sequencing of events.
On 08/31/2024, at approximately 2312 hours I was dispatched to a report of collision with unknown
injury at the intersection of SE Petrovitsky RD and 116th Ave SE. Dispatch advised it started as an
automatic crash notification. Dispatch later advised a witness called in and confirmed there was an
accident and one of the involved parties requested aid. The call was updated to a blocking collision
with injury.
At approximately 1322 hours I arrived on scene with my FTO, Officer Fajarillo. I observed 2 cars with
significant damage to each of them. Fire was already on scene and evaluated both parties. The driver
of Unit 2 was complaining of pain and tingling in her left arm. She was transported to Valley Medical.
The other involved party was medically cleared by fire. Prior to my arrival, Officer Castain interview
both involved parties. She relayed the following information to me.
The Driver of Unit 1 advised the following. He was driving Southbound in lane 1 of 1 on 116th Ave SE
approaching the intersection of SE Petrovitsky Rd. He drove into the intersection and realized he had
a red light. The Driver of Unit 2 As she entered the intersection, she hit the front passenger fender
and wheel well of his car with the front bumper of her car.
The Driver of Unit 2 advised the following. She was driving eastbound on SE Petrovitsky Rd in lane 2
of 2 approaching the intersection of 116th Ave SE. As she was approaching the light at the
intersection, she noticed it was green. She continued into the intersection. She saw the driver of Unit
1 was driving southbound on 116th Ave SE approaching the intersection of SE Petrovitsky Rd. He
entered the intersection and she hit the front passenger fender and wheel well of his car with the front
bumper of her car.
I contacted a witness identified as Tyler K. Ashley DOB 05/08/2002 via WADL. He stated the
following. He was driving eastbound on SE Petrovitsky Rd approaching the intersection of 116th Ave
SE. He stopped at the redlight in the turn lane preparing to turn northbound onto 116th Ave SE. The
Driver of Unit 1 was driving Southbound on 116th Ave SE approaching the intersection of SE
Petrovitsky RD. The driver of Unit 2 was driving eastbound on SE Petrovitsky Rd approaching the
intersection of 116th Ave SE. The driver of Unit 2 had a green light and entered the intersection. The
driver of Unit 1 had a redlight and entered the intersection. Unit 2 hit the front passenger fender and
wheel well of unit 1 with the front bumper of unit 2.
1 contacted a second witness identified as Isabelle M. Kekic DOB 03/03/2003 via WADL. She advised
the following. She was driving northbound in lane 1 of 1 on 116th Ave SE. She was stopped at a
redlight at the intersection of SE Petrovitsky Rd. The Driver of Unit 1 was driving Southbound on
116th Ave SE approaching the intersection of SE Petrovitsky RD. The driver of Unit 2 was driving
eastbound on SE Petrovitsky Rd approaching the intersection of 116th Ave SE. The driver of Unit 2
had a green light and entered the intersection. The driver of Unit 1 had a redlight and entered the
intersection. Unit 2 hit the front passenger fender and wheel well of unit 1 with the front bumper of unit
2.
Both vehicles were unable to be driven of the road and had to be towed. They were both towed by
Bankers.
Based on the above statements, I believe that the driver of Unit#1 (Proctor-Mills) was the proximate
cause for the cause of collision as he failed to obey the traffic signals running a red light.
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 J. Kearse #12994 09/01/2024 0312 Hours Renton, King County,
Washington
PAGE 3 OF 4
REPORT NO. EF10565 CASE# ' 24-9166 DATE AND TIME 08/31/24 23:12
OF COLLISION
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PAGE 4 OF 4