HomeMy WebLinkAbout24-9495 iiTFiNII IIIII III IIIII II IIII IIIII I . 27c REPORT NO EF14467oc� RA
COLLISION REPORT 1591971
❑ FIRE I
�/�$E$ 24-9495 2 1 7
INTERSTATE CITY STREET RESULTEDSTOLENSTATE ROUTE OTHER VEHICLE LDCAI-A`NG 4100 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 TOTAL#OF OBJECT 1 s 28
TRIBAL UNITS 02 STRUCK
RESERVATION : 1 1
2
3� M M D D Y Y Y Y TIME(2400) COUNTY# MILES CITY#
DATE OF N E
eDLLISION' 09 - 10 - 2024 0804 17 =.= S 8 W E INOF 1070 a
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓
BENSON DR S BLOCK NO. e 1'7200 .�
4a❑ MILE POST
❑ DISTANCE OF(REFERENCE OR CROSS STREET)
5 1251.1 00-] MILES N
FEET e✓ S 8✓ E e SE 172ND ST
1 6 29
MOTOR ✓ PEDAL- DAM AG THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE ❑ YES ✓NO 0 1 30
6 LAST NAME HASSEN FIRST NAME YESIHAK MIDDLE Y 1 1 2 31
INITIAL
STREET ❑ 17402 127TH PL SE CITY; RENTON ST WA ZIP; 980586123 2
NEW ADDRESS
7 CDL IGN(TIUN REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
INTERLOCKYEs NO INTERLOCKVEs NO YES NO
8 DRIVER # STATE WA SEX M MM0,13. 04 - 04 - 1958 t 1 2 32
9 ON DUTY STATUS' AIRBAG 2 RESTR 4 EJECT 1 1HELM
USEET CLASSY 1 NAruRE of INJURIES 2
10 LI ENSE', BMV0768 STATE WA VIN# JTDKBRFU7G3528998 3
TRAILER STATE TRAILER STATE ROM To 11 4 0 PLATE# PLATE#
TRLR zRLR 1 1 5 33
12 4 0 VIN#' vIN#
FROM TO
13 2 VEH.YEAR2016 MAKE TOYT MODEL PRIUS STYLE VEHICLE TOYED NO�iS46LIN T�VyED.6LRS GESIT` CLE 1 5 34
DAMAGE IIII._IIII HHttVVii((tt u
REGISTERED OWNER INFO YESIHAK HASSEN 17402127TH PL SE RENTON WA 980586123 D:2063567718 VEHICLE NO. 1
SHADE IN DAMAGED AREA 35
3 4
14 LIABILITY INSURANCE NSURANCE CO PROGRESS/VE 958946274
IN EFFECT &POLICY#
VEHICLE
Yes NO
r NOLNG ❑ CITATION# 4A0652646 CHARGE NEGLIGENT DRIVING 2ND DEGREE o oorrob ❑ 36
15
MOTCSR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT VEHICLE CYCLE nWNFR YES�/ NO D:3605566538
16�
LAST NAME GIRT FIRST NAME MANU MIDDLE' N
INITIAL
17 F1 STREET ❑❑ 11100 SE PETROVITSKY RD APT R CITY RENTON ST, yyq ZIP 980556468 37
NEW ADDRESS
18❑ CDL IGNITION REC]UIRED IGNITION PRESENT MEDICAL TRANSPORTED: ❑ 38
INTERLOCKYES No INTERLOCK YES NO vEs NO
19 DRIVERS STATE WA SEX F I D.o.a. To, 27 1996 � 39
LICENSE# MMDDYY —
20❑ ON DUTY❑ STATUS AIRBAG'6 RESTR 4 EJECT 1 HELMET INJURy', 7 NATURE OF INJURIES ❑ 40
USE CLASS TBD
21 LICENSE I PLATE# BUS7298 rare WA vIN# 19XFC1F3XLE208469 41
22❑ PLATE# STATE PLAAILER
TE# STATE 42
23 r TRLR RLR 43
UIN#. 'IN#
VEH.YEAR 2020 MAKE HOND MODEL CIVIC STYLE VEHICLE TOWED TO BLIN
TOWED BY GOV HI 44
24 DAMAGE YES NO BANKERS VES NO
REGISTERED OWNER INFO MANUGIR111100SEPETROVITSKYRDAPTR RENTON WA 980556468 D:3605566538 VEHICLE NO.2
SHADE DEGAREA
LIABILITY INSURANCE INSURANCE CO PROGRESSIVE 979297994
IN EFFECT &POLICY#VEHICLEEEEILY YES❑ N`.L J,J—ICITATION# CHARGE C�Ql
25 a
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
J
26
M.LEVERTON 2517 WA0171300
PAGE 01 OF
PART A 3000-348-189(R 11/18)
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EF14467
COLLISION REPORT III III III III III 111
1591972 CASE# 24-9495
E NA ADDITIONAL PERSONS INVOLVED(PASSENGERS AND/OR WITNESSES ONLY)
M
(LAST,FIRST,MIDDLE INITIAL) DELGADO ALONSO SANDRA N
ADDRESS&PHONE# D O B
11408 SE 305TH PL AUBURN WA 980923104 2067189237 SEXi F MMDDYVYY 02 IT
25 — 1975
PASSENGER WITNESS UNIT# SEAT ' AIRBAG RESTR. EJECT I HELMET I INJURY1 NATURE OF INJURIES
POPOS. USE CLASS ----�
:NAME
Lnsr EIRST,MIDDLE INITIAL) MONTANEZ SANTOS ROCIO N
ADDRESS&PHONE# D B
11100 SE PETROVITSKY RD APT K RENTON WA 980555660 2062800000 SEX'' F MM DDYYYY 03 _ 28 _ 1974
PASSENGER EAT AIRBAG RESTR. EJECT HELMET INJURY NATURE OF INJURIES
[:]WITNESS�✓ UNIT# S POS. USE CLASS ----�
: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.
M.LEVERTON 09-10-24 10:57 AM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST.DET DATED PLACE SIGNED
APPROVED BY DATE
C.JACOBS 1953 1 911212024 3:41:36 PM
BADGE OR ID# ; 2517 ORI# WA0171300 TIME POLICE DISPATCHED 8:05 AM TIME POLICE ARRIVED i 8:11 AM
PAST B 3 Do-3mx—attar(t 1Mff) PAGE 2�OF 4
REPORT NO. EF14467 CASE# 24-9495 OF DATE AND r�N + 09/10/24 08:04
O�COLLISION
NARRATIVE
orange nb lane 2/unit 2 gray unit 1 wrong lane loc
CC
Within the city limits of Renton/King/WA I responded to a 2 vehicle blocking crash near the 17200
block of Benson Dr S.
I contacted the driver of unit 2 who told me she was northbound on Benson Dr S on lane 2 when she
noticed it appeared unit 1 was going too fast and crossed over into her lane. She swerved to avoid
contact with unit 1 but was hit in the front driver wheel ripping it from the car then had most of the
impact behind the B pilar. She was checked and treated by Renton Fire on scene. Her vehicle was
towed for damages.
I contacted the driver of unit 1 ID'd by picture WADL. He was still seated in the driver seat and I had
to force the driver door open. I did not detect any odor of intoxicants, and he did not appear to be
under the influence of ETOH and.or other drugs. Unit 1 told me he had no recollection of the crash.
He was still in his scrubs and heading home from work in patient care at Harborview hospital in
Seattle. He told me he was driving along and then suddenly a loud boom and provided no additional
information. I asked him if he was taking medications of drugs and he said no. He told me he didnt
fall asleep. I asked him what he thinks lead up to the crash and could not answer me.
It was very easy to determine the POI which was clearly in NB lane 2. Both vehicles lett very
descriptive marks in the road as to the POI and POS. The information provided by unit 2 was very
clear along with two other witnesses. Other witness statements puts unit 1 at above the posted
speed, by their perception only, was not actually measure, and on the wrong side of the road, left of
center on a double yellow with no evasive action taken to avoid the collision. Either unit 1 was asleep
or completely engaged in some other distract or activity inside his vehicle at the time of this crash.
I cited unit 1 Ref RCW 46.61.525 Negligent driver second degree 2 vehicle injury crash via complaint.
Unit 1 did operate a motor vehicle in a manner that is both negligent and endangers or is likely to
endanger any person or property.
I certify (declare) under penalty of perjury under the laws of the State of Washington that the
foregoing is true and correct.
M.Leverton/2517 City of Renton/King/Wa 9/10/2024
PAGE 3 OF 4
IREPORTNO. EF14467 CASE# 24-9495 DATE AND TIME 09/10/2408:04
OF COLLISION
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PAGE 4 OF 4
