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HomeMy WebLinkAbout24-9653 POLICETRAFF'c" III !�� I IIIllI111IN II II I REPORT NO. EF16151 170
27
COLLISION REP FIT 1591971
CASE 24-9653 z
INTERSTATE ❑ CITY STREET FIRE ❑RESULTED
1 STATE ROUTE OTHER STOLEN
❑ ❑ HFHIC;I F ❑ LOCAL AOENC 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# ❑
COLLISION 09 — 1—— 2024 0652 17 ❑. S 8 W Li OF e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
NE 4TH ST BLOCK NO. e✓ 4700
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ �.❑ FEET e S ❑ W e DUVAL!AVE NE
2 0 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
�/No D:4256528289 0 4 30
6❑ LAST NAME KAMWENDO FIRSTNAME ANN MIDDLE L 1 1 2 31
INITIAL
STREET ❑, 6123 242ND PL#12-204 CITY KENT ST WA ZIP 98032 z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
INTERLOCK YES[:]NO INTERLOCKYEs NO YES R NO
8❑ LDRIVER # STATE WA SEX'F MID
.O B 08 1- 31 - 1964 2 32
9 ON DUTY❑ STATUS AIRBAG 3 RESTR 4 EJECT 1 H U SE
ICNLJAUSSY 1 NATURE OF INJURIES z❑
3
10� PI ATE 14 CMP6667 JBTATIJ WA u N#' JN16J1 CV9LW265412
11[-j7TRAILER STATE TRAILER STATE
11 0 0 PLATE# PLATE# ROM ro
TRLR. TRLR 3 7 33
12 0 0 VIN#' VIN#
ROM TO
VEH.YEARN MAKE NISS MODEL ROGUE STYLE SW VEHICLE TOWED fn TO VBLINJ TOWED BY I GOVT.VEHICLE 7 1 34
DAMAGE YES NO YES[:] NO✓
13❑ REGISTERED OWNER INFO ANN KAMWEND06123242NOPL#12-204 KENT WA98032 D:4256528289 VEHICLE NO. 1
SHADE IN DAMAGED AREA ❑ 35
14❑ LIABILI INSURANCE INSURANCE CO INTEGON NATIONAL GENERAL 2023511097 3 4
IN EFFECT &POLICY# 9TOP
vEHICLE CHARGE 5 36
LEGALLv Yes❑NO❑ CITATION# 10 BOTTOM
15❑ STANDING 7 6
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT VEHICLE ❑ CYCLE ❑ ❑
16 : OWNER ❑ YES 1/ NO D:2067476706
a
LAST NAME GUILLEN PENALOZA FIRST NAME VICTOR MIDDLE M
INITIAL
17❑ STREET ❑', 154 S 152ND ST#2 CITY' BURIEN ST WA ZIP 98148 37
NEW ADDRESS ❑
18� CDL IGNITION REQUIRED IGNITION PRESENT MEDICALTRANSPORTED 38
INTERLOCK YEs❑NO� INTERLOCK YEs❑NOF YEs❑NOF,/
19 DRIVER'S STATE WA SEX M D.C.B. 10 _ 02 _ 1984 0 39
LICENSE# MMDDYY
WELMET INJURY1 NATURE OF INJURIES 40
20❑ ON DUTY STATUS AIRBAG 3 RESTR 4 EJECT 1 USE CLASS ❑
21❑ LICENSE I D63930D TAre WA VIN# 1GCEK14KXPZ144727
❑ 41
PLATE#
42
22❑ PLATE# STATE PLATE# STATE
23❑ UIN#. 43
TRLR RLR
'IN#.
VEH YEAR 1993 MAKE CHEV MODEL GMT-400 STYLE PK VEHICLETOWED TO BLIN TOWEDBY GOV HI �44
L4❑ DAMAGE YES NO YES NO
REGISTERED OWNER INFO VICTOR GUILLENPENALOZA 154 S 152ND ST#2 BURIEN WA 98148 D:2067476706 VEHICLE NO.2
SHADEDAMAGEDAREA
3 4
LIABILITY
INSURANCE &POINSURGY#E CO BRISTOL WEST G01188740000IN �16
VEHICLE ❑ ,.II CITATION# CHARGELEGALLY YES N25
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# JAGENCY
26
/SABELlA DANIlYUK 13001 WA0171300
PART A PAGE 01 OF C7
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EF16151
COLLISION REPORT III III III III III 111
1591972 CASE# 24-9653
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
PM 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'
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.
ISABELLA DANILYUK 09-14-24 08:56 AM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
S.WOODWARD 11528 911812024 4:08:37 PM
BADGE OR ID# 13001 OR]# WA0171300 TIME POLICE DISPATCHED! 6:52 AM TIME POLICE ARRIVED',6:59 AM
PART I PAGE IT]OF 4�
REPORT NO. EF16151 CASE# 24-9653 OF COLLISION
09/14/24 06:52
OF CbLLI510N
NARRATIVE
24-9653
On 09/14/2024 at approximately 0654 hours, I, Officer Danilyuk responded to an unknown injury and
blocking accident in the intersection of NE 4TH ST and DUVALL AVE NE the City of Renton, County
of King, and the State of Washington.
Arriving on scene fire already checked out both parties involved and cleared them of any severe
injury. Two tows were called to the location as both vehicles had airbag deployment.
The driver of Unit 2 who was the RO and driver of the 2020 NISSAN ROGUE (Plate CMP6667)
identified herself as KAMWENDO, ANN LUCK (DOB 08-31-1964) and was verified via her WA DOL.
Kamwendo stated that she was traveling westbound on NE 4th St. She had a steady green light and
was planning on passing the intersection when the other vehicle, which was in the left turning lane on
the eastbound side of the roadway turned in front of her striking her vehicle left driver corner.
The driver of Unit 1 who was the RO 1993 CHEVY GMT-400 (Plate D63930D) using language line
identified himself as GUILLEN PENALOZA, VICTOR MANUEL (DOB 10-02-1984) and was also
verified via WA DOL. Guillen stated via usage of Language Line that he was waiting in the eastbound
turning lane for a clear turn to head northbound on Duval Ave NE. He saw Unit 2 but at the time
thought she was proceeding to turn southbound on Duval Ave NE. At the last moment Unit 2 changed
to the middle lane, changing her direction of travel from turning southbound, to proceeding
westbound through the intersection. At that point Guillen already pulled forward into the intersection
and was attempting to turn northbound onto Duval and struck Unit 2.
Both parties were provided and exchange of information with the case number and Kamwendo and
Guillen both used the tows requested.
Officer Long took pictures of both involved vehicles and of the roadway which will be uploaded to
Axon.
It should be noted that on the SECTOR depiction of the incident Kamwendo is showing as Unit 1 and
Guillen is showing as Unit 2 which upon further investigation showed that;
Guillen is Unit 1 and Kamwendo is Unit 2, Unit number were listed for both vehicles for identification
purposes only, not for identifying the at fault vehicle.
This concludes my involvement with this case.
My involvement in this case was captured on my department-issued Axon body camera. This report is
a summary of events that occurred and is not an exact sequencing of events. Statements have been
paraphrased and summarized. At the time of this call, I was in a full police uniform equipped with a
Renton Police badge and police patches.
I certify under penalty of perjury under the laws of the State of Washington that the foregoing is true
and correct.
Electronically signed by Ofc. I. Danilyuk#13001, 09/14/2024 at 0840 hours in Renton, Washington.
**** AUTO-POPULATED SECTION ****
THE FOLLOWING ARE DESCRIPTIONS ENTERED FOR ITEMS SELECTED AS "OTHER":
Motor Vehicle Unit 1
Traffic Control: STEADY GREEN
**** END OF AUTO-POPULATED SECTION ****
PAGE 3 OF 4
REPORT NO.! EF16151 CASE# 24-9653 DATE AND TIME 09/14/24 06:52
OF COLLISION
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