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HomeMy WebLinkAbout24-10391 a POLICETRAFFic" II I f I) 11I1ll(111(111l If( f 11 REPORT NO. EF31954 170
27
COLLISION REP FIT 1591971
CASE 24-10391 z
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 03 RESERVATION STRUCK
z
3❑ DATE of M M D D Y Y Y Y TIME(2400) COUNTY# MILES N E IN CITY# ❑
COLLISION'. 10 - 1-- 2024 1328 17 ❑.= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓
SW SUNSET BLVD BLOCK e✓ 200
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ 150 00 FMILES EET e S B E e MAPLE AVE SW
2 0 29
MOTUNIT O1 VEHIOR Z PEDAL-CLE CYCLE ElYYESA�NO THRESHOLD MET PHONE 0 11
30
6� LAST NAME SLONE FIRSTNAME JESSICA MIDDLE M 1 1 2 31
INITIAL
STREET ❑1 1205 GRANT AVE S APT R202 CITY RENTON ST WA ZIP 980556034 z
NEW ADDRESS
]❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
iNTERLOCKYEs NO INTERLOCKYEs NO YEs NO
LRIIVER # STATE WA SEX'F MM D Y' 09
8❑ — 24 — 1983 1 2 32
9 ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 H USEET ICNLJAURY 1 NATURE OF INJURIES z❑
3
10 9❑ Pi aT�S� BfU5773 sTArI WAurN# KMHDH4AHXFU379608
TRAILER STATE TRAILER STATE
11 3 5 PLATE# PLATE# FR.. ro
TRLR. YRLR. 5 1 33
12 3 5 VIN#' VIN#
>; FROM TO
VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE 5 1 34
13 2015 HYUN ELANTR DAMAGE YES NO YES❑ NO✓
REGISTERED OWNER INFO JESSICA SLONE 1205 GRANTAVE S APTR202 RENTON WA 980556034 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
14 LIABILITY INSURANCE INSURANCE CO PROGRESSIVE 914997724 4
IN EFFECT &POLICY# 9TOP
LEHICLE CHARGE 5 36
LECALLv YES No CITATION# 4A0765710 IMPROPER LANE USAGE )o eorroM
15❑ STANDING 7 6
MOTOR PEDAL- ❑ PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT 02 VEHICLE ❑ CYCLE ❑ OWNER ❑ YES 1/ NO D:2068998843
16 a
LAST NAME NGUYEN FIRST NAME HANG-NGA MIDDLE I D
INITIAL
17❑ STREET ❑', 407 RAYMOND PL SW CITY' RENTON ST WA ZIP 980572202 37
NEW ADDRESS ❑
18� CDL IGNITION REQUIRED IGNITION PR—E-1SENT MEDICAL TRANSPORTED 38
INTERLOCKYES�NOR INTERLOCK YEs It I NOF YES
t t— l NO❑
19 D IVEW #
INJURY1 NATURE OF INJURIES 40
20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 USE CLASS ❑
21❑ LICENSE BGK9191 TAre WA VIN# JTMRFREV9HD203455
❑ 41
PLATE#
42
22❑ PLATE# STATE PLATE# STATE
TRLR
23❑ UIN#. N#.
43
RLR
'I
VEH YEAR 2017 MAKE TOYT MODEL RAV4 STYLE VEHICLETOWED TO BLIN TOWEDBY GOV HI 44
L4❑ DAMAGE YES NO YES NO
REGISTERED OWNER INFO THANH NGUYEN 407 RAYMOND PL SW RENTON WA 98057 VEHICLE NO.2
SHADE IN DAMAGED AREA
2 3 4
INAEFFITY ECTNSURANCE INSU&POLICY#E CO SAME. IUR'E""LE
❑ ,J� CITATION# CHARGELEGALLYYES N`LJ
25 OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
J
26
M.LEVERTON 2517 WA0171300
PART A PAGE 01 OF C7
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EF31954
COLLISION REPORT III III III III III 111
1591972 CASE# 24-10391
ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY)
NAME
(/AST 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.
M.LEVERTON 10-04-24 02:47 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY E
DAT
C.JACOBS 1953 111412024 1:48:07 PM
BADGE OR ID# 2517 OR]#' WA0171300 TIME POLICE DISPATCHED 1:41 PM TIME POLICE ARRIVED',Y:02 Pry
PART I PAGE IT]OF 5�
REPORT NO. EF31954 CASE# 24-10391 OF COLLISION
10/04/24 13:28
OF CbLLI510N
NARRATIVE
wht 1/ In 2 into In 1 huts blue unit 2 bounces off hits slv unit 3 in In 2
CC
Within the city limits of Renton/King/WA I responded to a 3 vehicle blocking crash at about the 200
block of SW Sunset Blvd.
I contacted the driver of unit 2 who told me she was northbound Sunset in lane one when unit 1
changes lanes into the side of her. Unit 1 then drove into the side/back of unit 3. Unit 2 told me she
was not injured and damages did not require a tow truck.
I contacted the driver of unit 3 who told me she was northbound lane 2 on Sunset blvd when she was
hit from the side and back by unit 1 after she had hit a blue car/unit 2. She did not complain of injury
and damages did not require a tow truck.
I contacted the driver of unit 1 ID'd by matching picture WADL. She told me she was northbound on
Sunset and was making a lane change from lane 2 into lane 1 when she believed it was clear.
However, lane one was occupied by unit 2 which during her lane change unit 1 hit. Unit 1 then told
me that she 'ricocheted" off unit 2 and hit unit 3 in lane 2. She did not complain of injury and
damages did not require a tow truck.
I cited unit 1 ref RCW 46.61.140-unsafe/improper lane use 3 car crash via complaint.
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 10/04/2024
PAGE 3 OF 5
SUPPLEMENTAL REPORT No. EF31954
r`I POLICE TRAFFIC 1 1 8 27
COLLISION REPORT CASE# 24-10391
1 COMMERCIAL MOTOR CARRIER INTERSTATE INTRASTATE G
UNIT'# USL70r !CC# VEHICLE TYPE CARGO BODY
TYPE
2 ❑ 1 28
CARRIER
NAME
3 CARRIER
ADDRESS `
CITY ST' ZIP'
4 ❑ NAME # PLACARD: :❑
GI NAME IF NO NUMBER
SOURCE AXLES +
4a ❑ ADDITIONAL UNITS
MOTOR PEDAL-
PROPERTY DAMAGETHRESHOLD MET PHONE
5 ❑ UNIT# 3 VEHICLE t_"J � PEDESTRIAN YES� NO
0 1 29
LAST NAME LIN FIRST NAME KUEI MIDDLE L
INITIAL
STREET[6 II 30
NFW AnnRFSP 7038 RAVENNA AVE NE CITY SEATTLE ST WA ZIP 981155840
6
CDL IGNITIttN REQUIRED IGNITION PRESENT MEDICAL TANSPORTED 1 1 2 31
INTERLOCK YES NO NTERLOCK YES[:]NO[:] YES N
DRIVER'S
LICENSE STATE I WA SEX F MMDDYYv 03 - 16 - 1953
7
ON DUTYl STATUS AIRBAG' 2 RESTR. Q EJECT 1 HELMET INJURY 1 NATURE OF INJURIES
USE CLASS
8 ❑ 1 32
LICENSE AQG3332 [TAT WA VIN# JT2BF22K5Y0266460
PLATE#
9 9] TRAILER TRAILER
PLATE# STATE PLATE# STATE
10 ❑ TRLR TRLR
VIN.#. VIN.#.
11 3 5 VEH.YEAR2000 MAKE TOYT MODEL CAM4D I STYLE VEHICLE TOWS E T SABLIN TOWED BY anvi vEH11' P FROM TO
DAMAGE YES NO YES NO
33
REGISTERED OWNER INFOMORGAN LIN 7038 RAVENNA AVE NE SEATTLE WA 98115 SHADE IN DAMAGED AREA rj 1
12 7 FROM TO
INSURANCE CO
LIABILITY INSURANCE❑ SAME. i - "` S 0 34
IN EFFECT &POLICY# 4 TCSP
13 LEGALLYL 01 CITATION# CHARGE 000 Y)M
STANDING
YES NO
STANDING �} 8 7 6
14 ❑ UNIT Tr Vd 1RE O CYDCLE OWNERRTY YES AGE NOHRESHOLD MET PHONE ❑ 35
PEDESTRIAN
15 LAST NAME FIRST NAME MIDDLE INITIAL
TIAL
❑
STR
16 NFlEETEETFs.Fl CITY ST ZIP
AnnRCDL IGNITION REdUiRED IGNITION PRESENT MEDICALTANSPORTED
NTERLUCK YES No NTERLOCK YEs NO YEs NO El
17 37
LICENSE# STATE SEX MMDDDYBYY
18 ❑ ON DUTY� STATUS AIRBAG RESTR. ; EJECT HELMET INJURY NATURE of INJURIES 38
USE ICLASS
19 ❑ 39
LICENSE rnr VIN#
PLATE#
20 ❑ TRAILER TRAILER El40
PLATE#< STATE PLATE# STATE
21 ❑ TRLR TRLR 41
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 AREA 43
3 4 71
LIABILITY INSURANCE INSURANCE CO '
VEHICLE
EFFECT &POLICY# i 970P - S 44
24 LEwcLE YES❑ NO❑ CITATION# CHARGE iq 60TiOM
LeGAlly
E:l
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.
K LEVERTON 10-04-24 02:47 PM
25 INVESTIGATING OFFICER'S SIGNATURE OFFICER'S PHONE UNIT OR DIST DET DATED: PLACE SIGNED
26 OBADGE R IID# 2517 O#I',WA0171300 APJACOBS 111412024 PAGE�OF F
3000-345-013(R 11118)
REPORT NO. EF31954 CASE# ' 24-10391 DATE AND TIME 10/04/24 13:28
OF COLLISION
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PAGE 5 OF 5