HomeMy WebLinkAbout24-10792 )STATE TFC 6 0 27I OCERAF EF26951 COLLISION REPRT 1591971 CASE# 24-10792 2 INTERSTATE CITY STREET FIRE ❑ RESULTED 1 STOLEN STATE ROUTE ❑ OTHER ❑ VEHICLE LOL`CO A`CENC'Y 4200 3[--� COUNTY RD NVOLVED CODING 2 PRIVATE WAY ❑ TRIBAL UNITS TOTAL#OF TRUCK BJECT 1 28 01 TREE OR STUMP RESERVATION 2 3� M M D D Y Y Y Y TIME(2400) COUNTY# MILES CITY# DATE OF'. N E coulsloN' 10 - 16 - 2024 1809 17 =.�� S W e IN OF 1070 3 4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION MONSTERRD MILE POST e 951 .� 4a❑ MILE POST ❑ DISTANCE OF(REFERENCE OR CROSS STREET) 5 590 00-1 MILES N E FEET e✓ S 8✓ W e OAKESDALE 0 1 29 MOTtlR PEDAL- DAM AG THRESHOLD MET PHONE UNIT 01 VEHICLE CYCLE' YES ✓NO D:2532850697 30 6❑ LAST NAME KHRYSTYCHENKO FIRST NAME OLENA MIDDLE 1 2 31 INITIAL STREET E1 34025 39TH AVE S CITY AUBURN ST WA ZIP 98001 2 NEW ADDRESS 7 CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED: 3 INTERLOCKYEs NO W/ INTERLOCKYEs No�/ YEs NDF,/ 8 DRIVE # MMorYY' 10 — 18 STATE WA SEX F — 1987 32 9 ON DUTY STATUS AIRBAG 6 RESTR 4 EJECT 1 N USEET 2 1 INJURY CLASS 1 NAruRE of INJURIES 2 LICENSE, CKG1471 STATE WA VN# 5UXCR6C05L9B46803 3 10 PI ATF tt TRAILER STATE TRAILER ,STATE 11 0 0 PLATE# PLATE# ROM TO rRLR TRLR 1 5 33 12 VIN# VIN ( FROM TO VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED By GOVT VEHICLE 13 4 2020 BMW X5 SV DAMAGE YES�NO� YES NO� m 34 REGISTERED OWNER INFO OLENA KHRYSTYCHENK03402539TH AVE S AUBURN WA 98001 D:2532850697 VEHICLE NO. 1 ❑ SHADE IN DAMAGED AREA 35 14❑ LIABILITY INSURANCE NSURANCE CO TRAVELERS 6162800142031 IN EFFECT &POLICY tt vEnicLE CHARGE 5 36 Lemur yes[:]NO[:] CITATION# <14, 15❑ STM ING �y MOTOR PEDAL-:. PROPERTY DAM THR OLD MET PHONE UNIT©2 PEDESTRIAN VEHICLE CYCLE' OWNER YES NO 16❑ LAST NAME FIRST NAME MIDDLE' INITIAL 17❑ STREET D CITY ST ZIP 4❑ 37 NEW ADDRESS 1$❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED ❑ 38 INTERLOCKYEs No INTERLOCK YES 0-001 Es NO' 19 LICIENSE#VER' SEY MMDDYY -� E 39 HELMET I INJURY' NATURE OF INJURIES 40 20❑ ON DUTY STATUS' AIRBAG RESTR EJECT USE CLASS ❑ 21 PLATE#LICENSE — rarE vIN# 41 22❑ [TILER TRAILER PLATE# STATE PATE# STATE ❑ 42 23 TRLR kRLR 43 UIN#. 'IN#. VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOV HI 44 24 DAMAGE YES NO YES NO REGISTERED OWNER INFO VEHICLE NO.2 SHADE IN DAMAGED AREA 2 3 4 LIABILITY INSURANCE❑ INSURANCE CO IN EFFECT &POLICY# 9TOP vemae ❑ ,.I—I CITATION# CHARGE tO BOTTOM A r YES N`LJ 25 s a OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY 26 JEREMY ENGEL 13006 WA0171300 PART A PAGE 01 OF 1 3000-345-159(R 11/181 POLIICFETRAFFICN CORRECTION REPORT NO. EF26951 COLLISION REPORT III III III III III 111 1591972 CASE# 24-10792 ADDITIONAL PERSONS INVOLVED(PASSENGERS AND/OR WITNESSES ONLY) 'NAME (LAST,FIRST MIDDLE INITIAL) ADDRESS&PHONE# SEX' D.O.B. - [----------� MMDDYYYY PASSENGER F-1 WITNESS El UNIT# SEAT AIRBAG RESTR. EJECT HELMET INJURY NATURE OF INJURIES--� POS. USE CLASS 'NAME (LAST FIRS,MIDDLE INITIAL) ADDRESS&PHONE# S ' D.O EX .B.MMDD —F L----------� YYYY PASSENGER ❑WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET INJURY NATURE OF INJURIESPOS. : USE CLASS ----� '.NAME (LAST,FIRST,MIDDLE INITIAL) ADDRESS&PHONE# SEX D.O.B. - L----------� MMDDYYYY PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET INJURY NATURE OF INJURIES ❑ Q POS. USE CLASS �____ ----j NARRATIVE This incident was captured on my body worn video camera. This report is a summary of events that occurred and is not an exact sequencing of events. Statements have been paraphrased and summarized. While on patrol on 10/16/2024 at approximately 1812 hours I was dispatched to an Unknown Injury accident at 951 Monster Rd SW, City of Renton, County of King, Washington. Upon my arrival I observed a White BMW X5 bearing WA/CGW2218 which had collided with a tree. I approached and spoke with the driver. Khrystychenko, Olena (10/18/1987) had left her place of work at Bogdan Delivery located at 951 Monster Rd SW when she turned South onto Monster Rd SW. Khrystychenko was the only occupant in her vehicle. She stated she turned South into lane 1 of 1 when she lost control of the vehicle and overcompensated her steering which took her off the road into a tree. Khrystychenko stated she had no injuries. However, I observed the front and side airbags deployed and started Renton Regional Fire Authority to conduct an evaluation. RRFA evaluated her and cleared her. Khrystychenko was able to have her vehicle towed at her own expense. I certify (or 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. Engel #13006 10/17/2024 4:21 AM Renton, King County, WA. I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT. JEREMY ENGEL 10-17-24 04:37 AM INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST.DET DATED PLACE SIGNED APPROVED BY DATE GREGORYBILLS 12495 1012212024 12:53:06 AM BADGE OR ID# 13006 ORI# ( WA0171300 TIME POLICE DISPATCHED'; 6:12 Pry TIME POLICE ARRIVED 6:13 PM PART B 3aaa-345-,aa(R11Y1s) PAGE 27OF 37 REPORT NO. EF26951 CASE# 24-10792 DATE AND TIME 10/16/24 18:09 OF COLLISION A eta fl. t' 41f r, Yew„ d u Y� y't A �u S� r PAGE 3 OF 3