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24-10800
iiTFiNII IIIII III IIIII II IIII IIIII I . 27c REPORT NO EF27041oc� RA COLLISION REPORT 1591971 CASE# 24-10800 2 INTERSTATE CITY STREET FIRE ❑ RESULTED 1 ❑STATE ROUTE OTHER STOLEN VEHICLE ❑ LOCAL AGENCY 3 HIT&RUN CODING COUNTY RD PRIVATE WAY ❑ INVOLVED 2❑ TRIBAL TOTAL UN TS#OF 04 SOTRUCK BJECT 11 8 28 RESERVATION 2 3� M M D D Y Y Y Y TIME(2400) COUNTY# MILES CITY# DATE OF'. N E COLLISION' 10 - 17 - 2024 0720 17 =.= S 8 W E IN OF M 1070 a 4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION NE 4TH ST BLOCK NO. e 3131 .� 4a❑ MILE POST ❑ DISTANCE OF(REFERENCE OR CROSS STREET) 5 0 FEET S 8 W e✓ MONROE AVE NE 2 0 29 MOTtlR PEDAL- DAMAG THRESHOLD MET PHONE UNIT 01 VEHICLE ❑ CYCLE ❑ YES �/No D:2534869044 2 0 30 6 LAST NAME ROACH FIRST NAME GARY MIDDLE M 1 2 31 INITIAL STREET ❑ 28111 34TH AVE S CITY AUBURN ST WA ZIP; 98001 2 NEW ADDRESS 7 CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED: 3 INTERLOCKYEs NOW INTERLOCK YEs Na�/ YES F NoF,/ 8� LICIENS# STATE WA SEx U MMOCSYY' 08 1 2 32 9 ON DUTY STATUS AIRBAG 2 RESTR 9 EJECT 1 N USEET 2 1 INJURY CLASS 1 NAruRE of INJURES 2 LICENSE, CMD5620 STATE WA VIN# 3VWPP7AJ8EM602365 3 10[9� PI ATP rt 11[-j- TRAILER STATE TRAILER ,STATE ROM TO 11 3 5 PLATE# PLATE# rRLR rRLR, 7 3 33 12 3 5 VIN# vIN# ( FROM TO VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED By GOVT VEHICLE 13 4 2014 YOLK JETTA GA DAMAGE YES NO ✓ YEs No 7 3 34 REGISTERED OWNER INFO GARY ROACH 2811134TH AVE S AUBURN WA 98001 D:2534869044 VEHICLE NO. 1 ❑ SHADE IN DAMAGED AREA 35 LIABILITY INSURANCE❑ INSURANCE CO 2 3 4 14 USAA 04864 72 45G IN EFFECT &POLICY# 4TOP 5 VEHICLE t CHARGE 36 Ec LgLLY YES❑NO❑ CITATION# 70 80TTOM 15❑ nNowc e MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE UNIT VEHICLE ❑ CYCLE' ❑ ❑ nWNFR YEs�/ NO D:2533976641 16� LAST NAME FAIZI FIRST NAME YASAR MIDDLEI A INITIAL STREET ❑ 17 '❑ 26608 111TH PL SE CITY KENT ST, Wq ZIP 98030 4 37 NEW ADDRESS 1g❑ CDL IGNITION REQUIRED IGMTION PRESENT MEDICALTRANSPORTED. 38 INTERLOCKYEs No INTERLOCK YES No YEs NC 19[ DRIVER'S STATE WA SEX U I D.C.B. 01 O6 2005 39 LICENSE# MMDDYY — 20❑ ON DUTY STATUS AIRBAG 2 RESTR 9 EJECT 1 R LMET 2 CLASSY 1 NATURE OF INJURIES 40 21 LICEN� BVZ1717 TATE WA vIN# JTDKN3DUXF1914784 41 PLATE 22❑ [TILER TRAILER PLATE# STATE PATE# STATE ❑ 42 23 TRLR kRLR 43 UIN#. 'IN#. VEH.YEAR 2015 MAKE TOYT MODEL PR/US STYLE I-IB VEHICLE TOWED TO BLIN TOWED BY GOV HI 44 24 DAMAGE YES NO YES NO REGISTERED OWNER INFO OWNEDBYDRIVER VEHICLE NO,2 SHADE DAGAREA LIABILITY INSURANCE❑ INSURANCE CO STATE FARM 515 9329-E20.47 IN EFFECT &POLICY# t STOP 5 veeiae ❑ ,J—I CITATION# CHARGE t080TTOM LecnLLY YES N`[_ 25 s 7 a OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY J 26 MIRIAM LONG 12790 WA0171300 PAGE 01 OF PART A 3000-345-159(R 11/18) POLIICFETRAFFICN CORRECTION REPORT NO. EF27041 COLLISION REPORT III III III III III 111 1591972 CASE# 24-10800 ADDITIONAL PERSONS INVOLVED(PASSENGERS AND/OR WITNESSES ONLY) 'NAME (LAST,FIRST MIDDLE INTTIAL) ADDRESS&PHONE# SEX' D.O.B. - [----------� MMDDYYYY PASSENGER F-1 WITNESS Ej 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 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. MIRIAM LONG 10-17-24 03:35 PM INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST.DET DATED PLACE SIGNED APPROVED BY E DAT S.WOODWARD 11528 1012212024 5:05:17 AM BADGE OR ID# 12790 ORI# ( WA0171300 TIME POLICE DISPATCHED'; 7:21 AM TIME POLICE ARRIVED 7:26 AM PART B 3 Do-lmx-,ao(Rtrras) PAGE 27 OF 57 REPORT NO.` EF27041 CASE# 24-10800 O COLLI COLLISION TIME OF 10/17/24 07:20 COLLI NARRATIVE 24-10800 Unless otherwise noted, the following occurred in the City of Renton, County of King, WA. On 10/17/2024 at about 0721 hours 1 was dispatched to a collision at UHAUL located at 3131 NE 4TH ST. I arrived at the location and observed Unit #1 blocking the driveway of Renton Collision Center located at 3205 NE 4th St with damage to its front left tire. I observed Unit#2 off the south side of the road where it appeared to have collided with Unit#3, which was on its passenger side. The vehicles appeared to be attached at the front bumper, where there was damage to both vehicles. Unit#3 had damage to the passenger side where it struck Unit #4, which was also off the road. All occupants of the vehicles were walking around and had no obvious injuries. I contacted the driver of Unit#1, who explained that he was the sole occupant of the vehicle and that prior to the collision he was driving east on NE 4th St approaching Monroe Ave N. He said he was in lane two when he decided to switch lanes into the left turn lane to go north on Monroe Ave N. He said just as he was switching lanes, Unit#2 was driving fast up the turn lane and he collided with him, causing Unit#2 to spin out and collide with Unit#3 and Unit#4. 1 contacted the driver of Unit#2, who explained he was the sole occupant of the vehicle and that prior to the collision he was driving east on NE 4th St approaching Monroe Ave N. He said he was in the left turn lane when Unit #1 changed lanes into his vehicle. I contacted the driver of Unit #3, who explained she was driving east on NE 4th St approaching Monroe Ave N just prior to the collision. She said she was in lane one and then all the sudden she was pushed off the road. She said it all happened so fast and she did not see what the cause of the collision was. I contacted the driver of Unit#4, who explained she was driving east on NE 4th St approaching Monroe Ave N just prior to the collision. She said she could not remember if she was in lane one or two when the collision occurred, just that she was pushed off the road and had vehicles on both sides of her. She advised she did not see the cause of the collision. Due to the drivers of Unit#3 and Unit#4 complaining of pain, Renton Fire Department responded to the location and medically evaluated them. Renton Fire Department arrived on scene and medically evaluated all occupants involved. I contacted Renton Collision Center and reviewed surveillance footage. 1 observed Unit#2 colliding with Unit#3, which collided with Unit#4 causing them all to go off the road on the south side of NE 4th in front of Renton Collision Center. The footage did not show the cause of the collision or Unit#4 during the collision. U-Haul advised they have no surveillance cameras facing the street where the collision occurred, and no one onsite witnessed the collision. took photos of both vehicle's and uploaded them Axon with the surveillance footage. All drivers provided me with valid WA DOL license, registration, and insurance. I provided all drivers with an exchange of information and the case number. I was unable to determine the cause of the collision. 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. 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 M Long#12790 on 10/17/2024 @ 1430 hours in Renton WA. PAGE 3 OF 5 SUPPLEMENTAL REPORT No. EF27041 POLICE TRAFFIC 1 1 8 27 COLLISION REPORT CASE#+ 24-10800 1 COMMERCIAL MOTOR CARRIER INTERSTATE INTRASTATE UNIT# USDOT ICC# VEHICLE TYPE CARGO BODY TYPE 2 ❑ 1 1 8 28 CARRIER NAME 3 CARRIER L ADDRESS CITY ST ZIP 4 NAME # PLACARD. GWVR NO NUMBER SOURCE' AXLES ' + NAME IF 4a ❑ ADDITIONAL UNITS MOTOR PEDAL- PROPERTY DAMAGE THRESHOLD MET PHONE UNIT }j� PEDESTRIAN �/ D:2063551389 5 UNIT vT 3 MOTOR � CYCLE C) C� OWNER C]' YES NO p 2930 I NNITIAITIAL ELAST NAME MOLINA FIRST NAME NANCY IL STREET NFW ADDRF. 15148 65TH AVE S,APT 609 CITY TUKWILA ST WA 7JP 98188 6 ❑ 1 1 2 31 CDL IGNITION REQUIRED ':iGNi710N PRESENT MEC7ICALT#NSPORTED: INTERLOCK YES.. NO .:INTERLOCK YEs NO G DRIVER'S STATE wq SEX F D-O'S LICENSE MMDDVYv08 - 29 - 1969 7 ❑ ON DUTY STATUS: AIRBAG 2 RESTR. g EJECT g HELMET 2 INJURY 1 NATUREOFINJURIES USE :GLASS 8 ❑ 1 1 2 32 LICENSE CBU3733 TAT WA VIN# JHLRM4H71CC005945 PLATE# 9 TRAILER TRAILER 2 PLATE# STATE PLATE# STATE 10 ❑ TRLR TRLR VIN.# VIN.R4 11 3 5 VEH.YEAR2012 MAKE HOND MODELCRV STYLE UT VEHICLE TOWE E T ABLIN TOWED BY GOVT.VFHICI F FROM TO DAMAGE YES NO ✓ YES NO REGISTERED OWNER INFONANCY MOLINA 1514865THAVES,APT609 TUKWILA WA 98188 D:2063551389 SHADE IN DAMAGED AREA 7 3 33 12 3 5 476 FROM TO INSURANCE COLIABILITY INSURANCE PROGRESS/VE 964460625 34 IN EFFECT � &POLICY#4 13 vewcEe YES NO CITATION# CHARGEN (� DAMAGE THRESHOLD MET PHONE ❑ 35 14 UNIT# 4 MOTOR PEDAL- ❑ PEDESTRIAN PROPERTY YES NO VEHICLE CYCLE OWNER D:2064667120 2 ❑ 36 15 � LAST NAME ' BROYLES FIRST NAME ELLEN MIDDLE: /tq INITIAL 2 �/ 16 ❑ STREET ❑'. 422 CEDAR AVE S CITY RENTON ST! WA ZIP 98057 NEW AnORE53 GDL IGNITION REQUIRED 1GNI71©N PRESENT MEDICAL TAN SPORTED 17 ❑ INTERLOCK YES NO :INTERLOCK YES NO ,.YES N0:1I ❑ DRIVER'S D.O,B 4 37 18 LICENSE# STATE WA SEX U MMDDVYY 06 - 03 - 1955 2 1 HELMET 2 INJURY,1 NATURE OF INJURIES 38 ON DUTY❑ STATUS AIRBAG RESTR. 9 EJECT USE GLASS 19 ❑ LICENSE I PLATE# CMA7988 TAT WA vIN# 2HGFC4601JH304667 3 39 20 ❑ TRAILER' TRAILER 40 PLATE# STATE STATE PLATE# - 21 ❑ ❑ 41 TRLR TRLR V1N#7 VIN#i 42 22 VEH.YEAR2O18 MAKE HOND MODEL CIVIV STYLE SD VEHICLE TOWED DUET SABLIN TOWED BY GOVT.VEHICLE E DAMAGE YES NO �/ YES NO 11/1 23 REGISTERED OWNER INFO.ELLEN BROYLES 422 CEDAR AVE S RENTON WA 98057 D:2064667120 SHADE IN DAMAGED AREA 43 2 3 NA EFFIECTNSURANCE INSURANCE CO AARP 55PHG459066 _`�:TOF'__ 44 ❑ &POLICY# •___ vFHICEE ❑ ❑ CITATION# CHARGE 70 BOTLOM 24 I..EGALLY YES NO _ ppi�pp STA NG 6`A I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT. MIRIAM LONG 10-17-24 03:35 PM 25 INVESTIGATING OFFICER'S SIGNATURE OFFICER'S PHONE UNIT OR DIST DET DATED: PLACE SIGNED 26 OR ID# 12790 O#RI WA0171300 APWOODtNARD 10%22/202 PAGE OF 3000-345-013(R 11/18) REPORT NO. EF27041 CASE# 24-10800 DATE AND TIME i 10/17/24 07:20 OF COLLISION a : � l r 3 ! ax F f n 1 k � ! }Yi PAGE 5 OF 5