HomeMy WebLinkAbout24-10971 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 0 27c
COLLISION REP FIT 1591971
SASE 24-10971 2
INTERSTATE ❑ CITY STREET FIRE ❑
RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHIC;I F ❑ LOCAL AGENC 4200 3
HIT 8 RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 3 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.. 10 - 1-- 2024 1738 17 ❑-= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
SOUTH 43RD STREET BLOCK ST e✓
MILEPOST 200 ❑
4a❑
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ ❑ FEET e S ❑ VV e SR-167 NB RAMP
0 1 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
,/No D:2063495030 0 81
30
6� LAST NAME MARLOTTY FIRSTNAME DONALD MIDDLE E 1 1 2 31
INITIAL
STREET ❑ 9622 S 178TH ST CITY RENTON ST WA ZIP 980555729 z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
INTERLOCK YES[:]NO INTERLOCKYEs NO YES R NO
8❑ LRIIVER #
ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 H USEET ICNLJAUSSY 1 NATURE OF INJURIES z❑
3
10❑ P1 aT�S� BHY7575 sTATI WAurN# 5N1AT2MV9FC810971
TRAILER STATE TRAILER STATE
11 3 5 PLATE# PLATE# FROM TO
TRLR. TRLR 3 7 33
12 3 5 VIN#' VIN#
>; FROM TO
VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE J 9 34
13 3 2015 NISS ROGUE SV DAMAGE YES NO YES[:] No✓
REGISTERED OWNER INFO BEVERLY.RL019622S S 178THST RENTON WA 98055 D:2063495030 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
14� LIABILITY INSURANCE INSURANCE CO ALLSTATE 807 209 691 �BOTTOM
IN EFFECTPOLICY#VEHICLE CHARGE 36
ALLY YES❑NO CITATION# 4A0612156 FOLLOW VEHICLE TOO CLOSELY 6
15❑ STANDING 8 7 6
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM1/ THR OLD MET PHONE
UNIT VEHICLE ❑ CYCLE' ❑ ❑ OWNER ❑ YES NO D:2066195595
16 a
LAST NAME GARCIA ROJAS FIRST NAME GUADALUPE MIDDLE
INITIAL
17❑ STREET ❑', 20014 13TH AVE S CITY SEATAC ST WA ZIP 981983368 37
NEW ADDRESS ❑
18� CDL IGNITION REQUIRED IGNITION PtR—E—S1ENT MEDICAL TRANSPORTED ❑ 38
INTERLOCKYES�NOR INTERLOCK YEs I I NOF YEs t l NO❑
19 DRIVER #
USE ET INJURY 7 C/O NECK PAIN.DECLINED RRFA EVAL ❑[-�A—TURE OF INJURIES 40
20❑ ON DUTY STATUS AIRBAG,2 RESTR 4 EJECT 1
21❑ LICENSE BCA7823 TATe WA VIN# 1C4RJFAGXGC462447
El41
PLATE#
42
22❑ PLATE# STATE PLATE# STATE
TRLR
23❑ UIN#. IN#.
43
RLR
'
VEH YEAR 2016 MAKE JEEP MODEL GRAND STYLE SI/ VEHICLETOWED TO BLIN TOWEDBY GOV HI �44
24❑ DAMAGE YES NO YES NO
REGISTERED OWNER INFO CARLOS BLANCO 2001413TH AVE S SEATACWA98198 D:2066195595 VEHICLE NO.2
SHADE IN DAMAGEbAREA
2 3 Cd
LIABILITY
INSURANCE 8 POINSURGY#E CO GEIC04313-17-54-26IN 1 9TOP
'E""LE CITATION# CHARGE
LEG
25 i o BOTTOM
ALLY YES N�
❑ s
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# 7AGENCY
26
MATTHEW NUGENT 11498 WA0171300
PART A PAGE 01 OF C7
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EF27715
COLLISION REPORT III III III III III 111
1591972 CASE# 24-10971
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.
MATTHEW NUGENT 10-22-24 02:14 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
CO.JOHNSON 0505 1012312024 2:12:24 PM
BADGE OR ID# 11498 ORI# WA0171300 TIME POLICE DISPATCHED! 5:43 PM TIME POLICE ARRIVED',5:53 PM
PART I PAGE IT]OF 4�
TIME
REPORT NO. EF27715 CASE# 24-10971 OF COLLISION10/21/24 17:38
NARRATIVE
24-10971
On 10/21/2024 at approximately 1743 hours, I was dispatched to a two-vehicle collision in the 200
block of South 43rd Street (JEO SR-167 NB Ramps), within the City Limits of Renton, County of King,
State of Washington.
Upon arrival, I contacted the involved parties and confirmed no injuries had occurred requiring
immediate medical response at the time of report. There, I collected the involved parties driving
documents and their independent recollection of events leading up to the collision.
The driver of Unit#1 said he was the sole occupant of his vehicle and was traveling westbound in
about the 200 block of S. 43rd ST just east of the intersection of SR-167 NB On/Off-Ramps in lane 3
of 3. The driver of Unit#1 stated he was traveling directly behind Unit#2 and saw as Unit#2 had
come to a stop at the stop-light controlled intersection. The driver of Unit#1 stated that due to the wet
and rainy road conditions, Unit#1 simply was unable to stop in time and subsequently collided with
the rear of Unit#2 causing moderate damage to the front of Unit#1.
The driver of Unit#2 said she was the sole occupant of her vehicle and was also traveling westbound
in about the 200 block of S. 43rd ST just east of the intersection of SR-167 NB On/Off-Ramps in lane
3 of 3. While Unit#2 was stopped at the controlled intersection, Unit#1 collided with the rear of Unit
#2 causing moderate damage to the rear of Unit#2.
The driver of Unit#1 (Marlotty) was following the vehicle in front of him too closely violating RCW
46.61.145. RCW 46.61.145 states that the driver of a motor vehicle shall not follow another vehicle
more closely than is reasonable and prudent, having due regard for the speed of such vehicles and
the traffic upon and the condition of the highway.
Based on the above statements, 1 determined that the Driver of Unit#1 (Marlotty) is the proximate
cause for the collision due to following too closely causing a collision.
I cited Marlotty via mail for Following Too Closely. Both Unit#1 and Unit#2 were able to be driven
away without further incident. An exchange of information was provided to all involved parties.
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 M. Nugent#11498 11:53 AM 10/22/2024 Renton, King County,
WA.
PAGE 3 OF 4
REPORT NO. EF27715 CASE# ' 24-10971 DATE AND TIME 10/21/24 17:38
OF COLLISION
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PAGE 4 OF 4