HomeMy WebLinkAbout24-11080 POLICETRAFF'c" III !�� I IIIllI111IN II II I REPORT NO. EF28936 170
27
COLLISION REP FIT 1591971
SASE 24-11080 2
INTERSTATE ❑ CITY STREET FIRE ❑
RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHIr.I F ❑ LOCAL AOENC 4Y00 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 1 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 1345 17 ❑-= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
S GRADY WAY BLOCK NO. e✓ ----� ❑
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ ❑ FEET e S ❑ W e RAINIER AVE S
0 4 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
NO F,/ I D:2063076514 0 81
30
6❑ LAST NAME ALl FIRSTNAME SEYIFUDINE MIDDLE J 1 2 31
INITIAL
STREET ❑ 14577 NE 35TH ST APT B311 CITY BELLEVUE ST WA 2jp, 98007 z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
iNTERLOCKYEs NO 1/ INTERLOCKYEs NO�/ YES R No�/
8❑ LDRIVER # STATE WA SEX'M MID
LOB 09 1— 02 — 1975 2 32
9 ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 HELMET
2 CLASS 1 NATURE OF INJURIES z❑
3
10❑ P1 aT�S� D05607F sTATI IN vIN# 4V4N99EH5HN974106
TRAILER 7254FP STATE OK TRAILER STATE
11 3 5 PLATE# PLATE# FROM TO
TRLR TRLR 5 7 33
12 3 5 vIN# LJRC5426571002668 YIN#'
FROM TO
VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE J 9 34
13 2 2017 VOLT VN SE DAMAGE YES NO YES❑ NO✓
REGISTERED OWNER INFO OWNEDBYDRIVER VEHICLE NO. 1
SHADE IN DAMAGED AREA ❑ 35
14� LIABILITY INSURANCE❑ INSURANCECO GREAT WEST CASUALTY COMPANYMCP75052C 3 4
IN EFFECT &POLICY# 9TOP
15❑ LE
vECALLv Hla.e 5 36
res❑NO❑ CITATION# CHARGE 10 BOTTOM
STANDING 8 7 6
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT 02 VEHICLE ❑ CYCLE ❑ ❑ OWNER [:]EA.
YES 1/ NO D:4255590679
16 a
LAST NAME LIU FIRST NAME BINGLIN MIDDLE N
INITIAL
17❑ STREET Z 2018 ROLLING HILLS AVE SE C{TY' RENTON ST Wq Zlp 98056 37
NEW ADDRESS ❑
18� CDL IGNITION REQUIRED IGNITION PRESENT MEDICALt—T�RANSPORTED ❑ 38
INTERLOCK ES❑No� INTERLOCK YEs I I NoF YEs t l NOz
19[ LDI IVEW # STATE WA SEX M M D.C.B.
08 _ 14 2002 39
WELMET {NJURY NATURE OF INJURIES 40
20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 USE 2 CLASS 1 ❑
21❑ LICENSE I CLF5461 rare.WA vlN. 5TDZA22C46S462705
❑ 41
PLATE#
42
22❑ PILER LATE# STATE pLATE# STATE
23❑ 43
TRLR RLR
VIN#. IN#.
GI
VEH YEAR 2006 MAKE 7'Oy7' MODEL SIENNA STYLE VN DEHICLE AMAGE TOWED✓ TOO BLIN TOWED BY ov HYES NO 1/ 44
24❑ REGISTERED OWNER INFO OWNED SY DRIVER VEHICLE N0.2
SHADEDAMAGED AREA
3 4
LIABILITY
INSURANCE INSU&PORGY#E CO pROGRESSIVE 980445273IN STOP 5
vE""LE LEGAL CITATION# CHARGE to BOTTOM
25 LY YES Nu
❑ J a
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
26
HUNTER DEIGHAN 13030 WA0171300
PART A PAGE 01 OF
3000-345-159 fR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EF28936
COLLISION REPORT III III III III III 111
1591972 CASE# 24-11080
ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY)
NAME MIDDLE INITIAL) HOLMES MARGARETJ
(LAST FIRST,
ADDRESS&PHONE# D O.B. '
7918 S LAKRIDGE DR SEATTLE WA 98178 2062931571 SEXi F MMDOYyry 02 - 24 - 1954
PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT ' HELMET INJURY NATURE OF INJURIES
�✓ POS. USE CLASS
NAME
'(LAST,FIRST MIDDLE INITIAL)
ADDRESS&PHONE# DOB
SEX MMDDYYYY
PASSENGER ❑WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET NJURY 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.
HUNTER DEIGHAN 10-24-24 04:02 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
P.KORDEL 9676 1012712024 10:52:28 AM
BADGE OR ID# 13030 OR]# WA0171300 TIME POLICE DISPATCHED 1:46 PM TIME POLICE ARRIVED 1:48 PM
PART I PAGE IT]OF 5�
REPORT NO. EF28936 CASE# 24-11080 OF COLLISION
10/24/24 13:45
OF CbLLI510N
NARRATIVE
24-11080
On 10/24/2024 at approximately 1326 hours, I was dispatched to a vehicle collision with unknown
injury at the intersection of S Grady Way and Rainier Ave S, within the City Limits of Renton, County
of King, State of Washington.
Upon my arrival, I noticed a Toyota mini-van facing eastbound on S Grady Way in the left turn lane.
The vehicle was slightly canted to the left and I could see damage to the front left side of the vehicle
and debris in the road behind the solid white line. There was a semi truck parked in westbound lane 1
on S Grady Way.
The driver of Unit#1 stated that he was the sole occupant of his vehicle and that prior to the collision
he was traveling northbound on 167 N as it turns into Rainier Ave S approaching the controlled
intersection of S Grady Way in the left-turn lane. The driver of Unit#1 said he had a green left turn
arrow and proceeded through the intersection headed west on S Grady Way. The driver of Unit#1
stated that the mini van that he collided with was driving eastbound on S Grady Way. The driver of
Unit#1 said the mini van seemed farther away before he turned and that when he turned it was
closer. The driver of Unit#1 said that Unit#2 drove into that back left side of his trailer as he went
through the intersection.
The driver of Unit#2 said he was the sole occupant of his vehicle and was traveling eastbound on S
Grady Way approaching the controlled intersection of Rainier Ave S in the left turn lane. The driver of
Unit#2 stated he came to a complete stop as he had a red light and was waiting to head north on
Rainier Ave S. The driver of Unit#2 stated that as he was stationary a semi truck was turning west on
S Grady Way. The trailer of the semi truck struck the front of his vehicle as it was turning.
Neither driver was injured. A woman who identified herself as Margaret J. Holmes (02/24/1954) was
stopped next to Unit#2 in eastbound lane 2 of S Grady Way said she witnessed the accident. She
said Unit#2 was fully stopped behind the white line of the left turn lane and that Unit#1 turned into
Unit#2.
Based on the above statements, I determined that the Driver of Unit#1 is the proximate cause for the
collision due to improperly turning too sharply left.
Unit#1 had to be towed by Gene Meyers Towing due to extensive damage to the front of the vehicle.
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 H. Deighan #13030 3:53 PM 10/24/2024 Renton, King County, WA.
PAGE 3 OF 5
SUPPLEMENTAL REPORT NO. EF28936
r`I POLICE TRAFFIC 1 27
COLLISION REPORT CASE# 24-11080
1 COMMERCIAL MOTOR CARRIER INTERSTATE ✓ INTRASTATE G
UNIT# 1 USDOT 3712463 ICC# 0 VEHICLE TYPE 6 CARGO BODY 3
TYPE
2 ❑ 1 28
CARRIER
NAME GALICHUU TRANSPORT SYSTEM
.......
3 CARRIER
ADDRESS 1519 SW 308TH ST
CITY FEDERAL WAY ST WA ZIP'', 98023
4 ❑ NAME # PLACARD: :❑
SOURCE 3 AXLES 05 GwvR 68000 + NAME IF NO NUMBER
4a ❑ ADDITIONAL UNITS
MOTOR PEDAL- PROPERTY DAMAGE THRESHOLD MET PHONE
5 ❑ UNIT# VEHICLE I_J CYCLE _) PEDESTRIAN � OWNER � YES NO
i MIDDLE'... 29
LAST NAME FIRST NAME INITIAL
STREET 30
NFW AnnRFrtP. CITY ST ZIP
6
CDL GNITIttN REQUIRED GNITION PRESENT MEDICAL TANSPORTED 1 31
INTERLOCK YES No INTERLOCK YES❑N0� vES N
LLIICIENSE STATE I SEX M��DYRYY' 2
7 F-1
ON DUTYl STATUS AIRBAG' RESTR. EJECT HELMET INJURY NATURE OF INJURIES
USE CLASS
8 ❑ ' 1 32
LICENSE+ rar VIN.#
PLATE#
9 TRAILER TRAILER
PLATE# STATE PLATE# STATE
10 ❑ TRLR TRLR
VIN.#. VIN.#.
11 VEH.YEAR MAKE MODEL STYLE VEHICLE TOWS T SABLIN TOWED BY anvi vEHIG P FROM TO
DAMAGE Y EES NO YES NO
REGISTERED OWNER INFO. m 33
12 SHADE IN DAMAGED AREA
FROM TO
LIABILITY INSURANCE❑ INSURANCE CO
IN EFFECT &POLICY# tGQ
EHICLE 34
13 ❑ LEGALLY YES[:] NO❑ CITATION# CHARGE
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 ❑ 36
STREET
16 NFln+AnntxFs.� CITY'. ST 21P
CDL IGNITION REDUIRED IGNITION PRESENT MEDICALTANSPORTED
INTERLOCK YES No INTERLOCK 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 (CLASS
19 ❑ vIN 39
LICENSE #
PLATE# rnr
20 ❑ TRAILER TRAILER ❑ 40
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 3 4 4 AREA F 43
z
LIABILITY INSURANCE INSURANCE CO '
VINE
EFFECT &POLICY# i 970P - 4 E:l
44
24 LEwGLE YES❑ NO❑ CITATION# CHARGE iq 60TiOM
C=DLv
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.
HUNTER DEIGHAN 10-24-24 04:02 PM
25 INVESTIGATING OFFICER'S SIGNATURE OFFICER'S PHONE UNIT OR DIST DET DATED: PLACE SIGNED
APPROVED BY 026 � BADGE O#IIWA0171300 12 PAGE OF
3000-345-013(R 11118)
REPORT NO. EF28936 CASE# ' 24-11080 DATE AND TIME 10/24/24 13:45
OF COLLISION
� I
a. Yi
k 1 4
silk
t�
ti
it 2
e �
n
i
t 4
3
S
c,
L
PAGE 5 OF 5