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HomeMy WebLinkAbout24-11568 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 1 27c COLLISION REP FIT 1591971 SASE 24-11568 2 INTERSTATE ❑ CITY STREET FIRE ❑ RESULTED 1 STOLEN STATE ROUTE ❑ OTHER ❑ VFHIr.I F ❑ LOCAL AOENC 4900 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# ❑ cowsloN 11 - 1-- 2024 1437 17 ❑.= S 8 IN e 1070 3 4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓ RAINIER AVE SOUTH BLOCK NO. e✓ 100 4a❑ MILEPOST DISTANCE OF(REFERENCE OR CROSS STREET) 5❑ 380 00 FEET e S B W e AIRPORT WAY 0 1 29 R PEDAL- DAMAGE THRESHOLD MET PHONE UNIT 01 VEHICLE ❑ CYCLE ❑ YES ✓NO D:2068981043 0 11 30 6� LAST NAME WHITE FIRSTNAME MELVIN MIDDLE L 1 1 2 31 INITIAL STREET ❑ 1620 12TH AVE APT 404 CITY SEATTLE ST WA 2jp, 981222568 z NEW ADDRESS 7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3 iNTERLOCKYEs NO INTERLOCKYEs NO YES R NO 8❑ LRIIVER # STATE WA SEX'M MI D Y' 07 - 15 - 1983 1 2 32 9 ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 H USEET ICNLJAURY 1 NATURE OF INJURIES 2❑ 3 10 9❑ P1 aT�S� D62266E sTArI WAVIN# 3GNFK12357G281727 TRAILER STATE TRAILER STATE 11 3 5 PLATE# PLATE# FROM TO TRLR. TRLR. 5 1 33 12 3 5 VIN#' VIN# >; FROM TO VEH.YEAR 2007 CHEV AVALAN PK MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE 5 1 34 13 4 DAMAGE YES NO YES[:] NO✓ REGISTERED OWNER INFO MELVIN WH/TE 111112THAVEAPT404 SEATTLE WA 98122 D:2068981043 VEHICLE NO. 1 ❑ ❑ SHADE IN DAMAGED AREA 35 14 LIABILITY INSURANCE[Z INSURANCE CO GEICO 6157-02.90.98 3 4 IN EFFECT &POLICY# 9TOP VEwcLe 1 5 36 LEGALLv res❑NO❑ CITATION# CHARGE BOTTOM 15❑ STANDING 7 6 MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE UNIT VEHICLE ❑ CYCLE ❑ ❑ 16 a OWNER ❑ YES 1/ NO D:2064227779 LAST NAME YOWSON FIRST NAME TANIA MIDDLE INITIAL 17❑ STREET ❑', 7421 S 127TH ST CITY' SEATTLE ST WA ZIP 981784308 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 F] LDI IVER # STATE WA ]SEX IF M D.C.B. 11 22 _ 1963 El 39 20� ON DUTY STATUS AIRBAG,2 RESTR 4 EJECT 1 HE MEET LAU SY 6 [-�A—TUREOF INJURIES C/O DIFFICULTY BREATHING.EVAL'D BY RRFA 40 21❑ LICENSE I DP83332 TArE WA VIN# 5J6YH28676L005679 ❑ 41 PLATE# 42 22❑ PLATE# STATE PLATE# STATE TRLR 23❑ UIN#. IN#. 43 RLR ' roweD By Gov H 44 VEH YEAR 2006 MAKE HOND MODEL ELEMENT STYLE SV DAMAGE TOWED✓ NOO BLIN TOWEDB YERS YES N.7 24❑ GENE REGISTERED OWNER INFO OWNED SY DRIVER VEHICLE N0.2 SHADEDAMAGEDAREA 3 4 LIABILITY INSURANCE INSUry�—I� &PORGY#E CO PROGRESSIVE 920131312IN STOP vewcLE CITATION# CHARGE BOTTOM LEGALLY YES N 25 s � a =UGENT PRINT) OFFICER PHONE BADGE OR ID# AGENCY 26 11498 WA0171300 PART A PAGE 01 OF C7 3000-345-159 OR 11/181 STATE OF POLICETRAFFICN CORRECTION REPORT NO. EF36706 COLLISION REPORT III III III III III 111 1591972 CASE# 24-11568 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 POS. 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 11-09-24 02:14 PM INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED APPROVED BY E DAT C.JACOBS 1953 1111812024 10:12:16 AM BADGE OR ID# 11498 ORI# WA0171300 TIME POLICE DISPATCHED 2:39 PM TIME POLICE ARRIVED',2:42 PM PART I PAGE IT]OF 4� REPORT NO. EF36706 CASE# 24-11568 OF COLLISION 11/07/24 14:37 OF CbLLI510N NARRATIVE 24-11568 On 11/07/2024 at approximately 1439 hours, I was dispatched to a non-blocking vehicle collision with reports of injury in the 100 block of Rainier Avenue South, within the City Limits of Renton, County of King, State of Washington. While en route, Dispatch advised that the collision occurred on Rainier Avenue South (JSO Airport Way), and that both parties had pulled into the parking lot of a McDonald's restaurant to wait for police contact. Upon my arrival, 1 confirmed that one of the involved parties (driver of Unit#2) was complaining of injury at the time of report, specifically that she had difficulty breathing following the collision therefore I requested the Renton Regional Fire Authority (RRFA) respond for evaluation. RRFA later responded and treated/released all involved parties at the scene. While on scene, I collected the involved parties driving documents and their independent summary of the collision. The driver of Unit#1 stated that he and his adult passenger were traveling northbound in about the 100 block of Rainier Ave S approaching the intersection of Airport Way in lane 2 of 3. The driver of Unit#1 stated that he was intending to turn west at the intersection of Airport Way. The driver of Unit #1 stated that while traveling north, Unit#2 came into his lane and contacted his front driver's side wheel, bumper, and fender. Unit#1 suffered minor damage and believes that Unit#2 came into his lane causing the collision. The driver of Unit#2 said she was the sole occupant of her vehicle and was also traveling northbound on Rainier Ave S approaching the intersection of Airport Way, but in lane 3 of 3. The driver of Unit#2 stated she saw Unit#1 in the adjacent lane of travel, specifically in lane 2 of 3. The driver of Unit#2 stated that upon continuing in her lane of travel, Unit#1 started to come over into her lane of travel and subsequently striking the front passenger side quarter panel of Unit#2 causing moderate damage. No witnesses were immediately available at the scene. I checked the nearby traffic cameras which were pointed to the east therefore the collision was not captured due to being out of frame. Based on the above statements, I was not able to determine the proximate cause for the collision. Both drivers claim that the other involved party came into their respective lanes of travel. I told both involved parties to contact their respective insurance companies for filing. Unit#1 was able to be driven away without further incident. Unit#2 had to be towed due to extensive damage. 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 11/9/2024 2:03 PM Renton, King County, WA. PAGE 3 OF 4 REPORT NO. EF36706 CASE# ' 24-11568 DATE AND TIME 11/07/24 14:37 OF COLLISION i i } f \' p I PAGE 4 OF 4