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HomeMy WebLinkAbout24-8782 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 0 27c
COLLISION REP FIT 1591971
SASE 24-8782 2
INTERSTATE ❑ CITY STREET FIRE ❑
RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHICI F ❑ LOCAL AOENC 4200 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 2 TOTAL#OF OBJECT 1 1 8 28
TRIBAL UNITS 03 STRUCK
RESERVATION
z
3❑ DATE OF M M D D Y Y Y Y TIME(2400) COUNTY# MILES N E IN CITY#
COLLISION.. OS - 1-- 2024 1435 17 ❑-= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
LOGAN AVE N
BLOCK NO. e✓ --- ----� ❑
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ ❑ FEET e S ❑ VV e N 6TH ST
0 6 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
✓NO D:3014376988 0 81
30
6� LAST NAME GODO FIRSTNAME NKEDI MIDDLE N 1 1 2 31
INITIAL
STREET ❑ 17701 17TH AVE E CITY SPANAWAY ST WA 2jp, 983871941 z
'NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
iNTERLOCKYEs NO INTERLOCKYEs NO YEs NO
8❑ LRIIVER #
ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 HELMET USE 2 CLASS 1 NATURE OF INJURIES 2❑
3
LICENSE CKM6698 sTArI WAvIN# 1HGCR3F88HA000787
10❑ PI ATE 14
TRAILER STATE TRAILER STATE
11 3 5 PLATE# PLATE# ROM ro
TRLR. TRLR. 5 1 33
12 3 5 VIN#' VIN#
>; FROM TO
VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE 9 9 34
13 2 2017 HOND ACCOR DAMAGE YES NO YES[:] No✓
REGISTERED OWNER INFO NKEDI GODO 1770117THAVEE SPANAWAYWA 98387 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
14 LIABILI INSURANCE INSURANCE CO AMERICAN FAMILY 41097-11136.69 4
IN EFFECT &POLICY# 9TOP
VE—LE CHARGE 5 36
LEGALLY, YES❑NO❑ CITATION# 10 BOTTOM
15❑ STANDIN 7 6
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT 02 VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES NO ,/ D:3663596586
16 a
LAST NAME PRATT FIRST NAME AMY MIDDLE R
INITIAL
17❑ STREET ❑', 23337 114TH PL SE CITY KENT ST WA ZIP 980313430 37
NEW ADDRESS ❑
18� CDL IGNITION REQUIRED IGNITION PtR-E-S1ENT MEDICAL t-T�RANSPORTED ❑ 38
INTERLOCKYES�NOR INTERLOCK YEs I I No� YES t l NO❑
19 D IVEW #
{NJURY NATURE OF INJURIES 40
20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 USE 2 CLASS 1 ❑
21❑ LICENSE I CGK9962 TAre WA vIN1t 3FA6POLU5LR135859
❑ 41
PLATE#
42
22❑ PILER LATE# STATE PLATE# STATE
23❑ 43
TRLR RLR
VIN#. IN#.
VEH YEAR 2020 MAKE FORD MODEL FUSION STYLE VEHICLETOWED TO BLIN TOWEDBY GOV HI 44
L4❑ DAMAGE YES NO YES NO
REGISTERED OWNER INFO AILEEN PRATT 23337114TH PL SEKENTWA98031 VEHICLE NO.2
SHADE IN DAMAGEbAREA
2 3 Cd
LIABILITY INSURANCE I PORGY#ECO STATE FARM 5509081-F11-47-001 1 9TOP
IN EFFECT
V'""LE ❑ ,J� CITATION# CHARGE
25 i o BOTTOM
LEGALLY YES N
$ '
7CA
NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
J
26LAN 12007 WA0171300
PART A PAGE 01 OF
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EF10931
COLLISION REPORT III III III III III 111
1591972 CASE# 24-8782
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'
On August 20, 2024, at 1335 hours, dispatch requested that I respond to a collision that occurred at
Logan Ave N and N 6th St, in the city of Renton.
Upon my arrival I spoke with the driver of unit 2 and he explained he was going northbound on Logan
Ave N when another vehicle in front of him came to an abrupt stop. The driver of unit 2 managed to
bring their vehicle to a stop but was subsequently struck from behind by unit 1.
I then spoke with the driver of unit 1, and he explained he was going northbound on Logan Ave N. He
was following unit 2. They mentioned that unit 2 and another vehicle came to an abrupt stop. Unit 1
locked his wheels to avoid a collision but still slid forward. He tried moving to the right turn lane, but
his vehicle only tilted right and continued to slide. In doing so, he struck unit 3 which was already in
the right turn lane. Unit 1 also struck unit 2's rear bumper.
I then spoke with the driver of unit 3 and they collaborated the same story. They mentioned that all
the vehicles in the through lane came to an abrupt stop. Unit 3 was in the right turn lane, approaching
N 6th St when the collision occurred. As they neared N 6th St, unit 1 struck the side of their vehicle.
All the vehicles sustained moderate damage, so an exchange of information was given to all the
drivers.
I believe that unit 1 was following too closely which was a contributing factor to the collision.
I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT.
C.CATALAN 08-27-24 08:29 AM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
C.JACOBS 1953 1 9/2/2024 12:14:46 PM
BADGE OR ID# 1Y007 ORI# WA0171300 TIME POLICE DISPATCHED; 2:38 Pry TIME POLICE ARRIVED',2:48 PM
PART I PAGE IT]OF 4]
SUPPLEMENTAL REPORT NO. EF10931
r`) POLICE TRAFFIC 1 1 8 27
COLLISION REPORT CASE# 24-8782
1 COMMERCIAL MOTOR CARRIER INTERSTATE INTRASTATE G
UNIT'# USDOT ICC# VEHICLE TYPE CARGO BODY
;TYPE
2 ❑ 1 28
CARRIER
NAME
3 CARRIER
ADDRESS `
CITY ST ZIP—1 I '
4 ❑ NAME # PLACARD: :❑
GI PLACARD IF NO NUMBER
SOURCE AXLES +
4a ❑ ADDITIONAL UNITS
MOTOR PEDAL- PROPERTY DAMAGE THRESHOLD MET PHONE
5 ❑ UNIT# 3 VEHICLE tSJ CYCLE I_) PEDESTRIAN � OWNER � YES� NO
D:2532248684
0 1 29
LAST NAME MAM FIRST NAME CHANMOLY MIDDLE' N
INITIAL
STREET 30
NEW AnDRFSP 36237 23RD PL S CITY FEDERAL WAY ST WA ZIP 1 980038369
6
CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TAN5PORTED 1 1 2 31
INTERLOCK YEs No NTERLOCK YES�NO� YEs N
DRIVER'S
LICENSE STATE I WA SEX F MMDDYYv', 09 - 27 - 1995
7
ON DUTY� STATUS AIRBAG' 2 RESTR. Q EJECT 1 HELMET 2 INJURY 1 1 NATURE OF INJURIES
USE CLASS
8 ❑ 1 32
LICENSE AWE0172 TAr Wq VIN# 1N4AL3AP2DC903219
PLATE#
9 TRAILER TRAILER
PLATE# STATE PLATE# STATE
10 ❑ TRLR TRLR
VIN.#. VIN.#.
11 3 5 VEH.YEAR2013 MAKE NISS I MODELALTIMA STYLE VEHICLE TOWS E T SABLIN TOWED BY anvi vEH1Ci E FROM TO
DAMAGE YES NO YES NO
33
REGISTERED OWNER INFO CHANNY MAM 3623723RD PL S FEDERAL WAY WA 98003 rj 1
12 SHADE IN DAMAGED AREA
7GQ
j4 FROM TO
LIABILITY INSURANCE INSURANCE CO ALL STATE 820 800 720 IN EFFECT &POLICY#VEHICLE 34
CITATION# CHARGE
13 IEGnuv YES NO
STANDING �}
14 ❑ UNIT Tr Vd IRE O CYDCLE OWNERRTY YES AGE NOHRESHOLD MET PHONE ❑ 35
PEDESTRIAN
15 LAST NAME FIRST NAME INITIAL
36
MIDDLE ❑
STREET"[-]
16 NEW nnR CITY ST ZIP
CDL IGNITION REdUiRED IGNITtGN PRESENT MEDICALTANSPORTED
NTERLOCK 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 ❑ 39
LICENSE rnr VIN#
PLATE#
20 ❑ TRAILER' TRAILER El40
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 AREA 43
3 4 71
LIABILITY INSURANCE INSURANCE CO '
VINE
EFFECT &POLICY# i 970P - 4 E:l
44
24 VEHICLE YES❑ NO❑ CITATION# CHARGE iq 60TiOM
LEGALLv
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.
C.CATALAN 08-27-24 08:29 AM
25 INVESTIGATING OFFICER'S SIGNATURE OFFICER'S PHONE UNIT OR DIST DET DATED: PLACE SIGNED
APPROVED BY DATE
26 ORID# 12007 O#I WA0171300 JACOBS 9/2/2024 PAGE F OF 4
3000-345-013(R 11118)
REPORT NO.! EF10931 CASE# ' 24-8782 DATE AND TIME 08/20/24 14:35
OF COLLISION
qt;
i,
PAGE 4 OF 4