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HomeMy WebLinkAbout24-12335 POLICETRAFF'c" III !�� I IIIllI111IN II II I REPORT NO. EF40978 170
27
COLLISION REP FIT 1591971
CASE 24-12335 z
INTERSTATE ❑ CITY STREET FIRE ❑RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHIC;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'. 11 - 1-— 2024 1138 17 ❑.= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓
S 2ND ST BLOCK e✓ 200
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ 232 00 FMILES EET e S ❑ E e LAKEAVES
0 4 29
MOTOR PEDAL- DAM THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El YES NO �/ D:2062283891 0 11
30
6� LAST NAME RAVENSCROFT FIRSTNAME JOE MIDDLE C 1 1 2 31
INITIAL
STREET ❑, 737 NE NORTHLAKE WAY CITY SEATTLE ST WA 2jp, 98105 z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
1/ I iNTERLOCKYEs NO NTERLOCKYEs NO�/ YES R No�/
8❑ LRIIVER #
ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 H USE 2 1 CLASS NATURE OF INJURIES z❑
3
LICENSE CCM0262 STATE WA u N# 5N1AN08W97C511466
10 9❑ Pr ATE�
11[-j- TRAILER STATE TRAILER STATE
11 3 5 PLATE# PLATE# 1R.. ro
TRLR. YRLR. 3 5 33
12 3 5 VIN#j VIN#
FROM TO
VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE 3 ] 34
2007 NISS XTERRA SV DAMAGE YES NO YES[:] NO✓
13 1
REGISTEREDOWNERINFO OWNEDBYDRIVER VEHICLE NO. 1
SHADE IN DAMAGED AREA ❑ 35
14 LIABILI INSURANCE INSURANCE CO PEMCO CA1121307 3 4
IN EFFECT &POLICY# 9TOP
VEHICLe CHARGE 1 5 36
LEGALLY YES No CITATION# 4A0896059 IMPROPER LANE USAGE 10 aorrom
15❑ STANDING 6
MOTOR PEDAL- PROPERTY DAM THR OLD MET PHONE
UNIT 02 ❑✓ ❑ PEDESTRIAN ❑ ❑ D:2062341733
VEHICLE CYCLE '. OWNER YES�/ NO
16 a
LAST NAME HUYNH FIRST NAME PHUC MIDDLE Q
INITIAL
17 STREET I❑ s❑' 15242 29TH AVE S CITY SEATAC ST WA ZIP 98188 4❑ 37
NEW ADDREs
18❑ CDL IGNITION REQUIRED IGNITION PtR-E-S1ENT MEDICAL-T�RANSPORTED � 38
INTERLOCKYES�NO� INTERLOCK YEs I I NOF YES t l NOF,/
19 DRIVER'S STATE WA SEX M D.O.B. 09 _ O6 _ 1965 39
LICENSE# MMDDYY
20❑ ON DUTY STATUS I
AIRBAG 2 RESTR 4 EJECT 1 H U EET 2 NJAURSY 1 NATURE OF INJURIES 40
❑LICENSE 21❑ PLA E# CBV7090 TATE WA VIN 1t 2T2BGMCA8GC001537 41
1
42
22❑ PILER LATE# STATE pLATE# STATE
23❑ VIN#. 43
TRLR RLR
'IN#.
TOWED BV Gov HI 44
VEH YEAR 2016 MAKE LEX$ MODEL RX450H STYLE $V —FEHICLE
TOWED✓ NOO BLIN GENE MEYERS YES No�/
24❑ REGISTERED OWNER INFO OWNED BY DRIVER VEHICLE N0.2
SHADEDAMAGEDAREA
3 4
LIABILITY
INSURANCE &POINSURGY#ECO STATE FARM 5047171 F1047IN CQVEHICLE
❑ C—I CITATION# CHARGE io
LEGALLY YES N`LJ
25
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# JAGENCY
26
ROBIN SMITH 12986 WA0171300
PART A PAGE 01 OF C7
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EF40978
COLLISION REPORT III III III III III 111
1591972 CASE# 24-12335
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.
ROBIN SMITH 11-29-24 01:14 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
P.KORDEL 9676 1112912024 2:09:04 PM
BADGE OR ID# 9Y988 OR]# WA0171300 TIME POLICE DISPATCHED 11:46 AM TIME POLICE ARRIVED',11:50 AM
PART I PAGE IT]OF 4�
REPORT NO. EF40978 CASE# 24-12335 OF COLLISION
11/29/24 11:38
OF CbLLI510N
NARRATIVE
24-12335
On 11/29/2024 at approximately 1146 hours, I was dispatched to a blocking no injury two vehicle
collision in the 200 block of S 2nd ST, within the City Limits of Renton, County of King, State of
Washington.
Upon my arrival, 1 confirmed there were no complaints of injury from any of the involved parties. 1
collected each of the involved party's information and their independent involvement leading up to the
collision. I requested a tow respond for Unit#2 because it was not drivable.
The driver of Unit#1 stated he was the sole occupant of his vehicle and that he was traveling
westbound in the 200 block of S 2nd ST in lane 2 of 4. The driver of Unit#1 says he attempted to pull
into the driveway of the Safeway parking lot on the south side of S 2nd ST from lane 2 of 4 when he
struck Unit#2 who was traveling westbound on S 2nd ST in lane 1. He stated he did not see Unit#2
and that is why he collided.
The driver of Unit#2 stated he was the sole occupant of his vehicle and that he was traveling
westbound in the 200 block of S 2nd ST in lane 1 of 4. He was continuing past the entrance to the
Safeway parking lot on the south side of S 2nd ST when Unit#1 attempted to turn into the parking lot
entrance from lane 2, colliding with him.
Unit#2 sustained passenger side front end damage when Unit#1 turned into Unit#2. Unit#1
sustained driver side front end damage from the collision. Unit#2 had to be towed due to extensive
damage. Unit#1 was able to be driven away without further incident. An exchange of information was
provided to all involved parties.
Based on the above statements, 1 determined that the driver of Unit#1 was the predominant factor for
the collision due to violating RCW 46.61.140, which states: "A vehicle shall be driven as nearly as
practicable entirely within a single lane and shall not be moved from such lane until the driver has first
ascertained that such movement can be made with safety."
I cited the driver of Unit#1 by mail for RCW 46.61.140 for attempting to turn into a parking lot from
lane 2 of 4 instead of utilizing lane 1 for the turn. If the driver of Unit#1 had safely checked to see if
lane 1 was clear before proceeding into the Safeway parking lot, a collision could have been avoided.
Sector citation #4A0896059.
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 R. Smith #12986 11/29/2024 @12:46 Renton, King County, WA.
PAGE 3 OF 4
REPORT NO. EF40978 CASE# ' 24-12335 DATE AND TIME 11/29/24 11:38
OF COLLISION
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