HomeMy WebLinkAbout25-1863 iiTFiNII IIIII III IIIII II IIII IIIII I . 27c REPORT NO EF71129oc� RA
COLLISION REPORT 1591971
CASE# 25-1863 2
INTERSTATE CITY STREET FIRE I
RESULTEDSTOLENSTATE ROUTE OTHER VEHICLE LOCCODICENC'Y 4200 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 TOTAL#OF OBJECT 1 s 28
TRIBAL UNITS 02 STRUCK
RESERVATION : 1 1
2
3� M M D D Y Y Y Y TIME(2400) COUNTY# MILES CITY#
eDCL s on' 02 - 28 - 2025 0452 17 =.= S 8 W e OF IN e 1070 s
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
LOGAN AVE N BLOCK NO.
4a❑
MILE POST e
❑ DISTANCE OF(REFERENCE OR CROSS STREET)
5 MILES 1.1 FEET e S 8 W e N 6TH ST
0 4 29
MOTOR ✓ PEDAL- DAM AG THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE ❑ YEs Vl No D:2538867252 0 1 30
5 LAST NAME OLSON FIRST NAME JORDAN MIDDLE S 1 1 2 31
INITIAL
STREET ❑ 4722129THAVEE CITY; EDGEWOOD ST WA ZIP; 98372 2
NEW ADDRESS
7 CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
INTERLOCKYEs NO✓ INTERLOCKVEs NO✓ YES F NO;,/
8❑ DCIENSE# STATE WA SEXI M MMDDYY' 05 - 03 - 1995 1 2 32
-NJUR
9� ON DUTY STATUS' AIRBAG 2 RESTR 9 EJECT 1 HELMET
2 CLASSY 1 [NATURE of INJURIES 2
LICENSE, CGZ3870 STATE WA VIN# KM8KRDAFOPU178806 3
10 Fl I PI ATP#
TRAILER STATE TRAILER STATE
11 3 5 PLATE# PLATE# FROM To
TRLR TRLR. 5 1 7 33
12 3 5 VIN# vIN#
FROM TO
VEH.YEAR ZO23 MAKE HYUN MODEL /ON/Q5 STYLE AT VEHICLE TOWED[n TO ZBLIN TOWED BY GOVT VEHICLE 1 5 34
13� DAMAGE YES II_II NO YESII_I) NO✓
REGISTERED OWNER INFO OWNEDBYDRIVER VEHICLE NO. 1
SHADE IN DAMAGED AREA 35
14❑ LIABILITY INSURANCE ElNSURANCE CO
IN EFFECT &POLICY#
4TOP _
3 4
< 7
srgNOLNG ❑ ❑ 5A0215173 CHARGE OP MOT VEH W/OUT INSURANCE t a ooTro�m z 36
11
Yes NO CITATION#
15
MOTOR ✓ PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT VEHICLE CYCLE nWNFR YES�/ NO D:2069095814
16�
LAST NAME ULRICH FIRST NAME DANIEL MIDDLE' E
INITIAL
17 F1 STREET ❑ 12641 SE 68TH PL CITY BELLEVUE ST, WA ZIP 98006 4 37
NEW ADDRESS ❑
18❑ CDL IGNITION REGlUIREl7 IGNITION PRESENT MEDICAL TRANSPORTED' 38
INTERLOCK YEs No✓ INTERLOCK YES No✓ YEs NO I✓
19 DRIVER'S STATE WA IIj
SEX M D.O.B. 09 20 1968 39
LICENSE# MMDDYY —
20❑ ON DUTY STATUS AIRBAG 2 RESTR 9 EJECT 1 R USE 2 CLASSY 1 NATURE OF INJURIES 40
21 LICEN� ARN1766 rare WA vIN# 2CNBJ13C1Y6941795 41
PLATE22❑ PLATE# STATE PLATE# STATE 42
23 TRLR RLR 43
UIN#. 'IN#
VEH.YEAR 2000 MAKE CHEV MODEL TRACKS STYLE UT VEHICLE TOWED TO BLIN
TOWED BY GOV HI 44
24 DAMAGE YES NO✓ VES NO✓
REGISTERED OWNER INFO DANIEL ULRICH 12641 SE 68TH PL BELLEVUEWA 98006 D:2069095814 VEHICLE NO.2
SHADE IN DAMAGED AREA
2 3 4
LIABILITY INSURANCE INSURANCE CO COSTCO CONNECT A103820714
IN EFFECT &POLICY# I
VEEGaEE L—J
CITATION CHARGE
25 EwEY ❑ UOo
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
26
MIRIAM LONG 12790 WA0171300
PAGE 01 OF
PART A 3000-348-189(R 11/18)
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EF71129
COLLISION REPORT III III III III III 111
1591972 CASE# 25-1863
ADDITIONAL PERSONS INVOLVED(PASSENGERS AND/OR WITNESSES ONLY)
'.NAME
(LAST,FIRST,MIDDLE INITIAL)
ADDRESS&PHONE
SEXi D.O.B. —
MMDDYYYY
PASSENGERQ WITNESS� UNIT SEAT AIRBAG RESTR. EJECT ; HELMET INJURY NATURE OF INJURIES
POS. ' USE CLASS 1 ----�
:NAME
(LAST FIRST MIDDLE INITIAL)
ADDRESS&PHONE#
SEX D.O.B. —
MMDDYYYY
PASSENGER❑WITNESS UNIT# : SEAT AIRBAG RESTR. EJECT HELMET INJURY: NATURECFINJURIES
POS. USE CLASS ----�
:NAME
(LOST,FIRST,MIDDLE INITIAL)
ADDRESS&PHONE#
SEX MMDDYY D.O.B.
YY
PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET NJURY NATURE OF INJURIES
PC& I 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.
MIRIAM LONG 02-28-25 06:45 AM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST.DET DATED PLACE SIGNED
APPROVED BY DATE
S.WOODWARD 11528 3/5/2025 4:43:56 AM
BADGE OR ID# 12790 ORI# WA0171300 TIME POLICE DISPATCHED 4:52 AM TIME POLICE ARRIVED i 4:52 AM
PAST B 3 Do-lmx—attar(t 1Mff) PAGE 2�OF 4
REPORT NO. EF71129 CASE# 25-1863 OF DATE AND r�N + 02/28/25 04:52
O�COLLISION
NARRATIVE
Unless otherwise noted, the following occurred in the City of Renton, County of King, WA.
On 2/28/2025 at about 0453 hours I responded to a collision at N 6th St/Logan Ave N.
I arrived at the location and observed both units were blocking eastbound traffic on N 6th St and
south bound traffic on Logan Ave N. Unit#2 had a large dent on the driver side, and Unit#1 had
damage to the front end of the vehicle.
I contacted the involved parties, who were walking around and had no obvious injuries. There, I
collected the involved parties driving documents and the independent recollection of events leading
up to the collision.
The driver of Unit#1 (Jordan) said he was the sole occupant of the vehicle and that prior to the
collision he was in the left turn lane on Logan Ave N and had a green light to turn left onto N 6th St.
Unit#1 advised he proceeded to turn left and that is when he struck Unit#2, who was driving
southbound through the intersection.
The driver of Unit#2 (Daniel) said he was the sole occupant of the vehicle and that prior to the
collision he was driving south on Logan Ave N approaching N 6th St. He advised he had a green light
and proceeded through the intersection and that is when he was struck on the driver side of his
vehicle by Unit#1, who was northbound on Logan Ave N in the left turn lane prior to the collision.
Based on the above statements, I determined that the Driver of Unit#1 (Jordan) is the proximate
cause for the collision due to not granting the right of way during a left turn causing a collision. The
driver of Unit#1 violated RCW 46.61.185(1) by being the driver of a vehicle intending to turn to the
left within an intersection and not yielding the right-of-way to any vehicle approaching from the
opposite direction which is within the intersection or so close thereto as to constitute an immediate
hazard. The driver of Unit#1 (Jordan) did not grant the right of way to Unit#2 traveling in the roadway
which had the right of way and was already underway. Due to Unit#1 having to traverse across
oncoming traffic, the driver of Unit#1 must wait until the intersection is clear of hazard prior to
proceeding.
I cited the driver of Unit#1 via mail for violating RCW 46.30.020-Liability Insurance as no person may
operate a motor vehicle subject to registration under chapter 46.16A RCW in this state unless the
person is insured under a motor vehicle liability policy with liability limits of at least the amounts
provided in RCW 46.29.090, is self-insured as provided in RCW 46.29.630, is covered by a certificate
of deposit in conformance with RCW 46.29.550, or is covered by a liability bond of at least the
amounts provided in RCW 46.29.090. Proof of financial responsibility for motor vehicle operation
must be provided on the request of a law enforcement officer in the format specified under RCW
46.30.030
Both involved vehicles had to be towed due to extensive damage. An exchange of information was
provided to all involved parties.
I certify (declare) under penalty of perjury under the laws of the state of Washington that the foregoing
is true and correct.
Electronically signed by M Long#12790 on 2/28/2025 @ 0622 hours in Renton WA.
PAGE 3 OF 4
REPORT NO. EF71129 CASE# 25-1863 DATE AND TIME 02/28/2504:52
OF COLLISION
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PAGE 4 OF 4