HomeMy WebLinkAbout22-13524 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 6 27c
COLLISION REP FIT 1591971
CASE 22-13524 z
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#
COLLISION'. 12 - 1-- 2022 1337 17 ❑-= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
BENSON DR S BLOCK NO. e✓ 3600 ❑
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ ❑ FEET e S ❑ VV a BENSON RD S
0 1 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
�/No D:4259419882 0 4 30
6� LAST NAME LA FIRSTNAME FONG MIDDLE 1 2 31
INITIAL
STREET ❑ 18102 113TH AVE SE CITY RENTON ST WA 2jp, 980556577 z=
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
INTERLOCK YES[:]NO 1/ INTERLOCKYEs NO�/ YES R No�/
8 LRIIVER #
ON DUTY❑ STATUS' AIRBAG 2 RESTR 4 EJECT 1 I I [NATURE OF
H U EET 2 1 INJURY CLASS ju C/O CHEST PAINS z❑
3
LICENSE 98520V sTArI WA urN# JTJHF10U820286898
10❑ PI ATE 14
TRAILER STATE TRAILER STATE
11 4 0 PLATE# PLATE# ROM TO
TRLR. TRLR. 5 1 33
12 3 5 VIN#' VIN#
>; FROM TO
❑ VEH.YEAR 2002 MAKE MODEL STYLE VEHICLE TOWED TO BLIN TR Y GOVT.VEHICLE 34
13 4 LEXU RX300 SV DAMAGE YES NO �MEYER 3 5 YES❑ No✓
REGISTERED OWNER INFO FONG LA 11111113TH AVE SE RENTON WA 98055 D:4259419882 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
14 LIABILI INSURANCE INSURANCE CO GEICO 6089-09.60.09 4
IN EFFECT &POLICY# TOPVEHCLE CHARGE 36
LEGALLYYES❑NO❑ CITATION# 2A0678637 FAIL TO OBEY TRAFFIC CONTROL <1�3
orrom
15❑ STANDING 7 6
MOTOR PEDAL-❑ ❑ ❑ PRPRTY ❑ O PHONE
UNIT VEHICLE CYCLEPEDESTRIAN S /OWNER Nrj.LDMET
D:3608783421
16 a
LAST NAME OUDEANS FIRST NAME TERRY MIDDLE W
INITIAL
17 STRENEW EET --' 1425 S PUGET DR#E-5 CITY' RENTON ST WA ZIP 98055 4❑ 37
18� CDL ., IGNITION REQUIRED IGNITION PtR-E-S1ENT MEDICAL t-TRANSPORTED 38
INTERLOCK YEs❑No� INTERLOCK YEs I I NOF YES
t l NOF,/
19[ DRIVER'S STATE WA SEX M D.C.B. 07 23 _ 1955 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 I ❑21❑ PLA E# BXK8642 TArE 41
WA VIN# 2T2BC16A7FC008294 1
42
22❑ PLATE# STATE PLATE# STATE
23❑ VIN#. 43
TRLR RLR
'IN#.
VEH YEAR 2015 MAKE LEXS MODEL RX STYLE SV VEHICLE TOWED TO BLIN TOWEDBY GOV HI 44
24❑ DAMAGE YES NO GENE MEYER YES NO
REGISTERED OWNER INFO TERRY OUDEANS 1425 S PUGET DR#E-5 RENTON WA 98055 D:3608783421 VEHICLE NO.2
SHADE IN DAMAGED AREA
2 3 4
LIABILITY
INSURANCE &POINSURGY#E CO CONNECT A103861248IN STOP
g
'E""LE ❑ N`L J
,J� CITATION# CHARGE
LEG
25 BOTTOM
ALLY YES $
=UGENT
(PRINT) OFFICER PHONE BADGE OR ID# JAGENCY
26 11498 WA0171300
PAGE 01 OF
PART A
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. ED19079
COLLISION REPORT III III III III III 111
1591972 CASE# 22-13524
ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY)
NAME MIDDLE INITIAL) NICHOLSON NANCYJ
(LAST FIRST,
ADDRESS&PHONE# D O.B. '
10932 SE 183RD CT RENTON WA 98055 2065950907 SEXi F MMDOYyry 12 - 04 - 1951
PASSENGER WITNESS SEAT AIRBAG RESTR. EJECT ' HELMET INJURY NATURE OF INJURIES
❑✓ UNIT# 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.
MATTHEW NUGENT 12-27-22 10:05 AM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
CO.JOHNSON 0505 1212712022 1:12:50 PM
BADGE OR ID# 11498 ORI# WA0171300 TIME POLICE DISPATCHED' 4:39 Pry TIME POLICE ARRIVED',1:42 PM
PART I PAGE IT]OF
TIME
REPORT NO. ED19079 CASE# 22-13524 OF COLLISION12/21/22 13:37
NARRATIVE
22-13524
On 12/21/2022 at approximately 1339 hours, I was dispatched to an unknown-if-injury and blocking
vehicle collision at the intersection of Benson Road South and Benson Drive South, within the City
Limits of Renton, County of King, State of Washington.
While en route, Dispatch advised that there was limited information provided due to one of the
involved parties possibly connected to their vehicle via a handsfree device as the call receiver could
not hear what was being said but heard hazard light clicking inside the vehicle. Dispatch did advise of
overhearing a possible dispute in the background.
Officer J. VanderHoek responded and arrived on scene prior to me. Upon my arrival, I noticed the
involved vehicles blocking both southbound lanes of travel on Benson Drive South. Officer
VanderHoek received a complaint of injury from one of the involved parties therefore he requested
Renton Fire respond for evaluation. Renton Fire later responded and treated all involved parties at
the scene.
The driver of Unit#1 was positively identified via pictured WADL and was the sole occupant of the
vehicle. The driver of Unit#1 said she was traveling northbound on Benson Drive South approaching
the intersection of Benson Road South in lane 1 of 2. The driver of Unit#1 stated that she was
intending to continue north on Benson Dr S. The driver of Unit#1 said she believed to have had a
green light and proceeded out into the intersection. Upon entering the intersection, Unit#1 was met
by Unit#2 which was traveling in the turn lane of Benson Rd S and attempting to turn onto Benson Dr
S. Upon Unit#1 entering the intersection, Unit#1 collided with the side of Unit#2 causing significant
damage to the front of Unit#1.
The driver of Unit#2 was the sole occupant of his vehicle and was identified via pictured WADL. The
driver of Unit#2 said he was traveling westbound in about the 17300 block of Benson Rd S
approaching the intersection at Benson Dr S in lane 1 of 2. The driver of Unit#2 stated that he was
approaching the intersection with the intent to make a left-turn to proceed southbound onto Benson
Dr S. The driver of Unit#2 stated that he was stopped at the intersection for a red light and that upon
the traffic light changing to green, traffic had proceeded before him and that the vehicle next to him
had already completed the turn. Upon entering the intersection, the driver of Unit#2 saw as Unit#1
continued north through the intersection. Unit#2 was unable to avoid the collision and Unit#1
collided into the driver's side of Unit#2, near the rear axle, causing significant damage to Unit#2.
An independent witness, verbally identified Nancy J Nicholson, stated that she was traveling in the
area at the time of collision. Nicholson stated that Unit#1 had proceeded against a red light displayed
and collided with Unit#2 which had a green light. Nicholson stated she would be willing to be a
witness for this collision investigation.
Based on the above statements, I determined that the Driver of Unit#1 (La) was the predominant
factor for the collision as La failed to obey a traffic control legend which per the other involved party
and an independent witness, the traffic control device was red indicating for Unit#1 to stop. La was
not paying attention to the traffic control legend causing a collision.
I issued La a citation in-person for failing to obey a traffic control device causing a collision.
Both Unit#1 and Unit#2 had to be impounded due to extensive damage. An exchange of information
and case number were 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.
PAGE 3 OF 5
TIME
REPORT NO. ED19079 CASE# 22-13524 OF COLLISION12/21/22 13:37
NARRATIVE
Electronically signed by Officer M. Nugent#11498 9:29 AM 12/27/2022 Renton, King County,
WA.
PAGE 4 OF 5
REPORT NO.! ED19079 CASE# ' 22-13524 DATE AND TIME 12/21/22 13:37
OF COLLISION
U�
_ � ®x#' lD agram raaftt+scale:
Un l
Benson Drive S (Sr 515)
PAGE 5 OF 5