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Home My WebLink About22-13342 POLICETRAFF'c" III !�� I IIIllI111IN II II I REPORT NO. ED20304 170 27 COLLISION REP FIT 1591971 CASE 22-13342 z INTERSTATE ❑ CITY STREET FIRE ❑RESULTED 1 STATE ROUTE OTHER STOLEN ❑ ❑ H F E:RUN AOENC 3 HIT IT&RUN � CODING COUNTY RD PRIVATE WAY INVOLVED 2 TOTAL#OF OBJECT 1 1 8 28 TRIBAL UNITS 04 STRUCK RESERVATION z 3❑ DATE of M M D D Y Y Y Y TIME(2400) COUNTY# MILES N E IN CITY# ❑ C{YLLISION 12 - 1-- 2022 1645 17 ❑.= S 8 W IN e 1070 3 4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓ BLOCK NE SUNSET BLVD MILEPOST ST e✓ 2400 4a❑ DISTANCE OF(REFERENCE OR CROSS STREET) 5❑ 300 00 FMILES EET e S B E e EDMONDS AVE NE 0 4 29 MOTU '�01 VEHtOCLEZ PEAL-CYMLE. El �ESAGE NHORE✓LD MET PHONE 0 1 30 6� LAST NAME UNKNOWN FIRSTNAME MIDDLE 1 1 2 31 INITIAL STREET ❑ CITY Sr zIP 2 NEW ADDRESS 7❑ CDL IGNITION REQUIRED IGNIT{ON PRESENT MEDICAL TRANSPORTED 3 iNTERLOCKYEs NO 1/ INTERLOCKYEs NO�/ YEs No�/ 8❑ LIRCIENSRE# SrA fE I SEX u MMDOBYY - 1 1 2 32 9 ON DUTY❑ STATUS I AIRBAG 9 RESTR 9 EJECT 1 H USEEr 9 CLAY 0 NATURE OF INJURIES z❑ 3 LICENSE sTATI urN#' 10[ PI ATE# C7 TRAILER STATE TRAILER STATE 11 3 5 PLATE# PLATE# ROM ro TRLR. TRLR 4 6 33 12 3 5 VIN# VIN# FROM TO ❑ VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE 4 T 34 13 2 UNKN UNKNO SO DAMAGE YES NO YES❑ NO✓ REGISTERED OWNER INFO UNKNOWN VEHICLE NO. 1 SHADE IN DAMAGED AREA ❑ 35 14 LABILI INSURANCE❑ NSURANCE CO 3 4 IN EFFECT &POLICY# 9TOP VEwcLE CHARGE 5 36 LECALLv Yes❑NO❑ CITATION# 10 BOTTOM 15❑ STANDING 8 6 MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE UNIT VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES No 1/ D:503477U465 16 a LAST NAME GORDON FIRST NAME MICHAEL MIDDLE C INITIAL 17 STREET I❑ 417 219TH AVE NE CITY' SAMMAMISH ST' WA ZIP 98074 37 NEW ADOREsS❑' 18❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED ❑ 38 INTERLOCK YES❑NOF,/l I INTERLOCK YES❑NoF YES❑NO 19 D IVEW # I {NJURY NATURE OF INJURIES 40 20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 USE CLASS 1 ❑ ❑ILICENSE 21❑ PLATE# BQD4518 TATe 41 WA VIN# STDJZRFH1KS928640 4 42 22 [TRAILER TILER ❑ PLATE# STATE PLATE# STATE 23❑ 43 TRLR RLR UIN#. 'IN#. Go VEH YEAR 2019 MAKE 7'Oy7- MODEL yIGHLAN STYLE $W DAMAGE TOWED NOO✓ B TOWED BY v HILIN YES NO 44 24❑ ES REGISTERED OWNER INFO OWNED SY DRIVER VEHICLE N0.2 SHADE IN DAMAGEbAREA 2 3 Cd LIABILITY INSURANCE� &POINSURGY#E CO STATE FARM 4294457-A26-47BIN 1 9TOP VE""LE ❑ Nu,J CITATION# CHARGE LEG 25 BOTTOM ALLY YES s � a OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# JAGENCY 26 R.ON/SHl 5738 WA0171300 PART A PAGE 01 OF 3000-345-159 OR 11/181 STATE OF POLICETRAFFICN CORRECTION REPORT NO. ED20304 COLLISION REPORT III III III III III 111 1591972 CASE# 22-13342 ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY) NAME MIDDLE INITIAL) LOPEZ MELANIE N (LAST FIRST, ADDRESS&PHONE# D O.B. ' 4308 NE SUNSET BLVD P1 RENTON WA 98059 2065375408 SEXi F MMDDvyry 02 - 10 - 1989 PASSENGER Z WITNESS� UNIT# 3 POS USE CLASS' 3 AIRBAG 2 RESTR. 4 EJECT ? 1 HELMET LASS NATURE OF INJURIES : 11 NAME (LAST,FIRST,MIDDLE INITIAL) FOSTER ARAYANNA C ADDRESS&PHONE# D O B 103 12TH AVE 322 SEATTLE WA 98122 2067538335 SEX F MMDDvvvv O6 _ 30 _ 1997 SEAT HELMET INJURY NATURE OF INJURIES PASSENGER WITNESS UNIT# 3 POS 7 AIRBAG 2 RESTR. 4 EJECT 1 USE CLASS 1 NAME (LAST FIRST,MIDDLE INITIAL) FOSTER KEITH O ADDREss&PHONE# 4308 NE SUNSET BLVD P1 RENTON WQ 98059 SEX MMDDYYYY 01 04 _ 2011 . M D.O.B. _ PASSENGER WITNESS UNIT# ! 3 SEAT 1 g AIRBAG 2 RESTR. 4 EJECT 1 HELMET INJURY 1 NATURE OF INJURIES ❑ POS. USE CLASS ��----� NARRATIVE' Roadway is two lanes running southeast-northwest, approaching a left turn lane onto Sunset Blvd NE. Units 1 and 4 are in lane 1, units 2 and 3 are in lane 2. Unit 1 abruptly signalled left, then turned across all lanes of traffic to get onto Sunset Blvd NE. This carried unit 1 across the path of unit 2; unit 2 driver Gordon braked to avoid collision with unit 1, and unit 3 driver Foster braked to avoid unit 2. Unit 3 struck the back of unit 2, and unit 4 driver Justice swerved right to avoid unit 3. Unit 4 left the roadway up an embankment, and was stuck in bushes there. Unit 1 fled scene; both Gordon and Foster described it as a brown car, but were unable to provide any other details. I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT. R.ONISHI 12-17-22 07:19 PM INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED APPROVED BY DATE CO.JOHNSON 0505 1 12/30/2022 8:46:18 AM BADGE OR ID# 5738 ORI# WA0171300 TIME POLICE DISPATCHED 4:48 Pry] TIME POLICE ARRIVED 4:53 PM PART I PAGE IT]OF STATE OF POLICETRAFFICN CORRECTION REPORT NO. ED20304 COLLISION REPORT III III III III III 111 1591972 CASE# 22-13342 ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY) NAME MIDDLE INITIAL) FOSTER MESS/AHA (LAST FIRST, ADDRESS&PHONE# 4308 NE SUNSET BlVD P1 RENTON WA 98059 SEX M MMDDYyry 12 - 30 - 2013 PASSENGER WITNESS UNIT# 3 PEA ' $ AIRBAG 2 RESTR. q EJECT ? HELMET INJURY NATURE OF INJURIES USE CLASS 11 NAME (LAST,FIRST,MIDDLE INITIAL) ADDRESS&PHONE# DOB SEX' MMDDYYYY PASSENGER ❑WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET INJURY NATURE OF INJURIES POS. USE CLASS NAME (LAST FIR57 MIDDLE INITIAL) AppRESS&PHONE# SEX D.O.B. MMDDYYYY. - PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET NJURY NATURE OF INJURIES ❑ ❑ POS. USE CLASS ----� NARRATIVE' Roadway is two lanes running southeast-northwest, approaching a left turn lane onto Sunset Blvd NE. Units 1 and 4 are in lane 1, units 2 and 3 are in lane 2. Unit 1 abruptly signalled left, then turned across all lanes of traffic to get onto Sunset Blvd NE. This carried unit 1 across the path of unit 2; unit 2 driver Gordon braked to avoid collision with unit 1, and unit 3 driver Foster braked to avoid unit 2. Unit 3 struck the back of unit 2, and unit 4 driver Justice swerved right to avoid unit 3. Unit 4 left the roadway up an embankment, and was stuck in bushes there. Unit 1 fled scene; both Gordon and Foster described it as a brown car, but were unable to provide any other details. I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT. R.ONISHI 12-17-22 07:19 PM INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED APPROVED BY DATE CO.JOHNSON 0505 1 12/30/2022 8:46:18 AM BADGE OR ID# 5738 ORI# WA0171300 TIME POLICE DISPATCHED 4:48 PM TIME POLICE ARRIVED 4:53 PM PART I PAGE IT]OF SUPPLEMENTAL REPORT NO. ED20304 r`I POLICE TRAFFIC 1 1 8 27 COLLISION REPORT CASE# 22-13342 1 COMMERCIAL MOTOR CARRIER INTERSTATE INTRASTATE G UNIT'# USL70r !CC# VEHICLE TYPE CARGO BODY TYPE 2 ❑ 1 1 8 28 CARRIER NAME 3 CARRIER L ADDRESS `❑ CITY ST' ZIP' 4 ❑ NAME # PLACARD: :❑ GI NAME IF NO NUMBER SOURCE AXLES + 4a ❑ ADDITIONAL UNITS MOTOR PEDAL- PROPERTY DAMAGE THRESHOLD MET PHONE 5 ❑ UNIT# 3 VEHICLE t_"J CYCLE _) PEDESTRIAN � OWNER � YES✓ NO D:2064507742 OF 1 29 LAST NAME FOSTER FIRST NAME RAPHAEL MIDDLE' ',, D INITIAL 0 1 30 STREET NFW AnDRFSP 4308 NE SUNSET BLVD P1 CITY RENTON ST WA ZIP 98059 6 [2 1 1 2 31 CDL IGNITIttN REQUIRED IGNITION PRESENT MEDICAL TANSPORTED INTERLOCK YEs NO✓ zERLOCK YEs❑NO❑✓ YES N ✓ DRIVER'S LICENSE STATE I WA SEX M MMDDyyv 07 - 17 - 1986 7 ❑ ON DUTY� STATUS AIRBAG' 2 RESTR. Q EJECT 1 HELMET INJURY 1 NATURE OF INJURIES USE CLASS 8 ❑ 1 1 2 32 LICENSE CDN4873 TAr WA VIN# 5NPD84LF8LH504515 PLATE# 9 9] TRAILER TRAILER PLATE# STATE PLATE# STATE 10 TRLR TRLR 91 VIN.It VIN.#. 11 3 5 VEH.YEAR2020 MAKE HYUN I MODELELANTRA STYLE 4D VEHICLE TOWE E T SABLIN TOWED BY anvi vFHIC P FROM TO DAMAGE YES NO ✓ YES NO ✓ 33 REGISTERED OWNER INFOOWNED SYDRIVER Q $ 12 3 5 SHADE IN DAMAGED AREA 34 FROM TO LIABILITY INSURANCE INSURANCE CO PROGRESSIVE 958947147 <�Ql IN EFFECT &POLICY# 4 $13VSTWGLE ❑ ❑ CITATION# CHARGE 34 INEFLEGALLY YES NO gg�@, STANDING l:9 6 DAMAGE THRESHOLD MET PHONE ❑ 35 14 UNIT# 4 MdT{7R ❑✓ PEDAL ❑ PEDESTRIAN ❑ PROPERTY ❑ YES NO VEHICLE CYCLE OWNER ✓ D:4255297686 15 JUSTICE DALEN MIDDLE T ❑ 36 LAST NAME FIRST NAME INITIAL 2 STREET 16 ❑ ❑ 15825 205TH AVE SE CITY RENTON ST WA ZIP 98059 NFn+AnntxFss CDL IGNITION REdUiRED IGNITION PRESENT MEDICALTANSPORTED 17 ❑ INTERLOCK YEs Nb✓ INTERLOCK YEs NO✓ YEs No;�/ ❑ DRIVER'S STATE WA SEX M D.O.B 37 LICENSE# MMDDYYY` 07 - 13 - 1986 18 ❑ El ON DUTY STATUS' AIRBAG 2 RESTR. 4 EJECT 1 HELMET INJURY 1 NATURE OF INJURIES 38 USE CLASS 19 ❑ LICENSE ❑ PLATE# CBN3544 TAr WA v!N# 1 NXBR32E76Z570051 39 20 ❑ TRAILER STATE TRAILER STATE ❑ 40 PLATE#< PLATE# 21 ❑ TRLR TRLR 41❑ VIN# YIN#i 42 22 VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED DUET SABLIN TOWED BY GOVT.VEHICLE 2006 TOYT COROL 4D DAMAGE vEs ✓No GENE MEYER YEs NO ✓ 23 ❑ REGISTERED OWNER INFOJAMIE ANDERSON 15825 205THAVE SE R..WA 98059 D:4254425878 SHADE IN DAMAGED AREA 43 3 4 LIABILITY INSURANCE INSURANCE CO PEMCO CA 1903409 ❑ IN EFFECT &POLICY# 9 1'OP - 4 44 24 L VEHICLE YES❑ NO El CITATION# CHARGE �00i rOtv1 LEGALLY STANDING 6 I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT. R.ONISHI 12-17-22 07:19 PM 25 INVESTIGATING OFFICER'S SIGNATURE OFFICER'S PHONE UNIT OR DIST DET DATED: PLACE SIGNED APPROVED BY DATE 26 OI BADGE 5738 O#I',WA0171300 JOHNSON 12130/202 PAGE 4 �OF❑ 3000-345-013 fR 11t18) REPORT NO. ED20304 CASE# ' 22-13342 DATE AND TIME 12/17/22 16:45 OF COLLISION 6., d eeey3, e 1� L3nit PAGE 5 OF 5