HomeMy WebLinkAbout23-329 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 6 27c
COLLISION REP FIT 1591971
❑ ❑ FIRE RESULTED ❑ CASE 23-329 z
INTERSTATE CITY STREET FIRE
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 CITY# ❑
cowsloN 01 - 09 - 2023 0820 17 ❑.❑ N E IN S 8 W H OF e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
AIRPORT WAY BLOCK NO. e✓ 300
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ �.❑ FEET e S ❑ W e SHATTUCKAVESOUTH
0 1 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
✓NO D:2068227490 0 4 30
6� LAST NAME LIANG FIRSTNAME YANFANG MIDDLE 1 F 2 31
INITIAL
STREET ❑ 5505 S WALLACE ST CITY SEATTLE ST WA 7jp 981782871 z=
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
iNTERLOCKYEs NO 1/ INTERLOCKYEs NO�/ YES R No�/
8 LRIIVER #
ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 H USEET 2 INJURY CLASS 1 NATURE OF INJURIES z❑
3
10❑ P1 ATE 14 BXJ2245 STATE WA VIN# 7FART6H85ME005654
TRAILER STATE TRAILER STATE
11 3 5 PLATE# PLATE# FROM TO
TRLR. TRLR 3 7 33
12 2 5 VIN#' VIN#
>; FROM TO
VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE 1 3 34
13 2 2021 HOND CR-V SV DAMAGE YES NO YES[:] NO✓
REGISTERED OWNER INFO YANFANG LIANG 975ABERDEENAVE NEAPTA201 RENTON WA 98056 D:2068227490 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
14 LIABILITY INSURANCE z INSURANCE CO AMERICAN FAMILY 41013-60969.91 <1�3 4
LI EFFECT I SUR N# TOPVEHICLE CHARGE 36
LE-ALLvYEs No clTAnoN# 3AO055422 FAIL TO OBEY TRAFFIC CONTROLorrom
15❑ NDING 6
1.' MOTOR PEDAL- PROPERTY DAM�/ THR OLD MET PHONE
UNIT VEHICLE CYCLE ❑ PEDESTRIAN ❑ OWNER ❑ YES NO D:4258704761
16 a
LAST NAME VAN PELT FIRST NAME SHANE MIDDLE K
INITIAL
17 STREET❑ NEW ADOREss❑' 241 SHELBY ST CITY GOLD BAR ST WA ZIP 982519233 4❑ 37
18❑ CDL IGNITION REQUIRED IGNITION PtR-E-S1ENT MEDICAL-T�RANSPORTED � 38
INTERLOCKYES�NO INTERLOCK YEs I I NOF YEs t l NOF,/
19 LDIIVER # STATE WA SEX M M .C.B. 10 _ 24 1975 39
20 ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 HELMET 2 INJURY 7 NATURE of INJURIES 40
USE CLASS C/O NECK PAIN
❑21❑ PLATE# CCX4211 TATE 41
WA VIN II 5TDGBRCH4NS556072 1
42
22❑ PLATE# STATE PLATE ILER# STATE
23❑ UIN#. 43
TRLR RLR
'IN#.
VEH YEAR 2022 MAKE TOYT MODEL HIGHLAN STYLE SI/ VEHICLE TOWED TO BLIN TOWEDBY GOV HI 44
24 DAMAGE YES NO GENE MEYERS YES NO
REGISTERED OWNER INFO SHANE VAN PELT 241 SHELBY ST GOLD BAR WA 98251 D:4258704761 VEHICLE NO.2
SHADE IN DAMAGED AREA
2 3 4
LIABILITY
INSURANCE INSU PORGY#E CO ALLSTATE 817-722-911IN 5Q,
'E""LE ❑ ,J� CITATION# CHARGELEGALYYES N`L J25
=UGENT
PRINT) OFFICER PHONE BADGE OR ID# AGENCY
26 11498 WA0171300
PAGE 01 OF
PART A
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. ED23877
COLLISION REPORT III III III III III 111
1591972 CASE# 23-329
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.
MATTHEW NUGENT 01-10-23 10:08 AM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
S.MORRIS 2613 111112023 8:26:16 AM
BADGE OR ID# 11498 ORI# WA0171300 TIME POLICE DISPATCHED; 8:22 AM TIME POLICE ARRIVED:8:49 AM
PART I PAGE IT]OF 4�
REPORT NO. ED23877 CASE# 23-329 OF COLLISION
01/09/23 08:20
OF CbLLI510N
NARRATIVE
23-329
On 01/09/2023 at approximately 0822 hours, I was dispatched to a non-injury and blocking vehicle
collision at the intersection of Airport Way and Shattuck Ave South, within the City Limits of Renton,
County of King, State of Washington.
While en route, Dispatch advised that two vehicles were involved in a collision at the intersection and
were blocking Shattuck Ave South.
Upon my arrival, 1 confirmed there were no complaints of injury. I collected each involved party's
information and their independent recollection of their involvement leading up to the collision. The
driver of Unit#2 later complained of neck pain but declined medical response and just asked that I
add this information to the police report.
The driver of Unit#1 stated she was the sole occupant of her vehicle and was traveling westbound on
Airport Way approaching the intersection of Shattuck Ave South in lane 2 of 3. The driver of Unit#1
stated she was intending to continue straight (west) at the intersection. The driver of Unit#1 stated
that she was momentarily distracted and did not recall the color of the traffic light. The driver of Unit
#1 stated that she then realized she had entered the intersection against a red light. The driver of Unit
#1 stated that upon entering the intersection, she was met by cross traffic, specifically Unit#2 and
that as a result, Unit#1 suffered moderate damage to the front of her vehicle.
The driver of Unit#2 said he was the sole occupant of his vehicle and was traveling southbound on
Shattuck Ave South and stopped at the intersection of Airport Way in lane 2 of 2 (left-turn lane). The
driver of Unit#2 stated he was intending to turn left to proceed eastbound onto Airport Way. Upon the
traffic light changing from red to green for his direction of travel, Unit#2 proceeded out into the
intersection and yielded to opposing traffic which had also received a green light. It was not until Unit
#2 was mid-way through his turn when he noticed Unit#1 approaching the intersection from the east
and believed that Unit#1 ran a red light. The driver of Unit#2 stated that he was unable to avoid the
collision and that Unit#1 struck Unit#2 causing significant damage to the front driver side wheel
bearing and quarter panel of Unit#2.
Based on the above statements, 1 determined that the Driver of Unit#1 (Liang) was the predominant
factor for the cause of collision due to Failing to Obey a Traffic Control Legend causing a collision. I
cited the Driver of Unit#1 in-person for Failing to Obey a Traffic Control Legend.
Unit#1 was able to be driven away without further incident. Unit#2 had to be impounded due to
extensive damage. An exchange of information was 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.
Electronically signed by Officer M. Nugent#11498 1/10/2023 9:53 AM Renton, King County, WA.
PAGE 3 OF 4
REPORT NO. ED23877 CASE# 23-329 DATE AND TIME 01/09/23 08:20
OF COLLISION
not to scaW
Airport Entrance
tJnftft2
to Airport Way S
a)
.2
U)
PAGE 4 OF