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Home My WebLink About23-571 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 0 27c COLLISION REP FIT 1591971 ❑ ❑ 23-571 z RESULTED ❑ CASE INTERSTATE CITY STREET FIRE 1 STOLEN STATE ROUTE ❑ OTHER ❑ VFHICI F ❑ LOCAL AGENCI 4200 3 HIT&RUN CODING COUNTY RD PRIVATE WAY INVOLVED 2� 1 1 8 28 TOTAL#OF OBJECT TRIBAL UNITS 02 STRUCK' UT/LITYPOLE RESERVATION 2 3❑ DATE of M M D D Y Y Y Y TIME(2400) COUNTY# MILES N E IN CITY# CowsloN 01 - 1-- 2023 1357 17 ❑-= S 8 IN e 1070 3 4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑ S 3RD ST BLOCK NO. e --- ❑ MILEPOST 4a❑ DISTANCE OF(REFERENCE OR CROSS STREET) 5❑ ❑ FEET e S ❑ VV e SHATTUCKAVE S 0 4 29 MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE UNIT 01 VEHICLE ❑ CYCLE El ,/No D:2063590894 0 11 30 6� LAST NAME NGUYEN FIRSTNAME KY MIDDLE L 1 2 31 INITIAL STREET ❑ 12634 16TH AVE S CITY SEATTLE ST WA 2jp, 981682252 2= 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 3 RESTR 4 EJECT 1 H U SE ICNLJAUSSY 1 NATURE OF INJURIES 2❑ 3 10❑ P1 aT�S� CET2497 sTArI WAurN# 4T3RWRFV9NU070600 TRAILER STATE TRAILER STATE 11 2 5 PLATE# PLATE# FROM TO TRLR. TRLR 7 1 33 12 2 5 VIN#' VIN# >; FROM TO ❑ VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN T GOVT.VEHICLE-11 7 $ 34 13 1 2022 TOYT RAV4 AT DAMAGE vEsNo �LII� RS vEs❑ No REGISTERED OWNER INFO KYNGUYEN176241STAVESAPTC301 BURIENWA98148 D:2063590894 VEHICLE NO. 1 ❑ SHADE IN DAMAGED AREA 35 14 LIABILI INSURANCE INSURANCE CO PROGRESSIVE 956525535 3 4 IN EFFECT &POLICY# 9TOP ❑ LEGALLY CHARGE 1 5 36 15 2 VE-LN YES❑No CITATION# 3AO030368 FLD SIGNAL STOPS/TURNS-UNSAFE o Borrob MOTOR PEDAL- ❑ PEDESTRIAN PROPERTY DAM THR OLD MET PHONE UNIT 02 VEHICLE ❑ CYCLE ❑ OWNER ❑ YES 1/ NO D:2064921068 16 a LAST NAME MACK-CAMPBELL FIRST NAME EDWARD MIDDLE I D INITIAL 17 STREET I❑ s❑' 13445 MARTIN LUTHER KING JR W UNIT L313 CITY' SEATTLE ST WA ZIP 981785255 4❑ 37 NEW ADOREs 18❑ CDL IGNITION REQUIRED IGNITION PtR-E-S1ENT MEDICAL-T�RANSPORTED � 38 INTERLOCK YEs❑NO INTERLOCK YEs I I NOF YEs t l NoF,/ 19 LDIIVEW # STATE WA SEX M M .O.B. 07 15 _ 1998 39 20❑ ON DUTY STATUS AIRBAG 3 RESTR 4 EJECT 1 H U EET NJAU EY 1 NATURE OF INJURIES ❑ 40 ❑21❑ PLATE# TArE vINIi 1VWCP7A37CCO26167 41 1 42 22❑ PILER LATE# STATE pLATE# STATE 23❑ VIN#. 43 TRLR RLR 'IN#. TOWED ev Gov HI 44 VEH YEAR 2012 MAKE VOLK MODEL PASSAT STYLE SD DAMAGE TOWED✓ NOO BLIN BANKERS YES NO 24❑ REGISTERED OWNER INFO OWNED SY DRIVER VEHICLE N0.2 SHADEDAMAGEDAREA 3 4 LIABILITY INSURANCE❑ INSURANCE CO IN EFFECT &POLICY# 970E 5 "F""LE YEs Nc❑ cIrATION# 3AO030367 CHARGE OP MOT VEH W/OUT INSURANCE o BOTTOM LE...LY 25 s a OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY J 26 P.LANTAGNE 12575 WA0171300 PAGE 01 OF PART A 3000-345-159 OR 11/181 STATE OF POLICETRAFFICN CORRECTION REPORT NO. ED26359 COLLISION REPORT III III III III III 111 1591972 CASE# 23-571 ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY) NAME MIDDLE INITIAL) OTH SOMNARTH N (LAST FIRST, ADDRESS&PHONE# D O.B. ' 17624 1ST AVE S APT C301 BURIEN WA 981483300 SEX M MMDDvyry 04 - 21 - 1992 PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT ' HELMET INJURY NATURE OF INJURIES ❑✓ ] 1 POS. 3 2 4 1 USE CLASS 1 NAME (LAST,FIRST,MIDDLE INITIAL) lGNACIO ✓ESSICA O ADDRESS&PHONE# D O B 2820 29TH AVE S SEATTLE WA 981446026 SEX IF MMDDvvvv 04 _ 19 _ 1995 SEAT HELMET INJURY NATURE OF INJURIES PASSENGER WITNESS UNIT# 1 POS $ AIRBAG 2 RESTR. 4 EJECT 1 USE CLASS 1 NAME (LAST FIRST,MIDDLE INITIAL) WASHINGTON REAVY ADDRESS&PHONE# 13445 MLK JR WAY SEATTLE WA 98178 2069091839 SEX MI. 08 _ 1961 MDDYYYY PASSENGER WITNESS NATURE UNIT# SEAT AIRBAG RESTR. EJECT HELMET INJURY 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. P.LANTAGNE 01-15-23 03:57 PM INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED APPROVED BY DATE S.WOODWARD 11528 1 111912023 8:14:18 AM BADGE OR ID# 12575 OR]4f WA0171300 TIME POLICE DISPATCHED Y:03 PM TIME POLICE ARRIVED Y:09 Pm PART I PAGE IT]OF 4] REPORT NO. ED26359 CASE# 23-571 OF COLLISION 01/15/23 13:57 OF CbLLI510N NARRATIVE 23-571 On 01/15/2023 at approximately 1357 hours, I, Officer Lantagne, responded to a blocking, non-injury collision in the intersection of S 3rd ST and Shattuck AVE S, which is located in the City of Renton, County of King, and the State of Washington. I responded in my fully marked police vehicle, wearing my patrol uniform. I arrived on scene and observed Unit#1, a 2022 Toyota Rav-4 with license plates CET2497 issued out of Washington State, and Unit#2, an unlicensed 2012 Volkswagen Passat, blocking the intersection. At the time of the collision, there was heavy rainfall. I contacted the driver of Unit#1, Ky L. Nguyen (DOB 03/07/1990). Nguyen told me the following: Nguyen was driving eastbound on S 3rd ST. Nguyen attempted to make a left turn onto Shattuck AVE S and the left side of his vehicle struck the right front of Unit#2. Nguyen believed he was in the left lane but was not sure. I contacted the driver of Unit#2, Edward D. Mack-Campbell (DOB 07/15/1998). Mack-Campbell told me the following: Mack-Campbell was traveling eastbound in the left lane of S 3rd ST. As Mack- Campbell's vehicle approached the intersection at Shattuck AVE S, the vehicle to the right of him made a sharp left turn and forced Mack-Campbell's vehicle into a traffic signal pole. Mack-Campbell's vehicle was unlicensed, and he did not have insurance for the vehicle. Sergeant Woodward contacted a witness, Reavy Washington (DOB 01/08/1961) who was standing near the northeast corner of the intersection. Washington stated both vehicles were traveling eastbound on S 3rd ST. Washington observed the driver of the Rav-4 attempt to make a left turn onto Shattuck AVE S from the far lane. The Rav-4 collided with the Passat which was in the near lane and forced the vehicle into the traffic signal pole. I observed the damage to the vehicles and other physical evidence was consistent with the statements made by Mack-Campbell and Washington. Unit#1 had significant damage to the left front side of the vehicle which consisted of crumpled hood, heavily dented doors, and damage to the left front wheel. Unit#2 had significant damage to the right front of the vehicle and the center front of the vehicle where it had hit the traffic signal pole. The front driver's side airbags of both vehicles deployed and the Renton Fire Department responded for medical evaluations of the driver's. The collision diagram is an accurate illustration of the events leading up to the collision. I provided an exchange of information to Nguyen and Mack-Campbell. I later issued Nguyen a citation for making an unsafe lane change to be mailed through the court. I issued Mack-Campbell a citation for operating an unlicensed motor vehicle without proof of insurance to be mailed through the court. I, Officer P. Lantagne #12575, certify (or declare) under penalty of perjury, under the laws of the State of Washington, the foregoing is true and correct. Electronically signed by Officer P. Lantagne #12575 at 1530 hours on 01/15/2023 at Renton, WA. PAGE 3 OF 4 REPORT NO. ED26359 CASE# ' 23-571 DATE AND TIME 01/15/23 13:57 OF COLLISION Case #23-571 0 Not t0 Scale Shattuck Ave P. Lantagne #1 257 Traffic Signal Pole Unit#2 1Nitness y,. 4ifR, {3h Unit#1 Ord St PAGE 4 OF 4