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Home My WebLink About23-311 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 1 27c COLLISION REP FIT 1591971 ❑ ❑ FIRE RESULTED ❑ CASE 23-311 z INTERSTATE CITY STREET FIRE 1 STOLEN STATE ROUTE ❑ OTHER ❑ VFHIr.I F ❑ LOCAL AOENC WA017.300 3 HIT&RUN CODING COUNTY RD PRIVATE WAY INVOLVED 2 3 TRIBAL 03 TOTAL#OF OBJECT 1 1 8 28 UNITS ❑ RESERVATION I I STRUCK z 3 M M D D Y Y Y Y TIME(2400) COUNTY# MILES CITY# c usloN' 01 - 08 - 2023 1530 17 ❑.= S 8 E IN e 1070 3 4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓ 108TH AVE SE BLOCK NO. e✓ 17800 4a❑ MILEPOST DISTANCE OF(REFERENCE OR CROSS STREET) 5❑ 4001. 00 FMILES EET e S B W e PETROVISKYRD 0 3 29 R PEDAL- DAMAGE THRESHOLD MET PHONE UNIT 01 VEHICLE ❑ CYCLE ❑ YES ,/No D:4258904907 N:4258904907 0 11 30 6� LAST NAME HOOKER FIRSTNAME CHRIS MIDDLE L 1 1 2 31 INITIAL STREET ❑ 512 23RD AVE E TTLE WA NEW ADDRESS ST ZIP'. 98112 2 CITY SEA 7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3 1/ I INTERLOCK YES[:]NO NTERLOCKYEs NO�/ YES R No�/ 8❑ LRIIVER # ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 H U EET ICNLJAURY 1 NATURE OF INJURIES 2❑ 3 10� PI ATE BYS5347 sTATI WAurN#' YV1612FS6D2181119 TRAILER STATE TRAILER STATE 11 0 0 PLATE# PLATE# FROM TO TRLR. RLR 1 7 33 12 0 0 VIN#' VIN# >; FROM TO VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN T /g[ GOVT.VEHICLE 1 $ 34 13 2013 VOLV S60 4D DAMAGE YES NO � '` RS YES❑ No✓ REGISTERED OWNER INFO CHRIS HOOKER 51223RD AVE E SEATTLE WA 98112 D:4258904907 N:4258904907 VEHICLE NO. 1 ❑ SHADE IN DAMAGED AREA 35 3 4 14 LIABILITY INSURANCE INSURANCE CO PROGRESSIVE 955064400 IN EFFECT &POLICY# 9TOP vEHICLe CHARGE 5 36 LEGALLY YES❑NO❑ CITATION# 10 BOTTOM 15❑ STANDING 7 6 MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE UNIT VEHICLE ❑ CYCLE' ❑ ❑ OWNER ❑ YES 1/ NO D:4257612361 N:4257612361 16 2 LAST NAME LEE FIRST NAME DAVID MIDDLE A INITIAL 17 STREET❑ NEW ADOREss❑' 718 GRIFFIN AVE 239 CITY ENUMCLAW ST WA ZIP 98022 37 18❑ CDL IGNITION REQUIRED IGNITION PR-E-1SENT MEDICAL-T�RANSPORTED � 38 INTERLOCK YES❑No� INTERLOCK YEs It I NOF YES t l NOF,/ 19 F] DRIVER'S STATE WA SEX M I D.C.B. 12 _ 29 _ 1988 39 LICENSE# MMDDYY F—NATURE OF INJURIES 20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 WEB EET LASSY 7 COMPLAINT OF BACK PAIN ❑ 40 ❑ILICENSE 21❑ PLA E# BWB8245 TATE 41 WA VIN# KNDJ53AFOM7739912 1 42 22❑ PLATE# STATE PLATE# STATE 23❑ VIN#. 43 TRLR RLR 'IN#. VEH YEAR 2021 MAKE KIA MODEL SOUL STYLE UT VEHICLE TOWED TO BLIN TOWEDBY GOV HI 44 24❑ DAMAGE YES NO BANKERS YES NO REGISTERED OWNER INFO DAVIDLEE718GRIFFINAVE239ENUMCLAIV..8 22 D:4257612361 N:4257612361 VEHICLE NO.2 SHADEDAMAGEDAREA 3 4 LIABILITY INSURANCE INSU&PORGY#ECO STATE FARM 4884585 C25-47-001IN 1GQI VEwCLE ❑ ,J� CITATION# CHARGE LEGALLY YES N`L J 25 =SLINKMAN AME(PRINT) OFFICER PHONE BADGE OR ID# 77P�1300 26 11618 PART A PAGE 01 OF C7 3000-345-159 OR 11/181 STATE OF POLICETRAFFICN CORRECTION REPORT NO. ED26873 COLLISION REPORT III III III III III 111 1591972 CASE# 23-311 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' Unit 1 was traveling southbound on 108th Ave SE in the far right lane. Unit 2 is traveling southbound on 108th Ave SE in the far left lane. Unit 3 had pulled into the driveway to Fred Meyer and was off the roadway. According to the driver of unit 1, she had slowed down and was making the turn into the driveway of Fred Meyer. At this same time, unit 2 came into her lane, driving at an excessive speed, and collided with her vehicle causing her to spin around. According to unit 2, he was driving south in the left lane, at the speed limit, when unit 1 turned into his lane. When unit 1 came into unit 2's lane, the collision occurred. This cause his vehicle to ride the median and then spin around as well. According to the driver of unit 3, she had just turned into Fred Meyer driveway when she felt a bump and realized that her vehicle had been hit from behind. She did not see what occurred behind her. Based on the damage on unit 3's vehicle, white in color, leads me to believe that when the collision occurred the force of the collision pushed unit 1 into unit 3. I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT. ROBERT SL/NKMAN 01-08-23 05:48 PM INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED APPROVED BY DATE P.KORDEL 9676 1 112012023 5:30:10 PM BADGE OR ID# 11618 OR]# WA0171300 TIME POLICE DISPATCHED 3:31 PM TIME POLICE ARRIVED';3:41 PM PART I PAGE IT]OF 4] SUPPLEMENTAL REPORT NO. ED26873 r`I POLICE TRAFFIC 1 1 8 27 COLLISION REPORT CASE# 23-311 1 COMMERCIAL MOTOR CARRIER INTERSTATE INTRASTATE G UNIT'# USL70r !CC# VEHICLE TYPE CARGO BODY TYPE 2 ❑ 1 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- 5 ✓ PROPERTY YD O OLDMET PHONE UN�T# 3 VEHICLE CYCLE PEDESTRIAN OWNER ESGN D:2064952802 N:2064952802 OF 1 29 LAST NAME HERNANDEZ FIGUEROA FIRST NAME MIDDLE MARIA INITIAL I G STREET 30 NEW AnDRFSP 21503 1221VD PL SE CITY KENT ST WA ZIP 98031 6 ❑ 1 1 2 31 CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TANSPORTED INTERLOCK YEs NO✓ NTERLOCK YES�NOf YEs N ✓ DRIVER'S LICENSE STATE I WA SEX U MMDDYYv 12 TO] - 1964 7 ON DUTY� STATUS AIRBAG' 2 RESTR. Q EJECT 1 HELMET I INJURY 1 1 NATURE OF INJURIES USE CLASS 8 ❑ 1 32 LICENSE BEY9556 TAr Wq VIN# WBXPA93416WG77729 PLATE# 9 9] TRAILER TRAILER PLATE# STATE PLATE# STATE 10 ❑ TRLR TRLR VIN.#. VIN.#. 11 O O VEH.YEAR MAKE MODEL STYLE VEHICLE TOWS E T SABLIN TOWED BY anvi vEH1I' P FROM TO 2006 BMW X3 UT DAMAGE YES NO ✓ YES NO ✓ 33 REGISTERED OWNER INFOMARIA HERNANDEZ FIGUEROA 21503 122ND PL SE KENT WA 98031 D:2064952802 N:2064952802 ] ] SHADE IN DAMAGED AREA 12 z 3 4 FROM TO LIABILITY INSURANCE INSURANCE CO STATE FARM 4024430-C19.478 GQO IN EFFECT &POLICY#VEHICLE 34 13Lecnuv YES❑ NO❑ CITATION# CHARGE STANDING } 8 7 14 ❑ UNIT Tr Vd IRE O CYDCLE 1:1OWNERRTY YES AGE NOHRESHOLD MET PHONE ❑ 35 PEDESTRIAN 15 LAST NAME FIRST NAME MIDDLE INITIAL TIAL ❑ ET 16 STRETRE "F ' CITY ST ZIP NEW CDL IGNITION REdUiRED IGNITtGN PRESENT MEDICALTANSPORTED NTERLOCK YES No NTERLOCK YEs NO YES NO ❑ 17 4 37 LICENSE# STATE SEX MMDDDYBYY 18 ❑ ON DUTY� STATUS AIRBAG RESTR. ; EJECT HELMET INJURY NATURE of INJURIES 38 USE CLASS 19 ❑ LICENSE TAT VIN# 39 PLATE# 20 ❑ TRAILER' TRAILER El40 PLATE#< STATE PLATE# STATE 21 ❑ ❑ 41 TRLR TRLR VIN# YIN#i 42 22 VEH.YEAR MAKE I MODEL STYLE I VEHICLE TO DUET SABLIN TOWED BY GOVT.VEHICLE DAMAGE YES NO YES NO 23 REGISTERED OWNER INFO_ SHADE IN DAMAGED AREA 43 3 4 71 LIABILITY INSURANCE INSURANCE CO ' VINE EFFECT &POLICY# i 970P - 4 E:l 44 24 VEHICLE YES❑ NO❑ CITATION# CHARGE iq 60TiOM LECALLv STANDING 8 7 6 1 CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT. ROBERT SLINKMAN 01-08-23 05:48 PM 25 INVESTIGATING OFFICER'S SIGNATURE OFFICER'S PHONE UNIT OR DIST DET DATED: PLACE SIGNED 26 ORID# 11618 O#II,WA0171300 APPROVED BY 112012023 PAGE F OF 4 3000-345-013(R 11118) REPORT NO. ED26873 CASE# ' 23-311 DATE AND TIME 01/08/23 15:30 OF COLLISION \� I 1��k III i {t} g Not to scare PAGE 4 OF 4