HomeMy WebLinkAbout23-1136 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 0 27c
COLLISION REP FIT 1591971
CASE 23-1136 z
INTERSTATE ❑ CITY STREET FIRE ❑RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHIr.I F ❑ LOCAL AOENC 4Y00 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 2 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# ❑
cawsloN 01 - 1-- 2023 1858 17 ❑.= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓
SUNSET BLVD N BLOCK NO. e✓ 200
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ ❑ FEET e S ❑ W e 0 1 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
NO D:2067717163 0 7 30
6� LAST NAME ALI FIRSTNAME NIMO MIDDLE D 1 1 2 31
INITIAL
STREET ❑✓ 1150 SUNSET BLVD NE CITY RENTON ST WA 2jp, 98056 z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
1/ I iNTERLOCKYEs NO NTERLOCKYEs Z/NO YES R NoF,/
LRIIVER # STATE WA SEXI F M .O B 01
8❑ - 01 - 1996 1 2 32
9 ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 H U EET ICNLJAURY i NATURE OF INJURIES z❑
3
10❑ P1 aT�S� CFD4717 sTAr� WA VIN# 3N16C13E97L459282
TRAILER STATE TRAILER STATE
11 3 5 PLATE# PLATE# IR.. To
TRLR. TRLR 1 5 33
12 3 5 VIN#' VIN#
ROM TO
VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE J 9 34
13 8 2007 NISS VERSA SD DAMAGE YES NO YES[:] No✓
REGISTERED OWNER INFO OWNEDBYDRIVER VEHICLE NO. 1
SHADE IN DAMAGED AREA ❑ 35
14 LIABILITY INSURANCE INSURANCE CO STATE FARMQ 5229781CO147001 4
LI EFFECT I SUR N# TOPVEHICLE CHARGE 36
LEGALLYYES NO CITATION# 3AO186113 INATTENTIVE DRIVING <1�3
orrom
15❑ STANDING 7 6
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UN�T 02 VEHICLE ❑ CYCLE ❑ ❑ OWNER : ❑ YES 1/ NO DD 2069409474
16 a
LAST NAME VOLLANDT FIRST NAME JEFFREY MIDDLE P
INITIAL
17❑ STREET NEW ADDREss❑' 6473 FRANCIS LOOP SE CITY AUBURN ST WA ZIP 98092 4❑ 37
18❑ CDL IGNITION REQUIRED IGNITION PtR-E-S1ENT MEDICAL t-T�RANSPORTED � 38
INTERLOCKYES�NO� INTERLOCK Y�EsI I I NOF YES
t l NO�
19 LICENSE# STATE WA SEX U M.C... 10 _ 17 1972 39
20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 HEJ EET NJAURSY 1 NATURE OF INJURIES 40
❑21❑ 41
PLA E# 1GC4YUEY7LF104504 TArE WA vIN# PF01774 1
42
22❑ PILER LATE# STATE PLATE# STATE
23❑ VIN#. 43
TRLR RLR
'IN#.
rowed ev Gov HI 44
VEH YEAR 2020 MAKE CHEV MODEL SILVERA STYLE PK VEHICLE DAMAGE TOWED NOO✓ BLIN YES NO
24❑ REGISTERED OWNER INFO OWNED SY DRIVER VEHICLE N0.2
SHADE IN DAMAGEbAREA
2 3 Cd
LIABILITY
INSURANCE I PORGY#ECO STATE FARM L009510-A06-47PIN 1 9TOP
VEHICLE YES CITATION# CHARGE i o BOTTOM
ALLY
NCNC[:]25❑ LE s
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# JAGENCY
26
D.MOYNIHAN 11288 WA0171300
PAGE 01 OF
PART A
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. ED31200
COLLISION REPORT III III III III III 111
1591972 CASE# 23-1136
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'
On 01-26-2023 1 was on routine patrol in a marked patrol car. At about 1909 hours I arrived in the
area of the Renton Inn, located at 219 Sunset Blvd N, in the City of Renton, King County, Washington
in reference to a recent non injury collision.
Upon arrival, I was contacted by the driver of unit 2. He was later positively identified via picture
matching WA DL photograph as Jeffrey P Vollandt (DOB 10-17-1972). A summary of my
conversation with Vollandt follows. Vollandt was driving southbound in lane 2 of Sunset Blvd N in the
200 block. Traffic in front of Vollandt's vehicle, a Chevrolet Silverado bearing WALP PF01774, came
to a sudden stop. Right after Vollandt came to a stop in traffic, he was rear ended by unit 1. Vollandt
was uninjured and provided all requested documentation for his vehicle.
I next contacted the driver of unit 1, a Nissan Versa bearing WALP CFD4717. The driver was
positively identified via US Passport as Nimo D Ali (DOB 01-01-1996). Ali confirmed that traffic came
to a sudden stop and she was unable to stop before colliding with Vollandt's unit 2. Nim's rear driver
side tire was a "donut" spare tire, and she provided a learner's permit in lieu of a driver's license. A
computer records check of Ali confirmed that her driver's status was Permit.
Based upon statements from both drivers, and my observations of the damage to both vehicles,
determined that Ali failed to operate unit 1 with the attentiveness required based on the prevailing
traffic conditions. Additionally, Ali's inattentiveness was the proximate cause of the collision. I
advised Ali she would receive and infraction via mail.
Both parties were provided with an exchange of info and the vehicles were able to drive from the
scene.
I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT.
D.MOYNIHAN 01-27-23 02:28 AM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
P.SUMMERS 8887 2/4/2023 4:17:26 PM
BADGE OR ID# ! 11Y88 ORI#' WA0171300 TIME POLICE DISPATCHED'! 7:09 PM TIME POLICE ARRIVED 7:09 PM
PART I PAGE IT]OF 3�
REPORT NO. ED31200 CASE# ' 23-1136 DATE AND TIME 01/26/23 18:58
OF COLLISION
Sunset:Blvd,N
BronHon
Maple Valley HVVY(SR 160).
1-405.On Ramp.
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