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Home My WebLink About23-1679 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 5 27c COLLISION REP FIT 1591971 CASE 23-1679 z INTERSTATE ❑ CITY STREET FIRE ❑RESULTED 1 STOLEN STATE ROUTE ❑ OTHER ❑ VFHIr.I F ❑ LOCAL AGENC 4200 3 HIT&RUN CODING COUNTY RD PRIVATE WAY INVOLVED 2 1 TOTAL#OF OBJECT 1 1 8 28 TRIBAL UNITS 03 STRUCK RESERVATION z 3❑ DATE of M M D D Y Y Y Y TIME(2400) COUNTY# MILES CITY# cowsloN 02 - 09 - 2023 1434 17 . N E IN� S 8 W H OF e 1070 3 4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑ MILEPOST S 7TH ST BLOCK 4a❑ e✓ p ❑ O. DISTANCE OF(REFERENCE OR CROSS STREET) 5❑ ❑ FEET e S ❑ W e SHATTUCKAVE S 0 1 29 MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE UNIT 01 VEHICLE ❑ CYCLE El ✓NO D:2069300646 0 11 30 6� LAST NAME MUSE FIRSTNAME DEEQO MIDDLE M 1 1 2 31 INITIAL STREET ❑✓ 8532 S 118TH ST CITY SEATTLE ST WA ZIP 98178 z NEW ADDRESS 7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3 iNTERLOCKYEs NO INTERLOCKYEs NO YEs No�/ 8❑ D RI VER # STATE WA SEX'F MMDDYY' 07 - 07 - 1985 1 2 32 9 ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 H USE CLASS 2 CLASS 1 NATURE OF INJURIES 2❑ 3 10[1P1 ATNES# BVA1131 sTAr WAv N# JTDZN3EU9GJ051801 TRAILER STATE TRAILER STATE 11 2 5 PLATE# PLATE# ROM ro 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 5 1 34 13 2 2016 TOYT PRIUS V DAMAGE YES NO YES[:] NO✓ REGISTERED OWNER INFO DEEQO MUSE 8532 S 118TH ST SEATTLE WA 98178 VEHICLE NO. 1 ❑ SHADE IN DAMAGED AREA 35 14 LIABILI INSURANCE INSURANCE CO NATIONWIDE 7246JO43117 3 4 IN EFFECT &POLICY# 9TOP VErIICLE CHARGE 5 El 36 LEGALLY YES No CITATION# 3AO179161 VEH ENTER INTERSEC STEADY RED o aorrom 15❑ STANDING 8 6 MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE 16 a UNIT 02 VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES 1/ NO D:2065913263 LAST NAME NGUYEN FIRST NAME HOANG MIDDLE p INITIAL 17❑ STREET ❑', 4702 S 122ND ST CITY TUKWILA ST WA ZIP 981783442 37 NEW ADDRESS ❑ 18� CDL IGNITION REQUIRED IGNITION PR-E-1SENT MEDICAL TRANSPORTED ❑ 38 INTERLOCKYES�NOR INTERLOCK YEs It I NOF YES t l NOF,/ 19 D IVERI # STATE WA SEX M M .C.B. 08 _ 10 _ 2001 39 —NATURE OF INJURIES H USE CLASS NJAURSY ADVISED WAS SHAKEN UP ❑ 40 20❑ ON DUTY STATUS AIRBAG,6 RESTR 4 EJECT 1 2 7 21❑ LICENSE BSSO453 TAre I WA vIN# 3FADP46J8KM155038 ❑ 41 PLATE# 42 22❑ PLATE# STATE PLATE# STATE 23❑ UIN#. 43 TRLR RLR 'IN#. VEH YEAR 2019 MAKE FORD MODEL FIESTA STYLE VEHICLE TOWED TO BLIN TOWEDBY GOV HI 44 24❑ DAMAGE YES NO BANKERS YES NO REGISTERED OWNER INFO XUAN NGUYEN 4702 S 122ND ST TUKWILA WA 98178 VEHICLE NO.2 SHADE IN DAGED AREA 2 4 LIABILITY INSURANCE Z &POINSURGY#E CO STATE FARM 4687580-D27-47AIN 1GQVEHICLE ❑ C—I CITATION# CHARGE LEGALLY YES N`LJ 25 OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# JAGENCY 26 K.LANE 10008 WA0171300 PART A PAGE 01 OF C7 3000-345-159 OR 11/181 STATE OF POLICETRAFFICN CORRECTION REPORT No. ED34976 COLLISION REPORT III III III III III 111 1591972 CASE# 23-1679 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 westbound on S 7th ST approaching a red light at Shattuck AVE S. Unit 2 was traveling northbound on S 7th ST approaching Shattuck AVE S with a green light planning to travel straight through with the right of way. Unit 3 was on southbound S 7th ST stopped just north of Shattuck AVE S waiting for Unit 2 to pass so that he could turn left onto eastbound S 7th ST. Unit 1 entered the intersection against the red light as Unit 2 was traveling lawfully through it. This is confirmed by the statements of Driver 2 and Driver 3. The front end of Unit 1 struck the passenger side of Unit 2 causing moderate damage to both vehicles. The force of this collision caused Unit 2 to rotate clockwise and the rear end of Unit 2 grazed the front driver's corner of Unit 3 causing minor damage. Unit 2 towed by Bankers tow. Driver 1 was cited for entering the intersection against a red circle (red light) which was the proximate cause of the collision. I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT. K.LANE 02-09-23 03:20 PM INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED APPROVED BY DATE CO.JOHNSON 0505 1 211712023 4:35:02 PM BADGE OR ID# 10008 OR]# WA0171300 TIME POLICE DISPATCHED 2:34 PM TIME POLICE ARRIVED 2:34 PM PART I PAGE IT]OF 4� SUPPLEMENTAL REPORT NO. ED34976 r`I POLICE TRAFFIC 1 1 8 27 COLLISION REPORT CASE# 23-1679 1 COMMERCIAL MOTOR CARRIER INTERSTATE INTRASTATE G UNIT'# USL70r !CC# VEHICLE TYPE CARGO BODY TYPE 2 ❑ 1 28 CARRIER NAME 3 CARRIER ADDRESS ` CITY ST' ZIP' 4 ❑ NAME # PLACARD: :❑ GINAME IF NO NUMBER SOURCE AXLES + 4a ❑ ADDITIONAL UNITS MOTOR PEDAL- PROPERTY DAMAGE THRESHOLD MET PHONE 5 ❑ UNIT# 3 VEHICLE tSJ CYCLE I_) PEDESTRIAN � OWNER � YES NO D:4259854782 OF 7 29 LAST NAME STAMP FIRST NAME GREGORY MIDDLE' ',, S INITIAL STREET 30 NEW AnDRFrtP 2300 BENSON RD S UNIT C4 CITY RENTON ST WA ZIP 980558878 6 CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TANSPORTED 1 1 2 31 INTERLOCK YEs No zERLOCK YES[:]NO[:] YEs N DRIVER'S LICENSE STATE I WA SEX M MMDDYYv', 01 - 19 - 1953 7 ON DUTYl STATUS AIRBAG' 2 RESTR. Q EJECT 1 HELMET 2 INJURY 1 NATURE OF INJURIES USE CLASS 8 ❑ 1 32 LICENSE B►T9718 TAr WA VIN# 5NPE24AF3GH344090 PLATE# 9 TRAILER TRAILER PLATE# STATE PLATE# STATE 10 ❑ TRLR TRLR VIN.#. VIN.#. 11 2 5 VEH.YEAR2016 MAKE HYUN I MODELSONATA STYLE VEHICLE TOVVE E T SABLIN TOWED BY anvi vEH1I' FROM TO DAMAGE YES 'E YES NO REGISTERED OWNER INFOMAYVICTORIA ALIPAO 2300 BENSON RD S UNIT C4 RENTON WA 98055 J 9 33 12 SHADE IN DAMAGED AREA 7 j 4 FROM TO LIABILITY INSURANCE INSURANCE CO PROGRESSIVE 926212141 q"i"Olx IN EFFECT &POLICY# 1 EHICLE 34 13 ❑ LEGALLY YES NO❑ CITATION# CHARGE 0 BOTTOM STANDING S} 7 6 14 ❑ UNIT Tr Vd IRE O CYDCLE 1:1OWNERRTY YES AGE NOHRESHOLD MET PHONE ❑ 35 PEDESTRIAN 15 LAST NAME FIRST NAME NII7 AL ❑ 36 ET STRE 16 NEW ETnnR"F] CITY ST ZIP CDL IGNITION REdUiRED IGNITtGN PRESENT MEDICALTANSPORTED INTERLOCK YES No INTERLOCK YES NO YES NO El 17 37 LICENSE# STATE SEX MMDDDYBYY - 18 ❑ ON DUTY� STATUS AIRBAG RESTR. ; EJECT HELMET INJURY NATURE of INJURIES 38 USE ICLASS 19 ❑ 39 LICENSE rnr VIN# PLATE# 20 ❑ TRAILER TRAILER El40 PLATE#< STATE PLATE# STATE 21 ❑ TRLR TRLR 41 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 3 4 4 AREA F 43 z LIABILITY INSURANCE INSURANCE CO ' VINE EFFECT &POLICY# i 970P - 4 E:l 44 24 LEHIcLE YES❑ NO❑ CITATION# CHARGE iq 60TiOM LEGALLv STANDING S 7 6 1 CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT. K.LANE 02-09-23 03:20 PM 25 INVESTIGATING OFFICER'S SIGNATURE OFFICER'S PHONE UNIT OR DIST DET DATED: PLACE SIGNED APPROVED BY DATE 26 ORID# 10008 O#I,WA0171300 JOHNSON 211712023 PAGE F OF 4 3000-345-013(R 11118) REPORT NO. ED34976 CASE# ' 23-1679 DATE AND TIME 02/09/23 14:34 OF COLLISION i I i' SHATTUCK ALE S ' — JOT TO SCALE*** cry PAGE 4 OF 4