The URL can be used to link to this page

Home My WebLink About23-1663 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 6 27c COLLISION REP FIT 1591971 CASE 23-1663 z INTERSTATE ❑ CITY STREET FIRE ❑RESULTED 1 STOLEN STATE ROUTE ❑ OTHER ❑ VFHICI F ❑ LOCAL AOENC 4100 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 0643 17 . N E IN� S 8 W H OF e 1070 3 4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑ GARDEN AVE N BLOCK NO. e ❑ 4a❑ MILEPOST DISTANCE OF(REFERENCE OR CROSS STREET) 5❑ �.❑ FEET e S ❑ W e N SOUTHPORT DR 0 1 29 MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE UNIT 01 VEHICLE ❑ CYCLE El NO D:2067136203 0 11 30 6� LAST NAME CLAYWORTH-SCOTT FIRSTNAME ELIZABETH MIDDLE J 1 2 31 INITIAL STREET El15711 SE 157TH ST CITy RENTON ST I WA 2jp, 980586345 z NEW ADDRESS 7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3 iNTERLOCKYEs NO INTERLOCKYEs NO YES R No�/ 8❑ LRIIVERS STATE WA SEX'F MID .O B 01 1- 23 - 1963 2 32 CENSE -' [NATURE OF INJURIES 9 ON DUTY❑ STATUS' AIRBAG 6 RESTR 4 . EJECT 1 HELMETU E 2 CLASS ,'NJURY7 I COMPLAINT OF CHEST PAW z❑ 3 10[1Pi ATNES# BHT2889 sTAr WAv N# 1 HGCT2BO6GA003858 5 TRAILER STATE TRAILER STATE 11 2 5 PLATE# PLATE# FROM TO TRLR. A'RLR. 1 5 33 12 3 5 VIN#j VIN# FROM TO ❑ VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN T Y GOVT.VEHICLE 3 ] 34 13 2 2016 HOND ACCOR DAMAGE vE6 0NO agW�MEYER vEs❑ No REGISTERED OWNER INFO ELIZABETH CLAYWORTH-SCOTT 15711 SE 157TH ST RENTON WA 98058 VEHICLE NO. 1 ❑ SHADE IN DAMAGED AREA 35 14 LIABILITY INSURANCE INSURANCE CO ALLSTATE 007271534 3 4 IN EFFECT &POLICY# 9TOP VEHICLE CHARGE 5 36 LEGALLY res No CITATION# 3AO179160 VEH ENTER INTERSEC STEADY RED o aorrom 15❑ STANDING 8 6 MOTOR PEDAL- PROPERTY DAM THR OLD MET PHONE UNIT 02 ❑✓ ❑ PEDESTRIAN ❑ ❑ D:2062949984 VEHICLE CYCLE OWNER YES�/ NO 16 a LAST NAME SANTIAGO MENDOZA FIRST NAME OSCAR MIDDLE INITIAL 17❑ STREET ❑', 1808 HARRINGTON AVE NE CITY RENTON ST WA ZIP 98056 37 NEW ADDRESS ❑ 18� CDL IGNITION REQUIRED IGNITION PtR-E-S1ENT MEDICAL TRANSPORTED ❑ 38 INTERLOCKYES�NOR INTERLOCK YEs I I NOF YEs t l NOF,/ 19 DRIVE # INJURY NATURE OF INJURIES 4O 20❑ ON DUTY STATUS AIRBAG 6 RESTR 4 EJECT 1 USE 2 CLASS 1 ❑ 21❑ LICENSE I BNE6939 TAre I WA VIN# 4T3ZF13C5WU014921 ❑ 41 PLATE# 42 22❑ PLATE# STATE PLATE# STATE 23❑ 43 TRLR RLR UIN It 'IN#. VEH YEAR 1998 MAKE TOYT MODEL SIENNA STYLE VEHICLE TOWED TO BLIN TOWEDBv GOV HI �44 24❑ DAMAGE YES�/ NO GENE MEYER YES NO REGISTERED OWNER INFO JOSE MENDOZA JIMENEZ 860912TH AVE S#C SEATTLEWA98108 VEHICLE NO.2 SHADE IN DAMAGED AREA 2 3 4 INAEFFITY ECTNSURANCE❑ &POINSULICY#E CO I VEHICLe ❑ ,.II CITATION# CHARGE ��D LEGALLYYES N25 Qs 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. ED34977 COLLISION REPORT III III III III III 111 1591972 CASE# 23-1663 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 northbound on Garden AVE N approaching N Southport DR planning to travel straight through onto northbound LK Washington BLVD N. Unit 2 was traveling westbound on N Southport DR approaching Garden AVE N/LK Washington BLVD N. Unit 3 was traveling southbound on LK Washington BLVD N staged to turn right onto westbound N Southport RD. Driver 2 advised he had a green light for westbound N Southport RD. Driver 1 stated that she saw the green light for the right lane of Garden AVE N which is a right turn only lane, and mistook it for a green light for her lane of travel which had a red light. Unit 1 traveled into the intersection against the red light at the same time Unit 2 lawfully entered the intersection westbound. The front end of Unit 1 struck the driver's side of Unit 2 causing moderate/heavy damage to both vehicles. The force of this collision diverted Unit 2's course and the front end of Unit 2 struck the rear driver's side of Unit 3 causing minor damage. Unit 1 and Unit 2 towed by Gene Meyer. 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 08:47 AM INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED APPROVED BY DATE CO.JOHNSON 0505 1 211712023 4:31:26 PM BADGE OR ID# 10008 OR]# WA0171300 TIME POLICE DISPATCHED; 6:45 AM TIME POLICE ARRIVED',6:52 AM PART I PAGE IT]OF 4� SUPPLEMENTAL REPORT NO. ED34977 r`I POLICE TRAFFIC 1 1 8 27 COLLISION REPORT CASE# 23-1663 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: :❑ GINAME IF NO NUMBER SOURCE AXLES + 4a ❑ ADDITIONAL UNITS MOTOR PEDAL- PROPERTY DAMAGE THRESHOLD MET PHONE 5 ❑ UNIT# 3 VEHICLE t_"J CYCLE _) PEDESTRIAN OWNER YES NO D:2065141147 OF 3 29 LAST NAME : OGINO FIRST NAME : KENTARO MIDDLE INI r:j TIAL STREET 30 NEW AnDRFrtP 1303 N 20TH STREET#B2005 CITY RENTON ST WA ZIP 980560000 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', 03 - 22 - 1974 7 ON DUTYl STATUS AIRBAG' 2 RESTR. Q EJECT 1 HELMET 2 INJURY 1 NATURE OF INJURIES USE CLASS 8 ❑ 1 32 LICENSE BVY3044 TAr Wq VIN# 5J6RW2H55LA011652 PLATE# 9 TRAILER TRAILER PLATE# STATE PLATE# STATE 10 ❑ TRLR TRLR VIN.#. VIN.#. 11 2 5 VEH.YEAR2020 MAKE HOND MODELCR-V STYLE VEHICLE TOWS E T SABLIN TOWED BY anvi vFH1I' FROM TO DAMAGE YES NO YES NO 33 REGISTERED OWNER INFO.SEKISUI AEROSPACE 705 SW 7TH ST RENTONWA98057 SHADE IN DAMAGED AREA 1 7 12 z 3 FROM TO LIABILITY INSURANCE INSURANCE CO TOKIO MARINE AMERICA INS CO CA6402929.12 GQ IN EFFECT &POLICY# 1VEHICLE 34 13Lecnuv YES❑ NO❑ CITATION# CHARGE STANDING S} 8 7 14 ❑ UNIT Tr Vd 1RE O CYDCLE 1:1OWNERRTY YES AGE NOHRESHOLD MET PHONE ❑ 35 PEDESTRIAN 15 LAST NAME FIRST NAME NITIAL ❑ 36 STRE 16 NEW ETETnnR"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 3 LIABILITY INSURANCE INSURANCE CO ' VINE EFFECT &POLICY# i 970P - 4 E:l 44 24 LERICLE 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 08:47 AM 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. ED34977 CASE# 23-1663 DATE AND TIME 02/09/23 06:43 OF COLLISION ert' LK W�tSN�NG1' O�8tV0 GARDEN AVE N 1� *"NOT TO SCALE- l i I PAGE 4 OF 4