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Home My WebLink About23-1457 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 1 27c COLLISION REP FIT 1591971 CASE 23-1457 z INTERSTATE ❑ CITY STREET FIRE ❑ RESULTED 1 STOLEN STATE ROUTE ❑ OTHER ❑ VFHIr.I F ❑ LOCAL AGENCI 4Y00 3 HIT&RUN CODING COUNTY RD PRIVATE WAY INVOLVED 2� 1 1 8 28 TOTAL#OF OBJECT TRIBAL UNITS 03 STRUCK' WOOD RESERVATION z 3❑ DATE OF M M D D Y Y Y Y TIME(2400) COUNTY# MILES N E IN CITY# CowsloN 02 - 1-- 2023 2025 17 ❑-= S 8 IN e 1070 3 4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑ 116TH AVE SE BLOCK NO. e ❑ 4a❑ MILEPOST DISTANCE OF(REFERENCE OR CROSS STREET) 5❑ ❑ FEET e S ❑ W e SE 164TH ST 0 1 29 MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE UNIT 01 VEHICLE ❑ CYCLE El ,/No D:4252718751 0 11 30 6� LAST NAME YOUNG FIRSTNAME MARVIN MIDDLE L 1 1 2 31 INITIAL STREET ❑ 16531 120TH AVE SE CITY RENTON ST WA ZIP 98058 z 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 6 RESTR 9 EJECT 1 H U SE ICNLJAUSSY 1 NATURE OF INJURIES z❑ 3 10 9❑ P1 aT�S� 055XPC sTATI WAurN# 1NXBR12E31Z520907 IT STATE TRAILER STATE 11 0 0 PLATE# PLATE# ROM ro TRLR. YRLR. $ 1 33 12 0 0 VIN#' VIN# FROM TO VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE DAMAGE YES NO 1 $ 34 13 2 2001 TOYT COROL YES❑ NO✓ REGISTERED OWNER INFO MARVIN YOUNG 16531120TH AVE SE RENTON WA 98058 D:4252718751 VEHICLE NO. 1 ❑ SHADE IN DAMAGED AREA 35 14 LIABILITY INSURANCE INSURANCE CO ALLSTATE 007004241 3 4 IN EFFECT &POLICY# 9TOP VE—LE 5 36 LEGALLY Yes❑NO❑ CITATION# CHARGE 10 BOTTOM 15❑ STANDING 6 MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE UNIT U2 VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES 1/ NO D:2063305936 16 1 LAST NAME BAILEY FIRST NAME RYAN MIDDLE I F INITIAL 17❑ STREET ❑', 1701 ROLLING HILLS AVE SE CITY' RENTON ST WA ZIP 980553727 37 NEW ADDRESS ❑ 18� CDL IGNITION REQUIRED IGNITION PtR-E-S1ENT MEDICAL TRANSPORTED ❑ 38 INTERLOCKYES�NO� INTERLOCK Y�EsI I I NOF YEs t l NO� 19 D IVEW # STATE WA SEX M M.O.B. 05 _ 13 _ 1993 0 39 WELMET INJURY 1 NATURE OF INJURIES 40 20❑ ON DUTY STATUS' AIRBAG 6 RESTR 9 EJECT ''1 USE CLASS ❑ 21❑ LICENSE I BJC5286 TATE WA VIN# 1C3CCCAB4GN171132 ❑ 41 PLATE# 42 22❑ PILER LATE# STATE PLATE# STATE 23❑ VIN#. 43 TRLR RLR 'IN#. VEH YEAR 2016 MAKE CHRY MODEL 200 STYLE VEHICLETOWED TO BLIN TOWEDBY GOV HI 44 24❑ DAMAGE YES NO YES NO REGISTERED OWNER INFO RYAN BAILEY 1701 ROLLING HILLS AVE SE RENTON WA 980553727 D:2063305936 VEHICLE NO.2 SHADE IN DAMAGED AREA 2 3 4 LIABILITY INSURANCE INSU&PORGY#E CO GEIC04509212735IN 1UQI 'E"'LE ❑ ,J� CITATION# CHARGEYES N`L J25 OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# JAGENCY 26 LACY SMITH 12613 WA0171300 PART A PAGE 01 OF C7 3000-345-159 OR 11/181 STATE OF POLICETRAFFICN CORRECTION REPORT NO. ED35107 COLLISION REPORT III III III III III 111 1591972 CASE# 23-1457 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 02/03/2023, 1 was assigned to District 13 as the, 3R13. At approximately 2026 hours I was dispatched to116TH AVE SE/SE 163RD ST for a two vehicle collision. This is located in the city of Renton, the county of King, and the state of Washington. Unit 1-055XPC Driver of unit 1-YOUNG, MARVIN Unit 2-BJC5286 Driver of Unit 2- BAILEY, RYAN I arrived on scene and contacted the driver/ sole occupant of unit 1. 1 identified the driver of unit 1 as, Marvin Young, by his Washington State DOL return. Young stated he was driving Northbound on 116th Ave SE when he was blinded by the headlights of unit 2 right before the collision. I contacted the driver/sole occupant of unit 2 and positively identified him as, Ryan Bailey, by his Washington State DOL return. Bailey stated he was driving Southbound on 116th Ave SE bound when unit 1 turned into him. Renton fire medicinally cleared both drivers on scene. Both vehicles were towed by Gene Meyer's Tow. I filled out an online Origami report for the damaged street sign. I declare under penalty of perjury under the laws of the State of Washington that the foregoing is true and correct. Electronically signed by Officer L.Smith 12613 on 02/05/2023 in Renton, WA. I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT. LACY SMITH 02-05-23 06:58 PM INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED APPROVED BY DATE J.THIELMAN 11462 1 211812023 4:28:56 AM BADGE OR ID# 12613 ORI#' WA0171300 TIME POLICE DISPATCHED 8:26 Pry/ TIME POLICE ARRIVED 8:Y8 Pry/ PART I PAGE IT]OF 4] SUPPLEMENTAL REPORT NO. ED351 O7 r`) POLICE TRAFFIC 1 27 COLLISION REPORT CASE# 23-1457 1 COMMERCIAL MOTOR CARRIER INTERSTATE INTRASTATE G UNIT'# USDOT ICC# VEHICLE TYPE CARGO BODY ;TYPE 2 ❑ 1 28 CARRIER NAME 3 CARRIER L ADDRESS ` CITY ST ZIP—1 I ' 4 ❑ NAME # PLACARD: :❑ GI PLACARD IF NO NUMBER SOURCE AXLES + 4a ❑ ADDITIONAL UNITS MOTOR PEDAL- PROPERTY DAMAGE THRESHOLD MET PHONE 5 ❑ UNIT# 3 VEHICLE I_J CYCLE u PEDESTRIAN � OWNER � YEs� IN MIDDLE' 29 LAST NAME RENTON FIRST NAME CITY INITIAL STREET 30 NEW AnDRFSP' 1055 SOUTH GRADY CITY RENTON ST WA ZIP 98055 6 CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TANSPORTED 1 31 INTERLOCK YES[:]NO zERLOCK YES E]Na� YEs N DRIVER'S STATE I SEX U M��DYSYv' —� 2 LICENSE 7F-ION DUTY STATUS AIRBAG RESTR. EJECT HELMET INJURY NATURE OF INJURIES F� USE CLASS 8 ❑ ' 1 32 LICENSE+ rar V1N.# PLATE# 9 TRAILER TRAILER PLATE# STATE PLATE# STATE 10 ❑ TRLR TRLR VIN.#. VIN.#. 11 VEH.YEAR MAKE I MODEL STYLE I VEHICLE TOWS E T SABLIN TOWED BY anvi vEHIG P FROM TO DAMAGE YES NO YES NO REGISTERED OWNER INFO. m 33 12 SHADE IN DAMAGED AREA FROM TO ((ABILITY INSURANCE❑ INSURANCE CO IN EFFECT &POLICY# tGQ VEHICLE 34 13 ❑ LEGALLY YES[:] NO❑ CITATION# CHARGE STANDING S} 8 7 6 14 ❑ UNIT Tr Vd IRE O CYDCLE OWNER YES AGE NOHRESHOLD MET PHONE El 35 PEDESTRIAN 15 LAST NAME FIRST NAME MIDDLE': INITIAL36 STREET"[—] ❑ 16 NEn+AnnRFs.�' 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 (CLASS 19 ❑ vIN# 39 LICENSE PLATE# rnr 20 ❑ TRAILER' TRAILER ❑ 40 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 AREA 43 3 4 71 LIABILITY INSURANCE INSURANCE CO ' VEHICLE EFFECT &POLICY# I 970P - 4 44 24 VEHICLE YES NO❑ CITATION# CHARGE iq 60TiOM E:l C=DLv 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. LACY SMITH 02-05-23 06:58 PM 25 INVESTIGATING OFFICER'S SIGNATURE OFFICER'S PHONE UNIT OR DIST DET DATED: PLACE SIGNED APPROVED 1126 � BADGE O#I'WA0171300 EAN 1 PAGE OF 4OI 3000-345-013(R 11118) REPORT NO. ED35107 CASE# 23-1457 DATE AND TIME 02/03/23 20:25 OF COLLISION 5E 163RD 5T Unit , rr This diagram is not to sca:ll `m D m n m PAGE 4 OF 4