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Home My WebLink About23-2869 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 5 27c COLLISION REP FIT 1591971 CASE 23-2869 z INTERSTATE ❑ CITY STREET FIRE ❑RESULTED 1 STOLEN STATE ROUTE ❑ OTHER ❑ VFHICI F ❑ LOCAL AOENC 4Y00 3 HIT&RUN CODING COUNTY RD PRIVATE WAY INVOLVED 2 2 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 N E IN CITY# ❑ cawsloN 03 - 10 - 2023 1231 17 ❑.❑ S 8 W H OF e 1070 3 4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓ SW 43RD ST BLOCK NO. e✓ 1600 4a❑ MILEPOST DISTANCE OF(REFERENCE OR CROSS STREET) 5❑ 800 00 FEET MILES e S ❑ W e S 72ND ST 0 1 29 UNIT 01 VEHICLE CYCLE ElYES A✓NOGE ESHOLDMET PHONE 0 6 30 6� LAST NAME MORRIS FIRSTNAME RACHEL MIDDLE L 1 1 2 31 INITIAL STREET El 17431 AMBAUM BLVD S UNIT D42 CITY BURIEN ST WA ZIP 981481738 z= NEW ADDRESS 7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3 :NTERLOCKYEs NO INTERLOCK YES NO YES No 8❑ DRIVERS # STATE WA SEX'F MIDI Y' 12 — 14 — 1986 1 2 32 9 ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 HELMETU SE CLASS 1 NATURE OF INJURIES z❑ 3 10 99 P1 ATNES# BNP7440 sTAT WAu N# JN8AS5MV5CW705559 5 TRAILER STATE TRAILER STATE 11 3 5 PLATE# PLATE# FROM TO TRLR. TRLR 3 7 33 12 3 5 VIN#' VIN# >; FROM TO ❑ VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN T /g[ GOVT.VEHICLE 3 ] 34 13 2 2012 NISS ROGUE DAMAGE YES NOBS YES : No✓ REGISTERED OWNER INFO RACHEL MORRIS 17431 AMBAUM BLVD S UNIT D42 BURIEN WA 981481738 VEHICLE NO. 1 ❑ SHADE IN DAMAGED AREA 35 14 ABILI V INSURANCE INSURANCE CO ST FARM 0935256-D1047E 3 4 IN EFFECT &POLICY# 9TOP VEHICLE CHARGE 5 36 LEGALLY YES❑NO❑ CITATION# 3AO081080 INATTENTIVE DRIVING )o eorrom 15❑ STANDING 7 6 UNIT 02 VE ICCLE CYCLE ❑ PEDESTRIAN ❑ OWN ARTY ❑ DYES✓ NO OLD MET PHONE 16 a LAST NAME SHEPPARD FIRST NAME MATTHEW MIDDLE R INITIAL 17❑ STREET ❑', 8426 REINIG PL SE CITY SNOQUALMIE ST WA ZIP 980655184 37 NEW ADDRESS ❑ 18� CDL IGNITION REQUIRED IGNITION PtR—E—S1ENT MEDICAL—T�RANSPORTED 38 INTERLOCKYES�NOR INTERLOCK YEs I I NOF YEs t l NO❑ 19[—] LDI IVER # STATE WA SEX M M D.C.B. 08 _ 25 _ 1971 0 39 WELMET INJURY1 NATURE OF INJURIES 40 20❑ ON DUTY STATUS AIRBAG 3 RESTR 4 EJECT 1 USE CLASS ❑ 21❑ LICENSE BYR7417 TATe WA VIN1t 3VW5T7AUOGM041790 ❑ 41 PLATE# 42 22❑ PILER LATE# STATE PLATE# STATE 23❑ VIN#. 43 TRLR RLR 'IN#. VEH YEAR 2016 MAKE VOLK MODEL GTI STYLE VEHICLE TOWED TO BLIN TOWEDBY GOV HI 44 24❑ DAMAGE YES✓ NO BANKERS YES NO✓ REGISTERED OWNER INFO MATTHEW SHEPPARD 8426 REINIG PL SE SNOQUALMIE WA 980655184 VEHICLE NO.2 SHADE DA GEbAREA LIABILITY INSURANCE INSU&PORGY#E CO FARMERS 200210067IN 1cl�� 'E""LE ❑ ,J� CITATION# CHARGE LEGALLY YES N`L J 25 OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY J 26 M.LEVERTON 2517 WA0171300 PART A PAGE 01 OF C7 3000-345-159 OR 11/181 STATE OF POLICETRAFFICN CORRECTION REPORT NO. ED42585 COLLISION REPORT III III III III III 111 1591972 CASE# 23-2869 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 PM 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' Please see subsequent narrative pages I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT. M.LEVERTON 03-10-23 01:30 PM INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED APPROVED BY DATE CO.JOHNSON 0505 1 311512023 9:06:59 AM BADGE OR ID# 2517 ORI# WA0171300 TIME POLICE DISPATCHED 12:50 PM TIME POLICE ARRIVED:12:57 PM PART I PAGE IT]OF REPORT NO. ED42585 CASE# 23-2869 OF COLLISION 03/10/23 12:31 OF CbLLI510N NARRATIVE gold/1 lane 1 rear sil/2 coupe 2 hits sil sedan 3 CC Within the city limits of Renton/King/WA I responded to a 3 car blocking crash at about the 1600 block of SW 43rd St. I contacted the driver of unit 3 who told me he was slowing when unit 2 hit the back of him after unit 1 had hit unit 2. He did not complain of injury and damages did not require a tow truck. I contacted the driver of unit 2 who told me he was slowing rapidly for traffic when he was hit from the back by unit 1. It pushed his car up and onto the sidewalk, then slid into the back of unit 3. He did not complain of injury and damages did require a tow truck. I contacted the driver of unit 1 ID'd by her picture WADL. She told me she westbound lane 1, was distracted and didnt realize traffic was slowing so rapidly. She braked and hit unit 2 pushing unit 2 into unit 3. She did not complain of injury and damages required a tow truck. I cited unit 1 ref RMC 10-12-25 Driver Inattention 3 car crash via complaint. I certify (declare) under penalty of perjury under the laws of the State of Washington that the foregoing is true and correct. M.Leverton/2517 City of Renton/King/Wa 3/10/2023 PAGE 3 OF 5 SUPPLEMENTAL REPORT NO. ED42585 r`) POLICE TRAFFIC 1 1 8 27 COLLISION REPORT CASE# 23-2869 1 COMMERCIAL MOTOR CARRIER INTERSTATE INTRASTATE G UNIT'# USDOT ICC# VEHICLE TYPE CARGO BODY ;TYPE 2 ❑ 1 28 CARRIER NAME 3 CARRIER ADDRESS ` CITY ST ZIP—1 I ' 4 ❑ NAME # PLACARD: :❑ GI PLACARD IF NO NUMBER SOURCE AXLES + 4a ❑ ADDITIONAL UNITS MOTOR PEDAL- PROPERTY DAMAGETHRESHOLD MET PHONE 5 ❑ UNIT# 3 VEHICLE t_"J � PEDESTRIAN YES NO 0 6 29 LAST NAME MORRIS FIRST NAME ROBERT MIDDLE' L INITIAL STREET 30 NEW AnDRFrtP 27524 SE 200TH ST CITY HOBART ST WA ZIP 980250000 6 CDL IGNITIttN REQUIRED IGNITION PRESENT MEDICAL TAN5PORTEO 1 1 2 31 INTERLOCK YEs No NTERLOCK YES[:]NO[:] YES N DRIVER'S LICENSE STATE I WA SEX M MMDDYYv 06 TOE] - 1957 7 ON DUTY� STATUS AIRBAG' 2 RESTR. Q EJECT 1 HELMET I INJURY 1 1 NATURE OF INJURIES USE CLASS 8 ❑ 1 32 LICENSE BHH4167 TAr Wq VIN# 1G11C5SL9EU161472 PLATE# 9 9] TRAILER TRAILER PLATE# STATE PLATE# STATE 10 ❑ TRLR TRLR VIN.#. VIN.#. 11 3 5 VEH.YEAR2014 MAKE CHEV I MODELMALIBU STYLE VEHICLE TOVVE E T SABLIN TOWED BY anvi vEH1Ci P FROM TO DAMAGE YES 'E YES NO REGISTERED OWNER INFOROBERT MORRIS 27524 SE 200TH ST HOBART WA 980250000 3 ] 33 12 � SHADE IN DAMAGED AREA 3 4 FROM TO LIABILITY INSURANCE INSURANCE CO ST FARM Ot06401 C2347H q"i"Olx IN EFFECT &POLICY# 1 VEHICLE 34 13 2 Lecnuv YES❑ NO❑ CITATION# CHARGE 10 BOTTUM STANDING } 8 7 6 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 REdUiREO IGNITION PRESENT MEDICALTANSPORTED NTERLUCK YES No NTERLOCK 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 ❑ 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 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. X LEVERTON 03-10-23 01:30 PM 25 INVESTIGATING OFFICER'S SIGNATURE OFFICER'S PHONE UNIT OR DIST DET DATED: PLACE SIGNED APPROVED BY DATE 26 OR ID 2517 O#I WA0171300 JOHNSON 3/15/2023 PAGE�OF F 3000-345-013(R 11118) REPORT NO. ED42585 CASE# ' 23-2869 DATE AND TIME 03/10/23 12:31 OF COLLISION It VF nit nit t PAGE 5 OF 5