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Home My WebLink About23-3073 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 5 27c COLLISION REP FIT 1591971 CASE 23-3073 z INTERSTATE ❑ CITY STREET FIRE ❑RESULTED 1 STOLEN STATE ROUTE ❑ OTHER ❑ VFHIr.I F ❑ LOCAL AOENC 4900 3 HIT 8 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 N E IN CITY# ❑ cowsloN 03 - 1-- 2023 1556 17 ❑.= S 8 IN e 1070 3 4❑ oN (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓ NE 4TH STREET BLOCK NO. e✓ 4100 4a❑ MILEPOST DISTANCE OF(REFERENCE OR CROSS STREET) 5❑ 300 00 FEET e MILES S ❑ W e UNION AVE NE 0 1 29 MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE UNIT 01 VEHICLE ❑ CYCLE El ✓NO D:2067900903 0 81 30 6� LAST NAME VILLANUEVA FIRSTNAME GREGORY MIDDLE A 1 1 2 31 INITIAL STREET ❑, 3820 156TH AVE SE CITY BELLEVUE ST WA ZIP 980061760 z 'NEW ADDRESS 7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3 iNTERLOCKYEs NO 1/ INTERLOCKYEs NO�/ YES R No�/ 8❑ LRIIVER # ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 HELMET 2 CLASS 1 NATURE OF INJURIES z❑ 3 10❑ P1 aTES� C48054J sTAr� WAvIN# 2FTZF18281CA03725 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 TOWED BY GOVT.VEHICLE g 9 34 13 2001 FORD F150 PK DAMAGE YES NO YES[:] No✓ REGISTERED OWNER INFO ORE.ORI VILLANUEVA 3820156TH AVE SE BELLEVUE WA 98006 D:2067900903 VEHICLE NO. 1 ❑ SHADE IN DAMAGED AREA 35 14 LIABILITY INSURANCE INSURANCE CO SAFECO H2408557 4 LI EFFECT I SUR N# TOPVEHICLE CHARGE 36 LEGALLYYES NO CITATION# 3AO055556 INATTENTIVE DRIVING <1�3 orrom 15❑ STANDING 7 6 MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE UNIT VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES 1/ No D:2062352241 N:2067660859 16 a LAST NAME VU FIRSTNAME LOC MIDDLE I V INITIAL 17 STREET I❑ 15800 SE 128TH ST CITY RENTON ST WA ZIP 980598520 37 NEW ADOREss❑' 18❑ CDL IGNITION REQUIRED IGNITION PtR-E-S1ENT MEDICAL—T�RANSPORTED � 38 INTERLOCK YEs❑No� INTERLOCK YEs I I NOF YEs t l NOF,/ 19 LDIIVER # STATE WA SEX M M .C.B. 04 16 _ 1952 39 20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 H U EET 2 NJAURSY 1 NATURE OF INJURIES 40 ❑ 41 21❑ PLATE# AGF3445 TArE WA vIN# 1HGES16305L000255 1 42 22❑ PLATE# STATE PLATE# STATE TRLR 23❑ VIN#. IN#. 43 RLR ' VEH YEAR 2005 MAKE HOND MODEL CIV4D STYLE qD VEHICLE TOWED TO BLIN TOWEDBY GOV HI 44 L4❑ DAMAGE YES NO YES NO REGISTERED OWNER INFO THANH TRAN 651643RD AVE S SEATTLE WA 98118 D:2067660859 N:2062352241 VEHICLE NO.2 SHADE IN DAMAGEbAREA 2 3 Cd LIABILITY INSURANCE 8 POINSURGY#E CO STATE FARM 176 6762-C19-47BIN STOP 'E""LE CITATION# CHARGE i o BOTTOM LEGALLY YES N� 25❑ s =UGENT PRINT) OFFICER PHONE BADGE OR ID# AGENCY26 11498 WA0171300 PAGE 01 OF PART A 3000-345-159 OR 11/181 STATE OF POLICETRAFFICN CORRECTION REPORT NO. ED44637 COLLISION REPORT III III III III III 111 1591972 CASE# 23-3073 ADDITIONAL PERSONS INVOLVED PASSENGERS AND/(OR WITNESSES ONLY) NAME MIDDLE INITIAL) TRAN THANH T (LAST FIRST, ADDRESS&PHONE# D O.B. ' 6516 43RD AVE S SEATTLE WA 981180000 2067660859 SEXi F MMDOYyry 08 - 07 - 1962 {� SEAT HELMET INJURY NATURE OF INJURIES PASSENGER Z WITNESS� UNIT# 2 POS 9 AIRBAG 2 RESTR. 4 EJECT 1 USE 2 CLASS '6 C/O BACK PAIN.EVAL'D AND.. BYRFA NAME (LAST,FIRST,MIDDLE INITIAL) ADDRESS&PHONE# D O B SEX MMDDYYYY PASSENGER ❑WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET NJURY POS. NATURE OF INJURIES USE CLASS NAME (LAST FIR57 MIDDLE INITIAL) AppRESS&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. MATTHEW NUGENT 03-20-23 06:21 PM INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED APPROVED BY DATE Co.JOHNSON 0505 3/22/2023 4:25:54 PM BADGE OR ID# 11498 ORI# WA0171300 TIME POLICE DISPATCHED; 3:57 PM TIME POLICE ARRIVED',4:06 PM PART I PAGE IT]OF REPORT NO. ED44637 CASE# 23-3073 OF COLLISION 03/15/23 15:56 OF CbLLI510N NARRATIVE 23-3073 On 03/15/2023 at approximately 1557 hours, I was dispatched to a 3-vehicle collision with injury in the 4100 block of NE 4th Street, within the City Limits of Renton, County of King, State of Washington. While en route, Dispatch advised of a 3-vehicle collision that was blocking one of the westbound lanes of travel. Additionally, Dispatch advised that one of the involved parties was complaining of head pain therefore the Renton Regional Fire Authority was dispatched to the scene. Upon arrival, Renton Fire was on scene treating the involved parties. There, I collected each involved party's driving information and their independent recollection leading up to the collision. The driver of Unit#1 said he was the sole occupant of his vehicle and was traveling westbound in about the 4100 block of NE 4th ST in lane 1 of 2 prior to the collision. The driver of Unit#1 stated he was traveling directly behind Unit#2 but believed that traffic had a fresh green light and assumed traffic was moving again. By the time the driver of Unit#1 noticed Unit#2 stopped, he was unable to bring his vehicle to a stop before colliding with the rear of Unit#2 subsequently causing moderate damage to the front end of Unit#1. Due to the initial impact, Unit#2 was pushed into the rear of Unit #3, which was also stopped for traffic and directly in front of Unit#2 causing additional damage. The driver of Unit#2 said he and his adult passenger were traveling westbound in about the 4100 block of NE 4th ST in lane 1 of 2. The driver of Unit#2 stated he was traveling directly behind Unit#3 and was stopped at the traffic light. While Unit#2 was stopped, Unit#1 collided with the rear of Unit #2 causing significant damage to the rear of Unit#2. The driver of Unit#2 stated his vehicle was then pushed forward into the rear of Unit#3 causing additional damage to the front of Unit#2. The passenger of Unit#2 complained of back pain following the collision and was treated and released at the scene by Renton Fire. The driver of Unit#3 said she was the sole occupant of her vehicle. The driver of Unit#3 stated she was also traveling westbound in the 4100 block on NE 4th ST in lane 1 of 2. The driver of Unit#3 stated she had come to a stop for the traffic light. While Unit#3 was stopped, Unit#2 collided with the rear of Unit#3 causing moderate damage to Unit#3. Based on the above statements, 1 determined that the Driver of Unit#1 (Villanueva) was the predominant factor for the collision due to inattention causing a collision. I cited the driver of Unit#1 via mail for Inattention due to not paying attention to stopped traffic in front of his vehicle. All involved Units were able to be driven away without further incident. An exchange of information was provided to all involved parties. I certify (or declare) under penalty of perjury under the laws of the State of Washington that the foregoing is true and correct. Electronically signed by Officer M. Nugent#11498 6:16 PM 3/20/2023 Renton, King County, WA. PAGE 3 OF 5 SUPPLEMENTAL REPORT No. ED44637 r`I POLICE TRAFFIC 1 1 8 27 COLLISION REPORT CASE# 23-3073 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: :❑ GI NAME IF NO NUMBER SOURCE AXLES + 4a ❑ ADDITIONAL UNITS MOTOR PEDAL- 5 ✓ PROPERTY YD O OLDMET PHONE UN�T# 3 VEHICLE CYCLE PEDESTRIAN OWNER ESGN D:4252643143 N:3035501449 OF 8 29 LAST NAME LATENDRESSE FIRST NAME SUZANNE MIDDLE D INITIAL STREET r:i 30 NEW AnDRFrtP 104 BURNETT AVE S UNIT 656 CITY RENTON ST WA ZIP 980572139 6 ❑ 1 1 2 31 CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TANSPORTED INTERLOCK YEs NO✓ NTERLOCK YES�NOf YEs N ✓ DRIVER'S LICENSE STATE I WA SEX F MMDDYYv 07 - O6 - 1945 7 ON DUTY� STATUS AIRBAG' 2 RESTR. Q EJECT 1 HELMET 2 INJURY 1 1 NATURE OF INJURIES USE CLASS 8 ❑ 1 32 LICENSE CDU9337 TAr WA VIN# 2T2BGMCA3HC015217 PLATE# 9 TRAILER TRAILER PLATE# STATE PLATE# STATE 10 ❑ TRLR TRLR VIN.It VIN.#. 11 3 5 VEH.YEAR2017 MAKE LEXS MODELRX STYLE UT VEHICLE TOWS E T SABLIN TOWED BY anvi vEH1I' P FROM TO DAMAGE YES NO ✓ YES NO ✓ REGISTERED OWNER INFOJOHN LATENDRESSE 104 BURNETTAVE S UNIT 656 RENTON WA 98057 J 9 33 12 � SHADE IN DAMAGED AREA 3 4 FROM TO ((ABILITY INSURANCE INSURANCE CO NATIONWIDE 7246J 066965 q"i"Olx IN EFFECT &POLICY# 1 VEHICLE 34 13 2 LEGALLY YESZ NO❑ CITATION# CHARGE 0 BOTTUM STANDING } 8 7 6 14 ❑ UNIT Tr Vd IRE O CYDCLE OWNERRTY YES AGE NOHRESHOLD MET PHONE ❑ 35 PEDESTRIAN 36 15 LAST NAME FIRST NAME INITIALAL MDDLE ❑ ET 16 STRETRE "F-]' CITY ST ZIP NEW CDL IGNITION REdUiRED IGNITtGN PRESENT MEDICALTANSPORTED NTERLOCK YES No NTERLOCK YES NO YES NO ❑ 17 4 37 LICENSE# STATE SEX MMDDDYBYY 18 ❑ ON DUTY� STATUS AIRBAG RESTR. ; EJECT HELMET INJURY NATURE of INJURIES 38 USE CLASS 19 ❑ LICENSE rnr VIN# 39 PLATE# 20 ❑ TRAILER STATE TRAILER STATE ❑ 40 PLATE#< PLATE# 21 ❑ ❑ 41 TRLR TRLR 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 ' VINE EFFECT &POLICY# i 970P - 4 E:l 44 24 VEHICLE YES❑ NO❑ CITATION# CHARGE iq 60TiOM LECAtty 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. MATTHEW NUGENT 03-20-23 06:21 PM 25 INVESTIGATING OFFICER'S SIGNATURE OFFICER'S PHONE UNIT OR DIST DET DATED: PLACE SIGNED APPROVED BY DATE 26 ORID# 11498 O#IL WA0171300 JOHNSON 3/22/2023 PAGE F OF 5 3000-345-013(R 11118) REPORT NO. ED4 6 7 CASE# 2y3 73 DATE m°M\ 03/15/23 ]e5 « : COLLISION < 2� _ � . . :. . , g. aw NE 6W St GE 5 OF 5