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HomeMy WebLinkAbout23-3343 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 4 27c COLLISION REP FIT 1591971 CASE 23-3343 z INTERSTATE ❑ CITY STREET FIRE ❑RESULTED 1 STOLEN STATE ROUTE ❑ OTHER ❑ VFHIr.I 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 - 1-- 2023 1619 17 ❑-= S 8 IN e 1070 3 4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑ 154TH PL SE BLOCK NO. e✓ 15700 ❑ 4a❑ MILEPOST DISTANCE OF(REFERENCE OR CROSS STREET) 5❑ ❑ FEET e S ❑ VV e MAPLE VALLEYHWY 0 1 29 MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE UNIT 01 VEHICLE ❑ CYCLE El ,/NO D:4258647021 0 81 30 6� LAST NAME SOLIS FIRSTNAME DOUGLAS MIDDLE 1 2 31 INITIAL STREET ❑ 21212 SE FALCON WAY CITY KENT ST WA ZIP, 980425930 z NEW ADDRESS 7❑ CDL IGNITION REQUIRED I IGNITION PRESENT MEDICAL TRANSPORTED 3 iNTERLOCKYEs 1/ I NO NTERLOCKYEs NO Z YES No�/ 8❑ LRIIVER # ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 H USE 2 1 CLASS NATURE OF INJURIES 2❑ 3 LICENSE C62719W STATE WA uN# 3GCUYDED7MG260913 10 1❑ PI ATE� TRAILER STATE TRAILER STATE 11 3 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 TOWED BY GOVT.VEHICLE g 9 34 13 2 2021 CHEV SILVER PK DAMAGE YES NO YES[:] No✓ REGISTERED OWNER INFO HD FOWLER CO INC 3.3136TH PL SE BELLEVUE WA 98006 D:4258647021 VEHICLE NO. 1 ❑ SHADE IN DAMAGED AREA 35 14 LIABILITY INSURANCE INSURANCE CO TRAVELERS 810-IN667537-21.146 4 LI EFFECT I SUR N# TOPVEHICLE CHARGE 36 LEGALLYYES NO CITATION# 3AO055593 INATTENTIVE DRIVING <1�3 orrom 15❑ STANDING 7 6 MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE UNIT 02 VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ 1/ NO DD 4254307400 16 a YES LAST NAME ROWLAND III FIRST NAME ROGER MIDDLE JA INITIAL 17 STREET❑ NEW ADDREss❑' 3555 NE 2ND ST CITY RENTON ST WA ZIP 98056 4❑ 37 18❑ CDL ., IGNITION REQUIRED IGNITION PtR-E-S1ENT MEDICAL t-T�RANSPORTED � 38 INTERLOCK YEs❑No� INTERLOCK YEs I I NOF YES t l NOF,/ 19[ LDI IVER # STATE WA SEX DDY M M D.C.B. 08 _ 10 _ 1992 39 20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 H U EET 2 NJAU EY 1 NATURE OF INJURIES ❑ 40 ❑ 41 21❑ ILICENSE PLATE# 59753D TATE WA vlNt 1GCHTBEA8G1124528 1 42 22❑ PILER LATE# STATE PLATE# STATE 23❑ UIN#. 43 TRLR RLR 'IN#. VEH YEAR 2016 MAKE CHEV MODEL COLORA STYLE PK VEHICLETOWED TO BLIN TOWEDBY GOV HI 44 24❑ DAMAGE YES NO,/ YES NO REGISTERED OWNER INFO CITY OF RENTON 3555 NE 2ND ST RENTON WA 98056 D:4254307400 VEHICLE NO.2 SHADE IN DAMAGEbAREA 2 3 Cd LIABILITY INSURANCE 8 POINSURGY#E CO CITY OF RENTON SELF-INSURED 1IN 9TOP VE""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. ED46966 COLLISION REPORT III III III III III 111 1591972 CASE# 23-3343 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. MATTHEW NUGENT 03-27-23 12:07 PM INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED APPROVED BY DATE CO.JOHNSON 0505 1 313012023 3:23:20 PM BADGE OR ID# 11498 ORI# WA0171300 TIME POLICE DISPATCHED 4:23 Pry TIME POLICE ARRIVED',4:33 PM PART I PAGE IT]OF REPORT NO. ED46966 CASE# 23-3343 OF COLLISION 03/23/23 16:19 OF CbLLI510N NARRATIVE 23-3343 On 03/23/2023 at approximately 1624 hours, I was dispatched to a non-injury and non-blocking vehicle collision at the intersection of 154th PI SE and Maple Valley Highway, within the City Limits of Renton, County of King, State of Washington. Upon arrival, I confirmed there were no complaints of injury from any of the involved parties. There, I collected the each of the involved driver's information and their independent recollection of the events leading up to the collision. The driver of Unit#1 said he was the sole occupant of his vehicle and was traveling southbound in the 15700 block of 154th PI SE in lane 3 of 3 (left-turn lane) approaching the intersection of Maple Valley Highway. The driver of Unit#1 stated he was traveling directly behind Unit#2 but admitted that he was momentarily distracted when he looked down at his cell phone. The driver of Unit#1 did not see that Unit#2 had stopped at the controlled intersection. Unit#1 stated that he subsequently collided with the rear of Unit#2 causing moderate damage to the front of Unit#1. The driver of Unit#2 said he was the sole occupant of his City of Renton work truck and was also traveling southbound in the 15700 block of 154th PI SE in lane 3 of 3 (left-turn lane) approaching the intersection of Maple Valley Highway. The driver of Unit#2 stated he had come to a stop for a red light at the controlled intersection. While Unit#2 was stopped, Unit#1 collided with the rear of Unit#2 causing moderate damage to the rear bumper of Unit#2. Due to the initial impact between Unit#1 and Unit#2, Unit#2 was pushed forward into the rear of Unit#3 causing additional damage to the front of Unit#2. The driver of Unit#3 said he was the sole occupant of his vehicle and was also traveling southbound in the 15700 block of 154th PI SE in lane 3 of 3 (left-turn lane) approaching the intersection of Maple Valley Highway. The driver of Unit#3 stated he had come to a stop for a red light at the controlled intersection. While Unit#3 was stopped, Unit#2 collided with the rear of Unit#3 causing minor damage to the rear bumper of Unit#3. Based on the above statements, I determined that the Driver of Unit#1 (Solis) was the predominant factor for the cause of collision due to not paying attention to traffic stopped in front of him causing a collision. I cited Solis by mail for Inattention causing a collision due to not paying attention to traffic in front of him. All involved vehicles 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 11:58 AM 3/27/2023 Renton, King County, WA. PAGE 3 OF 5 SUPPLEMENTAL REPORT NO. ED46966 r`) POLICE TRAFFIC 1 1 8 27 COLLISION REPORT CASE# 23-3343 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 DAMAGE THRESHOLD MET PHONE 5 ❑ UNIT# 3 VEHICLE tSJ CYCLE _) PEDESTRIAN � OWNER � YES NO D:6193066463 rOF 8 29 LAST NAME : CHATTARAJ FIRST NAME : SURAJIT MIDDLE INITIAL STREET 30 NEW AnDRFrtP 23645 SE 269TH CT CITY MAPLE VALLEY ST WA ZIP 1 980385042 6 [2 1 1 2 31 CDL IGNITIttN REQUIRED IGNITION PRESENT MEDICAL TANSPORTED INTERLOCK YEs NO NTERLOCK YES❑N0� YES N DRIVER'S LICENSE STATE I WA SEX M MMDDYYv 09 - 29 - 1981 7 ON DUTY� STATUS AIRBAG' 2 RESTR. Q EJECT 1 HELMET 2 INJURY 1 1 NATURE OF INJURIES USE CLASS 8 ❑ 1 32 LICENSE AZX1375 TAr WA VIN# 1NXBR32EO3Z164494 PLATE# 9 TRAILER TRAILER PLATE# STATE PLATE# STATE 10 ❑ TRLR TRLR VIN It VIN.#. 11 3 5 VEH.YEAR2003 MAKE TOYT MODEL COROLL STYLE 4D I VEHICLE TOWS E T SABLIN TOWED BY anvi vFH1I' P FROM TO DAMAGE YES NO YES NO REGISTERED OWNER INFO OWNED BY DRIVER J 9 33 SHADE IN DAMAGED AREA 12 z 3 4 FROM TO ((ABILITY INSURANCE INSURANCE CO AMERICAN FAMILYA104109930 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 1 RE O CYCLE 1:1OWNERRTY YES AGE NOHRESHOLD MET PHONE ❑ 35 El PEDESTRIAN 15 LAST NAME FIRST NAME MIDDLE INITIAL TIAL ❑ ET 16 STRETRE "F1' CITY ST ZIP NEW CDL IGNITION REdUiRED IGNITION 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 TAr VIN# 39 PLATE# 20 ❑ TRAILER' TRAILER El40 PLATE#< STATE PLATE# STATE 21 ❑ ❑ 41 TRLR TRLR VIN# YIN#i 42 22 VEH.YEAR MAKE I MODEL STYLE I VEHICLE TOWED 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 LEGALLv 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. MATTHEW NUGENT 03-27-23 12:07 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 3/30/2023 PAGE F OF 5 3000-345-013(R 11118) REPORT NO. ED46966 CASE# ' 23-3343 DATE AND TIME 03/23/23 16:19 OF COLLISION Unit w.#t ( �.. i Aorwuh Unit.#2-- Lo "Diagram not 8o sC,afe Unit#3:- i � VJ N L T PAGE 5 OF 5