HomeMy WebLinkAbout23-4679 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 1 27c
COLLISION REP FIT 1591971
CASE 23-4679 z
INTERSTATE ❑ CITY STREET FIRE ❑RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHIC;I F ❑ LOCAL AOENC 4Y00 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 1 TOTAL#OF OBJECT 1 1 8 28
TRIBAL UNITS OZ STRUCK
RESERVATION
z
3❑ DATE OF M M D D Y Y Y Y TIME(2400) COUNTY# MILES N E IN CITY# ❑
cawsloN 04 - 1-- 2023 1030 17 ❑.= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓
RAINIER AVE S BLOCK NO. e✓ 400
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ 100 00 FEET MILES e S B W e S 4TH PL
0 1 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
,/NO D:2069925943 0 6 30
6� LAST NAME PERRY FIRSTNAME KRISTIN MIDDLE K 1 1 2 31
INITIAL
STREET ❑, 5702 143RD ST SW CITY EDMONDS ST WA ZIP 980260000 z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
1/iNTERLOCKYEs NO INTERLOCKYEs NO YES R No�/
8❑ LRIIVER #
ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 HELMET INJURY 7 NATURE OF INJURIES 2❑
USE CLASS COMPLAINT PAIN RT SHOULDER,LOWER BACK
3
10[1LI QTNFS# BES1384 STATE WA VIN#' KM8JU3AC9DU684284
- TRAILER STATE PL TRAILER STATE
11 3 5 PLATE# PLATE# FROM TO
TRLR. TRLR. 5 1 33
12 3 5 VIN#' VIN#
>; FROM TO
VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE 5 1 34
13 2 2013 HYUN TUCSO 4H DAMAGE YES NO YES[:] No✓
REGISTERED OWNER INFO KRISTINPERRY5702143RD STSW EDMONDS WA 98026 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
14 LIABILI INSURANCE INSURANCE CO HARTFORD 55PHL536768 3 4
IN EFFECT &POLICY# 9TOP
VEHICLE 5 36
LEGALLv res❑NO❑ CITATION# CHARGE 1 o BOTTOM
15❑ STANDING 8 7 6
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT VEHICLE ❑ CYCLE ❑ ❑
16 a OWNER ❑ YES 1/ NO D:2068527724
LAST NAME RYE FIRST NAME ANDREA MIDDLE M
INITIAL
17❑ STREET ❑', 1029 N 27TH PL CITY RENTON ST WA ZIP 980561475 37
NEW ADDRESS ❑
18� CDL IGNITION REQUIRED IGNITION PtR-E-S1ENT MEDICAL TRANSPORTED 38
INTERLOCK YEs❑No� INTERLOCK YEs I I NOF YEs t l NOF,/
19 DRIVER'S STATE WA ]SEX IF D.C... 10 � 1943_ 13 _ El 39
LICENSE# MMDDYY
WELMET INJURY1 NATURE OF INJURIES 40
20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 USE CLASS ❑
21❑ LICENSE I CFY1284 TATe WA VIN1t 2T2BBMCAOPC002552
❑ 41
PLATE#
42
22❑ PILER LATE# STATE pLATE# STATE
23❑ UIN#. 43
TRLR RLR
'IN#.
VEH YEAR 2023 MAKE LEXS MODEL RX STYLE qH VEHICLETOWED TO BLIN TOWEDBY GOV HI 44
24❑ DAMAGE YES NO,/ YES NO
REGISTERED OWNER INFO ANDREA RYE 1029 N 27TH PL RENTON WA 98056 VEHICLE NO.2
SHADE IN DAMAGEbAREA
2 3 Cd
LIABILITY
INSURANCE INSU&POLICY#E CO PEMCO CA 0743166IN 1 9TOP
VEHICLE ❑ ,.I—I CITATION# CHARGE
25 i o BOTTOM
LEGALLY YES N
$
7.111CjEo-S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
26
HNSON 0505 WA0171300
PART A PAGE 01 OF
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. ED55404
COLLISION REPORT III III III III III 111
1591972 CASE# 23-4679
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.
CO.JOHNSON 04-26-23 02:59 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
CO.JOHNSON 0505 1 412812023 2:52:26 PM
BADGE OR ID# 0505 OR]# WA0171300 TIME POLICE DISPATCHED 10:46 AM TIME POLICE ARRIVED',10:50 AM
PART I PAGE IT]OF 4�
REPORT NO. ED55404 CASE# 23-4679 OF COLLISION
04/26/23 10:30
OF CbLLI510N
NARRATIVE
U2 NB 400 blk RAS In #3, U1 behind U2; light @ S 4th PI red to green and U2 slows for vehicles
ahead stopped for previous red; front U1 collides with rear U2
On 04-26-23 at about 1046 hours, I was dispatched to a 2-car blocking collision in the vicinity of
Rainier Ave S and S 4th PI in the City of Renton, County of King, Washington. There were no injuries
reported and the vehicles were blocking north bound. I arrived in the area at about 1050 hours. I
observed two (2) dark colored vehicles blocking lane #1 (of 3) of Rainier Ave S, just north of S 4th PI.
I contacted the drivers of the vehicles and determined there were no injuries requiring immediate
medical attention. 1 instructed the drivers to move their vehicles off the roadway and into the parking
lot of 440 Rainier Ave N for further contact.
The driver of Unit 01 was identified by WA DL and admitted to driving the listed vehicle. The driver
said she was wearing a seatbelt at the time of the collision. The driver did not appear to have any
observable injuries but complained of pain in her right shoulder and lower back. The driver of Unit 01
initially declined medical attention from RRFD but later requested they respond. The driver was
treated and released at the scene by RRFD.
Unit 01 was north bound in lane #3 (of 4) of Rainier Ave S, approaching the intersection with S 4th PI.
The driver of Unit 01 observed a green traffic signal for north bound traffic but said Unit 02 had come
to a stop for no reason. The driver said she was unable to stop in time to avoid colliding with the rear
of Unit 02.
The driver of Unit 02 was identified by WA DL and admitted to driving the listed vehicle. The driver
said she was wearing a seatbelt at the time of the collision. The driver did not appear to have any
observable injuries.
Unit 02 was north bound in lane #3 (of 4) of Rainier Ave S approaching the intersection of S 4th Pl.
The driver of Unit 02 said the traffic signal had just turned from red to green and there were vehicles
in front of her that were just starting to move slowly. Unit 02 began to slow down for the slow moving
vehicles to the front when the rear of her vehicle was hit by Unit 01.
I observed moderate damage to the rear hatch of Unit 02 and front bumper/passenger fender of Unit
01. The damage to both vehicles was consistent with the information provided by both drivers. Unit
02 departed the location under its own power. Unit 01 was in a parking stall and the driver arraigned
for a private tow.
The proximate cause of the collision was Unit 01 failing to stop in time to avoid colliding with Unit 02.
Were it not for the actions of the driver of Unit 01, the collision would not have occurred.
No citations or infractions issued. Report for information purposes only.
PAGE 3 OF 4
REPORT NO. ED55404 CASE# ' 23-4679 DATE AND TIME 04/26/23 10:30
OF COLLISION
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