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Home My WebLink About23-4592 POLICETRAFF'c" III !�� I IIIllI111IN II II I REPORT NO. ED55724 170 27 COLLISION REP FIT 1591971 ❑ ❑ FIRE ❑ CASE$# 23-4592 2 0 5 INTERSTATE CITY STREET RESULTED 1 STOLEN STATE ROUTE ❑ OTHER ❑ VFHIC;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' BUILDING RESERVATION 2 3❑ DATE OF M M D D Y Y Y Y TIME(2400) COUNTY# MILES N E IN CITY# ❑ cawsloN 04 - 1-- 2023 1124 17 ❑.= S 8 IN e 1070 3 4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓ BLOCK NE SUNSET BLVD MILEPOST ST e✓ 3241 4a❑ DISTANCE OF(REFERENCE OR CROSS STREET) 5 MILES❑ 800 00 FEET e S ❑ W e NE 12TH ST 0 4 29 MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE UNIT 01 VEHICLE ❑ CYCLE El ✓NO D:6082061074 0 11 30 6� LAST NAME KABWISO FIRSTNAME ESAU MIDDLE 1 2 31 INITIAL STREET ❑ 6301 SAINT ALBION WAY#K-211 CITY MOUNTLAKE TERRACE ST WA 7jp, 98043 2 NEW ADDRESS ]❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3 1/ I iNTERLOCKYEs NO NTERLOCKYEs NO�/ YES R No�/ 8❑ LRIIVER # ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 HELMET 2 CLASS 1 NATURE OF INJURIES 2❑ 3 LICENSE CDX7290 sTArI WAvIN# 3FAHPOJG8CR378975 10 F91 PI ATE# TRAILER STATE TRAILER STATE 11 3 5 PLATE# PLATE# FROM TO TRLR. TRLR 2 3 33 12 3 5 VIN#' VIN# >; FROM TO VEH.YEAR 2012 MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE 3 7 34 13 4 FORD FUSION SD DAMAGE YES NO YES[:] NO✓ REGISTERED OWNER INFO OWNEDBYDRIVER VEHICLE NO. 1 ❑ SHADE IN DAMAGED AREA ❑ 35 14 LIABILITY INSURANCE INSURANCE CO PROGRESSIVE 964297006 3 IN EFFECT &POLICY# 9TOP vE—LE CHAR 36 LEGALLY YES NO CITATION# 3A0084635 GE FAIL YIELD LEFT TURN MOTOR BOTTOM 15❑ STANDING 8 7 MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE 16 a UNIT 02 VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES 1/ NO D:4258292405 LAST NAME LEE FIRST NAME KAREN MIDDLE K INITIAL 17 STREET I❑ s❑' 4825 122ND AVE SE CITY' BELLEVUE ST WA ZIP 98006 4❑ 37 NEW ADOREs 18❑ CDL IGNITION REQUIRED IGNITION PR—E-1SENT MEDICAL—T�RANSPORTED � 38 INTERLOCK YEs❑No� INTERLOCK YEs It I NOF YES t l NOF,/ 19 DRIVER'S STATE WA ]SEX IF D.O.B. 07 30 _ 1981 39 LICENSE# MMDDYY 20❑ ON DUTY STATUS I AIRBAG 2 RESTR 4 EJECT 1 H U EET 2 NJAURSY 1 NATURE OF INJURIES 40 ❑21❑ PLATE# BGF3973 TArE WA vIN 41 STDDZ3DCSSHS173339 1 42 22❑ PILER LATE# STATE PLATE# STATE TRLR 23❑ VIN#. IN#. 43 RLR ' GI VEH YEAR 2017 MAKE 7'Oy7- MODEL SIENNA STYLE VN DAMAGE TOWED NOO✓ BLIN TOWED BY ov HYES NO 1/ 44 24❑ ES REGISTERED OWNER INFO OWNED SY DRIVER VEHICLE N0.2 SHADEDAMAGED AREA 3 4 LIABILITY INSURANCE INSU PORGY#E CO STATEFARM 382-0093-CO3-47BIN STOP 5 VEHICLE ❑ C—I CITATION# CHARGE to BOTTOM LEGALLY YES N`LJ OQ 25 s � a 7c-, S NAME(PRINT) OFFICER PHONE BADGE OR ID# JAGENCY 26 MET 10058 WA0171300 PAGE 01 OF PART A 3000-345-159 OR 11/181 STATE OF POLICETRAFFICN CORRECTION REPORT NO. ED55724 COLLISION REPORT III III III III III 111 1591972 CASE# 23-4592 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. C.DESMET 04-24-23 01:07 PM NVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED APPROVED BY DATE D.MOYNIHAN 11288 413012023 4:56:47 AM BADGE OR ID# 10058 ORI# WA0171300 TIME POLICE DISPATCHED; 11:26 AM TIME POLICE ARRIVED 11:29 AM PART I PAGE IT]OF 5� REPORT NO. ED55724 CASE# 23-4592 OF COLLISION 04/24/23 11:24 OF CbLLI510N NARRATIVE 23-4592 AXON AVAILABLE On 04-24-23, at about 1126 hours, while working as a commission police officer for the City of Renton on routine patrol, wearing a clearly identifiable police uniform with badge and patches, I was sent to Arrow Animal Urgent Care located at 3241 NE Sunset Blvd, in the City of Renton, County of King, State of Washington, reference an unknown if injury, two vehicle collision with one vehicle contacting the building. Upon arrival, I contacted involved parties and identified them via their WA DL's. No injuries were complained of, and none were observed. Per both drivers, Unit#1 exited the private driveway of Plum Delicious on the north side of NE Sunset Blvd, to turn left (eastbound) on NE Sunset Blvd when Unit#2, traveling westbound on NE Sunset Blvd, was unable to stop in time and collided with Unit#1. Driver of Unit#1, Kabwiso, said when he looked it was clear, when he exited the driveway, he saw Unit#2 closing the distance rapidly, so he stepped on the gas to avoid a collision. After being collided into by Unit#2, Unit#1 continued southbound across all lanes of NE Sunset Blvd, over the curb, sidewalk, shrubbery into the parking lot of Arrow Animal Urgent Care and contacting the wooded porch of the clinic. Unit#1 sustained major debilitating damage to the left rear tire/quarter panel area from the collision, and minor damage to the undercarriage/wheel-well from the shrubbery. Unit#2 sustained moderate non-debilitating damage to the right front bumper area. I provided Arrow Animal Urgent Care with my business card with this case number on it for reference, due to the contact with the wooden porch from Unit#1. I provided both parties with an exchange of information and cited Kabwiso via complaint for Failing to Yield the right of way to Unit#2 while making a left turn exiting from a private driveway, causing an accident. Refer to citation 3A0084635. I certify (declare) under penalty of perjury under the laws of the State of Washington, that the foregoing is true and correct. C. De Smet/ 10058 Electronically signed by C. De Smet on 04-24-23 / 1300 hours Renton, WA. PAGE 3 OF 5 SUPPLEMENTAL REPORT NO. ED55724 r`I POLICE TRAFFIC 1 27 COLLISION REPORT CASE# 23-4592 1 COMMERCIAL MOTOR CARRIER INTERSTATE INTRASTATE G UNIT'# USL70r ICC# 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- PROPERTY DAMAGETHRESHOLD MET PHONE UNIT# 3 PEDESTRIAN � ✓�' YEs NO 5 VEHICLE CYCLE OWNER ✓ D:4252702991 MIDDLE.. 29 LAST NAME WIERINGA FIRST NAME LAURIE INITIAL STREET 30 NEW AnDRFSP 3241 NE SUNSET BLVD CITY RENTON ST WA ZIP 98055 6 II 1 31 CDL GNITItN REQUIRED GNITION PRESENT MEDEC INTERLOCK YEsNo zERLOCK YES❑N0� T DRIVER'S STATE I SEX F M��DVSYv' -� 2 LICENSE 7 F-I ON DUTY STATUS AIRBAG RESTR. EJECT HELMET INJURY NATURE OF INJURIES USE CLASS 8 ❑ ' 1 32 LICENSE+ rar VIN.# 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 LIABILITY 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 IGNITION 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 ICLASS 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 ' VE EFFECT &POLICY# i 970P - 4 E:l 44 24 VEHICLE YES❑ NO❑ CITATION# CHARGE iq 60TiOM 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. C.DESMET 04-24-23 01:07 PM 25 INVESTIGATING OFFICER'S SIGNATURE OFFICER'S PHONE UNIT OR DIST DET DATED: PLACE SIGNED APPROVED BY DATE 26 OR ID# 10058 O#I,WA0171300 MOYNIHAN 4/30/2023 PAGE�OF 3000-345-013(R 11118) REPORT NO. ED55724 CASE# ' 23-4592 DATE AND TIME 04/24/23 11:24 OF COLLISION AN va„ Pa[h of Unit#fi q Unit#2; Pc ntatlmpad l P.thsofUrllt#1 ��/. Unit-dY2 aoirit cif lmpnc[2 PAGE 5 OF 5