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Home My WebLink About23-4860 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 5 27c COLLISION REP FIT 1591971 CASE 23-4860 z INTERSTATE ❑ CITY STREET FIRE ❑RESULTED 1 STOLEN STATE ROUTE ❑ OTHER ❑ VFHIr.I F ❑ LOCAL AOENC 4900 3 HIT&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 04 - 1-- 2023 1200 17 ❑.= S 8 IN e 1070 3 4❑ oN (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓ NE 4TH ST BLOCK NO. e✓ 3300 4a❑ MILEPOST DISTANCE OF(REFERENCE OR CROSS STREET) 5❑ 400 00 FMILES EET e S ❑ W e MONROE AVE NE 0 1 29 MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE UNIT 01 VEHICLE ❑ CYCLE El ✓NO D:2064346649 0 7 30 6� LAST NAME LOI FIRSTNAME DAVID MIDDLE 1 2 31 INITIAL STREET ❑ 573 SHADOW AVE NE CITY RENTON ST WA ZIP 98059 z NEW ADDRESS 7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3 iNTERLOCKYEs NO 1/ INTERLOCKYEs NO�/ YEs No�/ 8❑ LRIIVER # STATE WA SEX'M MM D Y' 10 - 10 - 1968CENS 1 2 32 9 ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 HELM U EET ICNLJASS URY 1 NATURE OF INJURIES z❑ 3 10 99 P1 ATNES# 25720Y srAT WAV N# JTNBF3EK1A3003441 5 TRAILER STATE TRAILER STATE 11 3-LATE# PLATE# FROM To TRLR. TRLR. 3 7 33 12 0 0 VIN#' VIN#' >; FROM TO ❑ VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN T v GOVT.VEHICLE J 9 34 13 2 2010 TOYT CAMRY SD DAMAGE vEs ONO W&g vEs❑ No REGISTERED OWNER INFO OWNEDBYDRIVER VEHICLE NO. 1 SHADE IN DAMAGED AREA ❑ 35 14 LIABILI INSURANCE INSURANCE CO AMERICAN FAMILYA104069652 4 IN EFFECT &POLICY# TOPVEHCLE CHARGE 36 LEGALLYYES❑NO❑ CITATION# 3AO344355 INATTENTIVE DRIVING <1�3 orrow 15❑ STANDING 7 6 MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE UNIT 02 VEHICLE ❑ ❑CYCLE ❑ OWNER ❑ YES 1/ No DD 4253624487 16 a LAST NAME CARDOSO SILVA FIRST NAME AMANDA MIDDLE IF INITIAL 17 STREET❑ NEW ADDREss❑' 463 EDMONDS CT NE CITY RENTON ST WA ZIP 98509 37 18❑ CDL IGNITION REQUIRED IGNITION PR-E-1SENT MEDICAL-T�RANSPORTED � 38 INTERLOCK YEs❑No� INTERLOCK vEs It I NOF YES t l NOF,/ 19 DRIVER'S STATE WA SEX F D.C.B. 12 _ 27 1998 39 LICENSE# MMDDYY —NATURE OF INJURIES W USE EET LASS 6 Y COMPLAINT OF NECK PAIN ❑ 40 20 ON DUTY STATUS AIRBAG,2 RESTR 4 EJECT 1 ❑ILICENSE 21❑ PLA E# BW6274 TATe 41 WA VIN# 3VWD17AJ7GM387634 1 42 22❑ PLATE# STATE PLATE# STATE TRLR 23❑ VIN#. IN#. 43 RLR ' y GoI VEH D YEAR 2016 MAKE VOLK MODEL JETTA STYLE SD AMAGE TOWED✓ NOO BLIN NONE roweD B v HYES No%/ 44 24❑ REGISTERED OWNER INFO OWNED SY DRIVER VEHICLE N0.2 SHADEDAMAGEbAREA s Cd LIABILITY INSURANCE &POINSURGY#E CO PROGRESSIVE 944734744IN STOP 'E""LE CITATION# CHARGE YES N 25 to BOTTOM LEGALLY u ❑ OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# FA017 NCY 26 BRETT WILLET 12257 1300 PART A PAGE 01 OF C7 3000-345-159 OR 11/181 STATE OF POLICETRAFFICN CORRECTION REPORT NO. ED56515 COLLISION REPORT III III III III III 111 1591972 CASE# 23-4860 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. BRETT WILLET 04-30-23 01:47 PM INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED APPROVED BY DATE DESIRES SCOTT 10272 5/2/2023 2:55:15 PM BADGE OR ID# 12257 ORI#' WA0171300 TIME POLICE DISPATCHED! 4Y:04 PM TIME POLICE ARRIVED',12:07 PM PART Ei PAGE IT]OF REPORT NO. ED56515 CASE# 23-4860 OF COLLISION 04/30/23 12:00 OF CbLLI510N NARRATIVE Portions of this incident were captured on my Body-Worn Camera. Please See that for complete detail of witness statements and incident details. On 04.30.2023, 1 was working for the Renton Police Department as 1-Robert-22, fully uniformed and in a marked patrol vehicle. At approximately 1207 hours, I was dispatched to the 3300 block of NE 4TH St in the City of Renton, County of King, and the State of Washington to investigate a collision. VEHICLES INVOLVED: Unit# 01: 2010 Toyota Camry, WA LIC# 257ZOY, Driven by: David Loi (DOB: 10.10.1968) Unit# 02: 2019 Volkswagen Jetta WA LIC# BVY6274, Driven by: Amanda F. Cardosa-Silva (DOB: 12.27.1998) Unit# 03: 2003 Honda Element WA LIC# CCN7118, Driven by: Christina M. Sanches (DOB: 08.31.1966) INCIDENT: I arrived on the scene and determined the following: Unit# 03 was stopped facing west in traffic waiting for the traffic signal at the intersection of NE 4th st and Monroe Ave NE to turn from steady red to steady green. Unit# 02 was stopped directly behind Unit# 03 in traffic. Unit# 01 was traveling west in the 3300 block of NE 4th St and failed to decrease the necessary speed to avoid a collision. Unit# 01 struck the rear of Unit# 02 which caused Unit# 02 to go forward and strike the rear of Unit# 03. Unit# 03 had damage to the rear bumper, Unit# 02 had damage to both the front and rear bumpers, and Unit# 01 had significant damage to the front of the vehicle. All parties stated they were wearing seatbelts and no airbags deployed. RFA arrived on the scene and evaluated the driver of Unit# 02 for complaints of head and neck pain. I provided all parties involved with information exchange sheets that contained my information. I also issued citation# 3AO344355 to David Loi, Unit# 01, for inattentive driving. All parties were then released on their own recognizance. This ended my involvement with this investigation. I declare under penalty of perjury under the laws of the State of Washington that the foregoing is true and correct. ELECTRONICALLY SIGNED Officer B. Willet# 12257 Renton, WA/ County of King State Of Washington 04.30.2023 1345 hours PAGE 3 OF 5 SUPPLEMENTAL REPORT No. ED56515 r`) POLICE TRAFFIC 1 1 8 27 COLLISION REPORT CASE# 23-4860 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 I_) PEDESTRIAN � OWNER � YEs� NO D:2062613894 0 7 29 LAST NAME SANCHES FIRST NAME CHRISTINA MIDDLE'. INITIAL STREET 30 NEW AnDRFSP. 2304 50TH AVE SW CITY SEATTLE ST WA ZIP 98116 5 ❑ 1 1 2 31 CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TANSPORTED INTERLOCK YEs NO zERLOCK YES❑N0� YEs N DRIVER'S LICENSE STATE I WA SEX F MMDDYYv 08 - 31 - 1966 7 ON DUTY� STATUS AIRBAG' 2 RESTR. Q EJECT 1 HELMET I INJURY 1 1 NATURE OF INJURIES USE CLASS 8 ❑ 1 32 LICENSE I CCN7118 [TAT WA VIN# 5J6YH28553L020233 PLATE# 9 9] TRAILER TRAILER PLATE# STATE PLATE# STATE 10 ❑ TRLR TRLR VIN.It VIN.#. 11 0 0 VEH.YEAR2003 MAKE HOND MODELELEMENT STYLE UT I VEHICLE TOME E T SABLI WEED BY anvi vFH1C P FROM TO DAMAGE YES NO YES NO REGISTERED OWNER INFO OWNED BY DRIVER J 9 33 12 � SHADE IN DAMAGED AREA 7 j FROM TO LIABILITY INSURANCE INSURANCE CO GEICO 4019249582 R"i"Olx IN EFFECT &POLICY# 1 VEHICLE 34 13 2 LEGALLY YESZ NO❑ CITATION# CHARGE 0 BOTTOM STANDING } 7 14 ❑ UNIT Tr Vd IRE O CYDCLE OWNERRTY YES AGE NOHRESHOLD MET PHONE ❑ 35 PEDESTRIAN 15 LAST NAME FIRST NAME MIDDLE ❑ 35 STREET 16Fl TEETFs.�' CITY ST ZIP CDL IGNITION REdUiRED IGNITtGN PRESENT MEDICALTANSPORTED INTERLOCK YES No INTERLOCK 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 ❑ 39 LICENSE rnr VIN# 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 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. BRETT WILLET 04-30-23 01:47 PM 25 INVESTIGATING OFFICER'S SIGNATURE OFFICER'S PHONE UNIT OR DIST DET DATED: PLACE SIGNED APPROVED BY DATE 25 OR ID# 12257 O#I WA0171300 SCOTT 5/2/2023 PAGE F OF 5 3000-345-013(R 11118) REPORT NO. ED56515 CASE# ' 23-4860 DATE AND TIME 04/30/23 12:00 OF COLLISION z: w NOT TO SCALE UNINVOLVED VEHI GEES. CASE#2023-0$60 w UNIT#Q3 UNIT#02: -UNIT#.Q3 NEr4TH:"ST PAGE 5 OF 5