HomeMy WebLinkAbout23-5281 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 0 27c
COLLISION REP FIT 1591971
CASE 23-5281 z
INTERSTATE ❑ CITY STREET FIRE ❑RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHICI F ❑ LOCAL AOENC 4900 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#
cowsloN 05 - 10 - 2023 1157 17 �. S 8 W H OF e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
NE 4TH ST BLOCK NO. e ❑
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ ❑ FEET e S ❑ W e QUEEN AVE NE
0 4 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
,/No D:4254994712 0 11
30
6 1❑ LAST NAME VILLABOVOS FIRST NAME MARIA MACARENA MIDDLE 1 2 31
INITIAL
STREET ❑✓ 341 SHANGRILA WAY NW APT 5-20 CITY I ISSAQUAH ST WA 2jp, 98027 z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
iNTERLOCKYEs 1/ I NO NTERLOCKYEs NO Z/ YES R No�/
$ LICIENSE# STATE SEX'F MDMDo� 04 - O6 - 1973 1 2 32
STATUS AIRBAG 3 RESTR 9 EJECT 1 HELMET 2 INJURY 7 NATURE OF INJURIES z
❑
9 EEnlUSE CLASS : POTENTIAL HEAD TRAUMA,SOME BLEEDING
3
10 9❑ pl ATE 14 BWF9875 STATE WA VIN#' KL8CD6S93DC614182
TRAILER STATE TRAILER STATE
11 3 5 PLATE# PLATE# FROM TO
TRLR. A'RLR. 1 3 33
12 3 5 VIN#' VIN#'
>; FROM TO
VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN T Y GOVT.VEHICLE 3 7 34
13 2013 CHEV SPARK HB DAMAGE YES No � �MEYER'S TOWING YES❑ No✓
REGISTERED OWNER INFO JOSE MARTINEZ GARCIA 341 SHANGRILA WAYNWAPT5.20 ISSAQUAH WA 98027 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
3 4
14 LIABILI INSURANCE INSURANCE CO NATIONWIDE7246J049717
IN EFFECT &POLICY# 9TOP
VEHICLE CHARGE 5 36
LEGALLY YES❑NO❑ CITATION# 10 BOTTOM
15❑ STANDING 6
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES 1/ NO D:3238408155
16 a
LAST NAME RUMYANTSEV FIRST NAME YAN MIDDLE N
INITIAL
17❑ NEW STREETREs7 749 VASHON PL NE CITY RENTON ST WA ZIP 98059 37
18❑ CDL IGNITION REQUIRED IGNITION PtR-E-S1ENT MEDICAL t-T�RANSPORTED � 38
INTERLOCK YEs❑No� INTERLOCK Y�EsI I I NOF YES
t l NO�
19 DRIVER'S STATE WA SEX M D.C... O6 _ 01 1987 39
LICENSE# MMDDYY
20❑ ON DUTY STATUS AIRBAG 6 RESTR 9 EJECT 1 HELMET 2 INJURY 7 NATURE OF INJURIES ❑ 40
USE CLASS BACK PAIN
❑21❑ PLATE# CGF8002 TATE 41
WA VIN# JTDKN3DU2D5689900 1
42
22❑ PLATE# STATE PLATE# STATE
TRLR
23❑ UIN#. IN#.
43
RLR
—TVEHICLE
'
roweD By Gov HI 44
VEH YEAR 2013 MAKE TOYT MODEL PRIUS STYLE SD DAMAGE TOWED✓ NOO BLIN GENE MEYER'S TOWING YES No�/
24❑ REGISTERED OWNER INFO OWNED SY DRIVER VEHICLE N0.2
SHADE DAGED AREA
4
LIABILITY INSURANCE INSU&PORGY#E CO THE STANDARD FIRE INSURANCE COMPANY 6133061072031 STOP 5
IN EFFECT
ve
LEGALLY YESwGLe ❑ N,J�J CITATION# CHARGE to BOTTOM
25 s � e
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
26
NATHANIEL BROWN 12765 WA0171300
PART A PAGE 01 OF
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. ED61913
COLLISION REPORT III III III III III 111
1591972 CASE# 23-5281
ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY)
NAME MIDDLE INITIAL) SANCHEZ GRACIELA
(LAST FIRST,
ADDRESS&PHONE#
341 SHANGRIlA WAY NW APT 5-20 /SSAQUAH WA 98027 4252133104 SEX F MMDovyvv 10 - 17 - 1986
SEAT HELMET I INJURY NATURE OF INJURIES
PASSENGERWITNESS❑ UNIT# 1 POS. 3 AIRBAG 3 RESTR. 9 EJECT 1 USE 2 CLASS 16 AT LIP
NAME
(LAST,FIRST,MIDDLE INITIAL) NEWING SCOTT A
ADDRESS&PHONE# D O E4
1055 S GRADY WAY RENTON WA 98057 2066593392 SEX M MMDovvvv 10 _ 27 _ 1982
PASSENGER ❑ POS. USE CLASS WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET NJURY NATURE OF INJURIES
NAME
(LAST FIR57 MIDDLE INITIAL)
AppRESS&PHONE#
SEX D.O.B.MMDD -❑
YYYY.
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.
NATHANIEL BROWN 05-10-23 05:46 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
S.WOODWARD 11528 1 512012023 10:09:36 AM
BADGE OR ID# 12765 ORI# WA0171300 TIME POLICE DISPATCHED 11:58 AM TIME POLICE ARRIVED',12:00 PM
PART I PAGE IT]OF 4]
REPORT NO. ED61913 CASE# 23-5281 OF COLLISION
05/10/23 11:57
OF CbLLI510N
NARRATIVE
On 05/10/2023, at approximately 1158 hours, I was dispatched to a vehicle collision with unknown
details at the intersection of NE 4th St and Queen Ave NE in Renton, King County, Washington.
According to a witness, verbally identified as Scott A. Newing (DOB 10/27/1982), unit 1, a black 2013
Chevrolet Spark (WA license # BWF9875), was facing south on Queen AVE NE and unit 2, a white
2013 Toyota Prius (WA license # CGF8002), was travelling westbound in lane # 2 of NE 4th St. Unit 1
then attempted to take a left turn onto eastbound NE 4th St from Queen Ave NE but was unaware of
oncoming traffic. Newing stated this caused unit 2 to collide with unit 1 in the intersection while unit 2
had the right of way. Officer Bills provided Newing with a written statement form. See Officer Bills'
report for additional details.
According to the driver of unit 1, verbally identified as Maria Macarena Villabovos (DOB 04/06/1973),
she was attempting to make a left turn onto eastbound NE 4th St, but she could not see around the
corner as unit 2 was driving westbound on NE 4th St, causing her vehicle to collide with unit 2 in the
intersection of NE 4th St and Queen Ave NE. Maria did not have a Washington State drivers license
and was not covered by unit 1's insurance policy.
Both drivers had possible injuries. The driver of unit 1 was taken to Valley Medical to have her injuries
further evaluated.
According to the driver of unit 2, identified by his WADL as Yan N Rumyantsev (DOB 06/01/1987), he
was traveling westbound on NE 4th St when unit 1 drove in front him as unit 1 attempted to make a
left turn onto NE 4th St from Queen Ave NE. Yan stated he was unable to steer out of the way to
avoid colliding with unit 1.
Photos were taken of the damages caused to unit 1 and unit 2.
See other officers' reports for additional details.
PAGE 3 OF 4
REPORT NO. ED61913 CASE# ' 23-5281 DATE AND TIME 05/10/23 11:57
OF COLLISION
NOT TO SCALE
PAGE 4 OF 4