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Home My WebLink About23-6004 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 0 27c COLLISION REP FIT 1591971 CASE 23-6004 z INTERSTATE ❑ CITY STREET FIRE ❑RESULTED 1 STOLEN STATE ROUTE ❑ OTHER ❑ VFHICI F ❑ LOCAL AGENCI 4900 3 HIT&RUN CODING COUNTY RD PRIVATE WAY INVOLVED 2 TOTAL#OF OBJECT 1 1 8 28 TRIBAL UNITS 04 STRUCK RESERVATION z 3❑ DATE OF M M D D Y Y Y Y TIME(2400) COUNTY# MILES N E IN CITY# CowsloN 05 - 1-- 2023 1540 17 ❑-= S 8 IN e 1070 3 4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑ RENTON AVE S BLOCK NO. e✓ 100 ❑ 4a❑ MILEPOST DISTANCE OF(REFERENCE OR CROSS STREET) 5❑ ❑ FEET e S ❑ W e TAYLOR AVE NW 0 1 29 MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE UNIT 01 VEHICLE ❑ CYCLE El ,/No D:8015206449 0 11 30 6� LAST NAME MARHSALL FIRSTNAME JACKIE MIDDLE B 1 1 2 31 INITIAL STREET ❑ 6422 S CORAL DR CITY SALT LAKE CITY ST UT ZIP, 84123 z NEW ADDRESS 7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3 INTERLOCK YES[:]No✓ INTERLOCKYEs NO✓ YES R No 8❑ LRIIVER # STATE UT SEX'M MD. I B Y' 05 - 30 1- 1951 1 2 32 9 ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 H U EET 2 I INJURY CLASS 1 NATURE OF INJURIES z❑ 3 10[1P1 ATNES# E071DN sTATe UT V N# 1 FTHX26F7VEC09378 5 TRAILER 6V7AA STATE UT TRAILER STATE 11 3 5 PLATE# PLATE# ROM To TRLR. TRLR 7 3 33 12 3 5 VIN#j VIN#' VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE 5 1 34 13 2 1997 FORD F250 PK DAMAGE YES NO ✓ YES❑ NO✓ REGISTERED OWNER INFO OWNEDBYDRIVER VEHICLE NO. 1 SHADE IN DAMAGED AREA ❑ 35 14 LIABILITY INSURANCE Z INSURANCE CO ALLSTATE 076610599 IN EFFECT &POLICY#ICLE CHARGE 36 LEGALLv res❑NO CITATION# <14, 15❑ STAIND'ING UNIT a2 VE ICCMOTOLE CYCLE ❑ PEDESTRIAN ❑ OWNER YES ❑ DYES✓ NO OLD MET PHONE 16 a LAST NAME MATTISON FIRST NAME ERIK MIDDLE L INITIAL 17❑ STREET Is❑' 11303 207TH AVE SE CITY' ISSAQUAH ST WA ZIP 98027 4❑ 37 NEW ADDREs 18❑ CDL IGNITION REQUIRED IGNITION PR-E-1SENT MEDICAL-T�RANSPORTED � 38 INTERLOCKYES�NO� INTERLOCK YEs It I NOF YES t l NOF,/ 19 DRIVER'S STATE WA SEX M D.C.B. 02 _ 09 _ 1976 39 LICENSE# MMDDYY 20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 H EET 2 NJAU EY 5 POSSIBLE BROKEN RIBS,NECK/BACK PAIN ❑[-�A—TURE OF INJURIES 40 ❑LICENSE I 21❑ PLA E# C90582V TATE WA VIN# 1(BCCS19X7T8134412 41 1 42 22❑ PLATE# STATE PLATE# STATE 23❑ VIN#. 43 TRLR RLR 'IN#. GI VEH YEAR 1996 MAKE CHEV MODEL S10 STYLE PK jVEHl DAMAGE TO WED NOO✓ BLIN TOWED BY 44 Yr ov H yES NO✓ 24❑ REGISTERED OWNER INFO OWNED SY DRIVER VEHICLE N0.2 SHADE IN DAMAGED AREA 2 3 4 INAEFFITY ECTNSURANCE❑ &POINSULICY#E CO I STOP 5 """LE ❑ N`LJ ,.I— CITATION# CHARGE LEG i o BOTTOM ALLY YES 25 =ORAJEWSKI (PRINT) OFFICER PHONE BADGE OR ID# JAGENCY 26 12399 WA0171300 PAGE 01 OF PART A 3000-345-159 OR 11/181 STATE OF POLICETRAFFICN CORRECTION REPORT NO. ED64509 COLLISION REPORT III III III III III 111 1591972 CASE# 23-6004 ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY) NAME (/AST FIRST,MIDDLE INITIAL)_ ADDRESS&PHONE# SEX D.O.B. - - MMDDYYYY. PASSENGER❑WITNESS UNIT# SEAT AIRBAG RESTR. EJECT ' HELMET INJURY NATURE OF INJURIES POS. 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. RAYMOND GORAJEWSK/ 05-27-23 05:11 PM INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED APPROVED BY DATE P.SUMMERS 8887 512712023 11:50:35 PM BADGE OR ID# ! 1Y399 OR]# WA0171300 TIME POLICE DISPATCHED 3:42 PM TIME POLICE ARRIVED',3:47 PM PART I PAGE IT]OF 6� REPORT NO. ED64509 CASE# 23-6004 OF COLLISION 05/27/23 15:40 OF CbLLI510N NARRATIVE ASSIGNMENT/ARRIVAL On 05/27/2023 at approximately 1544 hours, I was dispatched to a four vehicle collision at the intersection of Taylor Avenue NW and Renton Avenue S in the city of Renton, King County, Washington. I arrived at approximately 1547 hours. UNIT 1: FORD F250 I observed a black Ford F250 (UT/ E017DN, Unit 1) stopped facing east in the westbound left turn lane of Renton Avenue S at Taylor Avenue NW. Unit 1 had damage to the front bumper. Unit 1 was towing a utility trailer (UT/ 6V7AA) that fell off the hitch during the collision. UNIT 2: CHEVROLET S10 1 observed a blue Chevrolet S10 (WA/ C90582V, Unit 2) stopped facing east in the westbound left turn lane of Renton Avenue S at Taylor Avenue NW east of Unit 1. Unit 2 had moderate damage to the driver door. UNIT 3: HONDA FIT I observed a silver Honda Fit (WA/ CFU7633, Unit 3) stopped facing west in the westbound number two (farthest from curb) lane of Renton Avenue S at Taylor Avenue NW east of Unit 1. Unit 3's front bumper was engaged with Unit 1's front bumper. Unit 3 had moderate front end damage. UNIT 4: AUDI Q5 I observed a silver Audi Q5 (WA/ BNW3867) stopped facing west in the westbound number two lane of Renton Avenue S at Taylor Avenue NW east of Unit 3. Unit 4 had minor damage to the front driver bumper. DRIVER 1: MARSHALL, JACKIE B. I contacted Jackie B. Marshall (DOB: 05/30/1951) standing near Unit 1. 1 identified Marshall by his valid Utah Driver License. Marshall was not injured from the collision. I established Marshall as the driver of Unit 1 by his admission. DRIVER 2: MATTISON, ERIK L. I contacted Erik L. Mattison (DOB: 02/09/1976) sitting in the driver seat of Unit 2 being seen by Renton Fire Authority. I identified Mattison by his Washington Department of Licensing photograph. 1 established Mattison as the driver of Unit 2 by my observations. Mattison received possible broken ribs on the left side of his body and complained of neck and back pain. Mattison was transported by ambulance to Valley Medical Center. DRIVER 3: GONZALEZ, GENESIS N. I contacted Genesis N. Gonzalez (DOB: 11/16/1999) standing near Unit 3. 1 identified Gonzalez by her valid Washington Driver License. Gonzalez was not injured from the collision. I established Gonzalez as the driver of Unit 3 by her admission. DRIVER 4: RAMDAS, AASHISH I contacted Aashish Ramdas (DOB: 03/22/1984) standing near Unit 4. 1 identified Ramdas by his valid Washington Driver License. Ramdas was not injured from the collision. I established Ramdas as the driver of Unit 4 by his admission. STATEMENT: MARSHALL, JACKIE B. I spoke with Marshall about the collision. The following is a summary of our conversation: Marshall drove Unit 1 east on Renton Avenue S toward Taylor Avenue NW at about 35 miles per PAGE 3 OF 6 REPORT NO. ED64509 CASE# 23-6004 OF COLLISION 05/27/23 15:40 OF CbLLI510N NARRATIVE hour. Unit 1's bed was loaded with furniture. The trailer Unit 1 towed was also loaded with household goods. The traffic signal for eastbound Renton Avenue S turned red, and Marshall applied Unit 1's brakes. Unit 1 failed to stop and entered the intersection. Marshall didn't believe Unit 1 had any mechanical defects, but the weight he was hauling didn't allow him to stop on the downgrade. Unit 1's front end collided with Unit 2's driver side as it entered the intersection north on Hardie Avenue SW (which turns into Taylor Avenue NW at Renton Avenue S). Unit 1 and Unit 2 continued, engaged, east on Renton Avenue S and collided with Unit 3 and Unit 4. This concluded my conversation with Marshall. STATEMENT: MATTISON, ERIK L. I was unable to speak with Mattison due to his medical condition. STATEMENT: GONZALEZ, GENESIS N. I spoke with Gonzalez about the collision. The following is a summary of our conversation: Gonzalez drove Unit 3 west on Renton Avenue S toward Taylor Avenue NW. Gonzalez stopped Unit 3 at the red signal at Taylor Avenue NW. Gonzalez saw Unit 1 driving east on Renton Avenue S toward Taylor Avenue NW. Unit 1 entered the intersection from the west at the same time as Unit 2 was entering the intersection from the south. Unit 1 collided with Unit 2. Unit 1 and Unit 2 engaged, continued east, and collided with Unit 3 while it was sitting at the red signal. This concluded my conversation with Gonzalez. STATEMENT: RAMDAS, AASHISH I spoke with Ramdas about the collision. The following is a summary of our conversation: Ramdas drove Unit 4 west on Renton Avenue S toward Taylor Avenue NW. Ramdas stopped for the red signal at Taylor Avenue NW behind Unit 3. Ramdas saw Unit 1 and Unit 2 collide in the intersection. Unit 1 and Unit 2 engaged, continued east, and collided with Unit 3. The force of the collision sent Unit 3 and Unit 2 into Unit 4, which was stopped in the traffic lane. This concluded my conversation with Ramdas. PHOTOGRAPHS Officer M. Fernandes took photographs of the collision and uploaded them to Axon's Evidence.com. VEHICLE DISPOSITIONS Unit 1 and the trailer were towed at Marshall's request. Unit 2 was impounded from the scene since Mattison was unable to care for the vehicle due to his medical condition. Unit 3 was towed from the scene at Gonzalez's request. Ramdas drove Unit 4 from the scene. DISPOSITION I gave the involved drivers (except Mattison because he was being transported to the hospital) an Exchange of Information form. This concluded my involvement in this case. I declare under penalty of perjury under the laws of the State of Washington that the foregoing is true and correct. Electronically signed by Officer R. Gorajewski, #12399, on 05/27/2023 at 1710 hours in Renton, Washington. PAGE 4 OF 6 SUPPLEMENTAL REPORT NO. ED64509 r`I POLICE TRAFFIC 1 1 8 27 COLLISION REPORT CASE# 23-6004 1 COMMERCIAL MOTOR CARRIER INTERSTATE INTRASTATE G UNIT'# USL70r !CC# VEHICLE TYPE CARGO BODY TYPE 2 ❑ 1 1 8 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 DAMAGE THRESHOLD MET PHONE 5 ❑ UNIT# 3 VEHICLE tSJ CYCLE I_) PEDESTRIAN OWNER YES✓ NO D:2069283718 0 8 29 LAST NAME GONZALEZ FIRST NAME GENESIS MIDDLE N INITIAL 0 8 30 STREET NFW AnnRFsP 676 REDMOND AVE NE CITY RENTON ST WA ZIP 98056 6 ❑ 1 1 2 31 CDL IGNITIttN REQUIRED IGNITION PRESENT MEDICAL TANSPORTED INTERLOCK YEs NO✓ zERLOCK YEs❑NO❑✓ YES N ✓ DRIVER'S LICENSE STATE I WA SEX F MMDDYYv 11 - 16 - 1999 7 ❑ ON DUTY� STATUS AIRBAG' 2 RESTR. Q EJECT I HELMET 2 INJURY 1 NATURE OF INJURIES USE CLASS 8 ❑ 1 1 2 32 LICENSE CFU7633 TAr WA VIN# 3HGGK5H54HM705898 PLATE# 9 TRAILER TRAILER PLATE# STATE PLATE# STATE 10 TRLR TRLR VIN.#. VIN.#. 11 3 5 VEH.YEAR2017 MAKE HOND MODELFIT STYLE SD VEHICLE TOWE E T SABLIN TOWED BY anvi vEHIC P FROM TO DAMAGE YES NO ✓ YES NO ✓ 33 REGISTERED OWNER INFOJOSE ENRIQUEZ CRUS 15040156TH PL SE RENTONWA 98058 SHADE IN DAMAGED AREA 9 9 12 3 5 2 a FROM TO LIABILITY INSURANCE INSURANCE CO LIBERTY MUTUAL AOS-268.462704.40.34 <�Q' IN EFFECT &POLICY# 9VEHICLE 34 CITATION# CHARGE 13 IEcnuv YES NO STANDING l:9 dg DAMAGE THRESHOLD MET PHONE ❑ 35 14 UNIT# 4 MdT{7R ❑✓ PEDAG ❑ PEDESTRIAN ❑ PROPERTY ❑ YES NO VEHICLE CYCLE OWNER ✓ D:4259791097 15 � RONDOS HASHISH MIDDLE' ❑ 36 LAST NAME FIRST NAME INITIAL 2 STREET 16 ❑ ❑ 4447 RENTON AVE S CITY SEATTLE ST WAIp 98108 NFln+AnntxFss CDL IGNITION REdUiREE7 IGNITION PRESENT MEDICALTANSPORTED 17 ❑ INTERLOCK YEs Nb✓ INTERLOCK YEs NC7✓ YEs No�/ E DRIVER'S D.O.B 37 LICENSE# STATE WA SEX M MMDO' :y 03 - 22 - 1984 18 ❑ ON DUTY❑ STATUS AIRBAG 2 RESTR, 4 EJECT 1 HELMET 2 INJURY 1 NATURE OF INJURIES 38 19 USE CLASS ❑ ❑ PLATE# BNW3867 TAr WA v!N# WAIBNAFY8J2247019 3 39 20 ❑ TRAILER' STATE TRAILER ST 40 PLATE#< PLATE# ATE 21 ❑ ❑ 41 TRLR TRLR ViN If YIN#i 42 22 VEH.YEAR2018 MAKE AUDI MODEL OS STYLE SV VEHICLE TOWED DUET SABLIN TOWED BY GOVT.VEHICLE 1 DAMAGE YES NO ✓ YES NO ✓ 23 ❑ REGISTERED OWNER INFO OWNED BY DRIVER SHADE IN DAMAGED AREA 43 4 71 LIABILITY INSURANCE INSURANCE CO PROGRESSIVE 946425552 910P ❑ VEHICLE EFFECT &POLICY# i _'.''__'_ 4 44 24 LE E ALE YESZ NO❑ CITATION# CHARGE iq 60TiOM LEGALLY E:l STANDING 7 6 I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT. RAYMOND GORAJEWSKI 05-27-23 05:11 PM 25 INVESTIGATING OFFICER'S SIGNATURE OFFICER'S PHONE UNIT OR DIST DET DATED: PLACE SIGNED APPROVED BY DATE 26 OI BADGE 12399 O#I',WA0171300 SUMMERS 512712023 PAGE❑OF❑ 3000-345-013(R 11118) REPORT NO. ED64509 CASE# ' 23-6004 DATE AND TIME 05/27/23 15:40 OF COLLISION Taylor Ave NW Not to Scale "tur. Renton Ave S Hardy Ave SW PAGE 6 OF 6