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Home My WebLink About23-11196 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 5 27c COLLISION REP FIT 1591971 CASE 23-11196 z INTERSTATE ❑ CITY STREET FIRE ❑RESULTED 1 STOLEN STATE ROUTE ❑ OTHER ❑ VFHIl.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 RESERVATION STRUCK z 3❑ DATE OF M M D D Y Y Y Y TIME(2400) COUNTY# MILES N E IN CITY# CowsloN 09 - 1-- 2023 1630 17 ❑-= S 8 IN e 1070 3 4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑ OAKSDALE AVE SW BLOCK NO. e✓ 4100 ❑ 4a❑ MILEPOST DISTANCE OF(REFERENCE OR CROSS STREET) 5❑ ❑ FEET e S ❑ W e SW41ST ST 0 4 29 MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE UNIT 01 VEHICLE ❑ CYCLE El ,/No D:2534974968 0 11 30 6❑ LAST NAME TAPIA RAMIREZ FIRST NAME YAHIER ARMANDO MIDDLE INITIAL 1 2 31 STREET ❑ 103 MIRROR LAKE PARK CITY FEDERAL WAY ST WA 2jp, 98023 z NEW ADDRESS 7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3 INTERLOCK YES[:]NO INTERLOCKYEs NO YES R NO 8 LDRIVER # STATE WA SEX'M MM ovY 02 1- 04 - 2003 2 32 9 ON DUTY❑ STATUS AIRBAG 2 RESTR 9 EJECT 1 HELMETU E 2 CLASS 1 NATURE OF INJURIES z❑ 3 LICENSE C90631J sTArI WAurN# WD3PFODD1GP241877 10 F91 PI ATE i4 TRAILER STATE TRAILER STATE 11 3 5 PLATE# PLATE# FROM TO TRLR. YRLR. 3 5 33 12 3 5 VIN#' VIN# >; FROM TO ❑ VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TR Y GOVT.VEHICLE 5 1 34 13 4 2016 MERZ SPRINT VN DAMAGE YES NO �MEYERS YES❑ No✓ REGISTERED OWNER INFO AUTO-CHLOR SYSTEM OF WASHINGTON INC 6840 S 196TH ST#STE 120 KENTWA98032 D:2534974968 VEHICLE NO. 1 ❑ SHADE IN DAMAGED AREA 35 4 INSURANCE CO 3 4 14 LIABILITY OLD REPUBLIC INSURANCE COMPANY MWT830775323 IN EFFECT &POLICY# 9TOP VEHICLE CHARGE 5 36 LEGALLY, YES❑NO❑ CITATION# 1 o BOTTOM 15❑ STANDING 7 6 MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE UNIT 02 VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES 1/ NO D:2063490430 16 a LAST NAME LEATH FIRST NAME BLAIR MIDDLE IM INITIAL 17❑ NEW STREETREs7 11607 72ND PL S CITY SEATTLE ST WA ZIP 98178 4❑ 37 18❑ CDL IGNITION REQUIRED IGNITION PtR—E—S1ENT MEDICAL—T�RANSPORTED � 38 INTERLOCKYES�NOR INTERLOCK YEs I I NOF YEs t l NO❑ 19 DRIVER # ❑ ON DUTY STATUS AIRBAG 2 RESTR 9 EJECT 1 HELMET 2 INJURY 7 NATURE of INJURIES ❑ 40 USE CLASS THROBBING LEG ❑LICENSE I 21❑ PLA E# CCH9889 TArE 41 WA VIN 1 3FADP46JOFM199573 1 42 22❑ PILER LATE# STATE pLATE# STATE 23❑ 43 TIN# N RLR #.UIN#. 'I TOWED BY GOV HI 44 VEH YEAR 2015 MAKE FORD MODEL FIESTA STYLE $D —FEHICLE TOWED✓ NOO BLIN GENE MEYERS YES No�/ 24❑ REGISTERED OWNER INFO OWNED SY DRIVER VEHICLE N0.2 SHADE DA GEbAREA LIABILITY INSURANCE❑ &POINSULICY#E CO NONE NONEIN I 9TOP 5 vE"'LE ❑ Nu J ,J� CITATION# CHARGE 25 to BOTTOM LEGALLY YES s � e OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# JAGENCY 26 TIM CUMMING 11488 WA0171300 PART A PAGE 01 OF 3000-345-159 OR 11/181 STATE OF POLICETRAFFICN CORRECTION REPORT NO. EE05640 COLLISION REPORT III III III III III 111 1591972 CASE# 23-11196 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 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. TIM CUMMING 09-29-23 05:59 PM INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED APPROVED BY DATE P.KORDEL 9676 1 101412023 4:01:11 PM BADGE OR ID# 91488 OR]# WA0171300 TIME POLICE DISPATCHED 4:35 PM TIME POLICE ARRIVED 4:43 PM PART I PAGE IT]OF 5� REPORT NO. EE05640 CASE# 23-11196 OF COLLISION 09/29/23 16:30 OF CbLLI510N NARRATIVE 23-11196 On 09/29/2023 at approximately 1635 hours, I was working as a Police Officer for the city of Renton. While I was working, I was dispatched to a collision with unknown injuries at the intersection of SW 41 st St and Oakesdale Ave SW in the City of Renton, the County of King, Washington. This report is a summary of events that occurred and is not an exact sequencing of events. Statements have been paraphrased and summarized. According to the notes in the call, a box truck struck an unknown second vehicle. It was unknown if there were any injuries. The reporting party heard the collision and then saw the box truck with the bumper off. As I drove to the location the call was updated. It was a two-vehicle collision. One vehicle was up on the curb and unable to move. It was not blocking the roadway. The female driver of the Ford Fiesta was heard saying that she could not move her leg. The two involved vehicles were described as a silver Ford Fiesta and a silver van. I arrived at the location around 1643 hours. I saw that the van was blocking the middle of the intersection and the Ford Fiesta was north of the intersection in the grassy area between the roadway and the sidewalk. The van was identified as a white 2016 Mercedes Benz Sprinter van (WA LIC# C90631J). The driver of the van was identified by WADOL photo as TAPIA RAMIREZ, YAHIER ARMANDO (DOB 02/04/2003). The driver's identity was confirmed by WADOL photo. The sedan was identified as a silver 2015 Ford Fiesta sedan (WA LIC# CCH9889). The driver of the Ford Fiesta was identified as LEATH, BLAIR MONIQUE (DOB 05/03/1999). The driver's identity was confirmed by WADOL photo. For the duration of this case the Mercedes Benz Sprinter van will be identified as Unit 1 and the Ford Fiesta will be identified as Unit 2. 1 met with the driver of Unit 2. 1 asked her to tell me what happened. She told me that she was driving north along Oakesdale Ave SW in lane 1. As she approached the intersection of Oakesdale Ave SW and SW 41st St, Unit 1 was pulling into the intersection. She did not have time to change lanes to avoid a collision and Unit 1 collided with the passenger side of Unit 2. This pushed her across oncoming lanes and into the grassy area between the road and the sidewalk. She said that she was not injured but her right leg was throbbing. She refused medical attention. She provided me with her driver's license, told me that she was the registered owner of the vehicle, and that she did not have insurance for the vehicle. 1 later confirmed that she was the registered owner. Officer Bills met with the driver of Unit 1. The driver told Officer Bills that he was at the intersection of Oakesdale Ave SW and SW 41 st St. He was inching out into the roadway and was going to turn left to go south along Oakesdale Ave SW. Unit 2 was driving north along Oakesdale Ave SW, and the two vehicles collided. The front of Unit 2 collided with the passenger side of Unit 1. The driver of Unit 1 provided officers with his driver's license, the registration for the vehicle, and the insurance. The van was a work van and belonged to a business called AUTO-CHLOR SYSTEM OF WASHINGTON INC. I reviewed the damage to both vehicles and the damage matched the statements made by the two parties. I took photos of both vehicles and the scene and later uploaded them to evidence.com. Kent fire was called to the location, and they assisted by blocking traffic and offering both parties medical attention if they desired. Neither party complained of injury. Gene Meyers towing was called to the location to tow the vehicles. Both parties were provided with my business card and the case number. Based on the statements made by both parties and the damage that was consistent with their statements it was clear that Unit 1 was the at fault driver. Unit 1 had a responsibility to make sure that the lane of travel was clear before he drove into the intersection. There is no further information available at this time. I certify (declare) under penalty of perjury under the laws of the state of Washington that the foregoing is true and correct. Electronically signed by T. Cumming #11488 on 09/29/2023 @ 1739 hours in Renton WA. PAGE 3 OF 5 REPORT NO. EE05640 CASE# 23-11196 OF COLLISION 09/29/23 16:30 OF CbLLI510N NARRATIVE PAGE 4 OF 5 REPORT NO. EE05640 CASE# ' 23-11196 DATE AND TIME 09/29/23 16:30 OF COLLISION i� 23-11196-Not Drawn To Scale Unit"1 Uni#2 PAGE 5 OF 5