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Home My WebLink About23-11944 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 1 27c COLLISION REP FIT 1591971 CASE 23-11944 z INTERSTATE ❑ CITY STREET FIRE ❑RESULTED 1 STOLEN STATE ROUTE ❑ OTHER ❑ VFHIC;I F ❑ LOCAL AOENC 4900 3 HIT&RUN CODING COUNTY RD PRIVATE WAY INVOLVED 2 2 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 CITY# ❑ cowsloN 10 - 19 - 2023 0720 17 ❑.❑ N E IN S 8 W H OF 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❑ 150 00 FMILES EET e S ❑ W e MONROE AVE NE 0 1 29 R PEDAL- DAMAGE THRESHOLD MET PHONE UNIT 01 VEHICLE ❑ CYCLE ❑ YES ,/No D:4252559602 0 7 30 6� LAST NAME RIDGE FIRSTNAME WILLIAM MIDDLE E 1 1 2 31 INITIAL STREET ❑, 18154 SE 128TH ST CITY RENTON ST WA Zlp' 98059 z NEW ADDRESS 7❑ CDL 1/IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3 INTERLOCK YES[:]NO INTERLOCKYEs Z/NO YES 1/ NO 8❑ DRIVERS E# STATE WA SEX'M MM D�Y' 05 1- 05 - 1967 2 32 LICEN —' [NATURE OF INJURIES 9 ON DUTY❑ STATUS' AIRBAG 2 RESTR 4 . EJECT 1 HELMETU E 2 CLASS'NJURY7 I BACKAND HEAD z❑ 3 10 1❑ Pi ATNES# BJE0808 sTAr WAu N# 3FAHPOHAOBR274870 TRAILER STATE TRAILER STATE 11 3 5 PLATE# PLATE# ROM ro TRLR. TRLR 3 7 33 12 0 0 VIN#j VIN# FROM TO ❑ VEH.YEAR 2011 MAKE MODEL STYLE VEHICLE TOWED TO BLIN T /g[ GOVT.VEHICLE 9 9 34 13 4 FORD FUSION 4D DAMAGE YES NOBS YES❑ No✓ REGISTERED OWNER INFO ELIZABETH KRANTZ 18314 SE 128TH ST RENTON WA 98059 VEHICLE NO. 1 ❑ SHADE IN DAMAGED AREA 35 4 14 LIABILITY INSURANCE❑ INSURANCE CO 3 IN EFFECT &POLICY# 9TOP VEHICLE CHARGE 5 36 LEGALLY, YES❑NO❑ CITATION# 1 o BOTTOM 15❑ STANDING 6 MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE UNIT 02 VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES 1/ NO D:2063354806 16 2 LAST NAME LIVINGSTON FIRST NAME MARCUS MIDDLE F INITIAL 17 STREET I❑ 3924 NE 5TH ST CITY' RENTON ST WA ZIP 980563981 37 NEW ADOREss❑' 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... 05 _ 28 _ 1997 39 LICENSE# MMDDYY 20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 H U EET 2 NJAU EY 7 COMPLAINED OF NECK AND BACK PAIN F—NATURE OF INJURIES 40 LICENSE ❑21❑ PLA E# BHS8532 TArE 41 WA vIN# 1HGCR2F56GA034810 1 42 22❑ PLATE# STATE PLATE# STATE 23❑ UIN#. 43 TRLR RLR 'IN#. VEH YEAR 2016 MAKE HOND MODEL ACCORD STYLE 4D VEHICLETOWED TO BLIN TOWEDBY GOV HI 44 L4❑ DAMAGE YES NO,/ YES NO REGISTERED OWNER INFO MARCUS LIVINGSTON 3924 NE STH ST RENTON WA 98056 VEHICLE NO.2 SHADEDAMAGEbAREA s Cd LIABILITY INSURANCE INSU PORGY#E CO pROGRESSIVE 944891179IN STOP vewCLe CITATION# CHARGE � to BOTTOM LEGALLY YES N 25❑ OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY J 26 C.JACOBS 1953 WA0171300 PAGE 01 OF PART A 3000-345-159 OR 11/181 STATE OF POLICETRAFFICN CORRECTION REPORT NO. EE19082 COLLISION REPORT III III III III III 111 1591972 CASE# 23-11944 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. C.JACOBS 10-24-23 08:01 AM NVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED APPROVED BY DATE C.JACOBS 1953 1111312023 9:27:36 AM BADGE OR ID# 1953 ORI# WA0171300 TIME POLICE DISPATCHED 7:32 AM TIME POLICE ARRIVED',7:40 AM PART I PAGE IT]OF 5� REPORT NO. EE19082 CASE# 23-11944 OF COLLISION 10/19/23 07:20 OF CbLLI510N NARRATIVE On 10-19-23 at about 0720 1 arrived in the 3300 block of NE 4th Street for a 3-vehicle collision. When I arrived unit 1 was still in the roadway and unoccupied. Units 2 and 3 were moved out of the roadway. I contacted drivers 2 and 3 in a nearby driveway. Driver 2 identified himself via WADL and told me he was the sole occupant of the vehicle. Driver 3 identified himself Oregon DL and told me he was the sole occupant of unit 3. Both drivers told me; They were stopped in traffic when they were struck from the rear. Driver 2 complained of back and neck pain but sought own medical care. Driver 1, William Ridge was transported from the scene before I could speak to him. I later contacted Ridge in the E.R. of Valley Medical Center. Ridge told me; He was the driver of vehicle 1. He was driving along with traffic and did not realize traffic had stopped in front of him before colliding with unit 2. He was not sure what his injuries were. He had another person in the vehicle (but he did not give me her information). He does not have insurance. Investigation revealed that units 2 and 3 were stopped for traffic in lane 2 of West bound 3300 block of NE 4th Street when unit 1 struck the rear of unit 2, causing unit 2 to strike the rear of unit 3. Unit 1 was towed due to no driver being available and disabling damage. I did not cite Ridge due to no one being able to identify him as the driver of unit 1. This incident occurred in the city of Renton, County of King. I declare under penalty of perjury under Washington state law that the foregoing is true and correct. C. Jacobs/1953 PAGE 3 OF 5 SUPPLEMENTAL REPORT NO. EE19082 r`) POLICE TRAFFIC 1 1 8 27 COLLISION REPORT CASE# 23-11944 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 _) PEDESTRIAN � OWNER � YES� NO D:5417350365 0 7 29 LAST NAME COVILLE FIRST NAME JEFFREY MIDDLE' ',, E INITIAL r:j STREET 30 NEW AnoR12SP 280E 47TH AVE CITY EUGENE ST OR ZIP 974053571 5 ❑ 1 1 2 31 CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TAN5PORTED INTERLOCK YEs NO zERLOCK YES❑N0� YEs N L LICVER'SENSE IC STATE OR SEX M MDYBYv', 08 TO] - 1968 7 ON DUTYl STATUS AIRBAG' 2 RESTR. Q EJECT 1 HELMET 2 INJURY 1 NATURE OF INJURIES USE CLASS 8 ❑ 1 32 LICENSE 60ONSY TAT OR VIN# 3TMDZ5BN8LM084650 PLATE# 9 TRAILER TRAILER PLATE# STATE PLATE# STATE 10 ❑ TRLR TRLR VIN It VIN.#. 11 0 0 VEH.YEAR2020 MAKE TOYT MODELTACOMA STYLE PK VEHICLE TOME E T SABLIN TOWED 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 34 FROM TO LIABILITY INSURANCE INSURANCE CO ALLSTATE 817860136 GQO IN EFFECT &POLICY# 1EwcLE 34 13LTANDINEGALLY YES NO❑ CITATION# CHARGE STANDING S} 8 7 6 14 ❑ UNIT Tr Vd IRE O CYDCLE 1:1OWNERRTY 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 ❑ LICENSE TAT VIN# 39 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 LEGALLv 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.JACOBS 10-24-23 08:01 AM 25 INVESTIGATING OFFICER'S SIGNATURE OFFICER'S PHONE UNIT OR DIST DET DATED: PLACE SIGNED APPROVED BY DATE 25 OR ID# 1953 O#I',WA0171300 JACOBS 11/13/202 PAGE�OF 3000-345-013(R 11118) REPORT NO.! EE19082 CASE# 23-11944 DATE AND TIME 10/19/23 07:20 OF COLLISION lrzmn %L now Not drawn to scale 1 fi : Unit 1 z �_�— - ,�;.; T m Unit 2 Unit 3 PAGE 5 OF 5