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HomeMy WebLinkAbout24-2948 ITFF' "POLCERA II I !�� I III I III I /III III II I . 0 27c COLLISION REP FIT 1591971 INTERSTATE ❑ CITY STREET FIRE ❑ CASE 24-2s48 2 RESULTED 1 STOLEN STATE ROUTE ❑ OTHER ❑ VFHIC;I F ❑ LOCAL AOENC 4100 3 HIT 8 RUN CODING COUNTY RD PRIVATE WAY INVOLVED 2 TOTAL#TRIBAL OF 02 OBJECT 1 1 8 28 UNITS RESERVATION I STRUCK z 3 DATE OF M M D D Y Y Y Y TIME(2400) COUNTY# MILES CITY# ❑ cowsloN 03 - 18 - 2024 1657 17 ❑.❑ N E IN S H W H OF 1070 3 4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓ SUNSET BLVD NORTH BLOCK NO. e✓ 300 4a❑ MILEPOST DISTANCE OF(REFERENCE OR CROSS STREET) 5❑ 6001. 00 FMILES EET ❑ S ❑ W❑ NORTH 3RD STREET 0 4 29 UNIT V HOC ❑ CYCLE ❑ DAMAYEI✓NO GE ESHOLD MET PHONE 0 1 30 6 LAST NAME POLANCO UICAB FIRSTNAME EDWIN MIDDLE S 1 2 31 INITIAL STREET ❑, 1150 SUNSET BLVD NE APT 210 CITY RENTON ST WA ZIP' 980562981 z NEW ADDRESS 7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3 iNTERLOCKYEs NO 1/ INTERLOCKYEs NO�/ YES No�/ 8❑ DRIVERS E# STATE WA SEX'M MM D�Y' 05 - 18 - 1994 1 2 32 [NATURE OF INJURIES 9 ON DUTY❑ STATUS' AIRBAG 6 RESTR 4 . EJECT 1 H USE 2 CLASS ,7 C/O ABDOMINAL PAIN AND SORENESS z❑ 3❑LICENE CHD5093 STATE WA V N# 3N1CN8EVOML877360 10 9❑ Pr ATF� TRAILER TRAILER STATE STATE 11 3 0 PLATE# PLATE# ROM TO TRLR 5 7. TRLR 33 12 3 0 VIN It UIN# FROM TO ❑ VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN T GOVT.VEHICLE 1 5 34 13 8 2021 NISS VERSA 4D DAMAGE YES NO �LII� RS vES❑ NO REGISTERED OWNER INFO EAN HOLDINGS LLC 1852 N STATE ST BELLINGHAM WA 98225 D:4252040432 VEHICLE NO. 1 ❑ SHADE IN DAMAGED AREA 35 14 LIABILITY ❑ INSURANCE CO 4 IN EFFECTINSURANCE &POLICY# 9TOP 5 VEH'CLL CHARGE BOTTOM 36 LEGALLY YES No CITATION# 4AO071584,4AO071584 OP MOT VEH W/OUT INSURANCE, 15❑ NDING 8 6 MOTOR PEDAL-: PEDESTRIAN PROPERTY DAM THR OLD MET PHONE UNIT 02 VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES 1/ NO D:4253581379 16 a LAST NAME SZKLARSK/ FIRST NAME WALTER MIDDLE L INITIAL 17 STREET❑ NEW ADOREss❑' 19226 200TH AVE SE CITY RENTON ST WA ZIP 980580255 4❑ 37 18❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED � 38 INTERLOCK YEs❑No� INTERLOCK YEs❑NOF YES❑NOF,/ 19[—] DRIVER # ON DUTY STATUS AIRBAG,6 RESTR 4 EJECT 1 H EET 2 NJAU Sy 7 C/O LOWER BACK AND SEA TBELT SORENESS[-�A—TURE OF INJURIES 40 ❑ILICENSE 21❑ PLA E# AOM2249 TATE 41 WA VIN# 1ZWHT61L9X5762156 1 42 22❑ PLATE# STATE PLATE# STATE 23❑ 43 TRLR RLR UIN#. 'IN#. VEH YEAR 1999 MAKE MERC MODEL COUGAR STYLE CP VEHICLETOWED TO BLIN TOWEDBY GOV HI �44 24❑ DAMAGE YES✓ NO BANKERS YES NO REGISTERED OWNER INFO WALTER SZKLARSK/11226200TH AVE SE RENTONWA98058 D:4253581379 VEHICLE NO.2 SHADEJN DAMAGEDAREA 4� 3 4 LIABILITY INSURANCE INSU8 PORGY#E CO STATE FARM 318 1323-D20-4IN 7I STOP 5 VE""LE ❑ ,J� CITATION CHARGE toBOTTOM LEGALLY YES N J 25 e OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# T AGENCY 26 MATT HEW NUGENT 11498 WA0171300 PART A PAGE 01 OF 3000-345-159 OR 11/181 STATE OF POLICETRAFFICN CORRECTION REPORT NO. EE62770 COLLISION REPORT III III III III III 111 1591972 CASE# 24-2948 ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY) NAME MIDDLE INITIAL) EGEDAL CAROLYN E (LAST FIRST, ADDRESS&PHONE# D O.B. ' 19226 200TH AVE SE RENTON WA 980580255 4253581379 SEXi F MMDOYyry 10 - 14 - 1947 PASSENGER Z WITNESS❑'[UNIT# 2 SEA 3 AIRBAG I g RESTR. q EJECT ? 1 HELMET INJURY NATURE OF INJURIES USE 2 CLASS 11 NAME (LAST,FIRST,MIDDLE INITIAL) COX TREVOR S ADDRESS&PHONE# O B 353 SUNSET BLVD NORTH RENTON WA 98055 4252040432 SEX M 4:O- vv 11 _ 03 _ 1994 PASSENGER UNIT# SEAT AIRBAG RESTR. EJECT HELMET INJURY NATURE OF INJURIES []WITNESS POS. USE CLASS 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. MATTHEW NUGENT 03-18-24 06:49 PM INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED APPROVED BY DATE CO.JOHNSON 0505 3/26/2024 2:16:35 PM BADGE OR ID# 11498 ORI# WA0171300 TIME POLICE DISPATCHED 4:89 Pry TIME POLICE ARRIVED',5:02 PM PART B PAGE IT]OF 4� TIM REPORT NO. EE62770 CASE# 24-2948 OFC LNaoy L isI©�ON 03/18/24 16:57 F cu NARRATIVE 24-2948 On 03/18/2024 at approximately 1659 hours, I was dispatched to an injury and blocking vehicle collision in the 300 block of Sunset Blvd North, within the City Limits of Renton, County of King, State of Washington. While en route, Dispatch advised that both vehicles were blocking the roadway with one involved patient grabbing their abdominal area therefore Renton Regional Fire Authority (RRFA) was simultaneously dispatched. Upon arrival, RRFA was on scene evaluating the involved parties. All involved parties were evaluated and treated at the scene. While on scene, I collected each involved party's information and involvement leading up to the collision. The driver of Unit#1 stated he was the sole occupant of his rental vehicle and that prior to the collision, he was traveling northbound in about the 300 block of Sunset Blvd N and approaching the intersection of Houser Way Bypass. The driver of Unit#1 stated that he was intending to pull into the private property parking lot just southwest of the intersection at Houser Way Bypass. The driver of Unit#1 stated that he had pulled into the dedicated center-turn-lane to yield to traffic for a left-turn. The driver of Unit#1 stated he intended to proceed west into the Enterprise Rental Car parking lot following the turn. The driver of Unit#1 stated that uninvolved traffic in two of the three opposing lanes had waved the driver of Unit#1 to proceed. The driver of Unit#1 stated that he did not see Unit #2 traveling in the one of the approaching lanes of travel, however, the driver of Unit#1 still proceeded to traverse across the southbound lanes of travel. Both Unit#1 and #2 collided in the roadway subsequently causing significant damage to front passenger wheel bearing/axle of Unit#1. The driver of Unit#2 said he and his adult passenger were traveling southbound in about the 300 block of Sunset Blvd N in lane 1 of 3. The driver of Unit#2 stated he was intending to continue south towards the intersection of North 3rd Street. The driver of Unit#2 stated while approaching where Unit#1 was intending to turn, Unit#1 turned in front of his vehicle. The driver of Unit#2 stated he was unable to avoid the collision and struck Unit#1 causing significant damage to the front of Unit#2. Based on the above statements, 1 determined that the Driver of Unit#1 (POLANCO UICAB) was the predominant factor for the collision due to not granting the right of way during a left turn causing a collision. The driver of Unit#1 violated RCW 46.61.185.1 by not granting the right of way to Unit#2 traveling in the roadway which had the right of way and was already underway. POLANCO UICAB was also unable to provide proof of motor vehicle insurance upon request. I cited POLANCO UICAB in-person for the Improper Left Turn and for operating a motor vehicle without insurance. Both Unit#1 and Unit#2 had to be impounded due to extensive damage. An exchange of information was provided to all involved parties. I certify (or declare) under penalty of perjury under the laws of the State of Washington that the foregoing is true and correct. Electronically signed by Officer M. Nugent#11498 3/18/2024 6:36 PM Renton, King County, WA. PAGE 3 OF 4 REPORT NO. EE62770 CASE# 24-2948 DATE AND TIME 03/18/2416:57 OF COLLISION ( U 7Ik L, q T s PAGE 4 OF 4