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Home My WebLink About23-14207 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 1 27c COLLISION REP FIT 1591971 CASE 23-14207 z INTERSTATE ❑ CITY STREET FIRE ❑ RESULTED 1 STOLEN STATE ROUTE ❑ OTHER ❑ VFHIr.I F ❑ LOCAL AGENCI 4900 3 HIT&RUN CODING COUNTY RD PRIVATE WAY INVOLVED 2� 1 1 8 28 TOTAL#OF OBJECT TRIBAL UNITS 03 STRUCK' FENCE RESERVATION z 3❑ DATE OF M M D D Y Y Y Y TIME(2400) COUNTY# MILES N E IN CITY# ❑ CowsloN 12 - 11 - 2023 1341 17 ❑.❑ S 8 W H OF e 1070 3 4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓ DUVALL AVE NE BLOCK NO. e✓ 1075 4a❑ MILEPOST DISTANCE OF(REFERENCE OR CROSS STREET) 5❑ 400 00 FEET MILES e S B W e NE 12 ST 0 1 29 MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE UNIT 01 VEHICLE ❑ CYCLE El ,/No D:4252698030 N:2063086770 0 11 30 6� LAST NAME WURZ-TELFORD FIRSTNAME SHIRLEY MIDDLE 1 2 31 INITIAL STREET ❑, 201 UNION AVE SE,UNIT 136 CITY RENTON ST WA 2jp, 98059 z NEW ADDRESS 7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3 1/ I INTERLOCK YES[:]NO NTERLOCKYEs NO�/ YES R No�/ 8❑ LRIIVER # ON DUTY❑ STATUS AIRBAG 6 RESTR 4 EJECT 1 HELMET 2 INJURY 5 NATURE OF INJURIES z❑ USE CLASS HEAD INJURY,PAIN IN CHEST,HIP PAIN 3 10[1Pl QTNFS# IG04FUN STATE WA VIN#' 5NPD84LF2HH2O6582 0 TRAILER STATE TRAILER STATE 11 2-LATE# PLATE# FROM TO rRLR. TRLR 1 5 33 12 2 0 VIN#' VIN# FROM TO VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN T v GOVT.VEHICLE 1 $ 34 13 3 2017 HYUN ELANTR P4 DAMAGE YES 0NO a �MYERS ves❑ No REGISTERED OWNER INFO OWNEDBYDRIVER VEHICLE NO. 1 SHADE IN DAMAGED AREA ❑ 35 14 LIABILITY INSURANCE INSURANCE CO PEMCO CA 0487509 4 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 VEHICLE ❑ CYCLE ❑ ❑ : OWNER ❑ YEs NO 1/ D:4254447604 16 2 LAST NAME LINDSAY FIRST NAME RICHARD MIDDLE A INITIAL 17 NEW STREETR 7' 15012 SE 138TH PL CITY RENTON ST WA ZIP 98059 37 18� CDL IGNITION REQUIRED IGNITION PR-E-1SENT MEDICAL TRANSPORTED 38 INTERLOCK YEs❑No� INTERLOCK vEs It I NOF YES t l NOF,/ 19 LDIIVEW # STATE WA SEX M MMDDW 08 _ 03 _ 1944 39 20❑ ON DUTY STATUS I AIRBAG 2 RESTR 4 EJECT 1 H U EET 2 NJAURSY 1 NATURE OF INJURIES 40 LICENSE I ❑21❑ PLA E# CBV2860 TATE WA VIN# 41 KM8SRDHF8JU278777 1 42 22❑ PLATE# STATE PLATE# STATE 23❑ VIN#. 43 TRLR RLR 'IN#. TOWED By Gov HI 44 VEH YEAR 2018 MAKE yyUN MODEL ELANTRA STYLE P4 DAMAGE TOWED NOO✓ BLIN YES NO 1/ 24❑ REGISTERED OWNER INFO OWNED SY DRIVER VEHICLE N0.2 SHADE IN DAMAGEbAREA 2 3 Cd LIABILITY INSURANCE &POLICY#E CO CONNECT NAIC 29068IN I STOP VE"LE ❑ N`L J ,J� CITATION# CHARGE i o BOTTOM LEGALLY YES 25 $ ' OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# JAGENCY 26 DES/REE SCOTT 10272 WA0171300 PART A PAGE 01 OF C7 3000-345-159 OR 11/181 STATE OF POLICETRAFFICN CORRECTION REPORT NO. EE29364 COLLISION REPORT III III III III III 111 1591972 CASE# 23-14207 ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY) NAME MIDDLE INITIAL) LINDSAY CHRISTINA E (LAST FIRST, ADDRESS&PHONE# 15012 SE 138TH PL. RENTON WA 98059 4252289771 SEXi F MMDovyvv 01 - 07 - 1948 PASSENGER I�I WITNESS❑ UNIT# 2 POS 3 AIRBAG 2 RESTR. 4 EJECT ? I HELMET LASS NATURE of INJURIES L�!1 USE 2 CLASS 11 NAME (LAST,FIRST,MIDDLE INITIAL) MURRAY NATHANIEL E ADDRESS&PHONE# D O B 650 DUVALL AVE NE Q1714 RENTON WA 98059 2065668268 SEX M MMDDvyvv 03 _ 07 _ 1991 PASSENGER [:]WITNESSZ UNIT# SEAT AIRBAG RESTR. EJECT HELMET NJURY POS. NATURE OF INJURIES USE CLASS NAME (LAST FIR57 MIDDLE INITIAL) AppRESS&PHONE# SEX D.Q.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. DESIRES SCOTT 12-11-23 06:27 PM INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED APPROVED BY E DAT DESIRES SCOTT 10272 1211112023 6:29:39 PM BADGE OR ID# 10272 ORI# WA0171300 TIME POLICE DISPATCHED 1:43 PM TIME POLICE ARRIVED',1:51 PM PART Ei PAGE 2�OF❑ TIME REPORT NO. EE29364 CASE# 23-14207 OF COLLISION12/11/23 13:41 NARRATIVE On 12/11/23 around 1341 hours Officers were dispatched to 1075 Duvall AVE NE (City of Renton, County of King, and State of Washington) due to a report of an injury accident. Upon arrival I contacted Driver#1 who was confused and appeared to have had a medical emergency. Driver#1 was complaining of head, chest, and hip pain. Driver#1 had an obvious injury to the left side of her forehead. Vehicle #1 had significantly damaged to the front end of the vehicle. Renton Fire Authority were treating Driver#1 getting her ready to transport to the hospital. While they were doing that, I followed the tire tracks and saw that Vehicle #1 had been traveling South bound in the 1100 block of Duvall AVE NE. Vehicle #1 left the road and jumped a curb toward the elementary school bus lane headed Westbound. The vehicle continued to travel across the lawn, stuck and broke a tree support, went off the curb into the bus lane. Drove across the bus lane, jumped another curb, and struck a fence that had a cement barrier to keep vehicles from driving into the playground. Driver#1 was transported to Overlake Hospital. I called Driver#1 family and let them know where they could locate her. I called for an update later in the evening and learned Driver#1 had broken her pelvis and they were still evaluating the extent of her injuries. Vehicle #1 was towed by Gene Myers towing. Driver#2 stated he was going around 20 miles an hour in Lane #1 headed southbound in a school zone when Vehicle #2 was struck from behind by Vehicle #1. Driver#2 said Vehicle #1 went off the road and crashed into a fence. Driver#2 checked on Driver#1 and Driver#1 told Driver#2 that believed she had fallen asleep. Vehicle #2 had minor damage to the rear bumper. No injuries were reported by Driver#2 or Passenger#2 Witness #1 stated he was behind Vehicle #1 traveling Southbound in Lane#1. Witness #1 saw Vehicle #1 strike Vehicle #2. Vehicle #1 then over corrected, accelerated, jumped several curbs, and crashed into a fence. I contacted Property owner#1 Renton School District. I could see damage to landscaping, the cement barrier under the fence and the security fence around the playground. No injuries were reported at the Elementary School. Pictures were taken of the damage and attached to the case file via AXON I certify under penalty of perjury under the laws of the State of Washington that the foregoing is true and correct. Electronically Signed by Officer Scott/10272 Renton Police Department PAGE 3 OF 5 SUPPLEMENTAL REPORT No. EE29364 r`) POLICE TRAFFIC 1 27 COLLISION REPORT CASE# 23-14207 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 I_J CYCLE _) PEDESTRIAN � OWNER � YES� NO D:4252044445 MIDDLE.. 29 LAST NAME RENTON FIRST NAME SCHOOL DISTRICT INITIAL STREET 30 NEW AnDRFSP 7812 S 124 ST CITY SEATTLE ST WA ZIP 98178 6 CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TANSPORTED 1 31 INTERLOCK YES[:]NO zERLOCK YES E]Na� YEs N DRIVER'S STATE I SEX U M��DYSYv' —� 2 LICENSE 7F-ION DUTY STATUS AIRBAG RESTR. EJECT HELMET INJURY NATURE OF INJURIES F� USE CLASS 8 ❑ ' 1 32 LICENSE+ rar V1N.# PLATE# 9 TRAILER TRAILER PLATE# STATE PLATE# STATE 10 ❑ TRLR TRLR VIN.#. VIN.#. 11 VEH.YEAR MAKE I MODEL STYLE I VEHICLE TOWS E T SABLIN TOWED BY anvi vEHIG P FROM TO DAMAGE YES NO YES NO REGISTERED OWNER INFO. m 33 12 SHADE IN DAMAGED AREA FROM TO LIABILITY INSURANCE❑ INSURANCE CO IN EFFECT &POLICY# tGQ VEHICLE 34 13 ❑ LEGALLY YES[:] NO❑ CITATION# CHARGE STANDING S} 8 7 6 14 ❑ UNIT Tr Vd 1RE O CYDCLE OWNER YES AGE NOHRESHOLD MET PHONE El 35 PEDESTRIAN 15 LAST NAME FIRST NAME MIDDLE': INITIAL36 STREET"[—] ❑ 16 NEn+AnnRFs.�' CITY'. ST ZIP CDL IGNITION REdUiRED IGNITtGN PRESENT MEDICALTANSPORTED INTERLOCK YES No INTERLOCK YEs NO YEs NO El 17 37 LICENSE# STATE SEX MMDDDYBYY 18 ❑ ON DUTY� STATUS AIRBAG RESTR. ; EJECT HELMET INJURY NATURE of INJURIES 38 USE (CLASS 19 ❑ vIN# 39 LICENSE PLATE# rnr 20 ❑ TRAILER' TRAILER ❑ 40 PLATE# STATE PLATE# STATE 21 ❑ TRLR TRLR 41 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 AREA 43 3 4 71 LIABILITY INSURANCE INSURANCE CO ' VEHICLE EFFECT &POLICY# I 970P - 4 44 24 VEHICLE YES NO❑ CITATION# CHARGE iq 60TiOM E:l C=DLv 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. DESIREE SCOTT 12-11-23 06:27 PM 25 INVESTIGATING OFFICER'S SIGNATURE OFFICER'S PHONE UNIT OR DIST DET DATED: PLACE SIGNED 26 � ORID# 10272 O#I',WA0171300 APPROVED BY 12111/202 PAGE F41 OFF 3000-345-013(R 11118) REPORT NO. EE29364 CASE# ' 23-14207 DATE AND TIME 12/11/23 13:41 OF COLLISION m R PAGE 5 OF 5