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Home My WebLink About23-14982 a ITFFi "POLCERA II IfI) 1 IlfII ('II (Illf If( fI I . 1 27c COLLISION REP FIT 1591971 CASE 23-14982 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 TOTAL#TRIBAL OF 03 OBJECT 1 1 8 28 UNITS RESERVATION STRUCK z 3❑ DATE of M M D D Y Y Y Y TIME(2400) COUNTY# MILES N E IN CITY# cowsloN 12 - 1-- 2023 1150 17 ❑-= S 8 IN e 1070 3 4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑ NE 4TH ST BLOCK NO. e✓ 5700 ❑ 4a❑ MILEPOST DISTANCE OF(REFERENCE OR CROSS STREET) 5❑ ❑ FEET e S ❑ W e NILEAVENE 0 1 29 MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE UNIT 01 VEHICLE ❑ CYCLE El NO F,/ I D:2062903809 0 11 30 6� LAST NAME RIDGE FIRSTNAME JOSHUA MIDDLE A 1 0 1 31 INITIAL STREET ❑✓ 18314 SE 128TH ST CITY RENTON ST WA ZIP 98059 z NEW ADDRESS 7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3 iNTERLOCKYEs NO 1/ INTERLOCKYEs No�/ YEs No�/ 8❑ LICENSE WA STATE Wq SEX'M MM DAY' 10 - 13 - 1988 1 2 32 9 ON DUTY❑ STATUS AIRBAG 1 RESTR 4 EJECT 1 H USEET 2 CLASS 1 NATURE OF INJURIES 2❑ 3 LICENSE C78989F sTArI WAvIN# 1FTHX26MXPKA89966 10❑ PI ATE 14 5 TRAILER STATE TRAILER STATE 11 3—LATE# PLATE# FROM To TRLR. TRLR 3 7 33 12 3 5 VIN#' VIN# >; FROM TO VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TR Y GOVT.VEHICLE 3 7 34 13 1993 FORD F250 PK DAMAGE YES NO �MEYERS YES❑ No✓ REGISTERED OWNER INFO JOSHUA RID GE 18314 SE 128TH ST RENTON WA 98059 D:2062903809 VEHICLE NO. 1 ❑ SHADE IN DAMAGED AREA 35 14 ❑ INSURANCE CO 3 4 LIABILITY INSURANCE IN EFFECT &POLICV# 9TOP VE—LE CHARGE to BOTTOM 5 36 LEGALLY YES❑NO CITATION# 3A0852527,3A0852527, FL RENEW EXPIRED REG<=2 MTHS, 15❑ STANDING 7 6 MOTOR PROPERTY PHONE UNIT 02 VEHICLE ❑ ❑ PEDESTRIAN ❑ D:20 64232673 16 a CYCLE OWNER M LAST NAME MONTGOMERY FIRST NAME BRIAN MIDDLE I S INITIAL 17 STREET I❑ 14814 162ND CT SE CITY RENTON ST WA ZIP 980598841 37 NEW ADDRESS❑' 18❑ CDL IGNITION REQUIRED IGNITION PtR-E-S1ENT MEDICAL-T�RANSPORTED � 38 INTERLOCK YEs❑No� INTERLOCK YEs I I NOF YEs t l NOF,/ 19 F] LICENSE# STATE WA SEX M M D.O.B. 04 � 11 1975 39 20❑ ON DUTY STATUS AIRBAG, 1 RESTR 4 EJECT 1 HELMET 2 INJURY 7 NATURE of INJURIES ❑ 40 USE CLASS NECK PAIN ❑21❑ PLATE# C16350K TArE 41 WA VIN1 3TMDZ58N6HM025636 1 42 22❑ PIR ILER LATE# STATE PLATE# STATE TRLR 23❑ UIN#. 'IN#. 43 RLR rowed By Gov HI 44 VEH YEAR 2017 MAKE TOYT MODEL TACOMA STYLE PK DAMAGETOWED TOO✓ BLIN yES NO 24❑ REGISTERED OWNER INFO OWNED SY DRIVER VEHICLE N0.2 SHADEDAMAGEbAREA s Cd LIABILITY INSURANCE &POLICY#E CO SAFECO M1903728IN STOP VEwGLE ❑ E[J CITATION# CHARGE io BOTTOM LEGALLY YES N J 25 ' OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# JAGENCY 26 KEVIN PETERSON 12808 WA0171300 PAGE 01 OF PART A 3000-345-159 OR 11/181 STATE OF POLICETRAFFICN CORRECTION REPORT NO. EE39314 COLLISION REPORT III III III III III 111 1591972 CASE# 23-14982 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 PM 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. KEVIN PETERSON 12-31-23 06:24 PM INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED APPROVED BY DATE S.WOODWARD 11528 1/11/2024 6:16:01 AM BADGE OR ID# 12808 OR]# WA0171300 TIME POLICE DISPATCHED; 11:55 AM TIME POLICE ARRIVED 11:59 AM PART I PAGE IT]OF TIME REPORT NO. EE39314 CASE# 23-14982 OF COLLISION12/31/23 11:50 NARRATIVE I was dispatched to the collision on 12/31/23 at 1514 hours at the intersection of NE 4th St and Nile Ave NE in city Renton, King County WA. Unit 1 C78989F Driver Joshua A Ridge (DOB 10/13/1988) Unit 2 C16350K Driver Brian S. Montgomery (04/11/1975) Unit 3 BKS9486 Driver Kayla R. Johnson (01/25/1994) Both drivers of vehicles 2 and 3 were identified by their WADL. Vehicle 1 was identified by his WA DOL photo. All 3 units were in lane 2 westbound on NE 4th St. Unit 3 was stopped at the intersection of NE 4th St and Nile Ave NE in lane 2. Unit 2 was stopped behind Unit 3 at the same intersection. Unit 1 was traveling West on NE 4th St when approaching the intersection of NE 4th St and Nile Ave NE in lane 2 when he could not stop. Unit 1 collided into Unit 2 which shoved Unit 2 into Unit 3 who was stopped at the light. Unit 1 stated that his only working break was his driver side front tire which locked up and slid. I observed that Unit 1 had channel locks on his passenger front brake line to hold it together. Fire arrived on scene to check on the driver of Unit 2 who had complaints of neck soreness. Upon request Joshua A Ridge (DOB 10/13/1988) was unable to provide proof of insurance and a valid driver license. Unit 1's vehicle was impounded. Joshua was cited for failure to renew expired registration more than 2 months, defective brakes on his vehicle, operating a motor vehicle without insurance, no valid operating license while operating a motor vehicle. PAGE 3 OF 5 SUPPLEMENTAL REPORT No. EE39314 r`) POLICE TRAFFIC 1 1 8 27 COLLISION REPORT CASE# 23-14982 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 t_"J CYCLE _) PEDESTRIAN OWNER YES NO D:4255124482 0 1 29 LAST NAME JOHNSON FIRST NAME : KAYLA MIDDLE R INITIAL STREET 30 NEW AnnRFrtP 2503 TALBOT CREST DR S CITY RENTON ST WA ZIP 980554218 6 ❑ 1 1 2 31 CDL IGNITIttN REQUIRED IGNITION PRESENT MEDICAL TAN5PORTED INTERLOCK YEs NO zERLOCK YES❑N0� YES N DRIVER'S LICENSE STATE I WA SEX F MMDDYYv 01 - 25 - 1994 7 ON DUTY� STATUS AIRBAG' 1 RESTR. Q EJECT 1 HELMET 2 INJURY 1 1 NATURE OF INJURIES USE CLASS 8 ❑ 1 32 LICENSE BKS9486 TAr Wq VIN# 5YJ3E1EAOJF023688 PLATE# 9 TRAILER TRAILER PLATE# STATE PLATE# STATE 10 ❑ TRLR TRLR VIN.#. VIN.#. 11 3 5 VEH.YEAR2018 MAKE TESL MODELMODEL 3 1 STYLE SD I VEHICLE TOWE E T SABLIN TOWED BY anvi vFH1C P FROM TO DAMAGE YES NO YES NO REGISTERED OWNER INFO.VAUGHN JOHNSON 4761 NELSON SIDING RD CLEELUM WA 98922 $ ] 33 12 � SHADE IN DAMAGED AREA 7 j FROM TO LIABILITY INSURANCE INSURANCE CO USAA 029769517R R"i"Olx IN EFFECT &POLICY# 1 EHICLE 34 13 4 LEGALLY YES[:] NO❑ CITATION# CHARGE 0 BOTTOM STANDING } 7 14 ❑ UNIT Tr Vd 1RE O CYDCLE OWNERRTY YES AGE NOHRESHOLD MET PHONE ❑ 35 PEDESTRIAN 15 LAST NAME FIRST NAME MIDDLE ❑ 36 STREET 16 TEETEs.�' CITY ST ZIP CDL IGNITION REdUiRED IGNITION PRESENT MEDICALTANSPORTED INTERLOCK YES No INTERLOCK YES NO YEs NO ❑ 17 4 37 LICENSE# STATE SEX MMDDDYBYY -� II 18 ❑ ON DUTY� STATUS AIRBAG RESTR. ; EJECT HELMET INJURY NATURE of 1NJURIEs 38 USE CLASS 19 ❑ LICENSE TAr VIN# 39 PLATE# 20 ❑ TRAILER' STATE TRAILER STATE ❑ 40 PLATE#< PLATE# 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 AREA 43 3 4 71 LIABILITY INSURANCE INSURANCE CO ' VINE EFFECT &POLICY# i 970P - 4 E:l 44 24 LEwcLE YES❑ NO❑ CITATION# CHARGE iq 60TiOM LECALLv 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. KEVIN PETERSON 12-31-23 06:24 PM 25 INVESTIGATING OFFICER'S SIGNATURE OFFICER'S PHONE UNIT OR DIST DET DATED: PLACE SIGNED APPROVED RD# 12808 O#IIWA0171300 OA 1 PAGE OF 5OI 3000-345-013(R 11118) REPORT NO. EE39314 CASE# ' 23-14982 DATE AND TIME 12/31/23 11:50 OF COLLISION 4. UnrAim- ' a r. � PAGE 5 OF 5