HomeMy WebLinkAbout23-6490 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 0 27c
COLLISION REP FIT 1591971
CASE 23-6490 z
INTERSTATE ❑ CITY STREET FIRE ❑RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHICI F ❑ LOCAL AOENC 4200 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 1 TOTAL#OF OBJECT 1 1 8 28
TRIBAL UNITS OZ STRUCK
RESERVATION
z
3❑ DATE OF M M D D Y Y Y Y TIME(2400) COUNTY# MILES N E IN CITY# ❑
cowsloN 06 - 1-- 2023 1057 17 ❑.= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓
PARKAVENORTH BLOCK MILEPOST ST e✓ 900
4a❑
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ 325 00 FMILES N EET e S B OF NORTH 8TH STREET
0 8 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
,/No D:4255162879 0 11
30
6� LAST NAME PHAMQUACH FIRSTNAME BRIANNA MIDDLE T 1 1 2 31
INITIAL
STREET ❑, 14566 SE 153RD PL CITy RENTON ST WA 2jp, 980588106 z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
INTERLOCK YES[:]NO 1/ INTERLOCKYEs NO Z/ YES R No�/
8❑ LRIIVER #
ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 HELMET U E 2 CLASS 1 NATURE OF INJURIES 2❑
3
10 9❑ P1 aT�S� CFE7237 sTArI WAurN# JTNKHMBX2M1117500
TRAILER STATE TRAILER STATE
11 0 0 PLATE# PLATE# FROM TO
TRLR. TRLR 7 5 33
12 2 5 VIN#' VIN#
>; FROM TO
❑ VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN T GOVT.VEHICLE 1 $ 34
13 9 2021 TOYT C-HR 4H DAMAGE vEs ONO f �AWkkRS vEs❑ No
REGISTERED OWNER INFO HOANG PRAM 14566 SE 153RD PL RENTONWA 98058 D:4255162879 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
3 4
14 LIABILITY INSURANCE INSURANCE CO AMERICAN FAMILY 41017-37691.63
IN EFFECT &POLICY# 9TOP
VEHICLE CHARGE 1 5 36
LEGALLY YES❑NO❑ CITATION# 3AO431062 FAIL STOP AT STOP BOTTOM
15❑ STANDING 7 6
MOTOR PEDAL-:. PEDESTRIAN PROPERTY DAMH TR OLD MET PHONE
UNIT U2 VEHICLE ❑ CYCLE ❑ ❑ OWNER
❑ YES 1/ NO D:2066222261
16 a
LAST NAME APELU FIRSTNAME TAGHLIMA MIDDLE I F
INITIAL
17 STREET NEW ADOREs�' 15653 129TH CT SE CITY' RENTON ST WA ZIP 980584743 37
18� CDL ., IGNITION REQUIRED IGNITION PtR-E-S1ENT MEDICAL TRANSPORTED 38
INTERLOCK YEs❑No� INTERLOCK YEs I I NOF YEs t l NOF,/
19[ D IVEW #
❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 H U EET 2 NJAURSY 1 NATURE OF INJURIES 40
❑ILICENSE 21❑ PLA E# 2962512 TArE IN VIN 1t 3HSDXTZN5KN080510 41
1
42
22❑ TRAILER !C333399 STATE ME TRAILER STATE
PLATE# PLATE#
23❑ UIN#. 43
TRLR RLR
'IN#.
VEH YEAR 2019 MAKE INTT MODEL TRACTO STYLE SE VEHICLETOWED TO BLIN TOWEDBY GOV HI 44
24❑ DAMAGE YES NO�/ YES NO✓
REGISTERED OWNER INFO SYSCO LEASING LLC 4000 W 62ND ST INDIANOPLIS IN46268 D:2066222261 VEHICLE NO.2
SHADEDAMAGEDAREA
3 4
LIABILITY INSURANCE INSU&PORGY#E CO AON RISK SERVICES SW,INC.BAP 2347204 13 1GQI
IN EFFECT'E""LE ❑ ,J� CITATION# CHARGE
LEGALLY YES N`L J
25 s � a
=UGENT
(PRINT) OFFICER PHONE BADGE OR ID# 77P�1300
26 11498
PART A PAGE 01 OF C7
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. ED70715
COLLISION REPORT III III III III III 111
1591972 CASE# 23-6490
ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY)
NAME MIDDLE INITIAL) PHAM JENNA L
(LAST FIRST,
ADDRESS&PHONE#
11356 NE OREGON ST PORTLAND OR 972200000 4255162879 SEXi F MMDOYyry 08 - O6 - 1998
PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT ' HELMET INJURY NATURE OF INJURIES
❑✓ ❑ 1 FOS, ! 3 2 4 1 USE 2 CLASS 1
NAME
'(LAST,FIRST MIDDLE INITIAL)
ADDRESS&PHONE# DOB
SEX MMDDYVYV
PASSENGER ❑WITNESS❑ UNIT# : SEAT AIRBAG RESTR. EJECT HELMET NJURY NATURE OF INJURIES
POS. USE CLASS
NAME
(LAST FIR57 MIDDLE INITIAL)
AppRESS&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.
MATTHEW NUGENT 06-08-23 02:36 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
c0.JOHNSON 0505 6/16/2023 8:38:13 AM
BADGE OR ID# 11498 ORI# WA0171300 TIME POLICE DISPATCHED 10:59 AM TIME POLICE ARRIVED i 11:06 AM
PART I PAGE ❑OF❑
REPORT NO. ED70715 CASE# 23-6490 OF COLLISION
06/07/23 10:57
OF CbLLI510N
NARRATIVE
23-6490
On 06/07/2023 at approximately 1059 hours, I was dispatched to a non-injury and non-blocking
vehicle collision in the 900 block of Park Avenue North, within the City Limits of Renton, County of
King, State of Washington.
Upon arrival, Renton Fire was on scene triaging the involved parties due to an initial report of injuries
being mentioned but later recanted. Renton Fire evaluated all involved parties and treated them at
the scene where they were later released. There, I was able to collect each involved party's
information and independent summary of the events leading up to the collision.
The driver of Unit#1 was identified by pictured WADL and stated she had an adult passenger inside
of her vehicle. The driver of Unit#1 stated she was attempting to exit the private parking lot at the
Landing Shopping Center, specifically in the 900 block of Park Ave N. The driver of Unit#1 stated she
was intending to turn southbound (right) onto Park Ave N. While approaching the intersection of Park
Ave N, the driver of Unit#1 stated that she stopped at the stop sign controlled intersection and looked
for oncoming traffic. The driver of Unit#1 said she noticed Unit#2 traveling south on Park Ave N with
its right turn signal on and assumed the vehicle was turning into the same parking lot that Unit#1 was
attempting to exit from. The driver of Unit#1 proceeded forward thinking it would allow additional
space for Unit#2 to complete the turn. Upon Unit#1 turning out into the roadway, both Unit#1 and
Unit#2 made contact causing moderate damage to the front driver's side of Unit#1.
The driver of Unit#2 was identified by pictured WACDL and was the sole occupant of his commercial
vehicle. The driver of Unit#2 stated that he was traveling southbound on Park Ave N approaching the
intersection of N 8th ST in lane 1 of 2. The driver of Unit#2 stated he was intending to turn
westbound (right) onto N 8th ST upon reaching the intersection. The driver of Unit#2 stated that he
continued south and that while attempting to continue past the entrance to the Landing Shopping
Center parking lot entrance, Unit#1 entered the roadway and into the same lane that Unit#2 was
occupying. The driver of Unit#2 stated that he could not avoid the collision before Unit#1 collided
with Unit#2 causing moderate damage to the front passenger side bumper of Unit#2.
Based on the above statements, I determined that the Driver of Unit#1 (Phamquach) was the
predominant factor for the cause of collision as Phamquach did not grant the right of way to traffic
already in the roadway and underway. Phamquach violated RCW 46.61.190(2) as every driver of a
vehicle approaching a stop sign shall stop where the driver has a view of approaching traffic on the
intersecting roadway before entering the roadway, and after having stopped shall yield the right-of-
way to any vehicle in the intersection or approaching on another roadway so closely as to constitute
an immediate hazard during the time when such driver is moving across or within the intersection or
junction of roadways.
Unit#1 had to be impounded due to extensive damage. Unit#2 was able to be driven away from the
scene without further incident. An exchange of information was provided to all involved parties.
I cited the driver of Unit#1 via mail for Failing to Stop at an Intersection (RCW 46.61.190.2) and
causing a collision.
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 6/8/2023 2:34 PM Renton, King County, WA.
PAGE 3 OF 5
SUPPLEMENTAL REPORT NO. ED7071 5
r`) POLICE TRAFFIC 1 27
COLLISION REPORT CASE# 23-6490
1 COMMERCIAL MOTOR CARRIER INTERSTATE INTRASTATE ✓ G
UNIT# 2 USDOT ICC# VEHICLE TYPE 3 CARGO BODY 12
TYPE
2 ❑ H28
CARRIER 1
NAME SYSCO LEASING LLC
.......
3 CARRIER
ADDRESS 4000 W 62ND ST
CITY INDIANAPOLIS ST IN ZIP 46268
4 ❑ NAME # PLACARD: :❑
NAME IF NO NUMBER
SOURCE 3 AXLES 03 GI30000 +
4a ❑ ADDITIONAL UNITS
MOTOR PEDAL- PROPERTY DAMAGE THRESHOLD MET PHONE
5 ❑ UNIT# VEHICLE I_J CYCLE _) PEDESTRIAN � OWNER � YES NO
i MIDDLE'... 29
LAST NAME FIRST NAME INITIAL
STREET 30
NFW AnnRFrtP. CITY ST ZIP
6 �
CDL GNITIttN REQUIRED GNITION PRESENT MEDICAL TANSPORTED 1 31
INTERLOCK YES No zERLOCK YES❑N0� vES N
LLIICIENSE STATE I SEX M��DYRYY' 2
7 F-1
ON DUTYl STATUS AIRBAG' RESTR. EJECT HELMET INJURY NATURE OF INJURIES
USE CLASS
8 ❑ ' 1 32
LICENSE+ rar VIN.#
PLATE#
9 TRAILER TRAILER
PLATE# STATE PLATE# STATE
10 ❑ TRLR TRLR
VIN.#. VIN.#.
11 VEH.YEAR MAKE MODEL STYLE VEHICLE TOWS T SABLIN TOWED BY anvi vEHIG P FROM TO
DAMAGE Y EES 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
STREETIAL
❑
16 NFln+AnnRFs.� CITY'. ST 21P
CDL IGNITION REDUIRED IGNITION 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 3 4 4 AREA F 43
z
LIABILITY INSURANCE INSURANCE CO '
VE EFFECT &POLICY# i 970P - 4 E:l
44
24 VEHICLE YES❑ NO❑ CITATION# CHARGE iq 60TiOM
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.
MATTHEW NUGENT 06-08-23 02:36 PM
25 INVESTIGATING OFFICER'S SIGNATURE OFFICER'S PHONE UNIT OR DIST DET DATED: PLACE SIGNED
APPROVED BY DATE
26F7 OI BADGE 11498 O#I,WA0171300 JOHNSON 611612023 PAGE F41 OF F
3000-345-013(R 11118)
REPORT NO. ED70715 CASE# ' 23-6490 DATE AND TIME 06/07/23 10:57
OF COLLISION
'Dogram net to:scat.
Park Avenue North
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00
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0
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mt 41
The L—Jmg Shnppsng:Centnr
PAGE 5 OF 5