HomeMy WebLinkAbout23-6866 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 6 27c
COLLISION REP FIT 1591971
CASE 23-6866 z
INTERSTATE ❑ CITY STREET FIRE ❑RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHICI F ❑ LOCAL AOENC 4100 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 1126 17 ❑-= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
LOGAN AVE NORTH BLOCK NO. e✓ 400 ❑
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ �.❑ FEET e S ❑ VV e NORTH 4TH STREET
0 1 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
NO D:2067050631 0 4 30
6� LAST NAME GHAZNAWI FIRSTNAME ABDUL MIDDLE S 1 2 31
INITIAL
STREET ❑ 12210 SE PETROVITSKY RD APT E CITy RENTON ST WA ZIP 980586662 z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
iNTERLOCKYEs NO 1/ INTERLOCKYEs NO�/ YES R No�/
8❑ LRIIVER # STATE WA SEXI M MM D Y' 12 1- 30 - 1975 2 32
CENS [NATURE OF
9 ON DUTY❑ STATUS AIRBAG 6 RESTR 4 EJECT 1 HELMET
2 CLASS 7 I C/O HEADI PNJURIES AIN,AIRBAGS DEPLOYED z❑
3
10[1LICENS P1 ATE 14 CGT2443 sTAr WAv N# 2T18URHE3GC692482
TRAILER STATE TRAILER STATE
11 3 0 PLATE# I PLATE# I I FROM To
TRLR. TRLR $ 1 33
12 3 0 VIN#' VIN#
FROM TO
VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TR Y GOVT.VEHICLE 3 $ 34
13 3 2016 TOYT COROL 4D DAMAGE YES NO MEYERS YES[:] NO✓
REGISTERED OWNER INFO ABDUL GH.4. I23719110TH AVE SEAPT 1D306 KENT WA 98031 D:2067050631 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
14 LIABILI INSURANCE INSURANCE CO PROGRESSIVE 963458426 4
IN EFFECT &POLICY# TOPVEHICLE CHARGE 36
LEGALLYYES❑NO❑ CITATION# 3AO431073 FAIL TO OBEY TRAFFIC CONTROL <1�3
orrow
15❑ STANDING 6
MOTOR PEDAL- 'PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT VEHICLE ❑ CYCLE ❑ ❑ : OWNER ❑ YES 1/ NO D:2064308041
16 a
LAST NAME CORTES RODRIGUEZ FIRST NAME OSCAR MIDDLE C
INITIAL
17 STREET NEW ADDRESS❑' 3911 S MEAD ST CITY SEATTLE ST WA ZIP 981182638 4❑ 37
18� CDL IGNITION REQUIRED IGNITION PR-E-1SENT MEDICAL TRANSPORTED 38
INTERLOCK YEs❑No� INTERLOCK YEs It I NOF YES
t l NOF,/
19 DRIVER'S STATE WA SEX M D.C.B. 09 _ 07 2000 39
LICENSE# MMDDYY
20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 H U EET 2 NJAURSY 1 NATURE OF INJURIES ❑ 40
❑21❑ PLATE# CAS3056 TArE 41
WA VIN# JT2BG22K6X0359743 1
42
22❑ PLATE# STATE PLATE# STATE
23❑ 43
TRLR RLR
UIN#. 'IN#.
VEH YEAR 1999 MAKE TOYT MODEL CAMRY STYLE 4D I VEHICLE TOWED TO BLIN TOWEDII GOV HI �44
24❑ DAMAGE YES NO GENE MEYERS YES NO
REGISTERED OWNER INFO DESIDERIO GAYTAN HERNANDEZ 3911 S MEAD STAPT C SEATTLE WA 98118 D:2064308041 VEHICLE NO.2
SHADE IN DAMAGED AREA
2 3 4
LIABILITY INSURANCE❑ INSURANCE CO
IN EFFECT &POLICY# O(�E9TOP 5
VE""LE YEs Nc❑ clrArloN# 3AO431074.3AO431074 CHARGE NO VALID OPER LICENSE WITH VALID
o BOTTOM
�E...�Y
25 a
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# JAGENCY
26
MATTHEW NUGENT 11498 WA0171300
PART A PAGE 01 OF C7
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. ED72237
COLLISION REPORT III III III III III 111
1591972 CASE# 23-6866
ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY)
NAME MIDDLE INITIAL) MEIER HEATHER
(IAST FIRST,
ADDRESS&PHONE#
23004 130TH PL SE RENTON WA 98031 2535698252 SEXi F MMDOYyry 02 - 17 - 1978
PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT ' HELMET INJURY NATURE OF INJURIES
❑ ❑✓ POS. USE CLASS
NAME
(LAST,FIRST,MIDDLE INITIAL)
ADDRESS&PHONE# Id DOB
E MMDDYVYY
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.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 06-16-23 01:08 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
C.JACOBS 1953 612112023 10:46:01 AM
BADGE OR ID# 11498 ORI# WA0171300 TIME POLICE DISPATCHED; 11:27 AM TIME POLICE ARRIVED',11:29 AM
PART I PAGE IT]OF 5�
REPORT NO. ED72237 CASE# 23-6866 OF COLLISION
06/16/23 11:26
OF CbLLI510N
NARRATIVE
23-6866
On 06/16/2023 at approximately 1127 hours, I was dispatched to a collision with report of injury at the
intersection of Logan Ave North and North 4th Street, within the City Limits of Renton, County of King,
State of Washington.
While en route, Officer P. Davis arrived on scene prior to my arrival and requested Renton Fire
respond due to reported injury.
Upon my arrival, both involved parties were being evaluated by Renton Fire. Everyone was treated at
the scene and released. While there, I collected each involved party's information and their
independent recollection of their involvement leading up to the collision.
The driver of Unit#1 stated he was the sole occupant of his vehicle and was traveling northbound on
Logan Ave North approaching the intersection of North 4th Street in lane 2 of 2. The driver of Unit#1
stated he was intending to continue straight (northbound) at the intersection to proceed. The driver of
Unit#1 stated that he did not recall what color the traffic light was. The driver of Unit#1 did not realize
that he had continued into the above intersection against a red light. Unit#2 had entered the same
intersection but from the East (N 4th ST) as Unit#1 entered the intersection. Both Unit#1 and Unit#2
collided in the intersection causing significant damage to the front of Unit#1.
The driver of Unit#2 said he was the sole occupant of his vehicle and was traveling westbound on
North 4th ST and stopped at the intersection of Logan Ave North in one of the two left turn-lanes (lane
2 of 3). The driver of Unit#2 stated he was intending to make a left turn to proceed southbound onto
Logan Ave North upon the traffic light changing from red to green. Upon the traffic light changing from
red to green for his direction of travel, the driver of Unit#2 stated he proceeded out into the
intersection. The driver of Unit#2 stated that Unit#1 then approached the intersection from the south
and believed that Unit#1 ran the red light. The driver of Unit#2 stated that he was unable to avoid the
collision and that Unit#1 struck Unit#2 mid-turn causing moderate damage to the front driver side of
Unit#2.
A witness, identified as Heather Meier, confirmed that Unit#2 did in fact have a green light for his
direction of travel.
A DOL records check revealed that the Driver of Unit#2 was not a licensed driver, DOL specifically
notating `Not Licensed -Eligible'. Additionally, the driver of Unit#2 was not an insured driver.
Based on the above statements, 1 determined that the Driver of Unit#1 (Ghaznawi) was the
predominant factor for the cause of collision due to Failing to Obey a Traffic Control Device. The
driver of Unit#1 was not paying attention to the posted traffic light at the intersection causing a
collision. I cited Ghaznawi in-person for failing to obey a traffic control legend.
I also cited the Driver of Unit#2 in-person for Not having a Valid Operator's License (NVOL) with
pictured WAID and for Operating a Motor Vehicle without insurance.
Both Unit#1 and Unit#2 had extensive damaged and had to be impounded out of the roadway. 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 6/16/2023 1:02 PM Renton, King County, WA.
PAGE 3 OF 5
REPORT NO. ED72237 CASE# 23-6866 OF COLLISION
06/16/23 11:26
OF CbLLI510N
NARRATIVE
PAGE 4 OF 5
REPORT NO. ED72237 CASE# ' 23-6866 DATE AND TIME 06/16/23 11:26
OF COLLISION
'Diagram not to scale
Unit#2
Unit#1
N 4th St
co
CM
0
PAGE 5 OF 5