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Home My WebLink About23-7051 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 5 27c COLLISION REP FIT 1591971 CASE 23-7051 z INTERSTATE ❑ CITY STREET FIRE ❑ RESULTED 1 STOLEN STATE ROUTE ❑ OTHER ❑ VFHIr.I F ❑ LOCAL AGENCI 4Y00 3 HIT&RUN CODING COUNTY RD PRIVATE WAY INVOLVED 2 TOTAL#OF OBJECT 1 1 8 28 TRIBAL UNITS 04 STRUCK RESERVATION z 3❑ DATE OF M M D D Y Y Y Y TIME(2400) COUNTY# MILES N E IN CITY# ❑ cawsloN 06 - 1-- 2023 1240 17 ❑.= S 8 IN e 1070 3 4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓ BENSON DR BLOCK NO. e✓ 17400 4a❑ MILEPOST DISTANCE OF(REFERENCE OR CROSS STREET) 5❑ 10 00 FEET MILES e S B W e SE CARR 0 1 29 MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE UNIT 01 VEHICLE ❑ CYCLE El ✓NO D:8477848428 0 81 30 6� LAST NAME LHEE FIRSTNAME THOMAS MIDDLE Y 1 F 2 31 INITIAL STREET ❑, 807 DAVIS ST 1904 CITY EVANSTON ST It ZIp' 60201 z= NEW ADDRESS ]❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3 iNTERLOCKYEs NO INTERLOCKYEs NO YES R NO 8❑ LRIIVER # ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 H U SE ICNLJAUSSY 1 NATURE OF INJURIES z❑ 3 10❑ P1 aT�S� BBZ3158 sTAr� WAvIN# 5FNRt 38816B014476 TRAILER STATE TRAILER STATE 11 4 0 PLATE# PLATE# FROM TO TRLR. A'RLA2 1 5 33 12 4 0 VIN#' VIN#' FROM TO VEH.YEAR 2006 MAKE HOND MODEL ODYSSE STYLE VEHICLE TOWED fn TO VBLINJ TOWED BY I GOVT.VEHICLE 9 9 34 DAMAGE YES NO YES[:] NO✓ 13❑ REGISTERED OWNER INFO THOMAS LHEE 14111 SEFAIRWOOD BLVD RENTON WA 98058 VEHICLE NO. 1 SHADE IN DAMAGED AREA ❑ 35 14❑ LIABILITY INSURANCE INSURANCE CO LIBERTY MUTUAL AOS 261 9467057024 4 LI EFFECT I SUR N# TOPVEHICLE CHARGE 36 LEGALLYYES NO CITATION# 3A0387736 INATTENTIVE DRIVING <1�3 orrom 15❑ STANDING 7 6 MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE �U-NIT VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES 1/ NO D:2068238705 16 a LAST NAME COOPER FIRST NAME SHELTON MIDDLE / INITIAL 17❑ STREET ❑', 18627 175TH AVE SE CITY RENTON ST WA ZIP 980589539 37 NEW ADDRESS ❑ 18� CDL IGNITION REQUIRED IGNITION PtR-E-S1ENT MEDICAL TRANSPORTED 38 INTERLOCKYES�NOR INTERLOCK YEs I I NOF YEs t l NO❑ 19 DRIVER'S STATE WA SEX M D.C.B. 08 _ 30 _ 1976 39 LICENSE# MMDDYY WELMET INJURY1 NATURE OF INJURIES 40 20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 USE CLASS ❑ 21❑ LICENSE BBA9961 TAre WA VIN# KM8SRDHF5HU176699 ❑ 41 PLATE# 42 22❑ PILER LATE# STATE PLATE# STATE 23❑ VIN 43 TIN##. IN RLR ' #. VEH YEAR 2017 MAKE HYUN MODEL SANTA STYLE VEHICLETOWED TO BLIN TOWEDBY GOV HI 44 L4❑ DAMAGE YES NO YES NO REGISTERED OWNER INFO SHELTON COOPER 18627175TH AVE SE RENTON WA 98058 VEHICLE NO.2 SHADEDAMAGEbAREA s Cd LIABILITY INSURANCE INSU PORGY#E CO PEMCO INS CA 1678552IN STOP VE""LE CITATION# CHARGE 25 to BOTTOM LEGALLY YES Nu ❑ OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# JAGENCY 26 J.M/TCHELL 10377 WA0171300 PAGE 01 OF PART A 3000-345-159 OR 11/181 STATE OF POLICETRAFFICN CORRECTION REPORT NO. ED76151 COLLISION REPORT III III III III III 111 1591972 CASE# 23-7051 ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY) NAME MIDDLE INITIAL) RODRIGUEZ MALDONADO MA E (LAST FIRST, ADDRESS&PHONE# D O.B. 13900 SE NEWPORT WAY BELLEVUE WA 980061410 SEX F MMDDYyvv 03 - 03 - 1972 PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT ' HELMET INJURY NATURE OF INJURIES ❑✓ ❑ 3 POS, 3 2 4 1 USE CLASS 1 NAME (LAST,FIRST,MIDDLE INITIAL) CASTANEDA LUZ A ADDRESS&PHONE# D O B 16206 SE 9TH ST BELLEVUE WA 980084909 SEX I F MMDDvvvv 02 _ 01 _ 1970 SEAT HELMET INJURY NATURE OF INJURIES PASSENGER WITNESS❑ UNIT# 3 POS 6 AIRBAG 2 RESTR. 4 EJECT 1 USE CLASS 1 NAME (LAST FIR57 MIDDLE INITIAL) AppRESS&PHONE# SEX D.0.8.MMDD -❑ YYYY. PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET NJURY NATURE OF INJURIES ❑ ❑ POS. USE CLASS ----� NARRATIVE' On 062123 1 responded to a 4-vehicle non-injury/blocking collision at the 17400 block of Benson Dr. I contacted the driver of unit 2 who told me they were stopped for traffic in the #2 lane of 108th Ave Se when they were hit from behind by unit 1. The driver was not injured. Two passengers in unit 2 were also uninjured. Unit 2 sustained rear bumper damage. I contacted the driver of unit 1, identified as Thomas Lhee Foster (dob 05-03-41) via his WA DL. LHee says as he is traveling on the inside left turn lane of Benson Dr approaching SE Petrovitsky, he accidentally accelerated instead of braking and drove into the back of unit 2. The initial collision caused unit 2 to be pushed into unit 3 and unit 3 into unit 4. A back seat driver in unit 3 was seen by Renton Fire for complaint of back pain. That patient did not require transport to a medical facility. No tow required for any of the vehicles. But not for the action of UNIT 1 DRIVER the result would not have happened. I cited Lhee via SECTOR under RMC 10-12-25- INNATENTIVE DRIVING I declare under penalty of perjury under the laws of the State of Washington that the foregoing is true and correct. I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT. J.MITCHELL 06-21-23 03:09 PM INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED APPROVED BY DATE C.JACOBS 1953 1 7/3/2023 3:16:42 PM BADGE OR ID# 10377 ORI# WA0171300 TIME POLICE DISPATCHED 12:40 PM TIME POLICE ARRIVED',12:45 PM PART I PAGE IT]OF 4� SUPPLEMENTAL REPORT NO. ED761 51 r`) POLICE TRAFFIC 1 1 8 27 COLLISION REPORT CASE# 23-7051 1 COMMERCIAL MOTOR CARRIER INTERSTATE INTRASTATE G UNIT'# USDOT ICC# VEHICLE TYPE CARGO BODY ;TYPE 2 ❑ 1 1 8 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 tSJ CYCLE I_) PEDESTRIAN OWNER YES NO D:4256155689 OF 8 29 FIRST NAME MIDDLE LAST NAME NAVARRO APREZA PABLO INITIAL N 0 g 30 STREET NFW AnDRFSP 13900 SE NEWPORT WAY CITY BELLEVUE ST WA ZIP 980061410 6 CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TANSPORTED 1 1 2 31 INTERLOCK YEs No zERLOCK YEs[:]NO[:] YEs N DRIVER'S LICENSE STATE I WA SEX M MMDDYYv', 04 — 28 — 1963 7 ❑ ON DUTY� STATUS AIRBAG' 2 RESTR. Q EJECT 1 HELMET I INJURY 1 1 NATURE OF INJURIES USE CLASS 8 ❑ 1 1 2 32 LICENSE BPVY4991 TAr INA VIN# 4T3ZF13C1YU258732 PLATE# 9 TRAILER TRAILER PLATE# STATE PLATE# STATE 10 TRLR TRLR VIN.#. VIN.#. 11 4 O VEH.YEAR MAKE MODEL STYLE VEHICLE TOWE E T SABLIN TOWED BY anvi vEH1O P FROM TO 2000 TOYT SIENNA DAMAGE YES 'E YES NO REGISTERED OWNER INFOPABLO NAVARRO APREZA 13900 SE NEWPORT WAY BELLEVUE WA 98006 SHADE IN DAMAGED AREA 9 9 33 12 4 0 a FROM TO LIABILITY INSURANCE INSURANCE CO STATE FARM INS 392 5313 C29 47C q TOP IN EFFECT &POLICY# 9 9 vewcL. 10 BOTTOM 34 CITATION# CHARGE 13 IEGnuv YES NO gg�@ STANDING � l:9 7 4 MOTOR O PEDAL ❑ ❑ PROPERTY ❑ DAMAGE THRESHOLD MET PHONE ❑ 35 14 ❑ UNIT# VEHICLE CYCLE PEDESTRIAN OWNER YES NO D:2062508741 15 ❑ LAST NAME PELAYO LOPEZ FIRST NAME RAYMUNDO MIDDLE'. '.N] ❑ 36 INITIAL 1 16 ❑ STREET ❑ 17115 116TH AVE SE APT Al CITY RENTON ST WA ZIP 980585921 NFln+AnnRFss CDL IGNITION REOUIREE7 IGNITtGN PRESENT MEDICALTANSPORTED 17 ❑ INTERLOCK YE. NO INTERLOCK YES NO YEs NO ❑ DRIVER'S STATE WA SEX M D.O.B 37 LICENSE# MMDOyYY' 03 — 15 — 1988 18 ❑ HELMET INJURY 1 ❑ON DUTY� STATUS' AIRBAG 2 RESTR. Q EJECT 1 ' NATURE OF INJURIES 38 USE CLASS 19 ❑ LICENSE ❑ PLATE# C44694C TAr WA v!N# 3GCRCSE03AG197262 39 20 ❑ TRAILER' STATE TRAILER STATE ❑ 40 PLATE#< PLATE# 21 ❑ TRLR TRLR 41F-I ❑ ViN# YIN#i 42 22 VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED DUET SABLIN TOWED BY GOVT.VEHICLE 2010 CHEV SILVER DAMAGE YES NO YES NOZI El 23 ❑ REGISTERED OWNER INFORAYMUNDO PELAYO LOPEZ 17115116TH AVE SEAPTAI RENTONWA98058 SHADE IN DAMAGED AREA � 43 LIABILITY INSURANCE INSURANCE CO SAFECO INS H2537810 9'1'OP ❑ VEHICLE EFFECT &POLICY# i _'.''_ ® 44 YESZ NOD CITATION# 24 LE ACHARGE iq 60TiOtvi LEGALLY E:l STANDING 8 7 1 CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT. J,MITCHELL 06-21-23 03:09 PM 25 INVESTIGATING OFFICER'S SIGNATURE OFFICER'S PHONE UNIT OR DIST DET DATED: PLACE SIGNED APPROVED BY DATE zs OI BADGE 10377 O#I',WA0171300 JACOBS 7/3/2023 PAGE❑OF❑ 3000-345-013(R 11118) REPORT NO. ED76151 CASE# ' 23-7051 DATE AND TIME 06/21/23 12:40 OF COLLISION BENSON DR cn w >Z w co PAGE 4 OF 4