HomeMy WebLinkAbout23-8734 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 0 27c
COLLISION REP FIT 1591971
CASE 23-8734 z
INTERSTATE ❑ CITY STREET FIRE ❑
RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHIC;I F ❑ LOCAL AGENCI 4900 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# ❑
CowsloN 07 - 1-- 2023 1413 17 ❑.= S 8 IN e 1070 3
4❑ oN (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓
SW GRADY WAY BLOCK NO. e✓ 555
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ 300 00 FEET MILES e S ❑ W e LIND AVE SW
2 0 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
No ,/ I D:2535170321 N:2535170321 0 11
30
6� LAST NAME BEU FIRSTNAME JOHN MIDDLE F 1 2 31
INITIAL
STREET ❑, 10101 102ND AVENUE CT SW CITY LAKEWOOD ST WA ZIP' 984983173 z
NEW
ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
INTERLOCK YES[:]NO,/ INTERLOCKYEs NO�/ YES R No�/
8❑ LRIIVERS STATE WA SEX'M MM DAY' 10 1- 04 - 1963 2 32
CENSE 9 ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 HELMETU E 2 CLASS 1 NATURE OF INJURIES z❑
3
10 9❑ P1 aT�S� XP45503 sTArI CA vrN# 4V5RC9DH3KN207779
[----� TRAILER 4SH5050 STATE CA TRAILER STATE
11 3 5 PLATE# PLATE# FROM ro
TRLR. TRLR 7 3 33
12 3 5 vIN#' SEOAA1649KG207403 VIN#'
>; FROM TO
❑ VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE 7 3 34
13 2 2019 VOLT CAB SE DAMAGE YES YES : NO✓
REGISTERED OWNER INFO HA NSENANDADKINSAUTO TRANSPORT 3552 GREEN AVE LOS ALAMITOS CA 90720 D:5624304100 N:7142481572 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
14 LIABILITY INSURANCE INSURANCE CO MCGRIFF INSURANCE SERVICES HMV200143.03 3
IN EFFECT &POLICY# 9TOP
vewcLE CHARGE 5 36
LECALLv Yes❑NO❑ CITATION# 10 BOTTOM
15❑ STANDING 8 7 6
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM,/ THR OLD MET PHONE
UNIT a2 VEHICLE ❑ CYCLE' ❑ ❑ OWNER ❑ YES No D:2069401382 N:4252716590
16 a
LAST NAME OLSON FIRST NAME KATHLEEN MIDDLE I D
INITIAL
17❑ NEW STREETR 12817 S
7 E 161 ST ST CITY RENTON ST WA ZIP 980585323 37
18❑ CDL IGNITION REQUIRED IGNITION PR-E-1SENT MEDICAL-T�RANSPORTED � 38
INTERLOCKYES�NO� INTERLOCK YEs It I NOF YES
t l NOF,/
19 LDI IVER # STATE WA ]SEX IF M D.C.B. 01 05 _ 1946 39
20 ON DUTY STATUS AIRBAG,6 RESTR 4 EJECT 1 H EET 2 NJAU Sy 6 C/O NECK,L.ARM,AND R.LEG PAIN[-�A—TUREOF INJURIES 40
❑ILICENSE 21❑ PLATE# 235ZIH rare WA vINIi 4T3BK11A99U013659 41
1
42
22❑ PILER LATE# STATE PLATE# STATE
23❑ VIN#. 43
TRLR RLR
'IN#.
VEH YEAR 2009 MAKE 7'Oy7- MODEL VENZA STYLE Qy�/ VEHICLE TOWED TO BLIN TOWED eY GOV HI 44
24 DAMAGE YES,/ NO GENE MEYERS YES NO
REGISTERED OWNER INFO KATHLEEN OLSON 12817SE 161STST RENTONWA98058 D:2069401382 VEHICLE NO.2
SHADEDAMAGEDAREA
3 4
LIABILITY
INSURANCE INSU PORGY#E CO GEIC04600-37-16-13IN 9TOP 5
Le
L..LLY YES❑ N,J� CITATION# CHARGE to BOTTOM
LEGA 6
25 OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# JAGENCY
26
MATTHEW NUGENT 11498 WA0171300
PAGE 01 OF
PART A
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. ED85954
COLLISION REPORT III III III III III 111
1591972 CASE# 23-8734
ADDITIONAL PERSONS INVOLVED PASSENGERS AND/(OR WITNESSES ONLY)
NAME MIDDLE INITIAL) OLSON ROGER N
(LAST FIRST,
ADDRESS&PHONE# D O.B. '
12817 SE 161 ST ST RENTON WA 980585323 4252716590 SEX M MMDOYyry 01 - 31 - 1941
SEAT HELMET INJURY NATURE OF INJURIES
PASSENGER WITNESS❑ UNIT# 2 SOS 8 AIRBAG 6 RESTR. 4 EJECT USE 2 CLASS +6 C/O CHEST PAIN
NAME
(LAST,FIRST,MIDDLE INITIAL) HALL KYRIN E
ADDRESS&PHONE# DOB
25110 163RD PL SE COVINGTON WA 98042 2534684380 SEX F MMDbvuvv 10 _ 01 _ 1974
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.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 08-02-23 04:37 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
CO.JOHNSON 0505 8/3/2023 4:38:30 PM
BADGE OR ID# 11498 ORI# WA0171300 TIME POLICE DISPATCHED 2:15 PM TIME POLICE ARRIVED',2:19 PM
PART I PAGE IT]OF
TIME
REPORT NO. ED85954 CASE# 23-8734 OF COLLISION07/31/23 14:13
NARRATIVE
23-8734
On 07/31/2023 at approximately 1415 hours, I was dispatched to a vehicle collision with reports of
injury at Walker's Renton Subaru, located at 555 SW Grady Way, within the City Limits of Renton,
County of King, State of Washington.
While en route, Dispatch advised that Renton Regional Fire Authority (RRFA) would be responding
due to complaints of injury from one of the involved vehicles.
Upon my arrival, RRFA had also arrived and began triaging the involved parties. RRFA treated the
involved patients on 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. It should be
noted that Unit#1 was a large auto transporter owned by Hansen & Atkins and per the driver of Unit
#1, did not realize his involvement in the collision until he was alerted by his company. Unit#1
returned to the scene shortly thereafter.
The driver of Unit#1 said he was the sole occupant of his commercial auto transporter vehicle. The
driver of Unit#1 stated that he was traveling eastbound in about the 500 block of SW Grady Way and
was approaching the intersection of Lind Ave SW in lane 2 of 2. The driver of Unit#1 stated that he
needed to get into the right lane (lane 1 of 2) to make an upcoming right turn to get onto the freeway.
The driver of Unit#1 stated that at some point he moved over into the right lane and did not feel nor
realize that a collision had taken place. The driver of unit#1 continued towards SR-167 and
eventually proceeded onto 1-405 northbound, according to a witness.
The driver of Unit#2 said she and her adult passenger were also traveling eastbound in about the
500 block of SW Grady Way approaching the intersection of Lind Ave SW but in lane 1 of 2. The
driver of Unit#2 stated she was intending to continue straight when Unit#1 changed lanes from lane
2 of 2 and into lane 1 of 2 which Unit#2 was occupying. Unit#2 was unable to avoid the collision and
subsequently collided with Unit#1. Unit#2 suffered moderate damage to the driver's side doors due
to the initial impact. Following the impact of the collision, Unit#2 was forced off the roadway, causing
Unit#2 to go up and over the curbed sidewalk, through a strip of grassed lawn, and into a parking lot
light pole as well as a parked and unoccupied new vehicle, both owned by Walker's Renton Subaru.
A witness, identified as Kyrin Hall, confirmed the above statements and her contact information has
been listed in the collision report.
Based on the above statements, 1 determined that the Driver of Unit#1 (Beu) was the predominant
factor for the cause of collision as Beu violated RCW 46.61.140(1) which states that a vehicle shall be
driven as nearly as practicable entirely within a single lane and shall not be moved from such lane
until the driver has first ascertained that such movement can be made with safety. Beu made a lane
change into Unit#2's lane of travel which had the right of way and was underway. Beu did not ensure
that traffic in lane 1 of 2 was clear of hazard before making the unsafe lane change.
It should also be noted that an irrigation water line was struck when the responding tow truck arrived
to remove Unit#2 from the crash location. Photos of the scene and damage were captured and later
uploaded to Axon's Evidence.com. Among the photos captured was a tie-down that had detached
from Unit#1 and become embedded into the rear driver's side door of Unit#2. This was later
matched up to the missing tie-down from Unit#1 which had come off during the collision.
Unit#1 was able to be driven away without further incident. Unit#2 had to be impounded due to
extensive damage. An exchange of information was provided to all involved parties.
PAGE 3 OF 6
TIME
REPORT NO. ED85954 CASE# 23-8734 OF COLLISION07/31/23 14:13
NARRATIVE
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 4:20 PM 8/2/2023 Renton, King County, WA.
PAGE 4 OF 6
SUPPLEMENTAL REPORT NO. ED85954
r`) POLICE TRAFFIC 1 1 8 27
COLLISION REPORT CASE# 23-8734
1 COMMERCIAL MOTOR CARRIER INTERSTATE ✓ INTRASTATE G
UNIT# 1 USDOT 568253 ICC# VEHICLE TYPE 6 CARGO BODY 7
TYPE
2 ❑ 1 28
CARRIER NAME HANSEN&ADKINS AUTO TRAN
.......
3 CARRIER
ADDRESS 3552 GREEN AVE
CITY LOS ALAMITOS ST CA ZIP 90720
4 ❑ NAME # PLACARD: :❑
NAME IF NO NUMBER
SOURCE 3 AXLES 05 GI 80000 +
4a ❑ ADDITIONAL UNITS
MOTOR PEDAL-
PROPERTY DAMAGETHRESHOLD MET PHONE
5 ❑ UNIT# 3 VEHICLE t_"J � PEDESTRIAN YES✓ IN
1 4 29
LAST NAME : UNKNOWN FIRST NAME MIDDLE
INITIAL
STREET 30
NEW AnnRFSP CITY RENTON ST ZIP
6 Fil CDL IGNITIttN REQUIRED
I GNITION PRESENT MEDE 1 31
C INTERLOCK YEsNO✓ zERLOCK YES❑N0 f T
DRIVER'S STATE I SEX U M��DVRYv' -� 2
LICENSE
7 F-I ON DUTY STATUS AIRBAG g RESTR. g EJECT 1 HELMET 9 INJURY 0 NATURE OF INJURIES
USE iCLASS
8 1 32
LICENSE TAr VIN# 4S4BTAPC9R3115757
PLATE#
9 TRAILER TRAILER
PLATE# STATE PLATE# STATE
10 ❑ TRLR TRLR
VIN.#. VIN.#.
11 0 0 VEH.YEAR MAKE MODEL STYLE VEHICLE TOME E T SABLIN TOWED BY anvi vEH1C P FROM TO
2023 SUBA OUTBAC 4W DAMAGE YES NO ✓ YES NO ✓
REGISTERED OWNER INFO.WALKERS SUBARU OF RENTON 555 SW GRADY WAY RENTON WA 98057 D:2063545736 m 33
12 � SHADE IN DAMAGED AREA
FROM TO
LIABILITY INSURANCE INSURANCE CO
IN EFFECT &POLICY# t 9 1"01?
vewCLE 10 6QTTUM 34
13 ❑ LEGALLY YES[:] NO❑ CITATION# CHARGE
STANDING 4 MOT{7R PEDAL- PROPERTY a 7 E
14 ❑ UNIT# 1:1DAMAGE THRESHOLD MET PHONE ❑ 35
VEHICLE CYCLE PEDESTRIAN OWNER ✓ Yes✓ No D:2063545736 N:2063545736
❑ WALKER ALEC MIDDLE ❑ 36
15
LAST NAME FIRST NAME INITIAL
16 ❑ STREET ❑ 555 SW GRADY WAY CITY RENTON STI WA ZIP 98057
NEW AnnRFSR
CDL IGNITION REQUIRED IGNITION PRESENT MEDICALTANSPORTED
17 ❑ INTERLOCK YES Nb INTERLOCK YES NC7 YES No ❑
DRIVER'S STATE SEX M D.O.B 5 37
18 ❑ LICENSE# MMDDYYY 07 11 - - 1991
ON DUTY STATUS AIRBAG RESTR, EJECT HELMET INJURY NATURE of INJURIES ❑ 38
USE (CLASS
19 ❑ 39
LICENSE rnr VIN#
PLATE#
20 ❑ TRAILER' STATE TRAILER STATE ❑ 40
PLATE#< PLATE#
21 ❑ [441
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 '
VEHICLE
EFFECT &POLICY# i 970P - 4 44
24 LEwcLE YES❑ NO❑ CITATION# CHARGE iq 60TiOM
LEGALLY
E:l
STANDING S 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 08-02-23 04:37 PM
25 INVESTIGATING OFFICER'S SIGNATURE OFFICER'S PHONE UNIT OR DIST DET DATED: PLACE SIGNED
APPROVED BY DATE
26 ORID# 11498 O#IL WA0171300 JOHNSON 8/3/2023 PAGE F51OF 6
3000-345-013(R 11118)
REPORT NO. ED85954 CASE# ' 23-8734 DATE AND TIME 07/31/23 14:13
OF COLLISION
nN
"C7iagr�rn not iq scaRB:. LU
Q
Grady Way
Unit 42 — "��-�---�J �-- �---_,—Ught iPWa G€eVetty
Una:#3
Walkers R.ntan.Subaru 556 SW Grady Way;Ran
PAGE 6 OF s