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HomeMy WebLinkAbout23-8735 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 1 27c COLLISION REP FIT 1591971 CASE 23-8735 z INTERSTATE ❑ CITY STREET FIRE ❑RESULTED 1 STOLEN STATE ROUTE ❑ OTHER ❑ VFHIr.I F ❑ LOCAL AOENC 4Y00 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# cawsloN 07 - 1-- 2023 1452 17 ❑-= S 8 IN e 1070 3 4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑ N.SOUTHPORT DR BLOCK NO. e✓ 1100 ❑ 4a❑ MILEPOST DISTANCE OF(REFERENCE OR CROSS STREET) 5❑ 1.❑ FEET e S ❑ W e PARKAVEN 0 1 29 MOTOR PEDAL- DAM THRESHOLD MET PHONE UNIT 01 VEHICLE ❑ CYCLE El YES NO ,/ D:4253991255 0 81 30 6� LAST NAME JOHNSON FIRSTNAME GAIL MIDDLE C 1 2 31 INITIAL STREET ❑✓ 1401 145TH PL SE#204 CITY BELLEVUE ST WA 2jp, 98007 z= NEW ADDRESS 7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3 INTERLOCK YES[:]NO 1/ INTERLOCKYEs NO�/ YES R No�/ 8❑ LRIIVER # ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 HELMET U E 2 1 CLASS NATURE OF INJURIES z❑ 3 LICENSE 98979C sTArI WAurN If 5FYD5YU0466039323 10❑ PI ATE 14 0 TRAILER STATE TRAILER STATE 11 0 0 PLATE# PLATE# FROM ro TRLR. TRLR 3 7 33 12 0 0 VIN#' VIN# >; FROM TO VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED By GOVT.VEHICLE J 9 34 13� 2011 NEW BUS BU DAMAGE YES NO YES[:] No✓ REGISTERED OWNER INFO CENTRAL PUGETSOUND REGIO 3227 CEDAR ST EVERETT WA 98201 D:2062632250 VEHICLE NO. 1 ❑ SHADE IN DAMAGED AREA 35 14 LIABILITY INSURANCE z INSURANCE CO KING COUNTY RISK MANAGEMENT 4 LI EFFECT I SUR N# TOPVEHICLE CHARGE 36 LEGALLv res❑NO❑ CITATION# <1�3 OTTOM 15❑ NDING 7 6 MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE UNIT 02 VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES NO ,/ D:2067083982 16 a LAST NAME PARRIS FIRST NAME COLLEEN MIDDLE lK INITIAL 17 STREET NEW ADDREs7 1121 SHELTON AVE SE CITY RENTON ST WA ZIP 98058 4❑ 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 DRIVER'S STATE WA ]SEX IF D.O.B. 07 10 _ 1972 39 LICENSE# MMDDYY 20❑ ON DUTY STATUS I AIRBAG 2 RESTR 4 EJECT 1 H U EET 2 NJAURSY 1 NATURE OF INJURIES ❑ 40 ❑LICENSE I 21❑ PLA E# CJK8780 TArE WA VIN 1t KNDPYDAH5P7090072 41 1 42 22❑ PLATE# STATE PLATE# STATE 23❑ UIN#. 43 TRLR RLR 'IN#. GI VEH YEAR 2023 MAKE /(//� MODEL SPORTAG STYLE $V DAMAGE TOWED NOO✓ BLIN TOWED BY ov HyES NO 1/ 44 24❑ ES REGISTERED OWNER INFO OWNED SY DRIVER VEHICLE N0.2 SHADE IN DAMAGEbAREA 2 3 Cd LIABILITY INSURANCE INSU PORGY#E CO MAIN ST INSURANCE 01J2225SIN I STOP VEHICLE CITATION# CHARGE i o BOTTOM LEGALLY YES N� 25❑ s OFFICER'S NAME(PRINT) 7OFFICER PHONE BADGE OR ID# AGENCY 26 WILLIAM RIDGEWAY 12500 WA0171300 PAGE 01 OF PART A 3000-345-159 OR 11/181 STATE OF POLICETRAFFICN CORRECTION REPORT NO. ED84875 COLLISION REPORT III III III III III 111 1591972 CASE# 23-8735 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,FIRS 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. W/LLIAM RIDGEWAY 07-31-23 04:51 PM INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED APPROVED BY DATE DESIRES SCOTT 10272 1 713112023 6:25:05 PM BADGE OR ID# 12500 ORI#' WA0171300 TIME POLICE DISPATCHED 2:55 PM TIME POLICE ARRIVED]2:58 PM PART Ei PAGE IT]OF TIME REPORT NO. ED84875 CASE# 23-8735 OF COLLISION07/31/23 14:52 NARRATIVE 23-8735 At about 1455 hours on 07/31/2023, 1 was dispatched to an unknown injury accident that occurred at Logan Ave N and Park Ave N in the City of Renton, King County, Washington. The accident involved a King County Metro city bus vs a Kia sedan. Upon arrival, I confirmed there were no injuries. Unit 1 was a 2011 New Flyer bus (King Co. Metro bus #9589K) (98979C/WA). The bus driver was Gail C. Johnson (DOB:04/19/1973 -verified by WADL photo. Unit 2 was a 2023 Kia Sportage (CJK8780/WA). The driver of the Kia was Colleen K. Parris (DOB:07/10/1972 -verified by WADL photo). Both units were advised they were being recorded. Both parties exchanged insurance information. Unit 2 said they were stopped at a red arrow in the outside left turn lane on N. Southport Dr, wanting to turn onto Park Ave N, when she was rear ended by the bus. Unit 2 has preexisting neck pain issues, and this accident caused her to feel pain in her neck. Unit 2 refused to be seen by FIRE. Unit 2 was wearing their seatbelt and had no passengers inside the vehicle. Unit 1 said she was stopped behind Unit 2 but may have fell asleep and rolled into the rear end of Unit 2. Unit 1 said they were tired and had been sleeping for only about 4 hours a night. Unit 1 was wearing a seatbelt. Unit 1 had 1 passenger on board the bus during the accident, but they got off the bus upon my arrival. There is no passenger information. King Co. Transit Service Supervisor Keita Kimura arrived on scene. He was provided the case number. Both units were provided a business card and case number. I observed no damage to the front of the bus and minor rear end damage to the rear bumper of Unit 2. Photos were taken and uploaded to the case. This concludes my involvement in this case. I declare under penalty of perjury under the laws of the State of Washington that the foregoing is true and correct. Electronically signed by W. Ridgeway#12500 on 07/31/2023 at 1649 hours in Renton, Washington. PAGE 3 OF 5 SUPPLEMENTAL REPORT NO. ED84875 r`) POLICE TRAFFIC 1 27 COLLISION REPORT CASE# 23-8735 1 COMMERCIAL MOTOR CARRIER INTERSTATE INTRASTATE ✓ G UNIT'# 1 USDOT ICC# ' VEHICLE TYPE 1 CARGO 6ODY 1 ;TYPE 2 ❑ 1 28 CARRIER KING CO METRO BUS NAME 3 CARRIER ADDRESS 500 4TH AVE#320 CITY SEATTLE ST WA ZIP'', 98104 4 ❑ NAME # PLACARD: :❑ NAME IF NO NUMBER SOURCE 3 AXLES 03 GI3000 + 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 SIP CDL IGNITION REDUIREE7 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. WILLIAM RIDGEWAY 07-31-23 04:51 PM 25 INVESTIGATING OFFICER'S SIGNATURE OFFICER'S PHONE UNIT OR DIST DET DATED: PLACE SIGNED APPROVED BY DATE 26 OR ID# 12500 O#I',WA0171300 SCOTT 7131/2023 PAGE F OF 3000-345-013(R 11118) REPORT NO. ED84875 CASE# ' 23-8735 DATE AND TIME 07/31/23 14:52 OF COLLISION Park Ave N UNIT 2 UNIT 1 LOGAN AVE N o N SOUTHPORT DR` i I PAGE 5 OF 5