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Home My WebLink About23-9012 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 2 27c COLLISION REP FIT 1591971 CASE 23-9012 z INTERSTATE ❑ CITY STREET FIRE ❑RESULTED 1 STATE ROUTE OTHER STOLEN ❑ ❑ HFH1C;l F ❑ LOCAL AOENC 3 HIT 8 RUN CODING COUNTY RD PRIVATE WAY INVOLVED 2 2 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# ❑ COLLISION 08 - 1-- 2023 0820 17 ❑. S 8 W Li OF e 1070 3 4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑ N 35TH ST BLOCK ST e✓ p 4a❑ MILE POST DISTANCE OF(REFERENCE OR CROSS STREET) 5❑ 1.❑ FEET e S ❑ W e PARKAVEN 1 5 29 MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE UNIT 01 VEHICLE ❑ CYCLE El No ,/ I D:3605560391 0 81 30 6❑ LAST NAME ALVIAR FIRSTNAME DANNY MIDDLE E 1 2 31 INITIAL STREET ❑ 22010 76TH AVE S CITY KENT ST WA 2jp, 98032 z= NEW ADDRESS 7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3 INTERLOCK YES[:]NO,/ INTERLOCKYEs NO�/ YES R No�/ 8❑ LDRIVER # STATE WA SEX'M MID LOB 09 1— 29 — 1973 2 32 9 ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 HELMETU E 2 CLASS 1 NATURE OF INJURIES z❑ 3 10 2❑ I Pi ATNES# C52679G sTAr WAu N# 38PDX20X3HF173918 TRAILER STATE TRAILER STATE 11 0 0 PLATE# PLATE# FROM TO TRLR. TRLR. 0 0 33 12 O VIN#' VIN#' FROM TO VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE J 9 34 13 4 2017 PTRB COE 270 GG DAMAGE YES NO YES❑ ✓NO REGISTERED OWNER INFO RABANCO LTD 2101076THAVE S KENT WA 98032 VEHICLE NO. 1 ❑ ❑ SHADE IN DAMAGED AREA 35 4 INSURANCE CO 3 4 14 INSURANCE ACE ISAH10735786 IN EFFECT EFFEE CT &POLICY# � 9TOP 15❑ vewCLE LECALLv Yes❑NO❑ CITATION# 10 BOTTOM CHARGE 36 STANDING 8 7 6 MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE UNIT 02 VEHICLE ❑ CYCLE ❑ ❑ OWNER [:]EA. YES,/ NO D:3609516180 16 a LAST NAME PRIGG FIRST NAME SAMANTHA MIDDLE IG INITIAL 17 STREET NEW ADDREs7 1114 N 37TH ST CITY RENTON ST WA ZIP 98055 37 18� CDL IGNITION REQUIRED IGNITION PRESENT MEDICALTRANSPORTED 38 INTERLOCK YES❑NO� INTERLOCK Y�EsI❑NOF YEs❑NO� 19 D IVERI # STATE WA ]SEX IF M D.C.B. 03 _ 24 2003 39 20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 H U EET 2 NJAURSY 1 NATURE OF INJURIES 40 ❑ 41 21❑ ILICENSE PLATE# 223ZHY TArE WA VIN 1 WDDHF5G82AA019799 1 42 22❑ PLATE# STATE PLATE# STATE TRLR 23❑ UIN#. IN#. 43 RLR ' VEH YEAR 2010 MAKE MERZ MODEL E280 STYLE SD VEHICLETOWED TO BLIN TOWEDBY GOV HI 44 24❑ DAMAGE YES NO,/ YES NO REGISTERED OWNER INFO MARISSA DUERR 3403 STEAMBOATISLAND RD NW OLYMPIA WA 98502 D:3609516103 VEHICLE NO.2 SHADEDAMAGEDAREA 3 4 LIABILITY INSURANCE INSURANCE #E CO FARMERS 194843146 IN ®TOP VEHICLE CITATION# CHARGE 25❑ BOTTOM LEGALLY YES NC[:] a OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY 26 PHILIP DAVIS 12018 WA0171300 PART A PAGE 01 OF C7 3000-345-159 OR 11/181 STATE OF POLICETRAFFICN CORRECTION REPORT NO. ED87450 COLLISION REPORT III III III III III 111 1591972 CASE# 23-9012 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 POS. USE CLASS NAME '(LAST,FIRST 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' 23-9012 On 8-7-23 around 0824 hours I was dispatched to a two vehicle non-injury, blocking collision at the intersection of Park Ave N/N 35th St, Renton, King Co, WA. Upon arrival I observed both vehicles, unit 2-223ZHY/WA, and unit 1-0526796, both stopped southbound on Park Ave N just south of N 35th St. Unit 2 appeared to have significant front end damage and unit 1 appeared to have little to no damage. I contacted Samantha Prigg, driver of unit 2, who advised the following. Prigg was stopped at the stop sign on N 35th St preparing to turn south on Park Ave N. Prigg observed unit 1 stop on southbound Park Ave N, just south of N 35th St, then begin to backup towards her vehicle on N 35th St. Prigg was unable to get out of the way and unit 1 collided with unit 2 causing significant damage to unit 2. 1 contacted Danny Alviar, driver of unit 1, who confirmed Priggs telling of events. Alviar added that he missed the turn onto N 35th St and tried to backup onto the street and did not see unit 2 behind him. Both drivers were uninjured. Unit 1 was drivable and unit 2 was moved to the side of the road and privately towed. I declare under penalty of perjury under the laws of the State of Washington that the foregoing is true and correct. Electronically signed by P Davis 12018 on August 7, 2023 at 09:33 hours in Renton, WA. I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT. PHILIP DAVIS 08-07-23 09:44 AM INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED APPROVED BY DATE S.WOODWARD 11528 1 8/8/2023 4:48:19 PM BADGE OR ID# 12018 ORI# WA0171300 TIME POLICE DISPATCHED! 8:24 AM TIME POLICE ARRIVED 8:34 AM PART I PAGE IT]OF 4� SUPPLEMENTAL REPORT NO. ED87450 r`I POLICE TRAFFIC 1 27 COLLISION REPORT CASE# 23-9012 1 COMMERCIAL MOTOR CARRIER INTERSTATE ✓ INTRASTATE G UNIT# 1 USDOT ICC# VEHICLE TYPE 3 CARGO BODY 8 TYPE 2 ❑ 1 1 28 CARRIER NAME RABANCO LTD ....... 3 CARRIER ADDRESS 22010 76TH AVE S CITY KENT ST WA ZIP'', 98032 4 ❑ NAME # PLACARD: :❑ NAME IF NO NUMBER SOURCE 1 AXLES 03 GI7000 + 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 INTERLOCK 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 ZIP 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 TOWED DUE TfABLINJ 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 ' VEHICLE EFFECT &POLICY# i 97OP - 4 44 24 LEHIcLE YES❑ NO❑ CITATION# CHARGE iq 60TiOM LeGALLv F-1 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. PHILIP DAVIS 08-07-23 09:44 AM 25 INVESTIGATING OFFICER'S SIGNATURE OFFICER'S PHONE UNIT OR DIST DET DATED: PLACE SIGNED BADGE O#I' APPROVED BY ORID# 12018 WA0171300 OOWA 88/2 PAGE F OF 4 3000-345-013(R 11118) REPORT NO. EU87450 CASE# 23-0012 DATE AND TIME 08/07/2308:20