HomeMy WebLinkAbout23-9140 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 0 27c
COLLISION REP FIT 1591971
CASE 23-9140 z
INTERSTATE ❑ CITY STREET FIRE ❑RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHICI F ❑ LOCAL AOENC 4200 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 CITY# ❑
cowsloN 08 - 09 - 2023 1325 17 ❑.❑ N E IN S 8 W H OF e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓
SOUTH 3RD STREET BLOCK ST e✓
MILEPOST 900
4a❑
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ 30 00 FMILES EET e S ❑ W e WELLS AVE SOUTH
2 0 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
NO D:2065719013 0 11
30
6 LAST NAME NAFIS ZADA FIRST NAME ABDUL MIDDLE H 1 1 2 31
INITIAL
STREET ❑, 12722 SE 312TH ST APT K516 CITY AUBURN ST WA Zjp, 980923387 z
NEW ADDRESS
7❑ CDL I 1/ NTGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
iNTERLOCKYEs NO ERLOCKYEs NO YES R NO
8❑ LRIIVER #
ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 HELMET U E 2 CLASS 1 NATURE OF INJURIES 2❑
3
10� P1 aT�S� CHD3644 sTATI WAvIN# JTDKAMFUOM3151772
TRAILER STATE TRAILER STATE
11 2 5 PLATE# PLATE# FROM TO
TRLR. TRLR 7 3 33
12 2 5 VIN#' VIN#
>; FROM TO
❑ VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE 7 $ 34
13 1 2021 TOYT PRIUS 4H DAMAGE YES NO YES❑ NO✓
REGISTERED OWNER INFO ABDUL NAFIS ZADA 12722 SE 312TH ST APT K516 AUBURN WA 98092 D:2065719013 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
14 LIABILI INSURANCE INSURANCE CO GENERAL 53-WA 6121026 3 4
IN EFFECT &POLICY# 9TOP
VE—L' 1 5 36
LEGALLY YEs No CITATION# 3A0431085 CHARGE IMPROPER LANE USAGE 1 o eorrom
15❑ STANDING 7 6
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT 02 VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES 1/ NO D:4256382502
16 2
LAST NAME SALAZAR FIRST NAME LIZBETH MIDDLE
INITIAL
17❑ STREET EDOREss❑' 3323 NE 8TH ST CITY' RENTON ST WA ZIP 98056 4❑ 37
18❑ CDL IGNITION REQUIRED IGNITION PR-E-1SENT MEDICAL-T�RANSPORTED � 38
INTERLOCK YEs❑No� INTERLOCK YEs It I NOF YES
t l NOF,/
19 LICENSE# STATE I WA SEX F M .C... 10 _ O6 _ 1989 39
20❑ ON DUTY STATUS I
AIRBAG 2 RESTR 4 EJECT 1 H U EET 2 NJAU EY 1 NATURE OF INJURIES 40
❑ 41
21❑ PLA E# AXS4998 TATE WA VIN# 4T1BF3EK6AU082440 1
42
22❑ PLATE# STATE PLATE# STATE
23❑ UIN#. 43
TRLR RLR
'IN#.
VEH YEAR 2010 MAKE TOYT MODEL CAMRY STYLE 4p VEHICLETOWED TO BLIN TOWEDBY GOV HI 44
24❑ DAMAGE YES NO YES NO
REGISTERED OWNER INFO JUAN SALAZAR RAMIREZ 506 N BAKER ST MOUNT VERNON WA 98273 D:4256382502 VEHICLE NO.2
SHADEDAMAGEDAREA
3 4
LIABILITY INSURANCE INSU&PORGY#E CO GRANWEST PROPERTY AND CASUALTY 5104440083197 1GQI
IN EFFECT'EwCLE ❑ ,J� CITATION# CHARGE
LEGALLY YES N`L J
25 s � a
7mHE
R'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
26
W NUGENT 11498 WA0171300
PART A PAGE 01 OF
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. ED89738
COLLISION REPORT III III III III III 111
1591972 CASE# 23-9140
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,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'
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 08-10-23 05:55 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
CO.JOHNSON 0505 1 8/16/2023 8:58:32 AM
BADGE OR ID# 11498 ORI# WA0171300 TIME POLICE DISPATCHED! 1:30 PM TIME POLICE ARRIVED i 1:34 PM
PART I PAGE IT]OF 4�
REPORT NO. ED89738 CASE# 23-9140 OF COLLISION
08/09/23 13:25
OF CbLLI510N
NARRATIVE
23-9140
On 08/09/2023 at approximately 1330 hours, I was dispatched to a non-injury and non-blocking
vehicle collision at the intersection of South 3rd Street and Wells Ave South, within the City Limits of
Renton, County of King, State of Washington.
Upon arrival, I was able to collect each involved party's information and summary. I also confirmed
there were no complaints of injury from any of the involved parties requiring immediate medical
response at the time of report.
The driver of Unit#1 said he and his adult passenger were traveling eastbound in about the 900 block
of South 3rd Street and were just beyond the intersection of Wells Ave South in lane 1 of 2 (one-way
road). The driver of Unit#1 stated that he needed to get into the next lane over therefore checked the
adjacent lane next to him and believed it was clear of traffic. Unit#1 proceeded to make a lane
change from lane 1 of 2 to lane 2 of 2 and stated that he did not see Unit#2 occupying lane 2 of 2.
The driver of Unit#1 stated that while making the lane change, Unit#1 and Unit#2 collided causing
moderate damage to the front driver's side bumper of Unit#1. The driver of Unit#1 believed that Unit
#2 was traveling too fast leading to the collision. The damage did not coincide with the driver of Unit
#1's statement regarding speed.
The driver of Unit#2 said she was the sole occupant of her vehicle and was also traveling eastbound
in about the 900 block of South 3rd Street and was just beyond the intersection of Wells Ave South
but in lane 2 of 2 (one-way road). The driver of Unit#2 stated she was intending to continue east
when Unit#1 changed lanes from lane 1 of 2 and into lane 2 of 2 which Unit#2 was occupying. Unit
#2 was unable to avoid the collision and subsequently received minor damage to the front passenger
side quarter panel of Unit#2.
Based on the above statements, 1 determined that the Driver of Unit#1 (Nafis Zada) was the
predominant factor for the cause of collision as Nafis Zada 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. Nafis Zada made a lane change into Unit#2's lane of travel which had the right of way and
was underway. Nafis Zada did not ensure that traffic in lane 2 of 2 was clear of hazard before making
an unsafe lane change.
Nafis Zada was cited by in-person for Improper Lane Usage.
Both Unit#1 and Unit#2 were able to be driven away without further incident. 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 5:54 PM 8/10/2023 Renton, King County, WA.
PAGE 3 OF 4
REPORT NO. ED89738 CASE# ' 23-9140 DATE AND TIME 08/09/23 13:25
OF COLLISION
0
U
"Diagram not to scale
Unit#2
0
S. 3rd ST
Unit#1
PAGE 4 OF 4