HomeMy WebLinkAbout22-13309 POLICETRAFF'c" III !�� I IIIllI111IN II II I REPORT NO. ED19075 170
27
COLLISION REP FIT 1591971
CASE 22-13309 z
INTERSTATE ❑ CITY STREET FIRE ❑RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHICI F ❑ LOCAL AOENC 4900 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#
COLLISION'. 12 - 1-- 2022 1341 17 ❑-= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
BLOCK NO.
OAKESDALE AVE SW
e✓ --- ----� ❑
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5 ❑ FEET e S ❑ w SW4IST ST
❑
0 4 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
,/No D:5303608371 0 11
30
6� LAST NAME NAIR FIRSTNAME SHEEBA MIDDLE K 1 1 2 31
INITIAL
STREET ❑ 13404 NEWCASTLE COMMONS DR AP CITY NEWCASTLE ST WA 2jp, 980593212 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'F MM DAY' 12 1— 12 — 1991 2 32
CENSE 9 ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 H U SE
ICNLJAUSSY 1 NATURE OF INJURIES z❑
3
10 9❑ P1 aT�S� BZSO443 sTArI WAurN# KMHD84LFOKU797438
TRAILER STATE TRAILER STATE
11 3 5 PLATE# PLATE# FROM To
TRLR. TRLR. 1 3 33
12 3 5 VIN#' VIN#
>; FROM TO
VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN T /g[ GOVT.VEHICLE 5 1 34
13 2019 HYUN ELANTR DAMAGE YES NO � '` RS YES[:] No✓
REGISTERED OWNER INFO SHERON CHAKALAKAL 13404 NEWCASTLE COMMONS DRAP NEWCASTLE WA 98059 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
14 ABILI V INSURANCE INSURANCE CO PROGRESSIVE 950711236 3 4
IN EFFECT &POLICY# 9TOP
VEHCLE CHARGE 5 36
LEGALLY YES❑NO❑ CITATION# 2A0276936 FAIL YIELD LEFT TURN MOTOR io eorrom
15❑ STANDING 7 6
MOTOR PEDAL- PROPERTY DAM THR OLD MET PHONE
UNIT 02 ❑✓ ❑ PEDESTRIAN ❑ ❑ YES NO HO 4012811170
VEHICLE CYCLE OWNER
16 a
LAST NAME ARSLAN FIRST NAME MELISA MIDDLE N
INITIAL
17❑ STREET ❑', 22010 OAK WAY CITY' BRIER ST WA ZIP 980368118 37
NEW ADDRESS ❑
18� CDL IGNITION REQUIRED IGNITION PR—E-1SENT MEDICAL TRANSPORTED ❑ 38
INTERLOCKYES�NOR INTERLOCK YEs It I NOF YES
t t— l NO❑
19 LDIIVEW # STATE WA ]SEX IF M .C.B. 08 _ 13 _ 1995 39
WELMET INJURY1 NATURE OF INJURIES 40
20❑ ON DUTY STATUS AIRBAG 3 RESTR 4 EJECT 1 USE CLASS ❑
21❑ LICENSE BYE1457 TAre WA VIN# JMIDEILZ7D0162734
❑ 41
PLATE#
42
22❑ PLATE# STATE PLATE# STATE
TRLR
23❑ UIN#. IN#.
43
RLR
'
VEH YEAR 2013 MAKE MAZp MODEL MAZDA2 STYLE VEHICLE TOWED TO BLIN TOWEDBY GOV HI 44
24❑ DAMAGE YES NO BANKERS YES NO
REGISTERED OWNER INFO MELISA ARSLAN 11100 SEPETROVITSKYRD APT H RENTONWA98055 VEHICLE NO.2
SHADEDAMAGEDAREA
3 4
LIABILITY
INSURANCE &POLICY#E CO GEICO 6055324336IN STOP 5
'E""Le ❑ ,J� CITATION# CHARGE E
BOTTOM
LEGALLY YES N`L J
25 ' a
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
J
26
M.LEVERTON 2517 WA0171300
PAGE 01 OF
PART A
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. ED19075
COLLISION REPORT III III III III III 111
1591972 CASE# 22-13309
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'
unit 1 sb It blk/sedan unit 2 nb In 2 blk coupe
CC
Within the city limits of Renton/King/WA I responded to a 2 car blocking crash at Oakesdale Ave SW
at SW 41 st St.
I contacted the driver of unit 2 who told me she was northbound in lane one when unit 1 turned left
across her path contacting her vehicle. She did not complain of injury but damages did require a tow
truck.
I contacted the driver of unit 1 ID'd picture WADL. She told me she wanted to turn left from
southbound Oakesdale onto SW 41 St St, but her view was blocked by other cars. As she proceeded
unit 2, lawful upon the roadway headed northbound was in her path where she made contact with unit
2. She did not complain of injury and damages did require a tow truck.
Unit 1 was cited via complaint ref RCW 46.61.185 FTYROW left turn 2 car crash.
I certify (declare) under penalty of perjury under the laws of the State of Washington that the
foregoing is true and correct.
M.Leverton/2517 City of Renton/King/Wa 12/20/2022
I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT.
M.LEVERTON 12-20-22 08:09 AM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
CO.JOHNSON 0505 12/27/2022 12:50:19 PM
BADGE OR ID# 2517 ORI# WA0171300 TIME POLICE DISPATCHED; 1:43 PM TIME POLICE ARRIVED I 1:50 PM
PART I PAGE IT]OF
REPORT NO.! ED19075 CASE# ' 22-13309 DATE AND TIME 12/16/22 13:41
OF COLLISION
Oro Dt
d � �
PAGE 3 OF 3