HomeMy WebLinkAbout22-13851 POLICETRAFF'c" III !�� I IIIllI111IN II II I REPORT NO. ED20305 170
27
COLLISION REP FIT 1591971
CASE 22-13851 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 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.. 12 - 1-— 2022 0637 17 ❑-= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
108TH AVE SE
BLOCK NO. e✓ --- ----� ❑
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ 1.❑ FEET e S ❑ W e SE182ST
0 3 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
✓NO D:2066024096 0 11
30
6� LAST NAME TALANAI FIRSTNAME Ml MIDDLE A 1 1 2 31
INITIAL
STREET ❑ 11009 SE 186TH ST CITY RENTON ST WA ZIP 980557112 z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
iNTERLOCKYEs NO INTERLOCKYEs NO YES R NO
8❑ LRIIVER #
ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 H USEET ICNLJAURY 1 NATURE OF INJURIES z❑
3
10 9❑ PI ATE 14 BPP2784 STATE WA u N#' 1 C4HJXDN4JW227429
11[-j- TRAILER STATE TRAILER STATE
11 2 5 PLATE# PLATE# IR.. ro
TRLR. TRLR. 3 1 33
12 4 0 VIN#j VIN#
FROM TO
❑ VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN T Y GOVT.VEHICLE 5 1 34
13 2 2018 JEEP WRANG DAMAGE vEs 0NO agW�MEYER vEs❑ No
REGISTERED OWNER INFO JANUJON TALANAI 11009 SE 186TH ST RENTON WA 98055 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
14 LIABILITY INSURANCE INSURANCE CO ST FARM 4523422-F01.47A 3 4
IN EFFECT &POLICY# 9TOP
VEHlcl.e CHARGE 5 36
LEGALLY YES❑NO❑ CITATION# 2A0276939 FAIL STOP AT STOP 10 BOTTOM
15❑ STANDING 8 7
MOTOR PEDAL- :PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT 02 VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES 1/ NO DD 2537661981
16 a
LAST NAME ZARATE RAMOS FIRST NAME OMAR MIDDLE N
INITIAL
17❑ STREET ❑', 11426 SE KENT KANGLEY RD CITY KENT ST WA ZIP 980307835 37
NEW ADDRESS ❑
18� CDL IGNITION REQUIRED IGNITION PtR—E—S1ENT MEDICAL TRANSPORTED ❑ 38
INTERLOCKYES�NOR INTERLOCK YEs I I NOF YEs t l NO❑
19 D IVEW #
INJURY1 NATURE OF INJURIES 40
20❑ ON DUTY STATUS AIRBAG 1 RESTR 4 EJECT 1 USE CLASS ❑
21❑ LICENSE I BJW5908 TATe WA VIN# 2T1AE94A9LC045378
❑ 41
PLATE#
42
22❑ PLATE# STATE PLATE# STATE
23❑ UIN#. 43
TRLR RLR
'IN#.
VEH YEAR 1990 MAKE TOYT MODEL COROLL STYLE VEHICLE TOWED TO BLIN TOWEDBv GOV HI �44
24❑ DAMAGE YES NO GENE MEYER YES NO
REGISTERED OWNER INFO ERIKA LOPEZ LEMUS 11426 SE KENT KANGLEY RD KENT WA 98030 VEHICLE NO.2
SHADE DAGED AREA
4
INAEFFIECTTY NSURANCE❑ &POINSULICY#E CO 9TOP 5
'E""LE ❑ ,J� CITATION# CHARGE io BOTTOM
LEGALLY YES Nu
25 s � e
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID#
26
M.LEVERTON 2517 [V7�ENCY
A0171300
PART A PAGE 01 OF
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. ED20305
COLLISION REPORT III III III III III 111
1591972 CASE# 22-13851
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'
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.
M.LEVERTON 12-29-22 07:38 AM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
CO.JOHNSON 0505 1 12/30/2022 1:44:41 PM
BADGE OR ID# 2517 ORI# WA0171300 TIME POLICE DISPATCHED' 6:38 AM TIME POLICE ARRIVED',6:41 AM
PART I PAGE IT]OF 4�
REPORT NO. ED20305 CASE# 22-13851 OF COLLISION
12/29/22 06:37
OF CbLLI510N
NARRATIVE
unit 2/red sm sedan lane 1 nb blk jeep/unit 1 rt from 182 nb
CC
Within the city limits of Renton/King/WA I responded to a 2 car blocking crash at 108th Ave SE at SE
182nd St.
I contacted the driver of unit 2 who told me he was northbound lane 1 108th Ave SE when unit 1
pulled out into his lane without space to avoid contact. He did not complain of injury and damages
did require a tow truck.
I contacted the driver of unit 1 ID'd by her picture WADL. She told me she was waiting to make a
right turn/nb onto 108th. She said she proceeded when it was clear and was hit "one minute later". I
asked her if it was actually right after she made her right turn. She said it was clear when she made
her turn. She did not complain of injury and damages initially looked like she needed a tow. The tow
driver said she could drive to her house few blocks away.
Unit 2 did have his lights on along with his 4 ways flashing. It didnt appear his lights were inoperable
while I was onscene.
I cited Unit 1 ref RCW 46.61.190.2 two car blocking crash via complaint.
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 12/29/2022
PAGE 3 OF 4
REPORT NO. ED20305 CASE# 22-13851 DATE AND TIME 12/29/22 06:37
OF COLLISION
n tws'
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