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Home My WebLink About23-579 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 1 27c COLLISION REP FIT 1591971 ❑ ✓❑ RESULTED ❑ CASE z3-s7s 2 INTERSTATE CITY STREET FIRE 1 STOLEN STATE ROUTE ❑ OTHER ❑ VFHIr.I F ❑ LOCAL AOENC 4200 3 HIT&RUN CODING COUNTY RD PRIVATE WAY INVOLVED 2 3 TOTAL#OF OBJECT 1 1 8 28 TRIBAL UNITS 03 STRUCK RESERVATION 2 3❑ DATE OF M M D D Y Y Y Y TIME(2400) COUNTY# MILES N E IN CITY# ❑ cawsloN 01 - 1-- 2023 1812 17 ❑.= S 8 IN e 1070 3 4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓ 2207 UNION AVE NE BLOCK NO. e✓ Y200 4a❑ MILEPOST DISTANCE OF(REFERENCE OR CROSS STREET) 5❑ ❑ FEET e S ❑ W e 0 1 29 MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE UNIT 01 VEHICLE ❑ CYCLE El ✓NO D:2062341695 1 4 30 6� LAST NAME JULIO FIRSTNAME JUAN MIDDLE T 1 1 2 31 INITIAL STREET ❑ 1150 UNION AVE NE APT 7-22 CITY RENTON ST I WA 7jp, 98059 2 NEW ADDRESS 7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3 ✓ I iNTERLOCKYEs No NTERLOCKYEs 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 LICENSE CDK9683 sTArI WAvIN If JTDDR32T630153566 10❑ PI ATE# TRAILER STATE TRAILER STATE 11 2 5 PLATE# PLATE# Rom ro FT -R TPILF1 1 5 33 12 0 0 VIN#j VIN# 2003 TOYT CEL/CA SD pL FROM 34 VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO u BLIN TOWED BY GOVT.VEHICLE 13 4 DAMAGE YES NO ✓ YES[:] NO✓ REGISTERED OWNER INFO ALSERTO ANDRES4455 NE 12TH ST APT 23-8 RENTON WA 98059 VEHICLE NO. 1 ❑ ❑ SHADE IN DAMAGED AREA 35 14❑ LIABILI INSURANCE❑ INSURANCE CO 3 4 IN EFFECT &POLICY# _ VEHCLE CHARGE 5 ❑ 36 LEGALLY YES❑NO❑ CITATION# BOTTOM 15❑ STAIN.D'ING 7 6 UNIT a2 VE IMOTOCLE CYCLE ❑ PEDESTRIAN ❑ OWNFR PEDAL RTY ❑ DYES✓ NO OLD MET PHONE 16❑ LAST NAME UNKNOWN FIRST NAME MIDDLE INITIAL STREET CITY RENTON ST ZIP 4 17❑ NEW ADDRESS❑ ❑ 37 18❑ CDL IGNITION REQUIRED IGNITION PtR-E-S1ENT MEDICAL-T�RANSPORTED � 38 INTERLOCK YEs❑No� INTERLOCK YEs I I NOF YEs t l NOF,/ 19 LLIICENS# STATE SEX U MMDDYY -�_ 39 WELMET INJURY NATURE OF INJURIES 4O 20❑ ON DUTY STATUS AIRBAG 2 RESTR 1 EJECT 1 USE 2 CLASS 1 ❑ ❑ 41 21❑ LICENSE I PLA E# BMS5223 TAre WA VIN# USE 1 42 22❑ PLATE# STATE PLATE# STATE 23❑ 43 TRLR RLR UIN#. 'IN#. VEH YEAR 2018 MAKE SUBAQ MODEL ►MPREZA STYLE UT VEHICLETOWED TO BLIN TOWEDBY GOV HI 44 L4❑ DAMAGE YES NO✓ YES NO✓ REGISTERED OWNER INFO MARLIE RENY 2207 UNION AVE NE RENTON WA 98059 D:7204714143 VEHICLE NO.2 SHADE IN DAMAGEbAREA 2 3 Cd LIABILITY INSURANCE INSU&PORGY#E CO ALLSTATE 817526294IN 1 9TOP —e E ❑ ,J� CITATION# CHARGE BOTTOM LEGALLY YES N J 25 Q. ' 7MICAELA NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY 26 CASTAIN 7 12573 WA0171300 PART A PAGE 01 OF C7 3000-345-159 OR 11/181 STATE OF POLICETRAFFICN CORRECTION REPORT No. ED25943 COLLISION REPORT III III III III III 111 1591972 CASE# 23-579 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 FIRST 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: (Driver) Juan Julio (DOB 03/15/1976), 2003 Toyota Celica (WA/CDK9683) Unit 2: (Owner) Marlie Reny (DOB 07/05/1985), Subaru Impreza (WA/BMS5223) Unit 3: (Owner) Marlie Reny (DOB 07/05/1985), Subaru Outback (WA/BBZ4504) On 01-15-2023 at approximately 1812 hours I was dispatched to a collision at 2207 Union Ave NE, in the City of Renton, King County, WA. Upon arrival, I contacted both parties and both agreed on what occurred during the collision. Unit 1 was traveling southbound at the 2200 block of Union Ave NE. Unit 1 lost control of the vehicle and collided into Unit 2 and 3. Unit 1 was traveling around 25 mph. Unit 2 and 3 were both parked in the driveway of 2207 Union Ave NE. Unit 1 knocked on the front door to notify the owners of Unit 2 and 3. There is damage to the front bumper of Unit 1. There is damage to the back bumper of Unit 2. There is damage to the passenger side doors of Unit 3. This report is for insurance purposes. This concludes my involvement in this case. 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. Castain #12573 1/15/2023 Renton, King County, WA. I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT. MICAELA CASTAIN 01-15-23 09:50 PM INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED APPROVED BY DATE J.THIELMAN 11462 1 111812023 4:19:51 AM BADGE OR ID# 12573 OR]# WA0171300 TIME POLICE DISPATCHED 6:12 PM TIME POLICE ARRIVED f 6:12 PM PART I PAGE IT]OF 4] SUPPLEMENTAL REPORT No. ED25943 r`) POLICE TRAFFIC 1 1 8 27 COLLISION REPORT CASE# 23-579 1 COMMERCIAL MOTOR CARRIER INTERSTATE INTRASTATE G UNIT'# USDOT ICC# VEHICLE TYPE CARGO BODY ;TYPE 2 ❑ 1 28 CARRIER NAME 3 CARRIER L ADDRESS ` CITY ST ZIP—1 I ' 4 ❑ NAME # PLACARD: :❑ GI PLACARD IF NO NUMBER SOURCE AXLES + 4a ❑ ADDITIONAL UNITS MOTOR PEDAL- PROPERTY DAMAGETHRESHOLD MET PHONE 5 ❑ UNIT# 3 VEHICLE t_"J � PEDESTRIAN YES� IN 1 4 29 LAST NAME : UNKNOWN FIRST NAME MIDDLE INITIAL STREET 30 NEW AnnRFS CITY ST ZIP 6 1 CDL GNITIttN REQUIRED GNITION PRESENT MEDICAL TANSPORTED 1 31 INTERLOCK YES NO zERLOCK YES❑N0� vES N DRIVER'S STATE I SEX U M��DYSYv' -� 2 LICENSE 7 ON DUTY STATUS AIRBAG 2 RESTR. 1 EJECT 1 HELMET 2 INJURY 1 NATURE OF INJURIES F� USE CLASS 8 ❑ 1 32 LICENSE BBZ4504 [TAT WA VIN# 4S4BSBEC3F3348461 PLATE# 9 TRAILER TRAILER PLATE# STATE PLATE# STATE 10 ❑ TRLR TRLR VIN.#. VIN.#. 11 0 0 VEH.YEAR201 Jr MAKE SUBA MODELOUTBAC STYLE UT I VEHICLE TOME E T SABLIN TOWED BY anvi vFH1C P FROM TO DAMAGE YES NO YES NO REGISTERED OWNER INFOMARLIE RENY 2207 UNION AVE NE RENTON WA 98059 D:7204714143 m 33 12 SHADE IN DAMAGED AREA LIABILITY� INSURANCE❑ INSURANCE CO FROM TO IN EFFECT &POLICY# 4 TLSP 13 LEGAL 01 CITATION# CHARGE 060 Y)M 34 LEGALLY YES NO STANDING �} 8 7 6 14 ❑ UNIT Tr Vd 1RE O CYDCLE OWNERRTY YES AGE NOHRESHOLD MET PHONE ❑ 35 PEDESTRIAN 15 LAST NAME FIRST NAME MIDDLE': INITIAL ❑ 36 STREET 16 NEW AnnRFs.� CITY'. ST ZIP CDL IGNITION REdUiREE7 IGNITION PRESENT MEDICALTANSPORTED INTERLOCK YES No INTERLOCK YEs NO YEs NO ❑ 17 4 37 LICENSE# STATE SEX MMDDDYBYY 18 ❑ ON DUTY� STATUS AIRBAG RESTR. ; EJECT HELMET INJURY NATURE of INJURIES 38 USE (CLASS 19 ❑ 39 LICENSE rnr VIN# PLATE# 20 ❑ TRAILER' TRAILER ❑ 40 PLATE# STATE PLATE# STATE 21 ❑ ❑ 41 TRLR TRLR 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 ' VINE EFFECT &POLICY# i 970P - 4 E:l 44 24 LEwcLE 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. MICAELA CASTAIN 01-15-23 09:50 PM 25 INVESTIGATING OFFICER'S SIGNATURE OFFICER'S PHONE UNIT OR DIST DET DATED: PLACE SIGNED APPROVED /126 � BADGE O#IIWA0171300 EAN 1 PAGE OF 4OI 3000-345-013(R 11118) REPORT NO. ED25943 CASE# ' 23-579 DATE AND TIME 01/15/23 18:12 OF COLLISION p' i Nr O V C Z 0 Z m Z m } �w I i i 4 PAGE 4 OF 4