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Home My WebLink About23-511 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 1 27c COLLISION REP FIT 1591971 ❑ ❑ FIRE RESULTED ❑ CASE 23-511 z INTERSTATE CITY STREET FIRE 1 STOLEN STATE ROUTE ❑ OTHER ❑ VFHIr.I F ❑ LOCAL AGENCI 4250 3 HIT&RUN CODING COUNTY RD PRIVATE WAY INVOLVED 2 TOTAL#OF OBJECT 1 8 2$ TRIBAL UNITS 03 STRUCK RESERVATION z 3❑ DATE OF M M D D Y Y Y Y TIME(2400) COUNTY# MILES N E IN CITY# ❑ cawsloN 01 - 13 - 2023 1522 17 ❑.= S 8 IN e 1070 3 4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓ SW SUNSET BLVD BLOCK NO. e✓ 2100 4a❑ MILEPOST DISTANCE OF(REFERENCE OR CROSS STREET) 5❑ 200 00 FEET MILES e S ❑ W e S 135TH ST 0 1 29 MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE UNIT 01 VEHICLE ❑ CYCLE El ✓NO D:2066653080 0 11 30 6� LAST NAME TASCA FIRSTNAME DAVID MIDDLE C 1 2 31 INITIAL STREET ❑ 300 S 55TH ST APT A102 CITY RENTON ST WA Zjp, 980557908 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 U SE ICNLJAUSSY 1 NATURE OF INJURIES z❑ 3 LICENSE CCW0195 sTATI WA vIN# 1C4HJWDG1DL660398 10 F91 PI ATE i4 TRAILER STATE TRAILER STATE 11 3 5 PLATE# PLATE# FROM TO TRLR. TRLR 7 3 33 12 3 5 VIN#' VIN# >; FROM TO VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE 7 $ 34 13 2 2013 JEEP WRANG DAMAGE YES NO YES[:] No ✓ REGISTERED OWNER INFO DAVID TASCA 300S SSTH STAPTA102 RENTON WA 98055 VEHICLE NO. 1 ❑ SHADE IN DAMAGED AREA 35 14 LIABILITY INSURANCE INSURANCE CO FIRST RATEH235707076 3 4 IN EFFECT &POLICY# 9TOP VE—LE 5 36 LEGALLY Yes❑NO❑ CITATION# CHARGE 10 BOTTOM 15❑ STANDING MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE UNIT a2 VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES 1/ NO D:2067862670 16 a LAST NAME RAMSEY FIRST NAME ELLEN MIDDLE I L INITIAL 17❑ STREET ❑', 312 SENECA AVE NW CITY' RENTON ST WA ZIP 980575129 37 NEW ADDRESS ❑ 18� CDL IGNITION REQUIRED IGNITION PtR-E-S1ENT MEDICALt-T�RANSPORTED 38 INTERLOCKYES�NOR INTERLOCK YEs I I NoF YES t l NO❑ 19 LICENSE# STATE WA ]SEX IF M D.O.B. 09 _ 30 _ 1956 0 39 HELMET I {NJURY NATURE OF INJURIES 40 20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 USE CLASS 1 ❑ 21❑ LICENSE I BZR7518 TATe WA vIN1i 1C3CCBCG2CN123979 ❑ 41 PLATE# 42 22❑ PILER LATE# STATE PLATE# STATE 23❑ 43 TRLR RLR UIN#. 'IN#. VEH YEAR 2012 MAKE CHRY MODEL 200 STYLE VEHICLE TOWED TO BLIN TOWEDBY GOV HI 44 24 DAMAGE YES NO GENE MEYER YES NO REGISTERED OWNER INFO ELLEN RAMSEY 312 SENECA AVE NW RENTON WA 980575129 VEHICLE NO.2 SHADE DAGELLAREA LIABILITY INSURANCE INSU&PORGY#ECO ALLSTATE 907 028 422IN IGQVE"'LE ❑ ,J� CITATION# CHARGE LEGALLY YES N`L J 25 OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY J 26 M.LEVERTON 2517 WA0171300 PART A PAGE 01 OF C7 3000-345-159 OR 11/181 STATE OF POLICETRAFFICN CORRECTION REPORT NO. ED26465 COLLISION REPORT III III III III III 111 1591972 CASE# 23-511 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 01-17-23 07:02 AM INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED APPROVED BY DATE CO.JOHNSON 0505 1 111912023 1:02:58 PM BADGE OR ID# 2517 ORI# WA0171300 TIME POLICE DISPATCHED 3:26 PM TIME POLICE ARRIVED]3:31 PM PART I PAGE IT]OF REPORT NO. ED26465 CASE# 23-511 OF COLLISION 01/13/23 15:22 OF CbLLI510N NARRATIVE blk unk unit 3 brake checked unit 1 slv jeep he slid into side of unit 2 slv sedan RTF Within the city limits of Renton/King/WA I responded to a 3 car hit and run near the 2100 block of W Sunset Blvd. I contacted the driver of unit 1 who told me he was eastbound on SW Sunset Blvd in lane when unit 3 slammed on his brakes for no apparent reason in front of unit 1. Unit one said there was nothing in front of unit 3 and it was as if unit 3 was being reckless. Unit 1 said he also slammed on his brakes to avoid contact with unit 3, rather he slid on the wet roadway and contacted the side of unit 2. He did not complain of injury and damages did not require a tow truck. Unit 1 could not provide any additional information Ref unit 3 other than the vehicle was black. I contacted the driver of unit 2 who told me she was eastbound on SW Sunset Blvd when unit 3 suddenly and no apparent reason slammed on his brakes. She thought it was strange and began to brake since she was in lane 2 and not immediately behind unit 3. As she was braking she was contacted on the side by unit 1 trying to avoid unit 3. She did not complain of injury and damages did require a tow truck. She was unable to provide any additional information in reference to unit 3 other than it was a black vehicle. Information/Insurance only. 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 1/17/2023 PAGE 3 OF 5 SUPPLEMENTAL REPORT NO. ED26465 r`) POLICE TRAFFIC 1 1 7 27 COLLISION REPORT CASE# 23-511 1 COMMERCIAL MOTOR CARRIER INTERSTATE INTRASTATE G UNIT'# USL70r ICC# VEHICLE TYPE CARGO BODY TYPE 2 ❑ 1 28 CARRIER NAME 3 CARRIER ADDRESS ` CITY ST' ZIP' 4 ❑ NAME # PLACARD: :❑ GI NAME IF NO NUMBER SOURCE AXLES + 4a ❑ ADDITIONAL UNITS MOTOR PEDAL- 5 ❑ AL � PROPERTY � OLDMET PHONE# 3 VEHICLE CYCL PEDESTRIAN OW OF 6 29 LAST NAME : UNKNOWN FIRST NAME , MIDDLE INITIAL STREET 30 NEW AnDRFS CITY RENTON ST ZIP 6 CDL IGNITIttN REQUIRED IGNITION PRESENT MEDICAL TANSPORTED 1 1 2 31 INTERLOCK YES No NTERLOCK YES❑N0� YES N DRIVER'S STATE I SEX U M��DYSYv' -� 2 LICENSE 7 ON DUTY STATUS AIRBAG 9 RESTR. 9 EJECT 1 HELMET 9 INJURY 0 NATURE OF INJURIES F� USE CLASS 8 ❑ ' 1 32 LICENSE+ Tar V1N.# PLATE# 9 TRAILER TRAILER PLATE# STATE PLATE# STATE 10 ❑ TRLR TRLR VIN.#. VIN.#. 11 3 5 VEH.YEAR MAKE I MODEL STYLE I VEHICLE TOWE E T SABLIN TOWED BY anvi vEH1C P FROM TO DAMAGE YES NO YES NO REGISTERED OWNER INFO.]NEW] RENTON ] 3 33 12 SHADE IN DAMAGED AREA FROM TO IIABiLITY INSURANCE❑ INSURANCE CO IN EFFECT &POLICY# tGQ VEHICLE 34 13 LEGALLY YES❑ NO❑ CITATION# CHARGE STANDING } 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 INITIAL TIAL ❑ STREET 16 STREET"[-] CITY ST ZIP CDL IGNITION REdUiREO IGNITION PRESENT MEDICALTANSPORTED NTERLUCK YES NO NTERLOCK YES NO 'YES NO ❑ 17 5 37 LICENSE# STATE SEX MMDDDYBYY 18 ❑ ON DUTY� STATUS AIRBAG RESTR. ; EJECT HELMET INJURY NATURE of INJURIES 38 USE ICLASS 19 ❑ vIN 39 LICENSE # PLATE# rnr 20 ❑ TRAILER TRAILER ❑ 40 PLATE# STATE PLATE# STATE 21 ❑ ❑ 41 TRLR TRLR VIN# YIN#i 42 22 VEH.YEAR MAKE I MODEL STYLE VEHICLE TOWED DUE T SABLIN TOWED BY GOVT.VEHICLE DAMAGE YES NO YES NO 23 REGISTERED OWNER INFO SHADE IN DAMAGED AREA 43 4 LIABILITY INSURANCE INSURANCE CO ' IN EFFECT &POLICY# i BOOT - 4 E 44 24 vewcLe YES❑ NO❑ CITATION# CHARGE iq 60TiON1 LEGALLY STANDING S 7 6 1 CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT. M.LEVERTON 01-17-23 07:02 AM 25 INVESTIGATING OFFICER'S SIGNATURE OFFICER'S PHONE UNIT OR DIST DET DATED: PLACE SIGNED APPROVED BY DATE 26 OR ID 2517 O#IL..WA0171300 JOHNSON 111912023 PAGE�OF F 3000-345-013(R 11118) REPORT NO. ED26465 CASE# ' 23-511 DATE AND TIME 01/13/23 15:22 OF COLLISION rats a, xp� re e9ci,. PAGE 5 OF 5