HomeMy WebLinkAbout23-1128 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 1 27c
COLLISION REP FIT 1591971
CASE 23-1128 z
INTERSTATE ❑ CITY STREET FIRE ❑
RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHIC;I F ❑ LOCAL AGENCI 4100 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 1❑ 6 0
TOTAL#OF OBJECT 1 28
TRIBAL UNITS 02 STRUCK' TRAFFIC SIGNAL POLE
RESERVATION
z
3❑ DATE OF M M D D Y Y Y Y TIME(2400) COUNTY# MILES N E IN CITY#
cawsloN 01 - 1-- 2023 1536 17 ❑-= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
TALBOT RD S BLOCK NO. e✓ 1200 ❑
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ �.❑ FEET e S ❑ W e ON RAMP NB 1-405
0 4 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
✓NO D:7604847660 0 11
30
6� LAST NAME ROMERO FIRSTNAME ZACKARY MIDDLE T 1 2 31
INITIAL
STREET ❑ 24675 HIGH COUNTRY RD CITy RAMONA ST CA 2jp, 920650000 z
NEW ADDRESS
7❑ CDL : IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
iNTERLOCKYEs NO INTERLOCKYEs NO YES R NO
❑ DRIVER'S' STATE CA SEX'M MM ovY' 09 1- 26 - 1991 2 32
8 LICENSE#
9 1 ON DUTY❑ STATUS AIRBAG 6 RESTR 4 EJECT 1 HELM USEET CLASSY 7 HAND KNEE NATURE OF INJURIES 2❑
❑ 3
10❑ P1 ATE 14 BE22242 STATE WA VIN# 5YFBURHE5EP098327
TRAILER STATE TRAILER STATE
11 3 5 PLATE# PLATE# FROM To
TRLR. A'RLR. 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 2 2014 TOYT COROL DAMAGE YES NOBS YES[:] No✓
REGISTERED OWNER INFO PS ROMEO PARK]155108TH AVE NE#202 BELLEVUE WA 98004 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
14 LIABILITY INSURANCE N CO TBA
IN EFFECT &POLICY##
ve'C ❑ 36
LEGA�Lv res❑NO❑ CITATION# CHARGE BOTTOM
15❑ NDING
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT 02 VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES 1/ NO D:2532436183
16 2
LAST NAME ALLEN FIRST NAME KIM MIDDLE R
INITIAL
17❑ STREET ❑', 25430 47TH PL S APT E201 CITY KENT ST WA ZIP 980324288 37
NEW ADDRESS ❑
18� CDL IGNITION REQUIRED IGNITION PR—E-1SENT MEDICAL TRANSPORTED ❑ 38
INTERLOCK YEs❑NOR INTERLOCK YEs It I NOF YES
t t- l NO❑
19 D IVEW # STATE WA SEX F M .C... 03 _ 25 _ 1955 El 39
20❑ ON DUTY STATUS AIRBAG,3 RESTR 4 EJECT 1 HELMET INJURY 7 NATURE OF INJURIES ❑ 40
USE CLASS HAND
21❑ LICENSE 880ZDP TATE WA VIN1 JT2BK18U620064345
❑ 41
PLATE#
42
22❑ PLATE# STATE PLATE# STATE
23❑ VIN#. 43
TRLR RLR
'IN#.
VEH YEAR 2002 MAKE TOYT MODEL PRIUS STYLE VEHICLE TOWED TO BLIN TOWEDBY GOV HI 44
24❑ DAMAGE YES NO BANKERS YES NO
REGISTERED OWNER INFO KIM ALLEN 2543047TH PL S APT E201 KENT WA 980324288 D:2532436183 VEHICLE NO.2
SHADEDAMAGEDAREA
3 4
LIABILITY
INSURANCE 8 POINSURGY#E CO ST FARM 466 5756 C13 47
IN 9TOP
'EwCLE ves� N� CITATION# CHARGE FAIL TO OBEY TRAFFIC CONTROL to BOTTOM
e,Ly `LJ
25 ' a
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
26
M.LEVERTON 2517 WA0171300
PAGE 01 OF
PART A
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. ED30167
COLLISION REPORT III III III III III 111
1591972 CASE# 23-1128
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 gray sb to eb left turn unit 1 slv nb lane 1
CC
Within the city limits of Renton/King/WA I responded to a two car blocking rollover crash at Talbot Rd
S and NB On-Ramp to 1-405.
1 contacted the driver of unit 1 who said he was making a left turn from Talbot/SB onto NB on ramp to
405 on his green just turned to yellow when he was hit by unit 2. The impact spun his car around and
tripped on the sidewalk rolling onto the roof. Renton Fire treated and released him onscene. His
vehicle was impounded for heavy damages.
I contacted the driver of unit 2 ID'd by picture WADL. She told me she was not familiar with the area
and looking to get a battery for her car. Distracted in the unfamiliar area she said she ran the red light
and caused the crash, apologizing. She did not complain of injury and damages did require a tow
truck.
I cited unit 2 ref RCW 46.61.055 FTCWTCD-red light 2 car 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 1/27/2023
I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT.
M.LEVERTON 01-27-23 09:25 AM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY E
DAT
CO.JOHNSON 0505 113112023 5:16:00 PM
BADGE OR ID# 2517 ORI# WA0171300 TIME POLICE DISPATCHED 3:38 PM TIME POLICE ARRIVED 3:39 PM
PART I PAGE IT]OF
REPORT NO. ED30167 CASE# 2y]]2 A m°M\ 019@23 ]e3
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