HomeMy WebLinkAbout23-1143 POLICETRAFF'c" III !�� I IIIllI111IN II II I REPORT NO. ED30168 170
27
COLLISION REP FIT 1591971
CASE 23-1143 z
INTERSTATE ❑ CITY STREET FIRE ❑RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHIC;I F ❑ LOCAL AOENC 4900 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.. 01 - 1-— 2023 0718 17 ❑-= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
BLOCK NO. e✓ --- ----� ❑
NE 3RD ST MILEPOST
4a❑
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ ❑ FEET e S ❑ W e MONTERYAVE NE
0 4 29
UNIT MOTOR
VEHICL Z CYCLE ElDDAMYESA✓THRESHOLD PHONE 0 11
30
6� LAST NAME PATTERSON FIRSTNAME SHREATHA MIDDLE N 1 1 2 31
INITIAL
STREET ❑ 2828 NE 3RD ST APT A302 CITY RENTON ST WA ZIP 980568836 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 3 RESTR 9 EJECT 1 H U SE
ICNLJAUSSY 1 NATURE OF INJURIES z❑
3
10❑ P1 aT�S� BXU6215 sTArI WAurN# 2C3CDXBG9GH277101
TRAILER STATE TRAILER STATE
11 3 5 PLATE# PLATE# FROM To
TRLR. TRLR. 3 5 33
12 3 5 VIN#j VIN#
FROM TO
VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN T Y GOVT.VEHICLE 7 $ 34
13 2016 DODG CHARG DAMAGE vE6 0 NO agW�MEYER ves❑ No
REGISTERED OWNER INFO SHREATHA PATTERSON 2828 NE 3RD STAPTA302 RENTON WA 980568836 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
14 LIABILITY INSURANCE❑ INSURANCE CO
IN EFFECT &POLICY# 9TOP 5
veHICLe CHARGE 1 o BOTTOM 36
LEGALLY YES No CITATION# 3A0081022,3A0081022, FAIL YIELD LEFT TURN MOTOR
15❑ NDING 8 6
MOTOR PEDAL-:. PEDESTRIAN PROPERTY DAM THR PHONE
UNIT 02 VE OLD MET HICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES 1/ NO D:2062713034
16 a
LAST NAME DANIELS FIRST NAME MARK IN DOLE E
IN MIDDLE
17❑ STREET ❑', 1205 GRANT AVE S 0203 CITY' RENTON ST WA ZIP 98055 37
NEW ADDRESS ❑
18� CDL IGNITION REQUIRED IGNITION PR-E-1SENT MEDICAL TRANSPORTED ❑ 38
INTERLOCKYES�NOF INTERLOCK YEs It I NOF YES
t t- l NO❑
19 F] DRIVERS
# STATE WA SEX M Mr D.C.B. 08 _ 24 1963 39
WELMET INJURY NATURE OF INJURIES 4O
20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 USE CLASS 1 ❑
21❑ LICENSE BYM6204 TAre I WA VIN1t JTJBZMCA8G2008918
❑ 41
PLATE#
42
22❑ PILER LATE# STATE PLATE# STATE
23❑ UIN#. 43
TRLR RLR
'IN#.
VEH YEAR 2016 MAKE LEX$ MODEL RX STYLE VEHICLE TOWED TO BLIN TOWED ev GOV HI 44
24❑ DAMAGE YES✓ NO GENE MEYER YES NO
REGISTERED OWNER INFO MARK DANIELS 23811132ND AVE SE APT N4 KENTWA980423255 D:2062713034 VEHICLE NO.2
SHADEDAMAGEDAREA
3 4
LIABILITY
INSURANCE I PORGY#ECO AMFAM41068-15268-77IN 9TOP 5
VEwCLE ❑ ,J CITATION# CHARGE
25 to BOTTOM
LEGALLY YES Nu
' e
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
J
26
M.LEVERTON 2517 WA0171300
PART A PAGE 01 OF 11
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. ED30168
COLLISION REPORT III III III III III 111
1591972 CASE# 23-1143
ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY)
NAME MIDDLE INITIAL) PATTERSON ANNALISE S
(LAST FIRST,
ADDRESS&PHONE#
1907 MARCUS AVE FL1 ST LOU/S MO 631130000 SEXi F MMDOYyry 02 - 01 - 1987
{� SEAT ! HELMET INJURY NATURE OF INJURIES
PASSENGER Z WITNESS UNIT# 1 POS. 3 AIRBAG 3 RESTR. 9 EJECT I USE CLASS 17 S/DE
NAME
'(LAST,FIRST MIDDLE INITIAL)
ADDRESS&PHONE# D O B
SEXI MMDDVYYY
PASSENGER ❑WITNESS UNIT# : SEAT AIRBAG RESTR. EJECT HELMET NJURY NATURE OF INJURIES
POS. USE CLASS
NAME
(LAST FIRST MIDDLE INITIAL)
AppRESS&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 01-27-23 09:25 AM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY E
DAT
Co.JOHNSON 0505 113112023 5:14:15 PM
BADGE OR ID# 2517 ORI# WA0171300 TIME POLICE DISPATCHED! 7:99 AM TIME POLICE ARRIVED]7:22 AM
PART I PAGE IT]OF EEI
REPORT NO. ED30168 CASE# 23-1143 OF COLLISION
01/27/23 07:18
OF CbLLI510N
NARRATIVE
red/unitl It unit beige suv eb lane 1
CC
Within the city limits of Renton/King/WA I responded to a 2 car blocking crash at the intersection of
NE 3rd St at Monterey Ave NE.
I contacted the driver of unit 2 who told me for 34 years he has traveled this roadway and like every
other morning he was eastbound in lane 1 on his green light when unit 1 made a sudden left turn in
front of him without reaction time he collided with unit 1. He was shaken but did not complain of
injury. Damages required a tow truck.
I attempted to contact the driver of unit 1. She was very distraught and somewhat not responsive,
only saying she wanted to take care of her wife. When I arrived on scene she was in the driver seat.
Later she was laying across the back seat from the driver side. The passenger was unresponsive and
extricated by Renton Fire. Unit 1 driver did provide her picture WADL. A WACIC/DOL check via
MDC revealed she was NVOL 2nd. Both unit 1 driver and passenger were transported to Harborview
for further checks.
I cited unit 1 ref RCW 46.61.185 FTYROW-Left Turn, RCW 46.20.015 NVOL 2nd W/ID and RCW
45.30.020 No insurance 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
PAGE 3 OF 11
REPORT NO. ED3016 RASE# 2y]]43 DATE m°M\ 019»23 O d a
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REPORT NO. ED30168 CASE# ' 23-1143 DATE AND TIME 01/27/23 07:18
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REPORT NO. ED30168 CASE# ' 23-1143 DATE AND TIME 01/27/23 07:18
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