HomeMy WebLinkAbout23-1700 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 0 27c
COLLISION REP FIT 1591971
CASE 23-1700 z
INTERSTATE ❑ CITY STREET FIRE ❑
RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHIC;I F ❑ LOCAL AGENCI 4200 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 TOTAL#OF OBJECT 1 1 8 28
TRIBAL UNITS 02 STRUCK NONE
RESERVATION
z
3❑ DATE OF M M D D Y Y Y Y TIME(2400) COUNTY# MILES N E IN CITY# ❑
cawsloN 02 - 10 - 2023 1212 17 ❑.❑ S 8 W H OF e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓
HARDIE AVE SW BLOCK NO. e
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ 70 00 FEET e S B W e SW 7TH ST
0 1 29
UNIT MOTOR
VEHICL Z CYCLE ElOYESA✓NOTHRESHOLDMET PHONE 0 11
30
6� LAST NAME QUINTUS FIRSTNAME LEStIE MIDDLE
INITIAL A 1 2 31
STREET ❑, 863 OLYMPIA AVE NE CITY RENTON ST WA 2jp, 980563886 z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
1/ I iNTERLOCKYEs NO NTERLOCKYEs NO Z/ YES R No�/
8❑ LRIIVER #
ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 H U EET ICNLJAURY 1 NATURE OF INJURIES z❑
3
10 9❑ PI ATE 14 BVt 1384 STATE WAa VIN#' 5YFBURHE7KP885808
TRAILER STATE TRAILER STATE
11 0 0 PLATE# PLATE# FR.. ro
TRLR. TRLR 3 7 33
12 0 0 VIN#' VIN#
FROM TO
VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE $ 34
13 9 2019 TOYT COROL DAMAGE YES NO YES❑ NO✓
REGISTERED OWNER INFO PAUL QUINTUS 863 OLYMPIA AVE NE RENTON WA 98056 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
14 ABILITY INSURANCE INSURANCE CO AARP 55PHG345863 <1�3 4
IN EFFECTPOLICY# TOPVEHICLE CHARGE 36
LEGALLY YES❑NO CITATION# 3AO095050 FAIL YIELD PRIVATE RD MOTORorrom
15❑ STANDING 6
UNIT ' MOTOR PEDAL ❑ PEDESTRIAN ❑ PROPERTY ❑ DAM THR OLD MET PHONE
VEHICLE CYCLE OWNER YES�/ NO
16 a
LAST NAME DAVIS FIRST NAME ONEIKA MIDDLE T
INITIAL
17❑ STREET Is❑' 600 SW 5TH CT APT G105 CITY RENTON ST WA ZIP 980572363 37
NEW ADOREs
18❑ CDL IGNITION REQUIRED IGNITION PR-E-1SENT MEDICAL-T�RANSPORTED � 38
INTERLOCKYES�NO� INTERLOCK YEs It I NOF YES
t l NOF,/
19 DRIVER'S STATE WA ]SEX IF D.C... 05 _ 24 1993 39
LICENSE# MMDDYY
20❑ ON DUTY STATUS AIRBAG 4 RESTR 4 EJECT 1 HEJ EET NJAU EY E NATURE OF INJURIES 40
❑ 41
21❑ ILICENSE PLATE# BRM0110 TATE WA VIN 1 2HGFG3B57DH512549 1
42
22❑ PILER LATE# STATE PLATE# STATE
23❑ UIN#. 43
TRLR RLR
'IN#.
VEH YEAR 2013 MAKE HOND MODEL CIVIC STYLE VEHICLETOWED TO BLIN TOWEDBY GOV HI 44
L4❑ DAMAGE YES NO,/ YES NO
REGISTERED OWNER INFO ONEIKA DAVIS 600SW5TH CTAPTG105 RENTONWA98057 VEHICLE NO.2
SHADE IN DAMAGED AREA
2 3 4
LIABILITY
INSURANCE INSURANCE
#E CO USAA USAA0389290387103IN IU�VE""LE
❑ ,J� CITATION# CHARGE
LEGALLY YES N`L J
25 OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# 77P�1300
26
ALEKSANDR IGNATOV 12619
PART A PAGE 01 OF C7
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. ED32958
COLLISION REPORT III III III III III 111
1591972 CASE# 23-1700
ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY)
NAME MIDDLE INITIAL) QUINTUS ALEXANDREJ
(LAST FIRST,
ADDRESS&PHONE# D O.B.
863 OLYMPIA AVE NE RENTON WA 980563886 SEX M MMDDYyry 08 - 24 - 1987
PASSENGER WITNESS❑ UNIT# 1 Pp 3 AIRBAG j 2 RESTR. 4 EJECT ? 1 HELMET NATURE OF INJURIES
USE CLASS
!1
NAME
(LAST,FIRST,MIDDLE INITIAL) TURNER ROBERT L
ADDRESS&PHONE# D Q 8
600 SW 5TH CT APT G105 RENTON WA 980572363 SEX M 4:oO-:vv 03 _ 02 _ 1992
SEAT HELMET INJURY NATURE OF INJURIES
PASSENGER WITNESS UNIT# 2 POS 3 AIRBAG 2 RESTR. 4 EJECT 1 USE CLASS 1
NAME
(LAST FIR57 MIDDLE INITIAL)
AppRESS&PHONE#
SEX D.Q.B.
MMDDYYYY. -
PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET NJURY NATURE OF INJURIES
❑ ❑ POS. USE CLASS ----�
NARRATIVE'
Unit one was attempting to cross Hardie AVE SW from a parking lot on the east side of the street to
the parking lot on the west side of the street. Unit two was traveling southbound on Hardie AVE SW
just south of SW 7th ST in lane 1 of 1. Unit one did not grant the right of way to unit two pulled out in
to the lanes of traffic and struck unit two on the driver's side.
Photos uploaded in to Axon Evidence.
Unit one cited.
I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT.
ALEKSANDR IGNATOV 02-11-23 05:58 AM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
QUINT TIBEAU 07691 1 211112023 12:13:33 PM
BADGE OR ID# ( 12619 OR]# WA0171300 TIME POLICE DISPATCHED` 12:21 PM TIME POLICE ARRIVED'12:29 PM
FART I PAGE IT]OF 3�
REPORT NO. ED32958 CASE# ' 23-1700 DATE AND TIME 02/10/23 12:12
OF COLLISION
W
C] i
HARDIE AVE SW
o �
u�
z
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