HomeMy WebLinkAbout23-2266 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 0 27c
COLLISION REP FIT 1591971
CASE 23-2266 z
INTERSTATE ❑ CITY STREET FIRE ❑RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHICI F ❑ LOCAL AOENC 4900 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 1 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# ❑
cowsloN 02 - 1-- 2023 1930 17 ❑.= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓
BENSON RD S BLOCK NO. e
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ 2001. 00 FEET MILES e S B W e S PUGET DR
0 3 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
,/No D:2533590763 0 11
30
6� LAST NAME ASUNCION FIRSTNAME ROSLYN MIDDLE A 1 2 31
INITIAL
STREET ❑1 16449 109TH AVE SE CITY RENTON ST WA 21p 98055 z=
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
INTERLOCK YES[:]NO 1/ INTERLOCKYEs NO�/ YES R No�/
8❑ LRIIVER #
ON DUTY❑ STATUS' AIRBAG 6 RESTR 4 EJECT 1 H USE 2 6 CLASS LEG PAIN[NATURE OF INJURIES 2❑
3
10 Pi ATNES# BLZ6860 sTATe WA u N# 19UU62F61 KA002857
TRAILER STATE TRAILER STATE
11 0 0 PLATE# PLATE# FROM ro
TRLR. TRLR 7 5 33
12 3 0 VIN#' VIN#
:: FROM TO
❑ VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN T Y GOVT.VEHICLE 1 $ 34
13 9 2019 ACUR TLX SD DAMAGE vEs 0NO agW�MEYERS ves❑ No
REGISTERED OWNER INFO ROSLYN ASU11101 16449109TH AVE SE RENTON WA 98055 D:2533590763 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
3 4
14 LIABILITY INSURANCE INSURANCE CO GEICO 4479753834
IN EFFECT &POLICY# 9TOP
VEHICLE CHARGE 1 36
LEGALLY YES❑NO❑ CITATION# 10 BOTTOM
15❑ STANDING
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT 02 VEHICLE ❑ CYCLE ❑ ❑ OWNER [:]EA.
YES 1/ NO D:7862857725
16 a
LAST NAME MURPHY FIRST NAME REBECCA MIDDLE L
INITIAL
17 STREET NEW ADOREs�' 4404 SW 127 CT CITY' MIAMI ST FL ZIP 331754137 37
18� CDL ., IGNITION REQUIRED IGNITION PtR—E—S1ENT MEDICAL TRANSPORTED 38
INTERLOCKYES�NO INTERLOCK YEs I I NOF YEs t l NOF,/
19 DRIVER'S STATE FL SEX IF D.C.B. 04 22 _ 1994 39
LICENSE# MMDDYY
20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 HELMET 2 INJURY 6 NATURE OF INJURIES 40
USE CLASS NECK PAIN
❑ILICENSE 21❑ PLA E# 8PWR144 TATE 41
WA VIN1 3FA6POD95LR191827 1
42
22❑ PLATE# STATE PLATE# STATE
23❑ VIN#. 43
TRLR RLR
'IN#.
VEH YEAR 2020 MAKE FORD MODEL FUSION STYLE SD VEHICLETOWED TO BLIN TOWEDBY GOV HI 44
L4❑ DAMAGE YES NO YES NO
REGISTERED OWNER INFO REBECCA MURPHY4404 SW 127 CT MIAMI FL 331754137 D:7862857725 VEHICLE NO.2
SHADE IN DAMAGED AREA
2 3 4
INAEFFITY ECTNSURANCE❑ &POINSULICY#E CO NA I 9TOP 5
VE."LE ES❑ N J
,J� CITATION# CHARGE i o BOTTOM
LEGALLY Y
25 s � e
=TURNER
NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
26 12650 WA0171300
PART A PAGE 01 OF
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. ED38547
COLLISION REPORT III III III III III 111
1591972 CASE# 23-2266
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
PM 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.
JASON TURNER 02-26-23 09:45 PM
NVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
DESIRES SCOTT 10272 31112023 11:39:18 AM
BADGE OR ID# 12650 OR]# WA0171300 TIME POLICE DISPATCHED! 7:39 Pry TIME POLICE ARRIVED:8:25 PM
PART Ei PAGE IT]OF 4�
REPORT NO. ED38547 CASE# 23-2266 OF COLLISION
02/24/23 19:30
OF CbLLI510N
NARRATIVE
23-2266
On 02/26/2023 at approximately 1930 hours I was working as a Police Officer for the city of Renton.
While working I was dispatched to a blocking vehicle collision at 2022 S Puget Drive, Renton, King
County, Washington.
Unit 1 Driver: Rosyln A. Ancheta (DOB: 03/18/1980)
Unit 1 Vehicle: White 2019 Acura TLX (WA LIC: BLZ6860)
Unit 2 Driver: Rebecca L. Murphy (DOB: 04/22/1994)
Unit 2 Vehicle: Silver 2019 Ford Fusion (CA LIC: 8PWR144)
Unit 1 was attempting to turn right out of the parking lot of the 76 Gas station located just north of the
intersection of Benson RD S and S Puget DR. Unit 2 was driving in a straight line south bound on
Benson RD S at approximately 30MPH. Unit 1 attempted to make a right turn out of the gas station
parking lot as Unit 2 was approaching. Unit 1 pulled out as unit 2 was approaching, causing a
collision. Unit 2 T-Boned Unit 1.
Unit 1 had airbag deployment in multiple areas of their vehicle. Unit 1 had significant damage to the
driver's side of their vehicle, the damage was well above $1000. The unit 1 driver had minor pain in
their leg.
Unit 2 had no airbag deployment. Unit 2 had significant damage to the front end of their vehicle, well
above $1000. The unit 2 driver had minor pain in their neck.
Both drivers were treated by fire on scene and cleared. Unit 2 could not provide insurance information
as it was a rental vehicle. She stated she had insurance on the vehicle but could not find it at the
time. I provided both drivers with an exchange of information that included each other's phone
number.
I declare under penalty of perjury under the laws of the State of Washington that the foregoing is true
and correct.
Electronically signed by J. Turner 12650 on 02/26/2023 at 2124 hours
PAGE 3 OF 4
REPORT NO. ED38547 CASE# ' 23-2266 DATE AND TIME 02/24/23 19:30
OF COLLISION
47
Lo
}; oY
,
)
SPugetL?r � �
PAGE 4 OF 4