HomeMy WebLinkAbout23-0969 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 0 27c
COLLISION REP FIT 1591971
CASE 23-0969 z
INTERSTATE ❑ CITY STREET FIRE ❑RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHICI F ❑ LOCAL AOENC 4200 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 01 - 1-- 2023 1254 17 ❑.❑ S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓
ANACORTES AVE NE BLOCK ST e✓
MILEPOST 1200
4a❑
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ ❑ FEET e S ❑ W e 0 1 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
,/No D:4253064767 1 51
30
6� LAST NAME KING FIRSTNAME WILLIAM MIDDLE R 1 1 2 31
INITIAL
STREET ❑✓ 17011 SE 136TH ST CITY RENTON ST WA 21p 98059 z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
INTERLOCK YES[:]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
10 9❑ PI ATFBit BPW6750 sTArI WA urN#' 5NPE24AF2KH759717
TRAILER STATE TRAILER STATE
11 2 5 PLATE# PLATE# FRom ro
TRLR. TRLR. 5 1 33
12 2 5 VIN#' VIN#
FROM TO
VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE Q 0 34
13 2 2019 HYUN SONATA SD DAMAGE YES NO YES[:] No✓
REGISTERED OWNER INFO OWNEDBYDRIVER VEHICLE NO. 1
SHADE IN DAMAGED AREA ❑ 35
14 LIABILI INSURANCE INSURANCE CO STATE FARM 3726285-C23.47C 3 4
IN EFFECT &POLICY# STOP
15❑ LE
vECALLv Hla.e 5 36
res❑NO❑ CITATION# CHARGE 1 o BOTTOM
STANDING 8 7 6
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UN�T VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YEs NO 1/ D:2533397011
16 a
LAST NAME ACOSTA MALDONADO FIRST NAME RAMIRO MIDDLE E
INITIAL
17❑ STREET ❑' 7406187TH ST CT E CITY' PUYALLUP ST' WA ZIP 98375 37
NEW ADDRESS ❑
18� CDL IGNITION REQUIRED IGNITION PR—E-1SENT MEDICAL TRANSPORTED 38
INTERLOCKYES�NOR INTERLOCK YEs It I NOF YES t t— l NO❑
19 DRIVER'S STATE WA SEX M D.Q.B. 07 31 1992 39
LICENSE# MMDDYY
WELMET INJURY1 NATURE OF INJURIES 40
20❑ ON DUTY STATUS AIRBAG 1 RESTR 4 EJECT 1 USE CLASS ❑
21❑ LICENSE 66282D TAre WA VINE 1FVACXFC2KHKJ7791
❑ 41
PLATE#
42
22❑ PILER LATE# STATE pLATE# STATE
23❑ VIN#. 43
TRLR RLR
'IN#.
VEH YEAR 2018 MAKE ELGN MODEL M2 STYLE SS VEHICLETOWED TO BLIN TOWEDBY GOV HI 44
L4❑ DAMAGE YES NO YES NO
REGISTERED OWNER INFO CITY OF RENTON 1055 S.GRADY WAY RENTON WA 98055 D:4254307500 VEHICLE NO.2
SHADE IN DAMAGED AREA
2 3 4
LIABILITY INSURANCE INSU&PORGY#ECO WASHINGTON STATE INSURANCE FLEET COVERAGE 1 STOP 5
IN EFFECT
'E""LE ❑ N`L J
,J� CITATION# CHARGE
LEG
25 i o BOTTOM
ALLY YES $ '
=KI
(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
J
26 12598 WA0171300
PAGE 01 OF
PART A
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. ED37024
COLLISION REPORT III III III III III 111
1591972 CASE# 23-0969
ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY)
NAME
(/AST 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'
On Monday, January 23, 2023 at 1300 hours, I was dispatched to a two-vehicle collision in the area
of Anacortes Ave NE and NE Sunset Blvd.
The following occurred within the City of Renton, King County; Unit 1 - WA/ BPW6750 was being
driven by William King and was driving northbound on Anacortes Ave NE in the 1200 block. Unit 2 -
WA/ 66282D was driven by Ramiro Acosta and was operating in the northbound lane in the 1200
block of Anacortes Ave NE. William stated he had just exited the McDonald's property onto Anacortes
AVE NE and began driving behind Unit 2. William stated he wanted to turn into the parking area of
Ace True Value, so he began to pass Unit 2 on the lefthand side. William stated Unit 2 started to back
up while he was trying to pass and stated he was unable to avoid colliding with Unit 2. The front
bumper of Unit 1 crashed into the rear bumper of Unit 2. The driver of Unit 2 stated he was operating
the City of Renton Street sweeper and had the appropriate lights activated. Ramiro stated he had just
cleaned the middle portion of Anacortes Ave NE and was making a second pass to clean closer to
the curb in the northbound section of roadway when he approached the driveway for Ace True Value,
he stopped and began to back up to vacuum up the debris. Ramiro stated he did not observe Unit 1 in
the rear-view mirrors or camera before the collision occurred.
Both vehicles sustained damage and neither vehicle needed to be towed.
I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT.
J.WISNIEWSKI 01-23-23 02:31 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY E
DAT
J.CHRISTIANSEN 10437 2/24/2023 6:15:48 PM
BADGE OR ID# 12598 ORI# WA0171300 TIME POLICE DISPATCHED' 4:00 PM TIME POLICE ARRIVED 4:08 PM
PART I PAGE IT]OF
REPORT NO. ED37024 CASE# ' 23-0969 DATE AND TIME 01/23/23 12:54
OF COLLISION
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