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HomeMy WebLinkAbout23-3098 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 5 27c COLLISION REP FIT 1591971 CASE 23-3098 z INTERSTATE ❑ CITY STREET FIRE ❑RESULTED 1 STOLEN STATE ROUTE ❑ OTHER ❑ VFHICI F ❑ LOCAL AOENC 4Y00 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# ❑ cawsloN 03 - 1-- 2023 0751 17 ❑.= S 8 IN e 1070 3 4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓ S GRADY WAY BLOCK NO. e✓ 355 4a❑ MILEPOST DISTANCE OF(REFERENCE OR CROSS STREET) 5❑ 135 00 FMILES EET e S ❑ E e L AVE S 0 1 29 MOTUNIT U1 VEHICR Z PEDAL-CLE CYCLE ElYESA,G/E NHORESHOLD MET PHONE 0 8 30 LAST NAME MARTINS BOECHAT MCLAUGHLIN FIRST NAME CAMILA MIDDLE N 6 INITIAL 1 1 2 31 STREET ❑, 11720 SE 165TH ST CITY RENTON ST WA ZIP 980585349 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 2 RESTR 4 EJECT 1 H USEET ICNLJAURY 1 NATURE OF INJURIES z❑ 3 10 1❑ PI ATE 14 BBA0881 STATE WA V N# JHLRD78834CO39820 TRAILER STATE TRAILER STATE 11 3 5 PLATE# PLATE# IR.. ro —1 1TRLR. TRLR $ 7 33 12 VIN#' VIN# ROM TO VEH.YEAR 2004 MAKE MODEL STYLE VEHICLE TOWED TO BLIN T Y GO VT.VEHICLE J 9 34 13 2 HOND CR-V DAMAGE YES NO �OEYER YES❑ NO✓ REGISTERED OWNER INFO MATTHEW MCLAUGHLIN 2300 JEFFERSON AVE NE APT H23 RENTONWA98056 VEHICLE NO. 1 ❑ SHADE IN DAMAGED AREA 35 14 ABILI V INSURANCE INSURANCE CO SAOE. 3 4 IN EFFECT &POLICY# 9TOP VEHICLE CHARGE 5 36 LEGALLY YES❑NO❑ CITATION# 3AO081083 INATTENTIVE DRIVINGMOTO I o eorrom 15❑ STAIN.D'ING 7 6 UNIT 02 VE ICCLE CYCLE ❑ PEDESTRIAN ❑ riWNFRRT ❑ DYES✓ NO OLD MET PHONE 16 a LAST NAME EDORA FIRST NAME RAQUEL MIDDLE I C INITIAL 17 STREET I❑ s❑' 2110 MONTEREY CT SE CITY RENTON ST WA ZIP 980554561 4❑ 37 NEW ADOREs 18❑ CDL IGNITION REQUIRED IGNITION PtR—E—S1ENT MEDICAL—T�RANSPORTED ❑ 38 INTERLOCKYES�NOR INTERLOCK YEs I I NOF YEs t l NO❑ 19 LICENSE# STATE WA SEX F M .C.B. 04 20 _ 1973 El 39 WELMET INJURY1 NATURE OF INJURIES 40 20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 USE CLASS ❑ ❑21❑ PLATE# CES1670 TATe 41 WA vIN# SYJYGDEE6MF210412 1 42 22❑ PLATE# STATE PLATE# STATE 23❑ UIN#. 43 TRLR RLR 'IN#. VEH YEAR 2021 MAKE TESL MODEL MODEL Y STYLE VEHICLETOWED TO BLIN TOWEDBY GOV HI 44 L4❑ DAMAGE YES NO✓ YES NO✓ REGISTERED OWNER INFO RAQUEL EDORA 2110 MONTEREY CT SE RENTON WA 98055 VEHICLE NO.2 SHADE IN DAMAGEbAREA 2 3 Cd INAEFFITY ECTNSURANCE INSU&POLICY#E CO SAOE. IU 9TOP 'E""LE CITATION# CHARGE o BOTTOMLEGALYYES Nu25❑ OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# 26 M.LEVERTON 2517 [V7�ENCY A0171300 PART A PAGE 01 OF C7 3000-345-159 OR 11/181 STATE OF POLICETRAFFICN CORRECTION REPORT NO. ED43179 COLLISION REPORT III III III III III 111 1591972 CASE# 23-3098 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' 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 03-16-23 09:01 AM INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED APPROVED BY DATE CO.JOHNSON 0505 311712023 10:00:39 AM BADGE OR ID# 2517 ORI# WA0171300 TIME POLICE DISPATCHED 7:51 AM TIME POLICE ARRIVED',7:55 AM PART I PAGE IT]OF 4� REPORT NO. ED43179 CASE# 23-3098 OF COLLISION 03/16/23 07:51 OF CbLLI510N NARRATIVE wht sedan In 2 eb stop slv suv/1 rear ph rang CC Within the city limits of Renton/King/WA I responded to a 2 car blocking crash at about the 355 block of S Grady Way. I contacted the driver of unit 1 still blocking westbound lane 2.Unit 1 was ID'd by her picture WADL. She told me she looked down and back up, not realizing traffic had stopped in front of her and rear- ended unit 2. She did not complain of injury and damages did require a tow truck. I contacted the driver of unit 2 who told me she was stopped for red light/traffic when she was hit from behind by unit 1. She told me that unit 1 told her she was answering the phone. She did not complain of injury and damages did not require a tow truck. When I told unit 1 what unit 2 said, she told me that she did not answer the phone, that it rang and she looked down at her phone then looked up when she hit unit 2. 1 cited unit 1 via complaint Ref RM 10-12-25 Driver Inattention 2 car crash. 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 3/16/2023 PAGE 3 OF 4 REPORT NO. ED43179 CASE# 23-3098 DATE AND TIME 03/16/23 07:51 OF COLLISION nts ,y, t PAGE 4 OF 4