HomeMy WebLinkAbout23-3256 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 0 27c
COLLISION REP FIT 1591971
CASE 23-3256 z
INTERSTATE ❑ CITY STREET FIRE ❑RESULTED
1 STATE ROUTE OTHER STOLEN
❑ ❑ HFHIC;I F ❑ LOCAL AOENC 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 0447 17 ❑. S 8 W Li OF e 1070 3
4 4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
LIND AVE SW BLOCK NO. e✓ 1900
4a 9❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ ❑ FEET e S ❑ W e SW 19TH ST
0 1 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
✓NO D:2067659627 0 11
30
6� LAST NAME ZANARINI FIRSTNAME GRICEL MIDDLE Y 1 1 2 31
INITIAL
STREET ❑ 3032 60TH AVE SW APT 4 CITy SEATTLE ST WA ZIP, 981165805 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 9 EJECT 1 H U SE
ICNLJAUSSY 1 NATURE OF INJURIES z❑
3
10 9❑ P1 aT�S� CAB5570 sTArI WAvIN# 19XF62F52FE276263
-- TRAILER STATE TRAILER STATE
11 3 5 PLATE# PLATE# FROM To
TRLR. TRLR 7 3 33
12 3 5 VIN#j VIN#
:: FROM TO
VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE 5 1 34
13 2 2015 HOND CIVIC SD DAMAGE YES NO YES[:] No✓
REGISTERED OWNER INFO GRICELZANARINI303260THAVESWAPT4 SEATTLEWA98116 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
14 LIABILITY INSURANCE NSURANCE CO GEICO 6038-26.06.23 3
IN EFFECT &POLICY# 9TOP
vewcLE CHARGE 5 36
LECALLv YEs❑NO❑ CITATION# 10 BOTTOM
15❑ NDING 8 7 6
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT 02 VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES 1/ NO PHONE
2067249472
16 a
LAST NAME ALVARADO ROMERO FIRST NAME MARVIN MIDDLE R
INITIAL
17❑ STREET ❑', 1432 S 129TH ST CITY' BURIEN ST WA ZIP 981682882 37
NEW ADDRESS ❑
18� CDL IGNITION REQUIRED IGNITION PRESENT MEDICALTRANSPORTED 38
INTERLOCK YEs❑NOR INTERLOCK YEs❑NOF YEs❑NO❑
19 LDIIVERI # STATE WA SEX M M .C.B. 08 _ 16 _ 1982 0 39
WELMET INJURY1 NATURE OF INJURIES 40
20❑ ON DUTY STATUS AIRBAG 2 RESTR 9 EJECT 1 USE CLASS ❑
21❑ LICENSE I C75345Y TAre WA vIN# JALC4W163N7015774
❑ 41
PLATE#
42
22❑ PLATE# STATE PLATE# STATE
TRLR
23❑ VIN#. IN#. 43
RLR
'
VEH YEAR 2022 MAKE ISU MODEL NPR STYLE VEHICLETOWED TO BLIN TOWEDBY GOV HI 44
L4❑ DAMAGE YES NO YES NO
REGISTERED OWNER INFO PENSKE LEASING AND RENTAL COM 1284048TH AVE S TUKWILA WA 98168 VEHICLE NO.2
SHADE IN DAMAGED AREA
2 3 4
LIABILITY INSURANCE INSU&PORGY#ECO NORTH POINTEINSURANCE COMPANY 100155886
IN EFFECTVEHICLE ❑ ,.I—I CITATION# CHARGEC�Ql
LEGALLY YES N`E]
25 s 7 6
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# JAGENCY
26
JESSE VANDERHOEK 11631 WA0171300
PART A PAGE 01 OF C7
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT No. ED44117
COLLISION REPORT III III III III III 111
1591972 CASE# 23-3256
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'
Vehicle #1 was traveling eastbound in the 500 block of SW 19th St, approaching Lind Ave SW.
Vehicle #2 was traveling northbound in the 1900 block of Lind Ave SW approaching SW 19th St.
Vehicle #1 proceeded through this intersection without stopping, due to the fact that the stop sign that
was supposed to be there for eastbound traffic was missing. It is unknown why this stop sign was
missing. It should be noted police confirmed this stop sign was not in place. As vehicle #2
proceeded northbound on Lind Ave SW approaching SW 19th St, the front end of vehicle #2 collided
with the back right corner of vehicle #1. Due to the fact the stop sign for eastbound traffic on SW 19th
St was missing, it is unknown which driver caused this collision.
I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT.
JESSE VANDERHOEK 03-21-23 07:36 AM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
D.SKELTON 9139 1 312112023 7:40:57 AM
BADGE OR ID# 11631 OR]# WA0171300 TIME POLICE DISPATCHED 4:51 AM TIME POLICE ARRIVED 4:58 AM
PART I PAGE IT]OF 3�
REPORT NO. ED44117 CASE# 23-3256 DATE AND TIME 03/21/23 04:47
OF COLLISION
I
i
Not t0 scale y
Q
C
J
SW 19th St
i
*Strap sign missing e 1
I
,:Vehicle#2
i
I'
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