HomeMy WebLinkAbout23-3406 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 5 27c
COLLISION REP FIT 1591971
CASE 23-3406 z
INTERSTATE ❑ CITY STREET FIRE ❑RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHIr.I F ❑ LOCAL AOENC 4Y00 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 03 - 1-- 2023 1335 17 ❑-= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
S 3RD ST BLOCK e✓ 400 ❑
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ ❑ FEET e S ❑ VV a MORR/S AVE S
0 1 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
,/No D:4254189132 0 11
30
6� LAST NAME HOWER FIRSTNAME CHARLES MIDDLE H 1 1 2 31
INITIAL
STREET ❑ 8460 171 ST AVE NE CITY REDMOND ST WA 2jp, 980523922 z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
INTERLOCK YES[:]NO 1/ INTERLOCKYEs NO Z/ YES R No�/
8❑ LRIIVER #
ON DUTY❑ STATUS AIRBAG 4 RESTR 4 EJECT 1 HELMET U E 2 1 CLASS NATURE OF INJURIES 2❑
3
10[1PI ATE 14 BQH1129 sTAr WAV N# JTEBU5JROH5426174
TRAILER STATE TRAILER STATE
11 2 5 PLATE# PLATE# Rom ro
TRLR. TRLt2 7 3 33
12 2 5 VIN#' VIN#'
FROM TO
❑ VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN T v GOVT.VEHICLE 5 1 34
13 1 2017 TOYT 4RUNNE UT DAMAGE YES NO � �MEYERS YES[:] No
REGISTERED OWNER INFO CHARLES HONER 8460 171ST AVE NE REDMOND WA 98052 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
14 LIABILITY INSURANCE U INSURANCE CO USAA 04873 94 79G 7102 3
IN EFFECT &POLICY# 9TOP
vENICLE CHARGE 5 36
LE ALLY YES❑NO CITATION# 3A0357389 INATTENTIVE DRIVING o Sorrom
15❑ STANDING 8 6
1.' MOTOR PEDAL- PROPERTY DAM THR OLD MET PHONE
UNIT a2 VEHICLE CYCLE ❑ PEDESTRIAN ❑ OWNER ❑ YES�/ NO D:2069811457
16 a
LAST NAME MARTIN FIRST NAME SAMUEL MIDDLE I D
INITIAL
17❑ NEW ADDRE— 429 MOSTREET RRIS AVE S CITY' RENTON ST WA ZIP 98057 4❑ 37
18❑ CDL IGNITION REQUIRED IGNITION PtR-E-S1ENT MEDICAL-T�RANSPORTED � 38
INTERLOCKYES�NO� INTERLOCK YEs I I NOF YEs t l NOF,/
19 DRIVER'S STATE I WA SEX M D.C... 07 29 _ 1990 39
LICENSE# MMDDYY
20❑ ON DUTY STATUS I
AIRBAG 3 RESTR 4 EJECT 1 H U EET 2 NJAURSY 1 NATURE OF INJURIES ❑ 40
❑ 41
21❑ ILICENSE PLA E# BYG1039 TArE WA VIN# SALVP28GOGH081299 1
42
22❑ PLATILER E# STATE PLATE# STATE
23❑ 43
TRLR RLR
VIN#. IN#.
TOWED BV Gov HI 44
VEH YEAR 2016 MAKE LNDR MODEL RANGE STYLE UT —FEHICLE
TOWED✓ NOO BLIN GENE MEYERS YES No�/
24❑ REGISTERED OWNER INFO OWNED BY DRIVER VEHICLE N0.2
SHADEDAMAGEDAREA
3 4
LIABILITY
INSURANCE INSU8 PORGY#E CO PROGRESSIVE 960 556 015IN STOP 5
VE""LE ❑ Nu,J CITATION# CHARGE
LEGAL io BOTTOM
LY YES
25 ' a
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
J
26
C.JAC08S 1953 WA0171300
PART A PAGE 01 OF C7
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. ED52749
COLLISION REPORT III III III III III 111
1591972 CASE# 23-3406
ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY)
NAME MIDDLE INITIAL) KWIK ANDREW C
(LAST FIRST,
ADDRESS&PHONE# D O.B. '
8700 42ND AVE S SEATTLE WA 98118 2069412171 SEX M MMDDYyry 09 - 07 - 1984
PASSENGER WITNESS UNIT# SEAT AIRBAG I RESTR. EJECT ' HELMET INJURY NATURE OF INJURIES
❑✓ ; POS. ' USE CLASS
NAME
(LAST,FIRST,MIDDLE INITIAL)
ADDRESS&PHONE# D O B
SEX MMDDYYYY
PASSENGER []WITNESSO 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 3-25-23 at about 1437 Officer Jibril and I were on walking patrol in the downtown corridor when
we were flagged down for a 2 vehicle collision that had recently occured in the 500 block of S 3rd St.
We contacted both vehicles still in the roadway. Both vehicles were disabled and required towing
from the scene. Both drivers identified themselves via WADL. Witness Andrew Kwik told me; He
was driving eastbound in the same direction as unit 1 when unit 1 ran the red light and collided with
unit 2. Driver 2 gave me a similar version of events. Driver 1, Charles Hower told me; He thought
the light was green, but he's been told he ran red light just prior to the collision. Gene Meyers towed
both vehicles from the scene at the drivers request. I cited driver 1, Hower for inattention via
complaint.
This collision occurred in the city of Renton, County of King.
I declare under peanity of perjury under the laws of Washington state that the foregoing is true and
correct.
C. Jacobs/1953
I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT.
C.JACOBS O4-18-23 12:13 AM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
G.BARFIELD 6476 1 411912023 7:05:33 PM
BADGE OR ID# 1953 OR]# WA0171300 TIME POLICE DISPATCHED; 1:37 PM TIME POLICE ARRIVED';1:37 PM
PART I PAGE IT]OF
REPORT NO. ED52749 CASE# ' 23-3406 DATE AND TIME 03/25/23 13:35
OF COLLISION
S. 3rd Street
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