HomeMy WebLinkAbout23-14420 POLICETRAFF'c" III !�� I IIIllI111IN II II I REPORT NO. EE35791 170
27
COLLISION REP FIT 1591971
CASE 23-14420 z
INTERSTATE ❑ CITY STREET FIRE ❑RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHICI F ❑ LOCAL AOENC 4150 3
HIT&RUN CODING'
COUNTY RD PRIVATE WAY INVOLVED
2❑ TOTAL#TRIBAL OF 02 OBJECT 1 1 8 28
UNITS
RESERVATION I
STRUCK
z
3 DATE OF M M D D Y Y Y Y TIME(2400) COUNTY# MILES N E IN CITY#
cawsloN 12 - 1-- 2023 2208 17 ❑.= S IN 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
S 3RD ST BLOCK e✓ 300 ❑
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ ❑ FEET e S ❑ W e RAINIER AVE S
0 4 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
NO D:2246598566 0 1 30
6❑ LAST NAME SARABIA FIRSTNAME EDUARDO MIDDLE J 1 1 2 31
INITIAL
STREET ❑✓ 206 12TH AVE S UNIT A511 CITY SEATTLE ST WA ZIP 98122 z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
iNTERLOCKYEs NO 1/ INTERLOCKYEs NO�/ YES R No�/
8❑ LDRIVER # STATE WA SEX'M MID
-O B 01 — 28 — 1993 1 2 32
9 ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 HELMET
2 CLASS 1 NATURE OF INJURIES z❑
3
10 9❑ P1 aTES� CJL9223 sTArI WAvIN# WBY43AW05PFR45859
TRAILER STATE TRAILER STATE
11 0 0 PLATE# PLATE# FROM TO
TRLR. TRLR 7 1 33
12 0 0 VIN#' VIN#
:: FROM TO
❑ VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TR Y GOVT.VEHICLE 3 3 34
13 1 2023 BMW 14 SD DAMAGE YES NO �MEYERS YES❑ NO✓
REGISTERED OWNER INFO OWNEDBYDRIVER VEHICLE NO. 1
SHADE IN DAMAGED AREA ❑ 35
14❑ LIABILI INSURANCE INSURANCE CO GEICO 4475-80.13.06 4
IN EFFECT &POLICY# TOPVEHCLE CHARGE 36
LEGALLY YES❑NO❑ CITATION# <1�3
OTTOM
15❑ STANDING 7 6
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT VEHICLE ❑ CYCLE ❑ ❑ : OWNFR ❑ YES 1/ NO D:2063717554
16 2
LAST NAME HENDERSON FIRST NAME DANIELLE MIDDLE IN
INITIAL
17 STREET❑ NEW ADORE SS❑' 12041 64TH PL S CITY SEATTLE ST' WA ZIP 98178 4❑ 37
18❑ CDL IGNITION REQUIRED IGNITION PR—E-1SENT MEDICAL—T�RANSPORTED � 38
INTERLOCKYES�NO� INTERLOCK YEs It I NOF YES
t l NOF,/
19 D IVEW #
❑ ON DUTY STATUS AIRBAG,2 RESTR 2 EJECT 1 HELMET 2 INJURY 7 NATURE of INJURIES ❑ 40
USE CLASS ISOREBODY
❑21❑ PLATE# RJ8T50 TArE MT vIN1t 1GKKNML42PZ105066 41
1
42
22❑ PLATE# STATE PLATE# STATE
23❑ VIN#. 43
TRLR RLR
'IN#.
VEH YEAR 2023 MAKE GMC MODEL ACADIA STYLE 5D VEHICLETOWED TO BLIN TOWEDBY GOV HI �44
24❑ DAMAGE YES NO YES NO
REGISTERED OWNER INFO DANIELLE HENDERSON 1204164TH PL S SEATTLE WA 98178 D:2063717554 VEHICLE NO.2
SHADEd DAtYGED AREA
4� 4
INAEFFIECTTY NSURANCE❑ &POINSULICY#E CO STOP 5
VE."Le ❑ ,J� CITATION# CHARGE
25 1oBOTTOM
LEGALLY YES N J
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. EE35791
COLLISION REPORT III III III III III 111
1591972 CASE# 23-14420
ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY)
NAME MIDDLE INITIAL) ELIJAH KYNDA/SHA
(IAST FIRST,
ADDRESS&PHONE# D O.B. '
15008 A ST S,APT Ell TACOMA WA 98444 SEXi F MMDDYYYY 12 - 04 - 1999
SEAT HELMET INJURY NATURE OF INJURIES
PASSENGER WITNESS❑!UNIT# 2 POS 3 AIRBAG 2 RESTR. 4 EJECT 1 USE 2 CLASS '7 NATURE
NAME
(LAST,FIRST,MIDDLE INITIAL) KENNEDY AHLAYA
ADDRESS&PHONE# D O B
12041 64TH PL S SEATTLE WA 98178 SEX'. F MMDDvvvv 01 _ 13 _ 2008
SEAT HELMET I INJURY NATURE OF INJURIES
PASSENGER P]WITNESS UNIT# 2 POS 9 AIRBAG'2 RESTR. 2 EJECT 1 USE 2 CLASS 7 BODY SORE
NAME
(LAST FIRST,MIDDLE INITIAL) EASTLANE KAYLA
AppREss&PHONE# 12041 64TH PL S SEATTLE WA 98178 F 09 _ 2007
SEX. D.O.B. _
MMDDYYYY 12
PASSENGER WITNESS UNIT# ! 2 SEAT 7 AIRBAG 2 RESTR. 4 EJECT 1 HELMET 2 NJURY 7 NATURE OF INJURIES
POS. USE CLASS BODY SORE
NARRATIVE'
Unit 2 was traveling eastbound in the left lane on S 3rd ST approaching the 300 block. Unit 1 was
traveling eastbound on S 3rd ST in the right lane. Unit 1 was attempted to make a left turn from the
right lane to enter a business parking lot. Unit 1 crossed into the right lane during the turn and
crossed into Unit 2's line of travel causing the collision. Unit 1's front bumper collided with Unit 2's
front passenger side.
Unit 1 reported no injuries. Unit 1 had significant damage to their front bumper and the vehicle was no
longer driveable. The vehicle was towed by a personal tow company.
Each occupant in Unit 2 reported to be in pain, the driver Danielle Henderson reported that her neck
was very stiff and sore. The front passenger, Kyndaisha Elijah reported that on the impact she had
urinated herself. Kyndaisha reported that the seatbelt had caused her severe stomach pain. Rear
passengers Kayla Eastlane and Ahlaya Kennedy both reported that their bodies' were sore.Fire
checked out all occupants and no major injuries were reported. All occupants reported that they
would get checked out a later date.
Unit 2's vehicle had sever damage to the passenger side front bumper and the passenger side tire
was popped. The vehicle was towed by a private company.
Party's exchanged information. The driver of Unit 1 was cited for Improper Turn as they made a left
turn from the right most lane. Please see attached citation for further information.
I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT.
JASON TURNER 12-16-23 10:17 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
J.CHRISTIANSEN 10437 1 12/31/2023 1:08:46 AM
BADGE OR ID# 12650 ORI#' WA0171300 TIME POLICE DISPATCHED' 10:08 PM TIME POLICE ARRIVED',10:08 PM
PART PAGE IT]OF
REPORT NO. EE35791 CASE# 23-14420 DATE AND TIME 12/15/23 22:08
OF COLLISION
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