HomeMy WebLinkAbout23-10980 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 6 27c
COLLISION REP FIT 1591971
CASE 23-10980 z
INTERSTATE ❑ CITY STREET FIRE ❑RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHICI F ❑ LOCAL AGENCI 4150 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 TOTAL#OF OBJECT 1 8 28
TR
IBAL UNITS OZ STRUCK
RESERVk710N
z
3❑ DATE of M M D D Y Y Y Y TIME(2400) COUNTY# MILES N E IN CITY#
cowsloN 09 - 1-- 2023 0200 17 ❑-= S 8 IN e 1070 3
4❑ oN (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
BRONSON WAY N BLOCK NO. e ❑
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ ❑ FEET e S ❑ W e SUNSET BLVD N
0 1 29
MOTU '�01 VEHtOR Z CLE CYCCLE. El �ESAGE NHORE✓LD MET PHONE 0 1 30
6❑ LAST NAME UNKNOWN FIRSTNAME MIDDLE 1 1 2 31
INITIAL
STREET ❑ CITY ST ZIP z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
:NTERLOCKYEs NO INTERLOCK YES No YES No
8 DRIVER'S. STATE SEX.U D.Q.B. 1 1 2 32
❑ :LICENSE# MMDDYY —❑
9 ON DUTY❑ STATUS I
AIRBAG 9 RESTR 9 EJECT 1 H USEEr 9 CLAY 0 NATURE OF INJURIES z❑
3
LICENSE srATI urN#'
10❑ PI ATE 14
TRAILER STATE TRAILER STATE
11 0 0 PLATE# PLATE# ROM ro
rRLR. TRLR. 1 5 33
12 0 0 VIN#' VIN#
FROM TO
VEH.YEAR MAKE TOYT MODEL CAMRY STYLE SD VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE R T 34
13❑ DAMAGE YES NO VES❑ NO
REGISTERED OWNER INFO UNKNOWN VEHICLE NO. 1
SHADE IN DAMAGED AREA ❑ 35
14 LIABILITY INSURANCE❑ INSURANCE CO 3 4
IN EFFECT &POLICY# 9TOP
VEHICLE CHARGE 5 36
LEGALLv res❑NO❑ CITATION# 1 o BOTTOM
15❑ STANDING 7 6
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT VEHICLE ❑ CYCLE ❑ ❑ : OWNER ❑ YES 1/ No D:4252695437
16 a
LAST NAME NORBY FIRST NAME ISAIAH MIDDLE J
INITIAL
17 STREET IIN AVE S APT 407 CITY RENTON ST WA ZIP 98057 37
NEW ADOREs�' 107 MA
18� CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL t—T�RANSPORTED 38
INTERLOCK YES❑No� INTERLOCK YES It1 I NoF t l YES NO
19[—] LDI IVEW # STATE WA SEX M MMDDYY 01 07 1988 39
20❑ ON DUTY STATUS AIRBAG 1 RESTR 13 EJECT 2 HELMET 5 INJURY 5 NATURE of INJURIEs ❑ 40
USE CLASS BROKEN LEG
❑21❑ PLATE# SJ1085 TATE WA VIN 41
1HD1LC318FC429510 `1
42
22❑ PILER LATE# STATE PLATE# STATE
23❑ UIN#. 43
TRLR RLR
'IN#.
TOWED eY Gov HI 44
VEH YEAR 2015 MAKE HDMC MODEL TWO STYLE MT DAMAGE TOWED✓ NOO BLIN BANKERS YES NOn
24❑ REGISTERED OWNER INFO OWNED SY DRIVER VEHICLE N0.2
SHADE IN DAMAGED AREA
2 3 4
INAEFFITY ECTNSURANCE❑ &POINSULICY#E CO I VE—LE ❑ ,J� CITATION# CHARGE
25 GQ
LEGALLY YES N`L J
s 7 6
=TURNER
NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
J
26 12650 WA0171300
PART A PAGE 01 OF C7
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EE06432
COLLISION REPORT III III III III III 111
1591972 CASE# 23-10980
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'
Unit 2 was traveling West Bound on Maple Valley Hwy approaching a green light at the intersection of
Sunset Blvd N and Maple Valley Hwy. Unit 1 was driving south bound on Sunset Blvd N approaching
a red light at the same intersection. Unit 2 proceeded through the green light, Unit 1 ran through the
red light and collided with Unit 2. Directly after the collision Unit 1 fled southbound on 1405.
Unit 2 was thrown off of his motorcycle and landed in the middle of the street. Unit 2 reported that his
leg was in extreme pain and belived that it was broken, he also multuple scrapes and bruises from
the impact. Unit 2's vehicle had damage all around totaling more than $1,000.
Unit 1 was described as a silver Toyota mid 2010-2015 Toyota Camry with an unknown license plate.
The vehicle should have front end damage. No one on scene got a description of the driver.
A bystander on scene provided dash cam footage of the incident which was uploaded to evidence.
I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT.
JASON TURNER 09-25-23 04:05 AM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
DESIRES SCOTT 10272 1 101612023 12:36:22 PM
BADGE OR ID# 12650 OR]# WA0171300 TIME POLICE DISPATCHED! 2:06 AM TIME POLICE ARRIVED',Y:06 AM
PART Ei PAGE IT]OF
REPORT NO. EE06432 CASE# 23-10980 DATE AND TIME 09/25/23 02:00
OF COLLISION
N
PAGE 3 OF 3