HomeMy WebLinkAbout23-12340 TFFiNouCERA II I l�� I III � I III I �IIII III II I . 2 27c
COLLISION REP FIT 1591971
CASE 23-12340 z
INTERSTATE ❑ CITY STREET FIRE ❑RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHICI F LOCAL AOENC 4250 3
HIT&RUN CODING'
COUNTY RD PRIVATE WAY INVOLVED
2❑ TOTAL#OF OBJECT 1 1 8 28
TRIBAL UNITS . 03 STRUCK
RESERVATION
z
3 DATE OF M M D D Y Y Y Y TIME(2400) COUNTY# MILES N E IN CITY#
GawsloN 10 - 27 - 2023 1635 17 ❑.= S IN 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
SUNSET BLVD NE BLOCK NO. e✓ ❑
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ ❑ FEET e S ❑ OF ABERDEEN AVE NE
0 5 29
UNIT 01 V�IOCLE CYCLE ElDYESA/NO FGETHRESHOLD MET PHONE 0 7 30
6❑ LAST NAME UNKNOWN FIRSTNAME MIDDLE 1 2 31
INITIAL
STREET ❑ CITY FRESNO ST ZIP 2
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNIT{ON PRESENT MEDICAL TRANSPORTED 3
iNTERLOCKYEs NO 1/ INTERLOCKYEs NO�/ YEs No�/
8 DRIVER'S. STATE SEX.U D.O.B. 1 1 2 32
❑ :LICENSE# MMDDYY —❑
9 ON DUTY❑ STATUS I
AIRBAG 9 RESTR 9 EJECT 9 H USEEr 9 CLAY 0 NATURE OF INJURIES zICE ❑
3
10 9❑ P1 ATNFS14 8VDU194 STATE CA VIN# KNDJ23AU2M7779965
TRAILER STATE TRAILER STATE
11 3 5 PLATE# PLATE# FR.. ro
TRLR. TRLR. 7 7 33
12 0 0 VIN#' VIN#'
>; FROM TO
❑ VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TR Y GOVT.VEHICLE 9 9 34
13 4 2021 KIA SOUL 4H DAMAGE YES NO �MEYER YES❑ NO✓
REGISTERED OWNER INFO BRIDGETTE MARTINEZ 2714 E HEDGES AVE FRESNO CA 93703 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
14❑ ABILIT INSURANCE❑ INSURANCE CO 3 4
IN EFFECT &POLICY#
VE 9TOP
HICLE CHARGE 5 36
LECALLv Yes❑NO❑ CITATION# 10 BOTTOM
15❑ STANDING 7 6
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
16
UNIT 02 VEHICLE ❑ CYCLE ❑ ❑ OWNFR ❑ YES NO ,/ D:2068228216
a
LAST NAME WONG FIRST NAME JEANISE MIDDLE N
INITIAL
17❑ STREET ❑', 3818 NE 12TH ST, CITY' RENTON ST WA ZIP 98056 37
NEW ADDRESS ❑
18� CDL IGNITION REQUIRED IGNITION PR—E-1SENT MEDICAL—T�RANSPORTED ❑ 38
INTERLOCK YEs❑No� INTERLOCK YEs It I NOF YES
t l NOF,/
19 DRIVER #
{NJURY 1 NATURE OF INJURIES 40
20❑ ON DUTY STATUS AIRBAG 2 RESTR 9 EJECT 1 USE 2 CLASS ❑
21❑ LICENSE I CHT2305 TATe WA vIN# WBA365G51FNS19760
❑ 41
PLATE#
42
22❑ PLATE# STATE PLATE ILER# STATE
23❑ 43
TRLR RLR
UIN#. 'IN#.
VEH YEAR 2015 MAKE BMW MODEL 828 STYLE 4D VEHICLETOWED TO BLIN TOWEDBY GOV HI �44
L4❑ DAMAGE YES NO YES NO
REGISTERED OWNER INFO KAHSOON WONG 3818 NE 12TH ST RENTON WA 98056 VEHICLE NO.2
SHADE IN DAMAGED AREA
2 3 4
LIABILITY INSURANCE INSU&PORGY#E CO LIBERTY MUTUAL AOS2610773649039 I STOP 5
IN EFFECT
VEHICLE YES N CITATION# CHARGE i o BOTTOM
LEGALLY �
25❑ s
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# JAGENCY
26
N.ODALOV/C 11628 WA0171300
PAGE 01 OF
PART A
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT No. EE14814
COLLISION REPORT III III III III III 111
1591972 CASE# 23-12340
ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY)
NAME MIDDLE INITIAL) M/TCHENER MARYA
(LAST FIRST,
ADDRESS&PHONE# D O.B. '
3431B 22ND AVE INSEATTLE WA 98199 2063692132 SEXi F MMDDYyry 01 - 18 - 1972
PASSENGER WITNESS SEAT ! AIRBAG RESTR. EJECT ' HELMET INJURY NATURE OF INJURIES
❑ Z UNIT# POS. USE CLASS
NAME
(LAST,FIRST,MIDDLE INITIAL)
ADDRESS&PHONE# DOB
SEX' MMDDYYYY
PASSENGER ❑WITNESS❑ UNIT# SEAT AIRBAG RESTR. EJECT HELMET NJURY NATURE OF INJURIES
POS. USE CLASS
NAME
(LAST FIR57 MIDDLE INITIAL)
AppRESS R PHONE#
SEX D.O.B.MMDD -❑
YYYY.
PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET NJURY NATURE OF INJURIES
❑ ❑ POS. USE CLASS ----�
NARRATIVE'
U1 was a reported stolen vehicle and was driving eastbound in lane two on Sunset Blvd NE and had
attempted to make an illegal u-turn to drive westbound on Sunset Blvd NE. U1 was reported to have
been driving recklessly. When U1 made the u-turn, U1 struck U2 who was traveling eastbound in lane
one of Sunset Blvd NE. U1 subsequently struck U3 who was in lane one traveling westbound on
Sunset Blvd NE. The driver of U2 and a witness on scene stated they saw five juveniles flee from U1
on foot. Please see other officer's narratives for further information regarding the recovery of the
stolen vehicle and the occupants. There were no reported injuries. U2 sustained damage to the left
side of the vehicle and was in drivable condition. U1 sustained heavy front-end damage and had all
airbags deployed. U3 sustained damage to the front left tire and left side of the front bumper and was
not drivable. U 1 and U3 were towed by Gene Meyer Towing.
I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT.
N.ODALOV/C 10-27-23 08:56 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY E
DAT
DESIRES SCOTT 10272 1013112023 7:14:21 AM
BADGE OR ID# 11628 OR]# WA0171300 TIME POLICE DISPATCHED 4:35 PM TIME POLICE ARRIVED 4:35 PM
PART B PAGE IT]OF 4]
SUPPLEMENTAL REPORT NO. EE 1 48 1 4
r`I POLICE TRAFFIC 1 1 8 27
COLLISION REPORT CASE# 23-12340
1 COMMERCIAL MOTOR CARRIER INTERSTATE INTRASTATE G
UNIT'# USL70r !CC# VEHICLE TYPE CARGO BODY
TYPE
❑ 1 28
2
CARRIER
NAME
3 CARRIER L
ADDRESS `
CITY ST' ZIP'
4 ❑ NAME # PLACARD: :❑
GINAME IF NO NUMBER
SOURCE AXLES +
4a ❑ ADDITIONAL UNITS
MOTOR PEDAL-
PROPERTY DAMAGETHRESHOLD MET PHONE
5 ❑ UNIT# 3 VEHICLE t_"J � PEDESTRIAN YEs NO
0 1 29
LAST NAME HRECHYLO FIRST NAME OLEKSANDR MIDDLE A
INITIAL
STREET 30
❑ NEWAnnRFSP 2111 SHATTUCKPL S CITY RENTON ST WA ZIP 98055
6 CDL IGNITIttN REQUIRED IGNITION PRESENT MEDICAL TAN5PORTED 1 1 2 31
INTERLOCK YEs NO zERLOCK YES❑N0� vES N
DRIVER'S
LICENSE STATE I WA SEX M MMDDYYv', 02 TO]
- 2005
7
ON DUTY� STATUS AIRBAG' 2 RESTR. g EJECT 1 HELMET 2 INJURY 1 NATURE OF INJURIES
USE CLASS
8 ❑ 1 32
LICENSE I CKF4406 [TAT WA VIN# 3N1AMAML703104
PLATE#
9 9] TRAILER TRAILER
PLATE# STATE PLATE If STATE
10 ❑ TRLR TRLR
VIN.#. VIN.#.
11 3 5 VEH.YEAR2012 MAKE NISS MODELSENTRA STYLE 4D VEHICLE TOWS E T SABLI T ';t9Le�'ER Gf1VT VFHIG P FROM TO
DAMAGE YES NO YES NO
REGISTERED OWNER INFO OWNED BY DRIVER ] 33
12 SHADE IN DAMAGED AREA
7 j 4 FROM TO
LIABILITY INSURANCE INSURANCE CO UNKNOWN 973930483 q"i"Olx
IN EFFECT &POLICY#
VEHICLE 1 o BarroM 34
13 ❑ LEGALLY YES[:] NO❑ CITATION# CHARGE p�
❑ STANDING dRDD PROPERTY FDAM NHRHOLD MET lJ 7 6
35
VEHICLE CYCLE OWNER ESGO
14 UNITr AL PHONE
[1
15 LAST NAME FIRST NAME I INITIAL
AL '.
❑ 36
STREET
16 NEW AnntxFs� CITY ST ZIP
CDL IGNITION REdUiRED IGNITION PRESENT MEDICALTANSPORTED
INTERLOCK YES No INTERLOCK YEs NO YES NO El
17 37
LICENSE# STATE SEX MMDDDYBYY
18 ❑ ON DUTY� STATUS AIRBAG RESTR. ; EJECT HELMET INJURY NATURE of INJURIES 38
USE ICLASS
19 ❑ 39
LICENSE VIN#
PLATE# rnr
20 ❑ TRAILER' TRAILER El40
PLATE#< STATE PLATE If STATE
21 ❑ TRLR TRLR 41
VIN# YIN#i
42
22 VEH.YEAR MAKE I MODEL STYLE I VEHICLE TO DUET SABLIN TOWED BY GOVT.VEHICLE
DAMAGE YES NO YES NO
23 REGISTERED OWNER INFO_ SHADE IN DAMAGED AREA 43
3 a 71
LIABILITY INSURANCE INSURANCE CO '
VINE
EFFECT &POLICY# i 970P - 4 E:l
44
24 LEwcLE YES❑ NO❑ CITATION# CHARGE iq 60TiOM
C=DLv
STANDING 8 7 6
1 CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT.
N.ODALOVIC 10-27-23 08:56 PM
25 INVESTIGATING OFFICER'S SIGNATURE OFFICER'S PHONE UNIT OR DIST DET DATED: PLACE SIGNED
APPROVED BY DATE
26 ORID# 11628 O#II,WA0171300 SCOTT 10131/202 PAGE F OF 4
3000-345-013 fR 1111B,
EE14814 CASE 23-12340 DATE AND TIME 10/27/2316:35
OF COLLISION
PAGE 4 OF *