HomeMy WebLinkAbout23-5953 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 1 27c
COLLISION REP FIT 1591971
CASE 23-5953 z
INTERSTATE ❑ CITY STREET FIRE ❑RESULTED
1 STATE ROUTE OTHER STOLEN
❑ ❑ H F ❑ LOCAL AOENC 3
HIT IT&RUN � CODING
COUNTY RD PRIVATE WAY INVOLVED
2 TOTAL#OF OBJECT 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 05 - 1-- 2023 1456 17 ❑-= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
BL
SW SUNSET BLVD OCK NO. e
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ ❑ FEET e S ❑ OF HARDIEAVESW
0 1 29
MOTU '�01 VEHtOR Z CLE CYCCLE. El �ESAGE NHORE✓LD MET PHONE 0 $ 30
6[ LAST NAME UNKNOWN FIRSTNAME MIDDLE 1 1 2]31
INITIAL
STREET ❑ CITY FEDERAL WAY ST 21P' 2
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNIT{ON PRESENT MEDICAL TRANSPORTED 3
iNTERLOCKYEs NO INTERLOCK YES NO YES No
$❑ LICIENSE#
STA fE I
SEX u MMDOBYY - 1 1 2 32
9 ON DUTY❑ STATUS I
AIRBAG 9 RESTR 9 EJECT 1 H U EEr 9 CLAY 0 NATURE OF INJURIES z❑
3
LICENSE sTATI urN#'
10❑ PI ATE 14
TRAILER STATE TRAILER STATE
11 2 5 PLATE# PLATE# ROM ro
TRLR. TRLR 7 3 33
12 2 5 VIN#' VIN#
FROM TO
❑ VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE R T 34
13 4 UNKN UNKNO DAMAGE YES NO YES❑ NO✓
REGISTERED OWNER INFO UNKNOWN UNKNOWN VEHICLE NO. 1
SHADE IN DAMAGED AREA ❑ 35
14 ABILI INSURANCE❑ INSURANCE CO UNKNOWN 3 4
IN EFFECT &POLICY# 9TOP
VErIicLE CHARGE 5 36
LECALLv Yes❑NO❑ CITATION# 10 BOTTOM
15❑ STANDING 8 6
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES NO ,/ D:2538806006
16 a
LAST NAME PHILLIPS FIRST NAME KAREN MIDDLE L
INITIAL
17❑ STREET ADDRESS❑' 1847 S 286TH LN APARTMENT U203 CITY FEDERAL WAY ST WA ZIP 98003 37
❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED ❑ 38
INTERLOCK YES❑NoF,/l I INTERLOCK YES❑NoF YES❑NO
19 LDIIVE # STATE I SEX U MMD
.CB. 03 _ 27 1968 39
HELMET I {NJURY NATURE OF INJURIES 40
20❑ ON DUTY STATUS AIRBAG 2 RESTR 9 EJECT 1 USE CLASS 1 ❑
❑ILICENSE 21❑ PLA E# BWR1813 TATe 41
WA VIN# 3N1CNSEVXML826741 4
42
22 [TRAILER T
❑ PLATE# STATE PLATE#ILER STATE
23❑ 43
TRLR RLR
VIN#. IN#.
YEAR 2021 MAKE NIS6 MODEL VERSA STYLE HB VEHICLETOWED TO BLIN TOWEDBY GOV HI 44
VEH
L4❑ DAMAGE YES NO YES NO
REGISTERED OWNER INFO EAN HOLDINGS LLC 500 NACHES AVE SW STE 300 RENTON WA 98057 VEHICLE NO.2
SHADE IN DAMAGED AREA
2 3 4
LIABILITY
INSURANCE INSU PORGY#E CO ENTERPRISE RENTA CARIN 1 9TOP
—e E ES[Z N CITATION# CHARGE
cl i o BOTTOM
LEGALLY Y
25❑ s a
7SHA
NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
J
26 CROW 12618 WA0171300
PART A PAGE 01 OF
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. ED69814
COLLISION REPORT III III III III III 111
1591972 CASE# 23-5953
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
PM 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'
Please see subsequent narrative pages
I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT.
SHAWN CROW 06-05-23 06:44 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY E
DAT
P.KORDEL 9676 6/13/2023 12:55:56 PM
BADGE OR ID# 12618 OR]# WA0171300 TIME POLICE DISPATCHED Y:89 Pry TIME POLICE ARRIVED',5:42 PM
PART I PAGE IT]OF 4�
REPORT NO. ED69814 CASE# 23-5953 OF COLLISION
05/26/23 14:56
OF CbLLI510N
NARRATIVE
On 05/26/2023 at about 1459 hours I was working uniform marked patrol as 1 R15 when I was
dispatched to take a report by phone of a hit and run collision that occurred at the intersection of SW
Sunset Blvd/Hardie Ave SW. I spoke to Karen L. Phillips over the phone who was the driver of Unit 2
(2021 Nissan Versa with Washington license plate BWR1813). An unidentified black male, 20s in
age, with a dreadlock hairstyle was the driver of Unit 1 (white colored unknown make/model vehicle
with a partial Washington state license plate of BKU486). There were no reported injuries, and both
vehicles were able to be driven from the scene.
Karen was stopped in the eastbound lane at a solid red light at the intersection of SW Sunset
Blvd/Hardie Ave SW. While stopped Unit 1 struck the rear bumper of Unit 2. The unidentified driver
of Unit 1 pulled alongside Unit 2 and informed Karen that he would be pulling into the Fred Meyer
parking lot that was located nearby at 365 Renton Center Way SW. Karen saw Unit 1 pull into the
parking lot, but Karen was under the impression that it was necessary to stay at the scene of the
collision until police arrived. Karen remained at the intersection for several minutes, but decided to
move into the Fred Meyer parking lot after noticing the line of vehicles lined up behind her. Karen
drove into the parking lot, but she did not find Unit 1. Karen eventually saw what appeared to be Unit
1 exit the parking lot at a distance, but she was unable to make contact with the driver.
Karen described Unit 1 as a white colored four door automobile that may have been an SUV. Karen
said the license plate on Unit 1 appeared to be BKU486. Karen said Unit 1 had two occupants inside
the vehicle, and she was only able to describe the driver as follows: male, 20s in age with dreadlock
style hair. The driver of Unit 1 has not been identified.
Unit 2 had scratches on the rear bumper from the collision. Unit 2 was a rented car from Enterprise
Rent a Car. I gave Karen a Renton PD case number over the phone. There were no known
witnesses to the collision.
PAGE 3 OF 4
REPORT NO. ED69814 CASE# 23-5953 DATE AND TIME 05/26/23 14:56
OF COLLISION
cs
rn
.Arllm�
SW Sunset Blvd
'Notdrawn to scale
Unitl UnitZ
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