HomeMy WebLinkAbout23-6824 POLICETRAFF'c" III !�� I IIIllI111IN II II I REPORT NO. ED70718 170
27
COLLISION REP FIT 1591971
CASE 23-6824 z
INTERSTATE ❑ CITY STREET FIRE ❑RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHICI F ❑ LOCAL AOENC 4200 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 2 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 06 - 1-- 2023 0751 17 ❑-= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
BLOCK NO. e✓ --- ----� ❑
SE CARR RD MILEPOST
4a❑
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ ❑ FEET e S ❑ VV e 106TH PL SE
2 0 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
,/No D:4695969496 0 11
30
6� LAST NAME SINGH FIRSTNAME NEETA MIDDLE N 1 1 2 31
INITIAL
STREET ❑ 17735 105TH PL SE APT F103 CITY RENTON ST I WA 21p 980558408 z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
INTERLOCK YES[:]NO INTERLOCKYEs NO YEs NO
8❑ LRIIVER #
ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 H USEET ICNLJAURY 1 NATURE OF INJURIES z❑
3
10❑ PI ATFBit PNW0581 sTArI TX urN#' 4T18F3EK1AU545942
TRAILER STATE TRAILED STATE
11 3 5 PLATE# PLATE# FROM To
TRLR. TRLR 7 3 33
12 3 5 VIN#' VIN#
>;. FROM TO
VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TR Y GOVT.VEHICLE 7 3 34
13 2010 TOYT CAMRY DAMAGE YES NO �MEYER YES : NO✓
REGISTERED OWNER INFO NEETA SINGH 17735105TH PL SE APT F103 RENTON WA 980558408 D:4695969496 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
14 LIABILITY INSURANCE INSURANCE CO GEICO 4606.86.42.49 4
IN EFFECT &POLICY# 9TOP
15❑ LE
vEGALLv HICLE 5 36
re8�No D CITATION# CHARGE IMPROPER LANE USAGE )o eorroM
STANDING 8 7 6
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES V NO D:2063269865
16 a
LAST NAME MELES FIRST NAME MUNA MIDDLE A
INITIAL
17❑ STREET ❑', 17341 32ND AVE S APT N311 CITY SEATAC ST WA ZIP 981884487 37
NEW ADDRESS ❑
18� CDL IGNITION REQUIRED IGNITION PR—E-1SENT MEDICAL TRANSPORTED ❑ 38
INTERLOCKYES�NOR INTERLOCK YEs It I NOF YES
t t— l No❑
19 DRIVER'S STATE WA ]SEX IF D.C... 01 09 _ 1978 El 39
LICENSE# MMDDYY
WELMET INJURY1 NATURE OF INJURIES 40
20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 USE CLASS ❑
21❑ LICENSE I CER7526 TAre WA VIN# 4S4BRBGC6D3240938
❑ 41
PLATE#
42
22❑ PLATE# STATE PLATE# STATE
TRLR
23❑ VIN#. IN#. 43
RLR
'
VEH YEAR 2013 MAKE SUBA MODEL OUTBAC STYLE VEHICLETOWED TO BLIN TOWEDBY GOV HI 44
L4❑ DAMAGE YES NO YES NO
REGISTERED OWNER INFO MUNA MELES 17341 32ND AVE S APT N311 SEATAC WA 98188 VEHICLE NO.2
SHADE IN DAMAGED AREA
2 3 4
INAEFFITY ECTNSURANCE INSU&POLICY#E CO SAME. IUR'E""LE
❑ ,J� CITATION# CHARGELEGALLYYES N`LJ
25 OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
J
26
M.LEVERTON 2517 WA0171300
PART A PAGE 01 OF C7
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. ED70718
COLLISION REPORT III III III III III 111
1591972 CASE# 23-6824
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'
blu/1 Ic into wht 2
CC
Within the city limits of Renton/King/WA I responded to a 2 car blocking crash near the intersection of
SE Carr Rd and !1 06th PI SE.
Lane one EB and part of lane 2 were blocked from the crash. I contacted the driver of unit 2 who told
me she was underway in lane one when unit 1 turned into the side of her car. She did not complain
of injury and damages did not require a tow truck.
I contacted the driver of unit 1 ID'd by picture WADL. She told me she signaled and made a lane
change, but into the side of unit 2. She did not complain of injury, but damages did require a tow
truck.
I cited unit 1 Ref RCW 46.61.140 Improper lane use/lane change two car crash via complaint.
I certify (declare) under penalty of perjury under the laws of the State of Washington that the
foregoing is true and correct.
M.Leverton/2517 City of Renton/King/Wa 5/15/2023
I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT.
M.LEVERTON 06-15-23 02:58 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
CO.JOHNSON 0505 6/16/2023 8:52:56 AM
BADGE OR ID# 2517 ORI# WA0171300 TIME POLICE DISPATCHED! 7i82 AM TIME POLICE ARRIVED f 7:58 AM
PART I PAGE IT]OF
REPORT NO. ED70718 CASE# 23-6824 DATE AND TIME 06/15/23 07:51
OF COLLISION
nts
i
unit 2
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