HomeMy WebLinkAbout23-6899 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 0 27c
COLLISION REP FIT 1591971
CASE 23-6899 z
INTERSTATE ❑ CITY STREET FIRE ❑RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHIC;I F ❑ LOCAL AOENC 4Y00 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 1 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 1405 17 ❑.= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓
SUNSET BLVD N BLOCK NO. e✓ 300
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ ❑ FEET e S ❑ W e 0 4 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
,/No D:4255259506 0 11
30
6� LAST NAME FERREYRA FIRSTNAME RICARDO MIDDLE N 1 1 2 31
INITIAL
STREET ❑✓ 300 VUEMONT PL NE#U303 CITY RENTON ST WA ZIP' 98056 z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
INTERLOCK YES[:]NO 1/ INTERLOCKYEs NO�/ YES R No�/
8❑ LRIIVERS STATE WA SEX'M MM DAY' 01 1- 17 - 1991 2 32
CENSE 9 ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 H USE 2 1 CLASS NATURE OF INJURIES z❑
3
10 9❑ PI CENS1ATE 14 E90930843 STATE WA u N# 3G1BE6SM6JS655294
-- TRAILER STATE TRAILER STATE
11 3 5 PLATE# PLATE# FROM To
TRLR. TRLR 5 7 33
12 3 5 VIN#' VIN#'
ROM TO
VEH.YEAR 2018 MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE 1 5 34
13 4 CHEV CRUZE HB DAMAGE YES NO YES[:] No
✓
REGISTERED OWNER INFO OWNEDBYDRIVER VEHICLE NO. 1
❑
SHADE IN DAMAGED AREA ❑ 35
14 ❑ INSURANCE CO <53 4LIABILITY INSURANCEIN EFFECT &POLICV# TOPVEH'CLe CHARGE OTTOM 5 36
LE�ALL'Y re5 NO CITATION# 3A0318966,3A0318966 FAIL YIELD LEFT TURN MOTOR
15❑ STANDING 6
MOTOR PEDAL- 'PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT a2 VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES 1/ NO D:4256521092
16 a
LAST NAME MC CREADY FIRST NAME RICHARD MIDDLE A
INITIAL
17 STREET I❑ s❑' 2304 NE 9TH ST CITY' RENTON ST WA ZIP 980562944 4❑ 37
NEW ADDREs
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 LDI IVEW # STATE WA SEX M M D.C.B. O6 _ O6 _ 1964 39
20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 HEJ EET NJAURSY 1 NATURE OF INJURIES 40
❑21❑ PLATE# C46775J TATE WA VIN# 1 GBJG31 U851164993 41
1
42
22❑ PILER LATE# STATE PLATE# STATE
23❑ VIN#. 43
TRLR RLR
'IN#.
TOWED BY Gov HI 44
VEH YEAR 2005 MAKE CHEV MODEL EXPRESS STYLE VN VEHICLE DAMAGE TOWED NOO✓ BLIN YES NO 1/
24❑ REGISTERED OWNER INFO OWNED SY DRIVER VEHICLE N0.2
SHADE IN DAMAGED AREA
2 3 4
LIABILITY
INSURANCE INSU PORGY#E CO PROGRESSIVE 06173082-8IN 1 STOP 5
'E""LE N
❑ ,J�J CITATION# CHARGE i o BOTTOM
LEGALLY YES
25 ' a
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# 7]�NCY26S.WOODWARD 11528 0171300
PAGE 01 OF
PART A
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. ED71256
COLLISION REPORT III III III III III 111
1591972 CASE# 23-6899
ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY)
NAME
(/AST 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'
Driver 1 (verified through his WADL) in Veh 1 stated he was stopped in the middle turn lane, waiting
to turn left across the southbound lanes of 300 Sunset Blvd N. The cars in the first two lanes closest
to him (Lane 2 and 3) stopped so he turned left, failing to see Veh 2 coming in Lane 1. When he
entered Lane 1, the front of his car struck the front driver's corner of Veh 2, causing moderate
damage to his car and minor damage to Veh 2.
Driv 1 didn't have any paperwork on his car and said he didn't have insurance either. He said he
bought his car a year ago and the dealer in Auburn has just kept giving him temporary permits since
then, failing to give him any other paperwork until he has paid it off.
Driv 2 provided all necessary paperwork.
For turning left and failing to yield to oncoming traffic while turning left, I determined Driv 1 to be the
proximate cause of the collision. I completed Sector citation 3AO318966 for this violation, along with
failure to have insurance on his vehicle, and sent it to the court to be mailed to him. He was advised
of the coming citation.
No injuries reported and no medical attention requested.
Nothing further
I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT.
S.WOODWARD 06-17-23 03:31 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
S.WOODWARD 11528 1 611812023 4:30:06 PM
BADGE OR ID# 11528 OR]# WA0171300 TIME POLICE DISPATCHED; 2:29 Pry TIME POLICE ARRIVED 2:29 Pry
PART I PAGE IT]OF
REPORT NO. ED71256 CASE# ' 23-6899 DATE AND TIME 06/17/23 14:05
OF COLLISION
Sunset Blvd N
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