HomeMy WebLinkAbout23-7319 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 6 27c
COLLISION REP FIT 1591971
CASE 23-7319 z
INTERSTATE ❑ CITY STREET FIRE ❑RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHICI F ❑ LOCAL AGENC 4200 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#
COLLISION' 06 - 1-- 2023 2208 17 ❑-= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
SUNSET BLVD N BLOCK NO. e ❑
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ ❑ FEET e S ❑ VV e N 3RD ST
0 1 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
,/No D:2536005974 0 11
30
6� LAST NAME OZCAN FIRSTNAME HILAL MIDDLE N 1 2 31
INITIAL
STREET ❑ 22004 128TH PL SE CITY KENT ST WA 2jp, 980313935 z
NEW ADDRESS
7❑ CDL I 1/ IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
iNTERLOCKYEs NO NTERLOCKYEs NO Z YEs No�/
8❑ LRIIVER #
ON DUTY❑ STATUS AIRBAG 6 RESTR 4 EJECT 1 HELMETU E 2 CLASS 1 NATURE OF INJURIES z❑
3
10❑ PI ATE BVA4728 sTArI WAurN# JTDKN3DU6D5648556
TRAILER STATE TRAILER STATE
11 0 0 PLATE# PLATE# FROM TO
TRLR. TRLR 7 3 33
12 0 0 VIN#' VIN#
>; FROM TO
❑ VEH.YEAR 2013 TOYT PRIUS MAKE MODEL STYLE VEHICLE TOWED TO BLIN TLI I� RS GOVT.VEHICLE 5 1 34
13 4 DAMAGE YES No � YES[:] No
REGISTERED OWNER INFO IBRA.OZCAN 22004128TH PL SE KENT WA 98031 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
14LIABILI INSURANCE INSURANCE CO AMERICAN FAMILYA104176714 3 4
IN EFFECT &POLICY# 9TOP
VEHICLE CHARGE 5 36
LEGALLY YES❑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:4258308911
16 a
LAST NAME VALENCIA FIRST NAME ANGELICA MIDDLE
INITIAL
17 STREET NEW ADOREs7 2818 NE 6TH PL CITY RENTON ST WA ZIP 98056 4❑ 37
18� CDL IGNITION REQUIRED IGNITION PR-E-1SENT MEDICAL TRANSPORTED 38
INTERLOCK YEs❑No� INTERLOCK YEs It I NOF YES
t l NOF,/
19 DRIVER'S STATE WA SEX U D.C.B. 07 09 _ 1991 39
LICENSE# MMDDYY
20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 HELMET 2 INJURY 7 NATURE OF INJURIES ❑ 40
USE CLASS NECK AND BACK PAIN
❑ILICENSE 21❑ PLA E# BIT1058 TArE WA VIN# 41
STDJGRFH2JS038488 1
42
22❑ PLATE# STATE PLATE# STATE
23❑ UIN#. 43
TRLR RLR
'IN#.
GI
VEH YEAR 201E MAKE 7'Oy7' MODEL yIGHLAN STYLE $D DAMAGE TOWED NOO✓ BLIN TOWED BY ov HYES NO 1/ 44
24❑ ES
REGISTERED OWNER INFO OWNED SY DRIVER VEHICLE N0.2
SHADEDAMAGEDAREA
3 4
LIABILITY INSURANCE INSU&PORGY#E CO AMERICAN FAMILY 232833000157FPPAWA STOP 5
IN EFFECT
VE—LE ❑ ,J� CITATION# CHARGE to BOTTOM
LEGALLY YES N`LJ 6
25 =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. ED76223
COLLISION REPORT III III III III III 111
1591972 CASE# 23-7319
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'
Unit 2 was traveling north bound on Sunset Blvd N in the right lane approaching a green light at the
intersection of N 3rd and Sunset Blvd N.
Unit 1 was traveling east bound on N 3rd ST in the right lane approaching a red light at the
intersection of N 3rd and Sunset Blvd N.
Unit 1 ran the red light at approximately 25-30mph just as Unit 2 was crossing the intersection. Unit 1
then collided with Unit 2. Unit 1's front bumper collided with the driver's side of Unit 2's front bumper.
Both Unit 1 and 2's vehicles had extensive front bumper damage; the damage exceeded $1000. Unit
1 had multiple different airbags deploy in their vehicle.
Unit 1 reported no injuries. Unit 2 reported that their head and neck were sore.
Unit 1 admitted fault in the incident stating that she ran the red light. Unit 2 agreed with her statement.
I declare under penalty of perjury under the laws of the State of Washington that the foregoing is true
and correct. Electronically signed by J. Turner 12650 on 06/30/2023 at 2006 hours.
I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT.
JASON TURNER 06-30-23 08:09 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
C.TOLLIVER 10540 1 7/3/2023 6:33:23 PM
BADGE OR ID# 12650 OR]#' WA0171300 TIME POLICE DISPATCHED! 10:08 PM TIME POLICE ARRIVED 10:10 PM
PART I PAGE IT]OF 3�
REPORT NO. ED76223 CASE# 23-7319 DATE AND TIME 06/27/23 22:08
OF COLLISION
{
i
PAGE 3 OF 3