HomeMy WebLinkAbout23-8165 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 1 27c
COLLISION REP FIT 1591971
CASE 23-8165 z
INTERSTATE ❑ CITY STREET FIRE ❑
RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHICI F ❑ LOCAL AGENCI 4150 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 TOTAL#OF OBJECT 1 7 2$
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 07 - 17 - 2023 0755 17 ❑.= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓
S GRADY WAY BLOCK NO. e ----�
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ 0 ,❑ FEET e S ❑ W V TALBOT RD S
0 1 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
No ,/ D:2539885817 1 9 30
6� LAST NAME HASTY FIRSTNAME JOHN MIDDLE D 1 1 2 31
INITIAL
STREET ❑, 4402 N 13TH ST CITY TACOMA ST WA ZIP 98406 z
NEW ADDRESS
7❑ CDL ,/ I IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
INTERLOCK YES[:]NO NTERLOCKYEs NO�/ YES R No�/
8❑ LRIIVER #
ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 HELMET INJURY 7 NATURE OF INJURIES z❑
USE CLASS LEFT SHOULDER AND LEFT SIDE NECK
3
10 PI ATE RS11240 STATE WA VIN#' 2C4RDGBG5FR719242
TRAILER STATE TRAILER STATE
11 3 5 PLATE# PLATE# FROM TO
TRLR. TRLR 7 3 33
12 3 5 VIN#' VIN#
>; FROM TO
VEH.YEAR 2015 MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED By GOVT.VEHICLE 7 3 34
13 4 DODG CARAVA VN DAMAGE YES NO YES[:] No
✓
REGISTERED OWNER INFO KING COUNTY211 S JACKSON ST SEATTLE WA 98104 VEHICLE NO. 1
❑ ❑
SHADE IN DAMAGED AREA 35
14 LIABILITY INSURANCE INSURANCE CO KING COUNTY NA 3 4
IN EFFECT &POLICY# 9TOP
VEHICLE CHARGE 5 36
LEGALLY
Yes❑NO❑ CITATION# 10 BOTTOM
1 5❑ STAIN"'C 6
UNIT VE IOOR Z CYCLE ❑ PEDESTRIAN ❑ OWNER RTY [:]I
DYES NO SOLD MET PHONE
16 a
LAST NAME UNKNOWN FIRST NAME MIDDLE
INITIAL
STREET CITY TACOMA ST ZIP 4
17❑ NEW ADDRESS ❑ 37
18❑ CDL IGNITION REQUIRED IGNITION PR—E-1SENT MEDICAL—T�RANSPORTED � 38
INTERLOCKYES�NOR INTERLOCK yEs It I NOF YES
t l NO❑
19 LLIICENS # STATE SEX U MMDDYY 39
WELMET INJURY NATURE OF INJURIES 40
20❑ ON DUTY STATUS' AIRBAG 9 RESTR 9 EJECT ''1 USE 9 CLASS 0 ❑
❑ILICENSE 21❑ PLA E# BUC1955 TATE 41
WA VIN# 1N4AA6CV5LC379419 1
42
22❑ PLATE# STATE PLATE# STATE
23❑ 43
TRLR RLR
UIN It 'IN#.
Gov HI
VEH YEAR 2020 MAKE jyI$$ MODEL MAXIMA STYLE 4D —FEHICLE
TOWED TOO✓ BLIN TOWED BY 44
fj
YES
NO,/
24❑ REGISTERED OWNER INFO NA UNKNOWN TACOMA VEHICLE NO.2
SHADEDAMAGED AREA
3 4
INAEFFITY ECTNSURANCE❑ &POINSULICY#E CO I 9TOP 5
VEHICLE ❑ C[:] CITATION# CHARGE io BOTTOM
LEGALLY
25 YES N
s a
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
26
WHITNEY NELSON 12789 WA0171300
PART A PAGE 01 OF
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. ED84854
COLLISION REPORT III III III III III 111
1591972 CASE# 23-8165
ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY)
NAME MIDDLE INITIAL) CHRIS BARNES M
(LAST FIRST,
ADDRESS&PHONE#
16315 59TH AVE E PUYALLUP WA 98375 2817011590 SEX i U MMDOYyry 12 - 02 - 1948
SEAT HELMET INJURY NATURE OF INJURIES
PASSENGER WITNESS❑;UNIT# 1 POS. 3 AIRBAG 2 RESTR. q EJECT 1 USE CLASS 7 NECK
NAME
(LAST,FIRST,MIDDLE INITIAL)
ADDRESS&PHONE# DOB
SEX MMDDYYYV
PASSENGER ❑WITNESS UNIT# SEAT I AIRBAG RESTR. EJECT HELMET NJURY NATURE OF INJURIES
POS. USE CLASS
NAME
(LAST FIR57 MIDDLE INITIAL)
AppRESS&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.
WHITNEY NELSON 07-17-23 11:32 AM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
DESIRES SCOTT 10272 1 713112023 6:24:08 PM
BADGE OR ID# 1Y789 OR]# WA0171300 TIME POLICE DISPATCHED 7:87 AM TIME POLICE ARRIVED]8:04 AM
PART Ei PAGE IT]OF 4�
REPORT NO. ED84854 CASE# 23-8165 OF COLLISION
07/17/23 07:55
OF CbLLI510N
NARRATIVE
23-8165
On 07/17/2023 at 0756 hours I was dispatched to SW Grady/Talbot Rd S, in the City of Renton, King
County, Washington. I was responding to a call of a hit and run.
While en route, dispatch advised the following, one minute ago reporting party advised dispatch they
were involved in a hit and run. The reporting party was following the suspect vehicle on S Grady onto
Talbot Rd S. There were no reported injuries at the time. The reporting party last saw the suspect
vehicle going south bound on Benson Rd S and then turning west on Puget Dr.
At approximately 08:04 hours, I arrived at 1055 S Grady Way, City of Renton County of King, to meet
the reporting party on level 5 to take a statement. When I arrived, I verbally identified the reporting
party as John D. Hasty (DOB 06/12/1959). 1 asked John what happened, and he told me the
following: John told me at approximately 07:55 hours he was driving a King County Metro van going
eastbound on S Grady between Shattuck/Talbot. He said he was in the righthand lane when he saw a
Black Nissan Maxima (LIC#BUC1955) swerve into his lane and hit his front left drivers side fender.
John said he thought they were trying to get in front of him to pull over until the black Nissan hit him a
second time. John said after hitting them they almost hit another car and fled through the Home
Depot parking lot to Benson Rd S at a high rate of speed. John said he could see two younger dark
complexion females, possibly Middle Eastern in the Black Nissan. John did report soreness in his left
shoulder leading up to his left side of his neck. John said he was possibly going to receive medical for
his injuries at urgent care sometime today.
I spoke with the passenger in the King County Van who had been riding with John at the time of the
collision. I verbally identified the passenger as Chris M Barnes (DOB 12/02/1948), Chris gave the
same version of events as John did. Chris told me he saw two females in the Black Nissan, and they
hit the van twice and left the area quickly. Chris did report that he had neck pain and was not sure if
he was going to seek medical at this time.
I ran the suspects (LIC#BUC1955) through WACIC/NCIC it came back to the registered owner EAN
Holdings LLC. Out of Centralia WA.
I met John in parking garage number 1 to take pictures of the damage. 1 also verified registration and
proof of insurance through King County Metro.
I took photographs with my department issued cell phone and uploaded the photographs to
Evidence.com via the Axon Capture cell phone application.
Based on the information gathered, there is probable cause to charge the driver of the Black Nissan
with hit and run.
At this time there is no suspect information.
This concludes my involvement in this case.
I certify under penalty of perjury under the laws of the State of Washington that the foregoing is true
and correct.
Electronically signed by Ofc. W. Nelson #12789, 07/17/2023 at 0931 hours in Renton, Washington
**** AUTO-POPULATED SECTION ****
THE FOLLOWING ARE DESCRIPTIONS ENTERED FOR ITEMS SELECTED AS "OTHER":
Motor Vehicle Unit 2
Action Code: SWERVING
**** END OF AUTO-POPULATED SECTION ****
PAGE 3 OF 4
REPORT NO. EU84854 CASE# 23-8165 DATE AND TIME 07/ 7/2307:55