HomeMy WebLinkAbout23-9697 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 0 27c
COLLISION REP FIT 1591971
CASE 23-9697 z
INTERSTATE ❑ CITY STREET FIRE ❑RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHIr.I F ❑ LOCAL AOENC 4900 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 3 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 2058 17 ❑.= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓
EAST VALLEY HIGHWAY BLOCK NO. e✓ 4200
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ 80 00 FEET e S B W e SW 43RD STREET
1 9 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
,/No D:2533685199 0 11
30
6� LAST NAME AEGERTER FIRSTNAME MYA MIDDLE L 1 2 31
INITIAL
STREET ❑, 1701 35TH ST SE I CITY AUBURN ST WA 2jp, 98002 z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
INTERLOCK YES NO INTERLOCK YES NO YEs No
8❑ LRIIVER #
� ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 HELMETUSE CLASS 1 NATURE OF INJURIES z❑
3
LICENSE CCY3933 sTArI WAurN# 1J4Gt48KX5W709083
10 F91 PI ATE#
TRAILER STATE TRAILER STATE
11 3 5 PLATE# PLATE# FROM TO
TRLR. YRLR. 3 5 33
12 3 5 VIN#' VIN#
>; FROM TO
VEH.YEAR 2005 JEEP LIBERT UT MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE 5 1 34
13 4 DAMAGE YES NO YES[:] No
✓
REGISTERED OWNER INFO MYA AEGERTER 110135TH STSE AUBURN WA 98002 VEHICLE NO. 1
❑ ❑
SHADE IN DAMAGED AREA 35
14 LIABILI INSURANCE❑ INSURANCE CO NONE NONE 3 4
IN EFFECT &POLICY# 9TOP
VEHICLE 5 36
LEGALLv res❑NO❑ CITATION# CHARGE 1 o BOTTOM
15❑ STANDING 8 7 6
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT 02 VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES 1/ NO D:2068410626
16 a
LAST NAME GARNER FIRST NAME BRENT MIDDLE
INITIAL
17❑ STREET ❑', 19628 104TH AVE E CITY GRAHAM ST WA ZIP 98338 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 LICENSE# STATE WA SEX M M .C.B. 04 05 _ 1961 39
WELMET INJURY NATURE OF INJURIES 40
20❑ ON DUTY STATUS' AIRBAG,4 RESTR 4 EJECT ''1 USE CLASS 1 ❑
41
21❑ LICENSE A/A6621 TAre WA VIN# 1B3CC4FB9AN195980
❑
PLATE#
42
22❑ PILER LATE# STATE PLATE# STATE
23❑ VIN#. 43
TRLR RLR
'IN#.
VEH YEAR 2010 MAKE DODG MODEL AVENGE STYLE SD VEHICLE TOWED TO BLIN TOWEDBY GOV HI 44
L4❑ DAMAGE YES NO YES NO
REGISTERED OWNER INFO BRENT GARNER 19628104TH AVE E GRAHAM WA 98338 VEHICLE NO.2
SHADE DA GEbAREA
LIABILITY
INSURANCE❑ &POINSULICY#E CO NONE NONEIN IGQ
VEHICLe ❑ ,.I—I CITATION# CHARGE
LEGALLY YES N`LJ
25 s � e
7ESAGIA0
S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
J
26
10339 WA0171300
PART A PAGE 01 OF C7
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. ED92884
COLLISION REPORT III III III III III 111
1591972 CASE# 23-9697
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.
E.SAGIAO 08-22-23 10:04 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
P.SUMMERS 8887 8/25/2023 7:53:05 PM
BADGE OR ID# ! 10339 ORI#' WA0171300 TIME POLICE DISPATCHED 9:04 PM TIME POLICE ARRIVED]9:10 PM
PART I PAGE IT]OF 4�
REPORT NO. ED92884 CASE# 23-9697 OF COLLISION
08/22/23 20:58
OF CbLLI510N
NARRATIVE
On 8-22-23 at 2104 hours I was dispatched to a blocking collision in the 4200 block of East Valley
Road, in the City of Renton, King County, State of Washington. Dispatch advise one of the involved
vehicles pulled into a neighboring business. The other was in the intersection.
I arrived and observed a green 2005 Jeep Liberty (WA-CCY3933) north of the intersection and
blocking the turn lane. The vehicle had damage to the front passenger side and front. This damage
appeared new the driver advised her vehicle was leaking something.
The driver and registered owner of Unit#1, Mya Aegerter who I identified by WA DL advised the
following. She was pulling out of Mary Jane's parking lot and Unit#2 was driving fast and switching
lanes and she collided with it.
Unit#2 was a black Dodge Avenger (WA-AIA6621) registered to a Brent Garner. The vehicle had
extensive damage that ran the length of the passenger side and side airbag deployment. This
damage and airbag deployment appeared recent. Garner who I also identified by WA DL was the
driver. He told me he was traveling northbound on East Valley Highway when Unit#1 entered traffic
from a private drive. He told me he going to HWY 167 to go home.
Both drivers refused aid on scene and verified their addresses. Both vehicles were located in private
parking lots at the conclusion of the investigation. Neither party had insurance. Both were provided
business cards with this case number. Unit#1 was the at fault driver for entering a public highway
from a private driveway. Even if Unit#2 was changing lanes, Unit#1 was still obligated to yield to it.
No citation issued and both drivers informed me they would make arrangements for their vehicles at
a later time.
The incident was captured on my body worn camera. The report is a summary of events that
occurred and is not an exact sequencing of events. Statements have been paraphrased and
summarized.
I certify or declare under penalty of perjury under the laws of the State of Washington that the
foregoing is true and correct.
E.Sagiao/10339
**** AUTO-POPULATED SECTION ****
THE FOLLOWING ARE DESCRIPTIONS ENTERED FOR ITEMS SELECTED AS "OTHER":
Motor Vehicle Unit 1
Action Code: ENTERING TRAFFIC FROM PRIVATE DRIVE
**** END OF AUTO-POPULATED SECTION ****
PAGE 3 OF 4
REPORT NO. ED92884 CASE# 23-9697 DATE AND TIME 08/22/23 20:58
OF COLLISION
SW 43rd Street .
S 1 80th Street
i�
East Valley Highway
Y
PAGE 4 OF 4