HomeMy WebLinkAbout23-10472 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 1 27c
COLLISION REP FIT 1591971
CASE 23-10472 z
INTERSTATE ❑ CITY STREET FIRE ❑RESULTED
1 STATE ROUTE OTHER STOLEN
❑ ❑ H F ❑ LOCAL AOENC 3
HIT IT&RUN � CODING
COUNTY RD PRIVATE WAY INVOLVED
2 TOTAL#OF OBJECT 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 09 - 10 - 2023 1731 17 ❑. S 8 W H OF e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓
2500BLK NE SUNSET BL BLOCK MILEPOST ST e✓ 0
4a❑
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ ❑ FEET e S ❑ W e 1 5 29
UNIT MOTOR
VEHICL Z CYCLE ElOYESA✓NOESHOLDMET PHONE O 11
30
6❑ LAST NAME UNKNOWN FIRSTNAME MIDDLE 1 2 31
INITIAL
STREET ❑ CITY ST ZIP z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
:NTERLOCKYEs NO INTERLOCK YES No YES No
8 DRIVERS. STATE SEX.U D.O.B. 1 1 2 32
❑ :LICENSE# MMDDYY —=
9 ON DUTY❑ STATUS I
AIRBAG 9 RESTR 9 EJECT 1 H U EEr 9 CLAY 0 NATURE OF INJURIES z❑
3
LICENSE UNK STATE VIN#' UNK
10 9❑ Pr ATF�
TRAILER STATE TRAILER STATE
11 0 0 PLATE# PLATE# ROM ro
TRLR. TRLR. O 0 33
12 0 0 VIN#' VIN#'
FROM TO
❑ VEH.YEAR MAKE DEEP MODEL UNK STYLE UT VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE 1 5 34
13 4 DAMAGE YES NO YES❑ NO
REGISTERED OWNER INFO UNKNOWN VEHICLE NO. 1
SHADE IN DAMAGED AREA ❑ 35
14 LIABILITY INSURANCE❑ INSURANCE CO 3
IN EFFECT &POLICV# Q
9TOPVE— CHARGE 36
LEGALLvYEs❑NO CITATION# 10 BOTTOM15❑ STANDIG 7
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT VEHICLE ❑ CYCLE ❑ ❑ : OWNER ❑ YES 1/ NO D:2064992754
16 a
LAST NAME DIALLO FIRST NAME ALPHA MIDDLE O
INITIAL
17 STREET NEW ADDRE--- 2060 S KENT DES MOINES RD CITY' DES MOINES ST WA ZIP 98198 ❑ 37
18� CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 38
INTERLOCK YEs❑NoF,/I I INTERLOCK YES❑NoF YES❑NO
19 DIVE
❑ ON DUTY STATUS AIRBAG 6 RESTR 4 EJECT 1 H U EET 2 NJAURSY 1 NATURE OF INJURIES 40
❑ILICENSE 21❑ PLA E# A6647049 TATE 41
WA VIN# 4T1BE32K54U828257 4
42
22 [TRAILER TILER
❑ PLATE# STATE PLATE# STATE
23❑ 43
TRLR RLR
UIN It 'IN#.
rowed ev Gov HI 44
VEH YEAR 2004 MAKE 7'Oy7' MODEL CAMRY STYLE $D
24 DAMAGETOWED TOO✓ BLIN yES NO
❑ REGISTERED OWNER INFO OWNED SY DRIVER VEHICLE N0.2
SHADEDAMAGEDAREA
3 4
INAEFFITY ECTNSURANCE❑ &POINSULICY#E CO 9TOP 5
VEHICLE ❑ C[:] CITATION# CHARGE to BOTTOM
LEGALLY YES N
25 ' e
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
26
PHILIP DAVIS 12018 WA0171300
PART A PAGE 01 OF C7
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EE02565
COLLISION REPORT III III III III III 111
1591972 CASE# 23-10472
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'
23-10472
On 9-10-23 around 1735 hours I dispatched to a blocking hit-and-run collision in the 2500 block of NE
Sunset Blvd, Renton, King Co, WA. Upon arrival 1 contacted Diallo, driver of unit 2, who advised the
following. Unit was traveling south in the 2500 blk of NE Sunset Blvd, just past the intersection at
Edmonds Ave NE. As unit 2 cleared the intersection, and observed heavy traffic, unit 1 began to back
up in front of unit 2 causing the vehicles to collide. Diallo got out to contact the driver of unit 1, but the
vehicle drove away. The suspect vehicle is only described as a white Jeep SUV and there is no
description of the suspect driver. Diallo was uninjured and declined to be seen by RFA. Unit 2 was
towed by Gene Meyer Towing.
I declare under penalty of perjury under the laws of the State of Washington that the foregoing is true
and correct.
Electronically signed by P Davis 12018 on September 10, 2023 at 18:20 hours in Renton, WA.
I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT.
PHILIP DAVIS 09-10-23 06:35 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
S.WOODWARD 11528 1 9/26/2023 12:00:38 PM
BADGE OR ID# 12018 OR]#' [ WA0171300 TIME POLICE DISPATCHED! 5:35 PM TIME POLICE ARRIVED',5:46 PM
PART I PAGE IT]OF
REPORT NO. EE02565 CASE# ' 23-10472 DATE AND TIME 09/10/23 17:31
OF COLLISION
AV 'mk
e,
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