HomeMy WebLinkAbout23-14549 POLICETRAFF'c" III !�� I IIIllI111IN II II I REPORT NO. EE32901 170
27
COLLISION REP FIT 1591971
CASE 23-14549 z
INTERSTATE ❑ CITY STREET FIRE ❑RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHICI F ❑ LOCAL AOENC 4Y00 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 2 TOTAL#OF OBJECT 1 0 3 28
TRIBAL UNITS OZ STRUCK
RESERVATION
z
3❑ DATE OF M M D D Y Y Y Y TIME(2400) COUNTY# MILES CITY#
cawsloN 12 - 19 - 2023 1247 17 . N E IN� S 8 W H OF e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
S 2ND ST BLOCK e✓ 900 ❑
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ ❑ FEET e S ❑ W e WELLS AVE S
0 4 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
✓NO D:2067784542 0 11
30
6� LAST NAME BONK FIRSTNAME AB/GAIL MIDDLE M 1 2 31
INITIAL
STREET ❑ 2918 SE 8TH ST UNIT 2124 CITY RENTON ST I WA Zlp' 980584419 z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
iNTERLOCKYEs NO INTERLOCKYEs NO YES R NO
8❑ LRIIVER #
ON DUTY❑ STATUS AIRBAG 2 RESTR 9 EJECT 1 H USEET ICNLJAURY 1 NATURE OF INJURIES z❑
3
10 9❑ PI ATE 14 AGD5688 STATE WA u N# 5TDDK3DC5CS032770
11[-j- TRAILER STATE TRAILER STATE
11 2 5 PLATE# PLATE# IRCIM ro
TRLR. YRLR. 3 5 33
12 2 5 VIN#j VIN#
FROM TO
VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE 3 ] 34
13 1 2012 TOYT SIENNA VN DAMAGE YES NO ves❑ No
REGISTERED OWNER INFO ABIGAIL BONK PO BOX 781 RENTON WA 98057 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
14 LIABILI INSURANCE INSURANCE CO PEMCO INSURANCE CA 1049650 3 4
IN EFFECT &POLICY# 9TOP
VEHICLe CHARGE 1 5 36
LEGALLY
Yes❑NO❑ CITATION# 10 BOTTOM
15❑ STANDING 6
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT 02 VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES 1/ NO D:R066768345
16 a
LAST NAME ALFARO FIRST NAME KYLIE MIDDLE D
INITIAL
17❑ STREET �' 12650 61ST PL S CITY' SEATTLE ST' WA ZIP 98178 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 DRIVER'S STATE I TX ]SEX IF I D.O.B. 10 _ 14 2003 0 39
LICENSE# MMDDYY
WELMET INJURY1 NATURE OF INJURIES 40
20❑ ON DUTY STATUS AIRBAG 2 RESTR 9 EJECT 1 USE CLASS ❑
21❑ LICENSE I CHF2527 TATe WA VIN# 1GIZD5EBOAF247108
❑ 41
PLATE#
42
22❑ PLATE# STATE PLATE# STATE
23❑ UIN#. 43
TRLR RLR
'IN#.
VEH YEAR 2010 MAKE CHEV MODEL MALIBU STYLE 4D VEHICLE TOWED TO BLIN TOWEDBY GOV HI 44
L4❑ DAMAGE YES NO YES NO
REGISTERED OWNER INFO AUTO TRANS TECH 515366TH ST W UNIVERSITY PLACE WA 98467 VEHICLE NO.2
SHADE IN DAGED AREA
2 4
INAEFFITY ECTNSURANCE❑ &POINSULICY#E CO I 9TOP 5
VEHICLE ❑ ,.I—I CITATION# CHARGE i o BOTTOM
LEGALLY YES N
25 s e
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
26
JESSE VANDERHOEK 11631 WA0171300
PAGE 01 OF
PART A
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EE32901
COLLISION REPORT III III III III III 111
1591972 CASE# 23-14549
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'
Vehicle #1 was in the far right lane traveling westbound in the 900 block of S 2nd St, approaching
Wells Ave S. Vehicle #2 was in the far left lane traveling westbound in the 900 block of S 2nd St,
behind vehicle #1. It should be noted S 2nd St is a one-way westbound road. The driver of vehicle
#1 told me she attempted to turn left onto Wells Ave S from the far right lane, which caused the front
left corner of her vehicle to collide with the right side of vehicle #2. The driver of vehicle #2 told me
she noticed vehicle #1's left turn signal was on for an extended period of time so she sped up to pass
by vehicle #1 to make more room for vehicle #1 to merge left. When she sped up, vehicle #1 started
to turn left onto Wells Ave S, causing the front left corner of vehicle #1 to collide with the right side of
vehicle #2. 1 located video surveillance at Sherwin Williams, a nearby business. I watched this video
and it confirmed that what both driver's told me was accurate. This video was uploaded to the case
file.
I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT.
JESSE VANDERHOEK 12-19-23 07:56 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
QUINT TIBEAU 07691 1 12/21/2023 9:53:23 AM
BADGE OR ID# 11631 OR]# WA0171300 TIME POLICE DISPATCHED' 12:57 PM TIME POLICE ARRIVED 12:57 PM
FART I PAGE IT]OF 3�
REPORT NO. EE32901 CASE# ' 23-14549 DATE AND TIME 12/19/23 12:47
OF COLLISION
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