HomeMy WebLinkAbout23-11412 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 5 27c
COLLISION REP FIT 1591971
CASE 23-11412 z
INTERSTATE ❑ CITY STREET FIRE ❑RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHIl.I F ❑ LOCAL AOENC 4200 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 1 TOTAL#OF OBJECT 1 1 8 28
TRIBAL UNITS OZ RESERVATION STRUCK
z
3❑ DATE of M M D D Y Y Y Y TIME(2400) COUNTY# MILES N E IN CITY#
cowsloN 10 - 1-- 2023 1246 17 ❑-= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
BLOCK NO. e✓ --- ----� ❑
NE 3RD ST MILEPOST
4a❑
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ ❑ FEET e S ❑ W e SUNSET BL N
0 4 29
MOTOR PEDAL- DAM THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El YES NO �/ D:2062934189 0 4 30
6 LAST NAME BADILLO CRUZ FIRSTNAME DANIEL MIDDLE N 1 2 31
INITIAL
STREET ❑ 36626 45TH AVE S CITY AUBURN ST WA 2jp, 980019381 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 4 EJECT 1 H U SE
ICNLJAUSSY 1 NATURE OF INJURIES z❑
3
LICENSE C03236X sTArI WAvIN# 3C6UR5DL1KG663575
10❑ PI ATE 14
TRAILER STATE TRAILER STATE
11 3 5 PLATE# PLATE# ROM To
TRLR. YRLR. 3 5 33
12 3 5 VIN#' VIN#
>; FROM TO
VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE 3 $ 34
13 2 2019 RAM 2500 DAMAGE YES NO YES[:] NO✓
REGISTERED OWNER INFO DANIEL BADILLO CRUZ3662645THAVE S AUBURN WA 980019381 D:2062934189 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
14 LIABILITY INSURANCE INSURANCE CO NAT GEN 2009243394 3 4
IN EFFECT &POLICY# 9TOP
vewcLe CHARGE 1 5 36
EGHALLY YES❑NO❑ CITATION# 3A0681702 IMPROPER LANE USAGE o aorrom
15❑ STANDING 8 7 6
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES V NO D:4252410451
16 a
LAST NAME MARDINI FIRST NAME IBRAHIM MIDDLE 10
INITIAL
17❑ STREET ❑', 16543 116TH AVE SE CITY' RENTON ST WA ZIP 980585240 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 NOF
19 STATEWASEXMD.C.B.C.. 39
LICENSE# M
WELMET INJURY1 NATURE OF INJURIES 40
20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 USE CLASS ❑
21❑ LICENSE I CJW0389 TAre WA vIN# JTHCE5C24B5000189
❑ 41
PLATE#
42
22❑ PLATE# STATE PLATE# STATE
23❑ VIN#. 43
TRLR RLR
'IN#.
VEH YEAR 2011 MAKE LEXS MODEL IS STYLE VEHICLETOWED TO BLIN TOWEDBY GOV HI 44
24❑ DAMAGE YES NO YES NO
REGISTERED OWNER INFO IBRAHIM MARDINI 16543116TH AVE SE RENTON WA 980585240 D:4252410451 VEHICLE NO.2
SHADE IN DAMAGED AREA
2 3 4
LIABILITY
INSURANCE &POINSURGY#E CO TRAVELERS 614175846 203 1IN I STOP 5
'E""LE ❑ N`L J
,J� CITATION# CHARGE
LEG
25 i o BOTTOM
ALLY YES s a
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
J
26
M.LEVERTON 2517 WA0171300
PAGE 01 OF
PART A
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EE10850
COLLISION REPORT III III III III III 111
1591972 CASE# 23-11412
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'
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.
M.LEVERTON 10-10-23 10:38 AM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY E
DAT
C.JACOBS 1953 1011912023 10:45:10 AM
BADGE OR ID# 2517 OR]# WA0171300 TIME POLICE DISPATCHED! 12:54 PM TIME POLICE ARRIVED 1:03 PM
PART I PAGE IT]OF 4�
REPORT NO. EE10850 CASE# 23-11412 OF COLLISION
10/05/23 12:46
OF CbLLI510N
NARRATIVE
blk sedan/1 lane 2 blk trk lane 2 both left turn
CC
Within the city limits of Renton/King/Wa I responded to a 2 car crash at the intersection of Sunset
Blvd N at NE 3rd St.
Both drivers moved the vehicles to a nearby parking lot and off the roadway.
I contacted the driver of unit 2 who told me he was in lane 1, a through/left turn lane making a left turn
when unit 1 moved into his lane contacting and damaging he vehicle. He did not complain of injury
and damages did not require a tow truck. Unit 2 told me he had the crash on video and would email it
to me later.
I contacted the driver of unit 1 ID'd by his picture WADL. He told me he was in lane 2 a left turn only
lane. He said he made the left turn and did not see unit 2. Unit 1 did not say he crossed over into
unit 2, only that he didnt see him. He did not complain of injury and damages were unremarkable as
it appeared only his tire touched unit 2.
Unit 2 did email the video which I reviewed. It shows both drivers describing their lane positions and
vehicle movement, however, unit 2 is clearly established in lane 1 of SB Sunset Blvd N when/where
he is contacted by the obvious impact/camera disruption from unit 1 unlawfully crossing into unit 2s
lane.
I cited unit 1 ref RCW 46.61.140 Improper lane use-2 car crash via complaint.
I certify (declare) under penalty of perjury under the laws of the State of Washington that the
foregoing is true and correct.
M.Leverton/2517 City of Renton/King/Wa 10/10/2023
PAGE 3 OF 4
REPORT NO.! EE10850 CASE# ' 23-11412 DATE AND TIME 10/05/23 12:46
OF COLLISION
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ti
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