HomeMy WebLinkAbout23-14884 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 1 27c
COLLISION REP FIT 1591971
CASE 23-14884 z
INTERSTATE ❑ CITY STREET FIRE ❑RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHICI F ❑ LOCAL AGENCI 4Y00 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 TOTAL#OF OBJECT 2$
TRIBAL UNITS 01 STRUCK' TREE OR STUMP
RESERVATION
z
3❑ DATE OF M M D D Y Y Y Y TIME(2400) COUNTY# MILES N E IN CITY# ❑
COLLISION.. 12 - 2$ - 2023 0008 17 ❑.= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓
S GRADY WAY BLOCK NO. e✓ 600
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ 1 ,❑ FEET e S ❑ W V TALBOT RD S
0 4 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
,/No D:4257607336 30
6 LAST NAME SENFF FIRSTNAME PAIGE EDWARD MIDDLE J 1 2 31
INITIAL
STREET ❑, 21208 ECHO LAKE RD CITY SNOHOMISH ST WA 2jp, 98296 z=
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
INTERLOCK YES[:]NO 1/ INTERLOCKYEs NO�/ YES R No�/
8❑ LRIIVERS STATE WA SEXI F MID
.O B 10 - 02 - 1989 32
CENSE 9 ON DUTY❑ STATUS AIRBAG 6 RESTR 9 EJECT 1 H USEET ICNLJAURY 1 NATURE OF INJURIES z❑
3
10❑ PIATNES14 AYU4170 STATE WA uN# JFlVAlE60G8814396
TRAILER STATE PLATE
STATE
11 0 0 PLATE# PLATE# Rom ro
TRLR. TRLR. $ 7 33
12❑ VIN#' VIN#'.
Rom 34
13❑ VEH.YEAR2016 MAKE SUBA MODEL WRX STYLE SD VEHICLE TOWEDNOOpLSABLIN T� I� RSTOWING YOs❑ENo /
DAMAGE IILLJJII
REGISTERED OWNER INFO PAIGE EDWARD SENFF 21208 ECHO LAKE RD SNOHOMISH WA 98296 D:4257607336 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
14❑ LIABILITY INSURANCE Z INSURANCE CO FIRST NATIONAL INSURANCE COMPANY OF AMER H2539059
IN EFFECT &POLICY# 9TOP
CHA
VEHICLE RGE 5 35
LECALLv res❑NO❑ CITATION# 1 o BOTTOM
15❑ NDING 8 6
UNIT U2 VEHICCLE ❑ CYCLE ❑ PEDESTRIAN ❑ oWNFRRTY ❑ DYES NO PHONE
MOTO OLD MET
16❑
LAST NAME FIRST NAME MIDDLE
INITIAL
STREET
CITY' ST ZIP 4❑ 37
17❑ NEW ADDRESS❑'
18❑ CDL IGNITION REQUIRED IGNITION PtR-E-S1ENT MEDICAL-T�RANSPORTED ❑ 38
INTERLOCKYES�NOR INTERLOCK YEs I I NOF YEs t l NO❑
19 LLIRIVEWSTICENS # STATE SEX MMDDYY 39
HELMET INJURY NATURE OF INJURIES 40
20❑ ON DUTY STATUS' AIRBAG RESTR EJECT USE CLASS ❑
❑21❑ TATE 41
IN#LICENSE V 1
PLATE#
42
22❑ PLATE# STATE PLATE# STATE
23❑ 43
TRLR RLR
VIN#. IN#.
VEH YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN
TOWED BY Gov HI 44
L4❑ DAMAGE YES NO YES NO
REGISTERED OWNER INFO VEHICLE NO.2
SHADE IN DAMAGED AREA
2 3 4
LIABILITY
INSURANCE❑ INSURANCE
#E CO
IN EFFECT &PO IGQVE""LE
❑ ,J� CITATION# CHARGE
LEGALLY YES N`L J
25
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# JAGENCY
26
J RAYGOZA 12503 WA0171300
PART A PAGE 01 OF C7
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EE36267
COLLISION REPORT III III III III III 111
1591972 CASE# 23-14884
ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY)
NAME
(/AST 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'
RPD CASE#: 23-14884
On 12/28/2023 at approximately 0012 hours, I responded to the 600 block of S Grady Way, in the
City of Renton, King County, Washington, for a report of a vehicle vs tree collision.
I was driving eastbound on S Grady Way from Shattuck Ave S in my fully marked patrol vehicle when
I saw a vehicle identified as a silver 2016 Subaru WRX WA/LIC AYU4170
VIN#JF1VA1 E60G8814396 on the curb at the 600 block of S Grady Way. The vehicle appeared to
have collided with a tree and had major damage to the driver's side door. Parked behind the vehicle
and turned on my emergency lights to prevent other vehicles from hitting us. I spoke to the driver of
the vehicle identified by her WADOL as Senff, Paige Edward Jeffrey DOB (10/02/1989) who was
standing in front of the vehicle. Paige informed me that she was driving north on Talbot Rd S when
she stopped at the intersection of S Grady Way and Talbot Rd S. Paige then made a left turn to go
west on S Grady Way when her vehicle started to skid. Paige then lost control of her vehicle and
collided with the tree on the sidewalk.
I called fire so that they could evaluate Paige due to multiple airbags being deployed inside her
vehicle due to the impact of the collision. Paige was cleared medically by fire and a tow was
dispatched for Paige's vehicle. Paige provided me with her license, registration, and insurance and
they were all valid. I gave Paige my business card with the case number and cleared the scene once
Paige's vehicle was towed off the road.
I certify (declare) under penalty of perjury under the laws of the State of Washington that the
foregoing is true and correct.
Electronically signed by J. Raygoza on 12/28/2023 at 0145 hours in the City of Renton.
I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT.
J RAYGOZA 12-28-23 01:39 AM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
J.THIELMAN 11462 1 11112024 7:49:32 PM
BADGE OR ID# 12503 OR]# WA0171300 TIME POLICE DISPATCHED 12:10 AM TIME POLICE ARRIVED'12:12 AM
PART I PAGE IT]OF
REPORT NO. EE36267 CASE# 23-14884 DATE AND TIME 12/28/23 00:08
OF COLLISION
Am
Unit I
CL
Talbot
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