HomeMy WebLinkAbout23-12177 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 6 27c
COLLISION REP FIT 1591971
CASE 23-12177 z
INTERSTATE ❑ CITY STREET FIRE ❑RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHIC;I F ❑ LOCAL AOENC 4Y00 3
HIT 8 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#
GowsloN 10 - 1-- 2023 1548 17 ❑-= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
WHITMAN CT NE
BLOCK NO. e✓ --- ----� ❑
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ ❑ FEET e S ❑ VV e NE 4TH ST
0 1 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
�/No D:2062456484 0 4 30
6� LAST NAME STRATTON FIRSTNAME BRIANA MIDDLE J 1 1 2 31
INITIAL
STREET ❑ 3701 NE 10TH ST C(TY RENTON ST I WA Zlp' 980563514 z
NEW ADDRESS'
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
INTERLOCK YES[:]NO INTERLOCKYEs NO YEs NO
8❑ LRIIVER #
ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 H USEET ICNLJAURY 1 NATURE OF INJURIES z❑
3
10 1❑ P1 ATE 14 AWt 1398 STATE WA u N#' 1 G 1AK58F787112519
11[-j- TRAILER STATE TRAILER STATE
11 3 5 PLATE# PLATE# FROM TO
TRLR. TRLR 3 7 33
12 2 5 VIN# VIN#
FROM TO
❑ VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE q 3 34
13 2 2008 CHEV COBALT DAMAGE YES NO YES❑ NO
REGISTERED OWNER INFO BRIANA STRATTON 3701 NE 10TH ST RENTON WA 980563514 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
14 ABILI INSURANCE NSURANCECO GEIC00714-86.50.03 3 4
IN EFFECT &POLICY# Q
VEHICLE CHARGE 36
L-ALLv YEs No clTAnoN# 3A0681711 FAIL TO OBEY TRAFFIC CONTROLo e
15❑ STANDING 6
MOTOR PEDAL- PROPERTY DAM THR OLD MET PHONE
UNIT a2 ❑ PEDESTRIAN ❑ ❑ YES�/ NO D:2064345172
VEHICLE CYCLE : OWNER
16 a
LAST NAME SEGOVIA FIRST NAME DORA MIDDLE I A
INITIAL
17❑ STREET ❑', 24905 133RD CT SE CITY' KENT ST WA ZIP 980426661 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 WA ]SEX IF D.C... O6 _ 18 _ 1975 0 39
LICENSE# MMDDYY
HELMET I INJURY NATURE OF INJURIES 40
20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 USE CLASS 1 ❑
21❑ LICENSE AMF4175 TATE WA VIN1 JTEBU5JROD5128038
El41
PLATE#
El 42
22❑ PLATILER E# STATE PLATE# STATE
23❑ 43
TRLR RLR
UIN#. 'IN#.
VEH YEAR 2013 MAKE 7'Oy7- MODEL 4RUNNER STYLE VEHICLE TOWED TO BLIN TOWED BY GOV HI 44
24❑ DAMAGE YES NO YES NO
REGISTERED OWNER INFO DORA SEGOVIA 24905133RD CT SE KENT WA 980426661 D:2064345172 VEHICLE NO.2
SHADE IN DAMAGED AREA
2 3 4
LIABILITY
INSURANCE 8 POINSURGY#E CO FARMERS 5344522B27-47IN 1 STOP 5
'EwCLE ❑ 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. EE15351
COLLISION REPORT III III III III III 111
1591972 CASE# 23-12177
ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY)
NAME MIDDLE INITIAL) BESA RAFAEL L
(LAST FIRST,
ADDRESS&PHONE# D.0
.B.
2066378841 SEX' U MMDDYYYY 07 - 19 - 2002
PASSENGER WITNESS IT# SEAT AIRBAG RESTR. EJECT ' HELMET INJURY
UN NATURE OF INJURIES
❑✓ POS. USE CLASS
NAME
'(LAST,FIRST MIDDLE INITIAL)
ADDRESS&PHONE# DOB
SEX MMDDYVYV
PASSENGER ❑WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET NJURY NATURE OF INJURIES
POS. USE CLASS
NAME
(LAST FIR57 MIDDLE INITIAL)
AppRESS&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 10-24-23 05:21 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
CO.JOHNSON 0505 1 111112023 2:11:30 PM
BADGE OR ID# 2517 ORI# WA0171300 TIME POLICE DISPATCHED! 3:49 PM TIME POLICE ARRIVED 3:55 PM
PART I PAGE IT]OF 4�
REPORT NO. EE15351 CASE# 23-12177 OF COLLISION
10/24/23 15:48
OF CbLLI510N
NARRATIVE
red sedan/1 In 1 ran red wb wht suv/2 It from pl to ne 4th
CC
Within the city limits of Renton/King/WA I responded to a 2 car blocking unknown if injury crash at the
intersection of NE 4th St at Whitman Ct NE.
I arrived to find both vehicles operable and had them move to the Safeway parking lot.
I contacted the driver of unit 2 who told me on her green light she was making a left turn from
Safeway onto NE 4th St when unit 1 hit her in the side. She did not complain of injury and damages
did not require a tow truck.
I contacted the driver of unit 1 ID'd by her picture WADL who told me what unit 2 said happened,
happened. I confirmed that she was in lane 1 west bound and while her light was red and unit 2 was
turning left on her green light she crashed into the side of unit 2 car and she told me yes. She did not
complain of injury and damages did not require a tow truck.
I contacted the Wit/Besa who told me he saw unit 2 proceed on her green light, and although he did
not see unit 1 red light watched unit 1 skid into unit 2. Unit 1 once again confirmed she crashed into
unit 2.
1 cited unit 1 ref RCW 46.61.055 FTCWTCD-Red Light 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 10/24/2023
PAGE 3 OF 4
REPORT NO.! EE15351 CASE# ' 23-12177 DATE AND TIME 10/24/23 15:48
OF COLLISION
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