HomeMy WebLinkAbout23-12265 POLICETRAFF'c" III !�� I IIIllI111IN II II I REPORT NO. EE14824 170
27
COLLISION REP FIT 1591971
CASE 23-12265 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 1 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# ❑
cowsloN 10 - 1-- 2023 1010 17 ❑.= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓
BLOCK
NE SUNSET BLVD MILEPOST ST e✓ 2700
4a❑
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ 200 00 FMILES EET e S ❑ E e HARRINGTON AVE NE
0 4 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
,/No D:4254964936 0 11
30
5❑ LAST NAME BUSTAMANTE FIRSTNAME SILVIA MIDDLE 1 2 31
INITIAL
STREET ❑ 1174 HARRINGTON AVE NE CITY RENTON ST WA 2jp, 98056 z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
1/ I INTERLOCK YES[:]NO NTERLOCKYEs NO Z/ YES R No�/
8❑ LDRIVER # STATE WA SEX'F MID
.O B 06 1— 03 — 1958 2 32
9 ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 HELMET USE 2 CLASS 1 NATURE OF INJURIES z❑
3
10 9❑ PI ATE BLT5902 sTArI WAVIN#' 2HKRW2H9XJH660717
TRAILER STATE TRAILER STATE
11 3 5 PLATE# PLATE# FROM 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 7 $ 34
13 2 2018 HOND CRV UT DAMAGE YES NO YES[:] No
✓
REGISTERED OWNER INFO OWNEDBYDRIVER VEHICLE NO. 1
SHADE IN DAMAGED AREA ❑ 35
14 LIABILI INSURANCE INSURANCE CO PROGRESSIVE 938810366 3
IN EFFECT z &POLICY# 9TOP
15❑ VEHLE�ALLv ICLE 1 5 36
YEs�No M CITATION# W23028187 CHARGE PROH/IMPROPER TURN 1 o Borrow
STANDING 8 7 6
MOTOR PEDAL PROPERTY DAM THR OLD MET PHONE
UNIT�2 ❑✓ ❑ PEDESTRIAN ❑ ❑ D:2065916878
VEHICLE CYCLE OWNER YES�/ NO
16 a
LAST NAME ZAVALA LOPEZ FIRST NAME JORGE MIDDLE A
INITIAL
17❑ STREET ❑', 2908 NE 12TH ST APT 205 CITY RENTON ST WA ZIP 98056 37
NEW ADDRESS ❑
18� CDL IGNITION REQUIRED IGNITION PR—E-1SENT MEDICAL TRANSPORTED 38
INTERLOCKYES�NO� INTERLOCK YEs It I NOF YES
t l NOF,/
19 DRIVER #
{NJURY 1 NATURE OF INJURIES 40
20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 USE 2 CLASS ❑
21❑ LICENSE I CFD9146 TAre WA VIN# KNDJE723987466373
❑ 41
PLATE#
42
22❑ PLATE# STATE PLATE# STATE
23❑ VIN#. 43
TRLR RLR
'IN#.
TOWED BY GOV HI 44
VEH YEAR 2008 MAKE 1(I/� MODEL SPORTAG STYLE (/T —FEHICLE
TOWED NOO✓ BLIN YES NO 1/
24❑ REGISTERED OWNER INFO OWNED SY DRIVER VEHICLE N0.2
SHADEDAMAGED AREA
3 4
LIABILITY INSURANCE❑ INSURANCE CO
IN EFFECT &POLICY# 1 9TOP 5
LEGALLY
E"I°LLE YEs Nu CITATION# W23028188 CHARGE OP MOT VEH W/OUT INSURANCE o aorroM
25 s � a
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
26
D.LAMOTHE 11677 WA0171300
PART A PAGE 01 OF
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EE14824
COLLISION REPORT III III III III III 111
1591972 CASE# 23-12265
ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY)
NAME MIDDLE INITIAL) ZAVALARIVERA ►RIANYG
(LAST FIRST,
ADDRESS&PHONE# D O.B. '
2908 NE 12TH ST APT 205 RENTON WA 98056 SEXi F MMDOYyry 11 - 14 - 2017
PASSENGER Z WITNESS UNIT# 2 SEA 7 AIRBAG 2 RESTR. q EJECT ? HELMET INJURY NATURE OF INJURIES
POS. USE 1 2 CLASS 11
NAME
'(LAST,FIRST,MIDDLE INITIAL)
ADDRESS&PHONE# D O B
MMDDYYYY
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.
D.LAMOTHE 10-26-23 11:09 AM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
DESIREE SCOTT 10272 1 1013112023 7:14:18 AM
BADGE OR ID# 11677 ORI# WA0171300 TIME POLICE DISPATCHED 10:14 AM TIME POLICE ARRIVED',10:14 AM
PART Ei PAGE IT]OF 4�
REPORT NO. EE14824 CASE# 23-12265 OF COLLISION
10/26/23 10:10
OF CbLLI510N
NARRATIVE
On 10/26/2023 at approximately 1014 hours, I was conducting routine patrol when I observed Driver
#1 and Driver#2 standing outside of their vehicles on the inside eastbound lane of NE Sunset Blvd in
the 2700 block, in the City of Renton, County of King, State of Washington.
Vehicle #1 was facing southbound with the front of the vehicle in the Safeway parking lot entrance
and its back end still protruding in the #1 eastbound lane. The rear passenger quarter panel was
resting against the front passenger side bumper corner of Vehicle #2. Vehicle #2 was facing
eastbound in the #1 eastbound lane on NE Sunset Blvd.
Vehicle #1 had moderate damage to the rear passenger quarter panel and Vehicle #2 had moderate
damage to the front passenger side corner bumper.
I spoke with Driver#1 who stated she was in the center turn lane facing westbound. She stated there
were no other vehicles coming eastbound, other than Vehicle #1, but she stated it was a distance
away. She made a left hand turn and Vehicle #2 collided with the rear of Vehicle #1. Driver#1 stated
she believed Driver#1 was driving too fast.
I spoke with Driver#2 who stated that he was traveling straight ahead in the #1 eastbound lane when
Vehicle #1 made a left turn in front of him. He stated he slowed but was unable to avoid colliding with
Vehicle #1.
No involved parties reported any injuries.
By making a left hand turn when it was not safe to do so, Driver#1 did conduct and improper turn.
Driver#1 was issued a written warning for this infraction.
By not having valid insurance for his vehicle, Driver#2 was issued a written warning for failure to
provide proof of valid insurance.
I provided both parties with an exchange of informatino and a case number.
This concludes my involvement in this case.
PAGE 3 OF 4
REPORT NO.! EE14824 CASE# ' 23-12265 DATE AND TIME 10/26/23 10:10
OF COLLISION
ism
ry
� .
Clsj%
PAGE 4 OF 4