HomeMy WebLinkAbout23-12680 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 0 27c
COLLISION REP FIT 1591971
CASE 23-12680 z
INTERSTATE ❑ CITY STREET FIRE ❑RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHIC;I F ❑ LOCAL AOENC 4900 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 2 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 11 - 1-- 2023 1508 17 ❑.= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓
BLOCK
NE SUNSET BLVD MILEPOST ST e✓ 3200
4a❑
DISTANCE OF(REFERENCE OR CROSS STREET)
5 MILES❑ 250 00 FEET e S ❑ W e NE 12TH ST
0 4 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
✓NO D:2067750310 0 11
30
6� LAST NAME VEETUTU FIRSTNAME VILIAMI MIDDLE I N 1 2 31
INITIAL
STREET El 16816 SE RENTON ISSAQUAH RD CITY RENTON ST WA Zjp, 980598308 z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
iNTERLOCKYEs NO INTERLOCKYEs NO YES R NO
8[—]
❑ L IIER # STATE yyq SEX'M I ELMM D Y' 09 - 15 - 1943 1 1 2 32
9 ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 H USE CLASS
ICNLJAURY 1 NATURE OF INJURIES z❑
3
10 9❑ PI ATE 14 D02368A STATE WA VIN# 3TYCZ5AN7NT083946
TRAILER STATE TRAILER STATE
11 3 5 PLATE# PLATE# FROM TO
TRLR. TRLR 7 1 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 ZO22 TOYT TACOM DAMAGE YES NO YES[:] No
✓
REGISTERED OWNER INFO VILIAM7 VEETUTU 16816 SE RENTON ISSAQUAH RD RENTON WA 98059 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
14 LIABILITY INSURANCE NSURANCE CO PROGRESSIVE TBA 3
IN EFFECT &POLICY# 9TOP
vewcLe CHARGE 1 5 36
LEIALLv YEs No CITATION# 3A0681724 FAIL YIELD LEFT TURN MOTOR o aorrom
15❑ NDING 8 7 6
MOTOR PEDAL- 'PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT 02 VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES 1/ NO D:6033061739
16 a
LAST NAME BONVINI FIRST NAME LAUREN MIDDLE I A
INITIAL
17❑ STREET ❑', 1140 EDMONDS AVE NE APT 216 CITY' RENTON ST WA ZIP 980568706 37
NEW ADDRESS ❑
18� CDL IGNITION REQUIRED IGNITION PtR-E-S1ENT MEDICAL TRANSPORTED 38
INTERLOCKYES�NOR INTERLOCK Y�EsI I I NOF YES t l NO❑
19 DRIVER # STATE WA ]SEX IF M D.C.B. 09 _ 13 _ 1985 39
WELMET INJURY NATURE OF INJURIES 40
20 ON DUTY STATUS AIRBAG,3 RESTR 4 EJECT 1 USE CLASS 7 AIRBAG/CHEST ARMS
21❑ LICENSE PO/NT14 TATe WA VIN# JMIBM1N76G1344641
❑ 41
PLATE#
42
22❑ PLATE# STATE PLATE# STATE
TRLR
23❑ UIN#. IN#.
43
RLR
'
VEH YEAR 2016 MAKE MAZp MODEL 3 STYLE VEHICLETOWED TO BLIN TOWEDBY GOV HI 44
24❑ DAMAGE YES NO BANKERS YES NO
REGISTERED OWNER INFO VILIAMI VEETUTU 16816 SE RENTON ISSAQUAH RD RENTON WA 980598308 D:2067750310 VEHICLE NO.2
SHADEDAMAGEDAREA
3 4
LIABILITY
INSURANCE INSU PORGY#E CO GEIC04554890858IN 9TOP 5
'E""LE ❑ ,J� CITATION# CHARGE to BOTTOM
LEGALLY YES N`L J
25 ' 6
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
J
26
M.LEVERTON 2517 WA0171300
PART A PAGE 01 OF
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EE20665
COLLISION REPORT III III III III III 111
1591972 CASE# 23-12680
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'
blu trk/1 It blk coupe lane 1 wb
CC
Within the city limits of Renton/King/WA I responded to a 2 car blocking crash near the 3200 block of
NE Sunset Blvd. I contacted the driver of unit 2 who told me she was in lane 1 westbound Sunset.
She said lane 2 was stopped from heavy traffic but lane 1 was wide open as she continued. Unit 2
said unit 1 made a left turn across both lanes without enough room to avoid contact. Unit 2 was
checked and released on scene by Renton Fire. Her vehicle was towed for damages. I contacted the
driver of unit 1 Id'd by his picture WADL. He told me he was making a left turn when the crash
happened. He provided very little information. He did not complain of injury and damages could have
required a tow truck, but he chose to drive it away. I cited Unit 1 ref RCW 46.61.185 FTYROW-Left
Turn 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
11/3/2023
1 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 11/3/2023
I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT.
M.LEVERTON 11-03-23 03:59 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY E
DAT
CO.JOHNSON 0505 1111712023 2:17:54 PM
BADGE OR ID# 2517 ORI# WA0171300 TIME POLICE DISPATCHED! 3:09 Pry TIME POLICE ARRIVED',3:17 PM
PART I PAGE IT]OF
REPORT NO. EE20665 CASE# ' 23-12680 DATE AND TIME 11/03/23 15:08
OF COLLISION
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