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Home My WebLink About23-13683 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 1 27c COLLISION REP FIT 1591971 CASE 23-13683 z INTERSTATE ❑ CITY STREET FIRE ❑ RESULTED 1 STOLEN STATE ROUTE ❑ OTHER ❑ VFHIr.I F ❑ LOCAL AGENCI 4250 3 HIT&RUN ✓ CODING COUNTY RD PRIVATE WAY INVOLVED 2 TOTAL#OF OBJECT 1 8 28 TRIBAL UNITS 03 STRUCK RESERVATION z 3❑ DATE OF M M D D Y Y Y Y TIME(2400) COUNTY# MILES N E IN CITY# cawsloN 11 - 1-- 2023 1456 17 ❑-= S 8 IN e 1070 3 4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑ BLOCK NO. e✓ --- ----� ❑ SE CARR RD MILEPOST 4a❑ DISTANCE OF(REFERENCE OR CROSS STREET) 5❑ ❑ FEET e S ❑ W e 105TH PL SE 0 1 29 UNIT 01 VEHICLE MOTZ PEDAL-ORCYCLE ElDESA✓NHORESHOLDMET PHONE 0 7 30 6� LAST NAME UNKNOWN FIRSTNAME MIDDLE 1 1 2 31 INITIAL STREET ❑ CITY ST ZIP 2 NEW ADDRESS 7❑ CDL IGNITION REQUIRED IGNIT{ON PRESENT MEDICAL TRANSPORTED 3 iNTERLOCKYEs NO INTERLOCK YES NO YES No 8❑ LIRCIENSRE# STATE I SEX u MMDDYY '❑- 1 1 2 32 9 ON DUTY❑ STATUS I AIRBAG 9 RESTR 9 EJECT 1 H U EEr 9 CLAY 0 NATURE OF INJURIES z❑ 3 LICENSE sTATI urN#' 10[ PI ATE# TRAILER STATE TRAILER STATE 11 3 5 PLATE# PLATE# FROM TO TRLR. TRLR 7 3 33 12 0 0 vIN#' VIN# FROM TO ❑ VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE J 9 34 13 2 DAMAGE YES NO ✓ YES❑ NO✓ REGISTERED OWNER INFO [NEW] VEHICLE NO. 1 SHADE IN DAMAGED AREA ❑ 35 14 ABILI INSURANCE❑ INSURANCE CO 3 4 IN EFFECT &POLICV# 9TOP VEHICLE CHARGE 5 36 LEGALLY YES❑NO❑ CITATION# 1 o BOTTOM 15❑ STAIN.D'ING 7 6 UNIT VE IMOTOOR CYCLE ❑ PEDESTRIAN ❑ OWNER PEDAL ES❑ DYES✓ NO AM THR OLD MET PHONE 16 a LAST NAME HECTOR FIRST NAME SENACA MIDDLE I D INITIAL 17 STREET I❑ 8426 205TH STREET CT E CITY SPANAWAY ST WA ZIP 983875354 37 NEW ADOREss❑' 18❑ CDL IGNITION REQUIRED IGNITION PRESENT tS1ENT MEDICAL TRANSPORT ❑ 38 INTERLOCK YEs❑NoR INTERLOCK YES It I NOF YES l NO❑ 19 F] D IVEW # I {NJURY NATURE OF INJURIES 40 20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 USE CLASS 1 ❑ ❑21❑ 41 LICENSE I PLA E# BJY0580 TATE WA vIN# WBA1F7C54FV367589 4 42 22 [TRAILER TILER ❑ PLATE# STATE PLATE# STATE 23❑ 43 TRLR RLR UIN#. 'IN#. YEAR 2015 MAKE BMW MODEL 228 STYLE VEHICLETOWED TO BLIN TOWEDBY GOV HI 44 VEH L4❑ DAMAGE YES NO✓ YES NO✓ REGISTERED OWNER INFO SENACA HECTOR 8426205TH STREET CTE SPANAWAY WA 983875354 D:2532297605 VEHICLE NO.2 SHADEDAMAGEbAREA s Cd LIABILITY INSURANCE &POINSURGY#E CO ST FARM 5483342-D29-47IN 9TOP 'E""LE CITATION# CHARGE YES N 25 to BOTTOM LEGALLY u ❑ OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY 26 M.LEVERTON 2517 WA0171300 PAGE 01 OF PART A 3000-345-159 OR 11/181 STATE OF POLICETRAFFICN CORRECTION REPORT NO. EE26993 COLLISION REPORT III III III III III 111 1591972 CASE# 23-13683 ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY) NAME MIDDLE INITIAL) LUND AARON T (LAST FIRST, ADDRESS&PHONE# D O.B. ' 17123 120TH LN SE APT S304 RENTON WA 980585992 SEX M MMDOYyry 07 - 19 - 1994 PASSENGER I�I WITNESS UNIT# 3 PES 3. AIRBAG 2 RESTR. 4 EJECT ? 1 HELMET INJURY NATURE OF INJURIES L�!1 USE CLASS 1 NAME (LAST,FIRST,MIDDLE INITIAL) ADDRESS&PHONE# D O B SEX MMDDYVYY PASSENGER ❑WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET NJURY NATURE OF INJURIES POS. USE CLASS NAME (LAST FIR57 MIDDLE INITIAL) AppRESS&PHONE# SEX D.Q.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 11-28-23 04:38 PM INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED APPROVED BY DATE C.JACOBS 1953 12/5/2023 11:29:55 AM BADGE OR ID# 2517 OR]#' WA0171300 TIME POLICE DISPATCHED' 2:56 PM TIME POLICE ARRIVED',2:56 PM PART I PAGE IT]OF 5� REPORT NO. EE26993 CASE# 23-13683 OF COLLISION 11/28/23 14:56 OF CbLLI510N NARRATIVE red/unit 1v sedan h/r 2 slv sedan gray wagon 3 lane 2 RTF Within the city limits of Renton/King/WA I was at a 2 car blocking crash near the intersection of SE Carr Rd at 105th PL SE when I heard screeching tires and watched a red car crash into the back of a stopped car which hit another. I notified Dispatch to start another unit as I was still blocking the roadway for the crash I was on and could not respond, athrough very close. I watched units 2 and 3 pull into the a nearby parking lot and watched the red car/unit 1 drive away. I was not able to ID the car make/model or plate. I was able to clear and take the onview crash before additional units arrived. I contacted the driver and passenger of unit 3. They said they were stopped in traffic EB SE Carr RD lane 2 and where hit from behind. They did not hit a car in front of them. They did not complain of injury and damages did not require a tow truck. I contacted the driver of unit 2 who was stopped in traffic when he was hit from behind by unit 1. This shoved his vehicle into the back of unit 3. As he was moving his vehicle to the parking lot he assumed unit 1 was following, but fled the area instead. He did not complain of injury and although damages could have used a tow truck, with the help of a tow driver made unit 1 operable and did not tow. There was not other people/Wit to provide additional information ref unit 1. Information/Insurance only. 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 11/28/2023 PAGE 3 OF 5 SUPPLEMENTAL REPORT NO. EE26993 r`) POLICE TRAFFIC 1 1 8 27 COLLISION REPORT CASE# 23-13683 1 COMMERCIAL MOTOR CARRIER INTERSTATE INTRASTATE G UNIT'# USDOT ICC# VEHICLE TYPE CARGO BODY ;TYPE 2 ❑ 1 28 CARRIER NAME 3 CARRIER ADDRESS ` CITY ST ZIP—1 I ' 4 ❑ NAME # PLACARD: :❑ GI PLACARD IF NO NUMBER SOURCE AXLES + 4a ❑ ADDITIONAL UNITS MOTOR PEDAL- PROPERTY DAMAGETHRESHOLD MET PHONE UNIT# 3 �✓ � PEDESTRIAN YES NO 5 VEHICLE CYCLE OWNER ✓ 0 7 29 LAST NAME :. COOPER FIRST NAME : JESSICA MIDDLE'.. ,.. A INITIAL STREET 30 NEW AnDRFrtP 17123 120TH LN SE APT S304 CITY RENTON ST WA ZIP 980585992 6 CDL IGNITIttN REQUIRED IGNITION PRESENT MEDICAL TANSPORTED 1 1 2 31 INTERLOCK YEs No NTERLOCK YES[:]NO[:] YES N DRIVER'S LICENSE STATE I WA SEX F MMDDYYv 02 - O6 - 1997 7 ON DUTY� STATUS AIRBAG' 2 RESTR. Q EJECT 1 HELMET I INJURY 1 1 NATURE OF INJURIES USE CLASS 8 ❑ 1 32 LICENSE BPP5550 [TAT WA VIN# 4S4BSAFC5H3257719 PLATE# 9 9] TRAILER TRAILER PLATE# STATE PLATE# STATE 10 ❑ TRLR TRLR VIN.#. VIN.#. 11 O O VEH.YEAR MAKE MODEL STYLE VEHICLE TOWS E T SABLIN TOWED BY anvi vEH1Ci E FROM TO 2017 SUBA OUTBAC DAMAGE YES NO ✓ YES NO ✓ REGISTERED OWNER INFOJESSICA COOPER 17123 120TH LN SE APT S304 RENTON WA 980585992 D:4257572337 J 9 33 12 � SHADE IN DAMAGED AREA 34 FROM TO ((ABILITY INSURANCE INSURANCE CO GEIC04546485147 GQO IN EFFECT &POLICY#VEHICLE 34 13Lecnuv YES NO❑ CITATION# CHARGE STANDING } 8 7 6 14 ❑ UNIT Tr Vd 1RE O CYDCLE 1:1OWNER YE YES AGE NOHRESHOLD MET PHONE ❑ 35 PEDESTRIAN 15 LAST NAME FIRST NAME MIDDLE INITIAL TIAL ❑ ET 16 STRETRE "F ' CITY ST ZIP NEW CDL IGNITION REdUiREO IGNITION PRESENT MEDICALTANSPORTED NTERLUCK YES No NTERLOCK YEs NO YEs NO El 17 37 LICENSE# STATE SEX MMDDDYBYY 18 ❑ ON DUTY� STATUS AIRBAG RESTR. ; EJECT HELMET INJURY NATURE of INJURIES 38 USE (CLASS 19 ❑ 39 LICENSE rnr VIN# PLATE# 20 ❑ TRAILER' TRAILER El40 PLATE#< STATE PLATE# STATE 21 ❑ TRLR TRLR 41 ViN# YIN#i 42 22 VEH.YEAR MAKE I MODEL STYLE I VEHICLE TO DUET SABLIN TOWED BY GOVT.VEHICLE DAMAGE YES NO YES NO 23 REGISTERED OWNER INFO SHADE IN DAMAGED 3 4 4 AREA F 43 z LIABILITY INSURANCE INSURANCE CO ' VINE EFFECT &POLICY# i 970P - 4 E:l 44 24 VEHICLE YES❑ NO❑ CITATION# CHARGE iq 60TiOM LECALLv STANDING 8 7 6 1 CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT. X LEVERTON 11-28-23 04:38 PM 25 INVESTIGATING OFFICER'S SIGNATURE OFFICER'S PHONE UNIT OR DIST DET DATED: PLACE SIGNED APPROVED BY DATE 26 OI BADGE 2517 O#I WA0171300 JACOBS 121512023 PAGE F41 OF F 3000-345-013(R 11118) REPORT NO. EE26993 CASE# ' 23-13683 DATE AND TIME 11/28/23 14:56 OF COLLISION t PAGE 5 OF 5