HomeMy WebLinkAbout23-13196 POLICETRAFF'c" III !�� I IIIllI111IN II II I REPORT NO. EE22364 170
27
COLLISION REP FIT 1591971
CASE 23-13196 z
INTERSTATE ❑ CITY STREET FIRE ❑RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHIC;I 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 RESERVATION STRUCK
z
3❑ DATE of M M D D Y Y Y Y TIME(2400) COUNTY# MILES N E IN CITY# ❑
cowsloN 11 - 1-- 2023 1255 17 ❑.= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
e✓ --- ----� ❑
S 2ND ST MILEPOST
4a❑
DISTANCE OF(REFERENCE OR CROSS STREET) BLOCK NO.
5❑ ❑ FEET e S ❑ W e WELLS AVE S
2 0 29
UNIT MOTOR
VEHICL PI CYCLE
ElOYESA✓THRESHOLD MET PHONE 0 1 30
6 LAST NAME CRUZ HERNANDEZ FIRST NAME LESLI MIDDLE N 1 1 2 31
INITIAL
STREET ❑ 12114 28TH AVE S APT S4 CITY SEATTLE ST WA 2jp, 981682419 z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
iNTERLOCKYEs 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❑ P1 aT�S� CBX0417 sTArI WAurN# 1G1JH12FX37231335
TRAILER STATE TRAILER STATE
11 2 5 PLATE# PLATE# IR.. ro
TRLR. TRLR. 3 5 33
12 2 5 VIN#' VIN#
>; FROM TO
VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN T Y GOVT.VEHICLE 34
13 1 2003 CHEV CALALI DAMAGE YES NO �MEYER 3 ]YES❑ No
REGISTERED OWNER INFO LESLI CRUZ HERNANDEZ 1211428TH AVE S APT S4 SEA TTLE WA 981682419 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
14 ❑ INSURANCE CO 3 4
LIABILITY INSURANCE
IN EFFECT &POLICY
# � 9TOP 5
VE—LL CHARGE 10 BOTTOM 36
LEGALLY YES No clTAnoN# 3A0681733,3A0681733 OP MOT VEH W/OUT INSURANCE,
15❑ STANDING 8 6
MOTOR PEDAL- PROPERTY DAM THR OLD MET PHONE
UNIT 02 ❑✓ ❑ PEDESTRIAN ❑ ❑ D:2067782302
VEHICLE CYCLE '. OWNER YES�/ NO
16 a
LAST NAME OLIVAREZ FIRST NAME FITZGERALD MIDDLE M
INITIAL
17❑ STREET ❑', 9802 55TH AVE S CITY SEATTLE ST WA ZIP 981185746 37
NEW ADDRESS ❑
18� CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED ❑ 38
INTERLOCKYES�NOR INTERLOCK YEs❑No� YES❑NO❑
19 D IVEW #
I INJURY NATURE OF INJURIES 40
20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 USE CLASS 1 ❑
21❑ LICENSE I CJR3016 TAre WA VIN1t JA32W6FVXAU033979
❑ 41
PLATE#
42
22❑ PILER LATE# STATE PLATE# STATE
23❑ 43
TRLR RLR
UIN#. 'IN#.
VEH YEAR 2010 MAKE MITS MODEL LANCER STYLE VEHICLE TOWED TO BLIN TOWEDBY GOV HI 44
24❑ DAMAGE YES NO GENE MEYER YES NO
REGISTERED OWNER INFO FITZGERALD OLIVAREZ 980255TH AVE S SEATTLEWA98118 VEHICLE NO.2
SHADEDAMAGEDAREA
3 4
LIABILITY
INSURANCE INSU&PORGY#E CO BRISTOL G01348094500IN 1GQV'""LE
❑ ,J� CITATION# CHARGE
LEGALLY YES N`L J
25
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
J
26
M.LEVERTON 2517 WA0171300
PART A PAGE 01 OF C7
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EE22364
COLLISION REPORT III III III III III 111
1591972 CASE# 23-13196
ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY)
NAME MIDDLE INITIAL) MARTINI►► HENRY
(LAST FIRST,
ADDRESS&PHONE# D O.B. '
2810 5TH AVE NE L05 PUYALLUP WA 98372 2532132900 SEX M MMDOYyry 05 - 03 - 1992
PASSENGER Z WITNESS❑'UNIT# I 2 PEATQS. 3 AIRBAG!2 RESTR. 4 EJECT ? 1 HELMET INJURY NATURE OF INJURIES
USE CLASS ;1
NAME
(LAST,FIRST,MIDDLE INITIAL) KELLEY SIERRA J
ADDRESS&PHONE# D O B
YY
SEX U MMDDYY 09 _ 01 _ 1994
PASSENGER ❑ POS. USE CLASS WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET NJURY NATURE OF INJURIES
NAME
(LAST FIR57 MIDDLE INITIAL)
AppRESS&PHONE#
SEX D.Q.B.MMDD -❑
YYYY.
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 11-15-23 04:09 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
C.JACOBS 1953 1 1112212023 10:36:37 AM
BADGE OR ID# 2517 OR]# WA0171300 TIME POLICE DISPATCHED 12:56 PM TIME POLICE ARRIVED 12:59 PM
PART I PAGE IT]OF 4�
REPORT NO. EE22364 CASE# 23-13196 OF COLLISION
11/15/23 12:55
OF CbLLI510N
NARRATIVE
blu sedan/2 lane 2 wht sedan/1 lane 1 into lane 2/unit 2
CC
Within the city limits of Renton/King/WA I responded to a 2 car blocking crash at the intersection of S
2nd St at Wells Ave S.
I contacted the drive of unit 2 who told me he was in lane 2 headed west when unit 1 turned left into
the side of his car. His passenger said he wasnt sure if she was turning left onto Wells or just
changing lanes but moved her car into the side of them. Neither complained of injury, but damages
did require a tow truck.
I contacted the driver of unit 1 ID'd by her picture WADL. She told me she was in lane 1 and was
moving her car into lane 2. She told me she was not turning left onto Wells just getting over one lane.
She claimed to have heard unit 2 speeding/having a loud muffler. Unit 1 was unable to provide valid
proof of insurance for her car.
I cited unit 1 ref RCW 46.61.140 Improper lane use 2 car crash and ref RCW 46.30.020 No proof of
insurance 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 11/15/2023
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REPORT NO. EE22364 CASE# ' 23-13196 DATE AND TIME 11/15/23 12:55
OF COLLISION
u
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