HomeMy WebLinkAbout24-7628 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 2 27c
COLLISION REP FIT 1591971
SASE 24as28 z
INTERSTATE ❑ CITY STREET ❑ FIRE ❑
RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ HIT F ❑ LOCAL AOENC 4200 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 CITY# ❑
cawsloN 07 - 19 - 2024 1544 17 ❑.❑ N E IN S 8 W H OF e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓
RAINIER AVE S BLOCK NO. e✓ 743
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ ❑ FEET e S ❑ W e 0 4 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
✓NO D:2063009750 30
6� LAST NAME SINSON FIRSTNAME ARTURO MIDDLE E 1 2 31
INITIAL
STREET ❑, 4250 S GRAHAM ST CITY SEATTLE ST WA 2jp, 981182748 z=
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION : PRESENT MEDICAL TRANSPORTED 3
iNTERLOCKYEs NO INTERLOCKYEs NO YES R NO
8 LRIIVER #
ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 HELMET
2 CLASS 1 NATURE OF INJURIES z❑
3
LICENSE C76071G sTAr1 WAvIN# JM2UF3116G0596049
10 F91 PI ATE i4
IT STATE TRAILER STATE
11 0 0 PLATE# PLATE# ROM ro
TRLR. TRLR. 3 5 33
12❑ vIN#' VIN#
FROM TO
❑ VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE R 3 34
13 2 1986 MAZE) B2300 I'K DAMAGE YES NO YES[:] NO✓
REGISTERED OWNER INFO OWNEDBYDRIVER VEHICLE NO. 1
SHADE IN DAMAGED AREA ❑ 35
14 LIABILITY INSURANCE INSURANCE CO GEICO 4349-66.44.50 4
IN EFFECT &POLICY# 9TOP
vE— CHARGE 5 36
LEGALLv YFS❑NO❑ CITATION# 10 BOTTOM
15❑ STANDING 8 7 6
MOTOR PEDAL PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT VEHICLE ❑ CYCLE ❑ ❑ : OWNER ❑ YES 1/ NO D:2062518364
16 a
LAST NAME LEE FIRST NAME GAR MIDDLE L
INITIAL
17❑ STREET ❑' 4900 28TH AVE S CITY' SEATTLE ST' WA ZIP 98108 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 DRIVE # STATE SEX M M .O.B. 09 _ 02 _ 1992 39
20 ON DUTY STATUS 1 AIRBAG RESTR EJECT 3 H EET 5 CLASSY 6 POSSIBLE CONCUSSION,ROADRASH 40
❑21❑ LICENSE TArE VIN# 41
PLATE#
42
22❑ PLATE# STATE PLATE# STATE
23❑ 43
TRLR RLR
VIN#. IN#.
VEH YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN
TOWED BY Gov HI 44
L4❑ DAMAGE YES NO YES NO
REGISTERED OWNER INFO VEHICLE NO.2
SHADE IN DAMAGED AREA
2 3 4
LIABILITY
INSURANCE❑ INSURANCE
#E CO
IN EFFECT &PO I 9TOP 5
vE""LE ❑ ,J� CITATION# CHARGE i o BOTTOM
LEGALLY YES N J
25 s 6
7CA
NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
26 4 4 LAN 12007 WA0171300
PART A PAGE 01 OF
3000-345-159 fR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EE99216
COLLISION REPORT III III III III III 111
1591972 CASE# 24-7628
ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY)
NAME
(LAST 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'
On July 19, 2024, at 1544 hours, Officer Battle reported he came across a collision at Walmart, 743
Rainier Ave S, in Renton. I responded as a backing officer.
Upon my arrival Officer Battle told me that a bicyclist was injured after unit 1 made a left turn into
Walmart. The bicyclist was going eastbound on S 7th St.
I then spoke with the driver of unit 1 and he explained he was going westbound on S 7th St and
approaching the entrance to Walmart when the collision occurred. He made a left turn into the parking
lot, but was subsequently struck by a bicyclist going eastbound on S 7th St. After they collided, the
bicyclist struck the bed of the truck and flipped into it.
Officer Battle mentioned he located the bicyclist in the bed of the truck, and he appeared to be
unconscious. Renton Fire was requested for a medical evaluation.
Eventually, I spoke with the bicyclist, and he explained he was going eastbound on S 7th St when unit
1 crossed in front of him. He was unable to stop or react in time.
It was also apparent that the bicyclist struck the vehicle hard and was possibly concussed because
he was unable to sit down, he kept repeating himself, and would forget things he had just said.
Renton Fire transported the bicyclist back to his house.
I provided both parties a copy of the exchange of information.
I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT.
C.CATALAN 07-19-24 04:43 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
CO.JOHNSON 0505 1 7/25/2024 3:48:27 PM
BADGE OR ID# 12007 ORI# WA0171300 TIME POLICE DISPATCHED 3:44 PM TIME POLICE ARRIVED',3:44 PM
PART I PAGE IT]OF
REPORT NO. EE99216 CASE# ' 24-7628 DATE AND TIME 07/19/24 15:44
OF COLLISION
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