HomeMy WebLinkAbout24-4982 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 1 27c
COLLISION REP FIT 1591971
SASE 24-4982 z
INTERSTATE ❑ CITY STREET FIRE ❑
RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHICI F ❑ LOCAL AGENCI 4900 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 TOTAL#OF OBJECT 1 8 2$
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# ❑
COLLISION'. 05 — O9 — 2024 1750 17 ❑.= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓
140TH WAY SE BLOCK NO. e✓ 15400
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ 75 00 FEET MILES e S B W e SE 154TH PL
0 1 29
MOTU '�01 VEHtOCLEZ PEAL-CYMLE. El �ESAGE NHORE✓LD MET PHONE 30
6� LAST NAME UNKNOWN FIRSTNAME MIDDLE 1 1 2 31
INITIAL
STREET ❑ CITY ST ZIP z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION : PRESENT MEDICAL TRANSPORTED 3
iNTERLOCKYEs NO 1/ INTERLOCKYEs NO�/ YEs No�/
DRIVERS
STATE SEX D — 328 LICENSE MMDYY❑
9 ON DUTY❑ STATUS I
AIRBAG 9 RESTR 9 EJECT 1 H USEEr 9 CLAY 0 NATURE OF INJURIES z❑
3
LICENSE sTATI urN#'
10[ PI ATE#
TRAILER STATE TRAILER STATE
11 4 0 PLATE# PLATE# ROM ro
rRLR. TRLR. 8 4 33
12❑ VIN# UIN#
FROM TO
❑ VEH.YEAR MAKE MODEL STYLE 4D VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE $ 4 34
13 2 DAMAGE YES NO YES❑ NO✓
REGISTERED OWNER INFO UNKNOWN VEHICLE NO. 1
SHADE IN DAMAGED AREA ❑ 35
14 LIABILI INSURANCE❑ NSURANCE CO 3 4
IN EFFECT &POLICV# 9TOP
vewcLE CHARGE 5 36
LEGALLY YES❑NO❑ CITATION# 1 o BOTTOM
15❑ STANDING 8 6
MOTOR PEDAL PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT VEHICLE ❑ CYCLE' ❑ ❑ OWNER ❑ YES 1/ NO D:2067133305 N:2067133305
16 a
LAST NAME HUNT FIRST NAME LISA MIDDLE R
INITIAL
17❑ STREET EDOREs7 14136 SE 154TH PL CITY' RENTON ST WA ZIP 98058 37
❑ CDL IGNITION REQUIRED IGNITION PRESENT tSENT MEDICAL—T�RANSPORTED � 38
INTERLOCK YEs❑NoR INTERLOCK YES It1 I NOF YES l NO❑
19 DRIVE # STATE SEX F M .C.B. 10 _ 28 _ 1961 39
ON DUTY STATUS 1 AIRBAG RESTR EJECT 3 H EET 6 INJAUSRSY 6 [NATURE.1 INJURIES
C/O RIGHT ARM AND HIP PAIN 40
❑21❑ TATE 41
LICENSE VIN# `1
PLATE#
42
22 [TRAILER TILER
❑ PLATE# STATE PLATE# STATE
23❑ 43
TRLR RLR
UIN#. 'IN#.
VEH YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN
TOWED BY Gov HI 44
24❑ 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 IGQVE""LE
❑ ,J� CITATION# CHARGE
LEGALLY YES N`L J
25
=UGENT
(PRINT) OFFICER PHONE BADGE OR ID# 771�NCY
26 4 4 11498 0171300
PART A PAGE 01 OF
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EE79846
COLLISION REPORT III III III III III 111
1591972 CASE# 24-4982
ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY)
NAME MIDDLE INITIAL) MUSGRAVE JEFFREYL
(LAST FIRST,
ADDRESS&PHONE#
13022 SE 188TH PL RENTON WA 98058 4257610629 SEX M MMDOYyvv 12 - 26 - 1964
PASSENGER❑ ❑ POS. USE CLASS WITNESS UNIT# SEAT AIRBAG RESTR. EJECT ' HELMET INJURY NATURE OF INJURIES
NAME
(LAST,FIRST,MIDDLE INITIAL) LOVE JAMES SARA E
ADDRESS&PHONE# DOB
15413 141ST PL SE RENTON WA 98058 2069921697 SEX I F MMDovvvv 07 _ 20 _ 1961
PASSENGER []WITNESSZ UNIT# SEAT AIRBAG RESTR. EJECT HELMET NJURY
POS. NATURE OF INJURIES
USE CLASS
NAME
(LAST FIRST,MIDDLE INITIAL) ANDERSON SHAYE C
AooREss&PHONE# 18489 136TH PL SE RENTON WA 98058 2064341936 SEX F D•O•B• 05 _ 29 _ 1981
MMDDYYYY
PASSENGER WITNESS Z I UNIT# SEAT AIRBAG RESTR. EJECT HELMET INJURY 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.
MATTHEW NUGENT 05-22-24 11:21 AM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST.DET DATED PLACE SIGNED
APPROVED BY DATE
CO.JOHNSON 0505 5/23/2024 3:45:55 PM
BADGE OR ID# 11498 ORI# WA0171300 TIME POLICE DISPATCHED! 5:51 PM TIME POLICE ARRIVED',5:59 PM
PART I PAGE IT]OF 4�
REPORT NO. EE79846 CASE# 24-4982 OF COLLISION
05/09/24 17:50
OF CbLLI510N
NARRATIVE
24-4982
On 05/09/2024 at approximately 1752 hours, I was dispatched to a hit-and run vehicle versus bicyclist
collision with reports of injury that occurred at the intersection of 140th Way SE and SE 154th PL,
within the city limits of Renton, County of King, Washington.
While en route, Dispatch advised that the involved vehicle had fled the scene southbound on 140th
Way SE following a collision with the cyclist. One of the witnesses described the collision as what
they believed to be an intentional act. Multiple witnesses stopped at the scene to assist and called
911. Dispatch simultaneously dispatched the Renton Regional Fire Authority (RRFA) due to
complaints of injury from the rider, specifically to her hip and arm.
Upon my arrival, RRFA was on scene attending to the bicyclist. The bicyclist was treated at the scene
and later released. I collected the bicycle rider's information and her recollection of the events leading
up to the collision. The following is her statement.
The bicyclist stated to me that prior to the collision, she was traveling southbound on 140th Way SE
and was approaching the intersection of SE 154th PL in the far-right shoulder of the roadway,
specifically on the south side of the road. While riding, the bicyclist stated she noticed a dark sedan
approach her from behind in her peripheral vision. The bicyclist stated that this is a rather steep hill
she was riding up and was just focused on getting up the hill not realizing that the sedan was getting
closer to her. The vehicle (Unit#1) eventually contacted the back of the bicycle causing the rider to
be pushed off/ejected from her bicycle where she landed partially into roadway. Witnesses stopped to
assist in getting the rider and her bicycle out of the roadway.
Witnesses and the rider recalled a dark-colored sedan as the causing vehicle and stated that it
continued southbound on 140th Way SE without stopping to attend to injuries of the fallen rider or
provide any of their driving documentation as required by law. One witness, Shaye Anderson,
described what appeared to be 3 people inside of the causing vehicle but was unable to describe the
driver or involved passengers, nor was there a license plate number obtained.
The driver of U1 committed one (1) counts of Hit-and-Run Attended by being involved in an accident
with another vehicle, which is attended, and failing to stop and remain at the scene until fulfilling all
statutory duties (provide name, address, insurance company, policy, vehicle license, exhibit driver's
license and render reasonable assistance to any person injured).
A business card and case number were provided to the bicycle rider. The rider's husband responded
to the scene and was able to transport her home.
I certify (or declare) under penalty of perjury under the laws of the State of Washington that the
foregoing is true and correct.
Electronically signed by Officer M. Nugent#11498 5/22/2024 10:50 AM Renton, King County, WA.
PAGE 3 OF 4
REPORT NO. EE79846 CASE# ' 24-4982 DATE AND TIME 05/09/24 17:50
OF COLLISION
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