HomeMy WebLinkAbout23-13275 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 0 27c
COLLISION REP FIT 1591971
CASE 23-13275 z
INTERSTATE ❑ CITY STREET FIRE ❑RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHICI F ❑ LOCAL AOENC 4900 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 N E IN CITY#
cowsloN 11 - 1-- 2023 1107 17 ❑-= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
BLOCK NO.
OAKESDALE AVE SW
e✓ --- ----� ❑
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ ❑ FEET e S ❑ VV e SW 7TH ST
0 3 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
�/No D:2064075301 0 4 30
6� LAST NAME WALKER FIRSTNAME KURTIS MIDDLE J 1 1 2 31
INITIAL
STREET ❑ 14838 4TH AVE S CITY BURIEN ST WA 2jp, 981683508 z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
INTERLOCK YES[:]NO INTERLOCKYEs NO YES R NO
8❑ LRIIVER #
ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 H U SE
ICNLJAUSSY 1 NATURE OF INJURIES z❑
3
10❑ Pi aT�S� D63796D sTArI WAurN# 1 GCGG25V071103515
TRAILER STATE TRAILER STATE
11 3 5 PLATE# PLATE# FROM To
TRLR. TRLR. 5 3 33
12 3 5 VIN#j VIN#
FROM TO
VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE q 3 34
13 2 2007 CHEV EXPRES DAMAGE YES NO YES[:] No
✓
REGISTERED OWNER INFO KURTIS WALKER 148384TH AVE S BURIEN WA 981683508 D:2064075301 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
14 ❑ INSURANCE CO 3 4
LIABILITY INSURANCE
IN EFFECT &POLICY# 9TOP
vewcLE CHARGE 10BOTTOM 5 36
EGHALLY YES❑NO CITATION# 3A0681738,3A0681738 FAIL TO OBEY TRAFFIC CONTROL
15❑ STANDING 8 7 6
MOT
iT VEHICLE PEDAL CYCLE ❑ PEDESTRIAN PROPERTY ❑ D 1/YES H OLD MET PHONE
16 a
LAST NAME PHOMMACHANH FIRSTNAME LUCKY MIDDLE I B
INITIAL
17❑ STREET ❑', 2121 26TH AVE S APT 209 CITY SEATTLE ST WA ZIP 981444756 37
NEW ADDRESS ❑
18� CDL IGNITION REQUIRED IGNITION PtR-E-S1ENT MEDICAL t-T�RANSPORTED ❑ 38
INTERLOCKYES�NOR INTERLOCK YEs I I No� YES t l NO❑
19 DRIVER'S STATE WA SEX M D.Q.B. 08 _ 15 _ 1966 39
LICENSE# MMDDYY
HELMET I {NJURY NATURE OF INJURIES 40
20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 USE CLASS 1 ❑
21❑ LICENSE I C62007W TAre WA VIN1i 2HJYK165X6H520308
❑ 41
PLATE#
42
22❑ PILER LATE# STATE PLATE# STATE
23❑ 43
TRLR RLR
UIN#. 'IN#.
VEH YEAR 2006 MAKE HOND MODEL RIDGELIN STYLE VEHICLETOWED TO BLIN TOWEDBY GOV HI 44
24❑ DAMAGE YES NO YES NO
REGISTERED OWNER INFO LUCKY PHOMMACHANH 212126TH AVE S APT 209 SEATTLE WA 98144 D:2069603102 VEHICLE NO.2
SHADEDAMAGEDAREA
3 4
INAEFFITY ECTNSURANCE INSU&POLICY#E CO SAME. IGQV'""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. EE23159
COLLISION REPORT III III III III III 111
1591972 CASE# 23-13275
ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY)
NAME MIDDLE INITIAL) SAECH/N FARM F
(LAST FIRST,
ADDRESS&PHONE#
3939 S OTHELLO ST APT 635 SEATTLE WA 981183684 SEXi F MMDOYyry 09 - 02 - 1964
SEAT HELMET INJURY NATURE OF INJURIES
PASSENGER I�I WITNESS� UNIT# 2 POS S AIRBAG 2 RESTR. 4 EJECT I USE CLASS 7 NHesr
NAME L�1
(LAST,FIRST,MIDDLE INITIAL)
ADDRESS&PHONE# D O B
SEX MMDDVYYY
PASSENGER []WITNESSO UNIT# SEAT AIRBAG RESTR. EJECT HELMET NJURY
POS. NATURE OF INJURIES
USE CLASS
NAME
(LAST FIR57 MIDDLE INITIAL)
AppRESS&PHONE#
SEX D.O.B.
MMDDYVYY. -
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 11-17-23 02:52 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
C.JACOBS 1953 1 11/25/2023 7:28:05 AM
BADGE OR ID# 2517 OR]#' WA0171300 TIME POLICE DISPATCHED 11:07 AM TIME POLICE ARRIVED',11:11 AM
PART I PAGE IT]OF 4]
REPORT NO. EE23159 CASE# 23-13275 OF COLLISION
11/17/23 11:07
OF CbLLI510N
NARRATIVE
blk trk It/2 wht van rt on red/1
CC
Within the city limits of Renton/King/Wa I responded to a 2 car crash at the intersection of Oakesdale
Ave SW at SW 7th St.
I contacted the driver of unit 2 who told me he was making a left turn from Oakesdale ave SW to EB
SW 7th St. He told me while he was in the middle of his turn unit 1 made a right turn and crashed into
him. Unit 1 did not complain of injury. Renton Fire responded to check his passenger. She was
released on scene. Unit 2 did not require a tow truck for damages.
I contacted the driver of unit 1 ID'd by picture WADL. Unit 1 said he was making a "free right turn on
red" when he collided with unit 2. 1 reminded him, its lawful to make a right on red after a complete
stop, that its not posted no turn on red or if there is no other immediate hazard, or if another vehicle
had the right of way. In this case unit 2 was turning left on a green which makes unit 2 lawful upon
the roadway. Unit 1 took responsibility for the crash. He was unable to provide valid proof of
insurance for his van. He did not complain of injury and after making a few repairs was able to driver
away in his vehicle not requiring a tow truck.
I cited unit 1 ref RCW 46.61.050 FTYROW-right turn on red 2 car crash and ref RCW 46.30.020 no
valid 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 11/17/2023
PAGE 3 OF 4
REPORT NO. EE23159 CASE# ' 23-13275 DATE AND TIME 11/17/23 11:07
OF COLLISION
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