HomeMy WebLinkAbout24-2548 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 1 27c
COLLISION REP FIT 1591971
CASE 24-2548 z
INTERSTATE ❑ CITY STREET FIRE ❑
RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHICI F ❑ LOCAL AGENCI 4150 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 TOTAL#OF OBJECT 1 7 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 03 - 07 - 2024 2205 17 ❑-= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
SE PETROVITSKY RD BLOCK NO. e✓ p ❑
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ ❑ FEET e S ❑ W e 180THAVESE
0 4 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
,/No D:4255450345 0 11
30
6� LAST NAME BOWMAN FIRSTNAME ZACHARY MIDDLE C 1 1 2 31
INITIAL
STREET ❑ 11100 SE PETROVITSKY RD B104 CITY RENTON ST WA Zjp, 98055 z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
1/ I INTERLOCK YES[:]NO NTERLOCKYEs NO�/ YES R No�/
8❑ LRIIVER #
ON DUTY❑ STATUS' AIRBAG 6 RESTR 4 EJECT 1 I I [NATURE OF INJURIES
H U EET 2 1 INJURY CLASS ,6 COMPLAINT OF CHEST PAW z❑
3
10❑ PI ATE 14 1J8922U sTAr ID uN#' 1C3CDF665FD117341
5 TRAILER STATE TRAILER STATE
11 1 5 PLATE# PLATE# FROM TO
TRLR. A'RLR. 1 3 33
12 1 5 VIN#' VIN#
>; FROM TO
VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TR Y GOVT.VEHICLE 3 ] 34
13 2015 DODO DART SD DAMAGE YES NO �MEYER YES❑ No✓
REGISTERED OWNER INFO CAROL.GLENDENNING-BOWMAN 3424 E 100 N RIGBYID 83442 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
14 LIABILITY INSURANCE Z INSURANCE CO USAA 017151737C
IN EFFECT &POLICY#
ve'C ❑ 36
LEGALLv res❑NO❑ CITATION# CHARGE BOTTOM
15❑ NDING
�UITN 02 VE ICCLE CYCLE ❑ PEDESTRIAN ❑ OWNERMOTO YES
❑
16 DYES NO OLD MET PHONE
a
LAST NAME UNKNOWN FIRST NAME MIDDLE
INITIAL
STREET CITY RENTON ST ZIP 4
17❑ NEW ADDRESS ❑ 37
18❑ CDL IGNITION REQUIRED IGNITION PtR—E—S1ENT MEDICAL—T�RANSPORTED � 38
INTERLOCKYES�NOR INTERLOCK YEs I I NOF YEs t l NO❑
19 LLIICENS # STATE SEX U MMDDYY —❑_ 39
WELMET INJURY NATURE OF INJURIES 40
20❑ ON DUTY STATUS' AIRBAG 9 RESTR 9 EJECT ''1 USE 9 CLASS 0 ❑
❑21❑ TArE LICENSE vIN# 41
1
PLATE#
42
22❑ PIR TRAILER LATE# STATE PLATE# STATE
23❑ 43
TRLR RLR
UIN#. 'IN#.
GI
VEH YEAR MAKE MODEL STYLE DAMAGE TOWED NOO✓ BLIN TOWED BY ov HYES NO 1/ 44
24❑ ES
REGISTERED OWNER INFO UNKNOWN UNKNOWN VEHICLE NO.2
SHADE DAGED AREA
4
INAEFFITY ECTNSURANCE❑ &POINSULICY#E CO I—e E ❑ ,J� CITATION# CHARGE25 GQ
LEGALLY YES N J
s � e
7MICAELA
NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
26 CASTAIN 7 12573 WA0171300
PART A PAGE 01 OF C7
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EE57566
COLLISION REPORT III III III III III 111
1591972 CASE# 24-2548
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
PM 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'
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.
MICAELA CASTAIN 03-08-24 01:26 AM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
DESIRES SCOTT 10272 31912024 10:29:42 AM
BADGE OR ID# 12573 OR]# WA0171300 TIME POLICE DISPATCHED 10:05 PM TIME POLICE ARRIVED 10:15 PM
PART Ei PAGE IT]OF 4�
REPORT NO. EE57566 CASE# 24-2548 OF COLLISION
03/07/24 22:05
OF CbLLI510N
NARRATIVE
Unit 1: black sedan (unknown license plate)
Unit 2: 2015 Dodge Dart (ID/1J8922U); Zachary Bowman (DOB 04/05/2006)
Witness: Richard Haney (DOB 05/01/1982) Phone number: (951) 282-1081
On 03-07-2024 at approximately 2205 hours I was dispatched to a hit and run collision at the
intersection of SE Petrovitsky Rd and 108th Ave SE, in the City of Renton, King County, WA.
While in route, dispatch advised there was recently a hit and run collision and the suspect vehicle fled
the scene traveling westbound on SE Carr Rd from the intersection. The suspect vehicle was
described as a black sedan.
Upon arrival, Zachary Bowman was contacted. Bowman advised he was stopped facing southbound
on 108th Ave SE at the intersection listed above. Bowman's light signal turned green. As he started
driving to make a left-hand turn onto SE Petrovitsky Rd to travel eastbound, a black sedan collided
into Bowman's vehicle while in the intersection. The black sedan was traveling westbound from SE
Petrovitsky Rd through the intersection. The black sedan did not attempt to stop after the collision and
traveled westbound onto SE Carr Rd. Bowman was unable to provide a description of any occupant
(s) in the black sedan.
Renton Fire arrived on scene to evaluate Bowman. Bowman had a complaint of chest pain and was
transported to Valley Medical Center.
A witness, Richard Haney (DOB 05/01/1982), advised that he saw the collision occur. Haney advised
that a black sedan was traveling westbound from SE Petrovitsky Rd, collided with Bowman's vehicle
in the intersection, and fled the scene onto SE Carr Rd after the collision. Haney was unable to
provide a description of the occupant(s) in the black sedan.
The Dodge Dart was damaged on the driver side doors, panels, and front bumper. The Dodge Dart
was towed to Gene Meyer Towing Lot.
The black sedan was not located.
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. Castain #12573 3/8/2024 Renton, WA
PAGE 3 OF 4
REPORT NO. EE57566 CASE# 24-2548 DATE AND TIME 03/07/24 22:05
OF COLLISION
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