HomeMy WebLinkAbout24-00170 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 1 27c
COLLISION REP FIT 1591971
CASE 24-00170 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 3 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#
COLLISION.. 01 - 1-- 2024 2144 17 ❑-= S 8 IN e 1070 3
4❑ oN (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
RAINIER AVE S BLOCK NO. e✓ p ❑
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ ❑ FEET e S ❑ W e S 2ND ST
0 1 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
✓NO D:2065828818 0 11
30
6� LAST NAME FORD FIRSTNAME JALAIA MIDDLE A 1 1 2 31
INITIAL
STREET ❑ 600 SW 5TH CT,APT K308 CITY RENTON ST WA ZIP 98057 z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
1/ I iNTERLOCKYEs NO NTERLOCKYEs NO�/ YES R No�/
8❑ LRIIVERS STATE WA SEXI F MM DAY' 02 1- 05 - 2004 2 32
CENSE 9 ON DUTY❑ STATUS AIRBAG 2 RESTR 9 EJECT 1 H U SE
ICNLJAUSSY 1 NATURE OF INJURIES z❑
3
10 9❑ Pi aT�S� CJR0525 sTATe WA vIN# 3VWC576U8MM090117
TRAILER STATE TRAILER STATE
11 0 0 PLATE# PLATE# FROM TO
TRLR. TRLR 3 7 33
12 0 0 VIN#' VIN#
>; FROM TO
VEH.YEAR 2021 MAKE MODEL STYLE VEHICLE TOWED TO BLIN 1 5 TOWED BY GOVT.VEHICLE 34
13 VOLK JETTA 4D DAMAGE YES NO YES❑ No✓
REGISTERED OWNER INFO JALAIA FORD 100 SW 5TH CT,APT K308 RENTON WA 98057 D:2065828818 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
14 LIABILITY INSURANCE Z INSURANCE E CO DAIRYLAND INSURANCE 11408917023 4
LI EFFECTISUR N# TOPVEHICLE CHARGE 36
LECALLv Yes❑NO CITATION# <1�3
OTTOM
15❑ STANDING 7 6
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT 02 VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES 1/ No D:5094306640
16 a
LAST NAME CARTER FIRST NAME AMANDA MIDDLE L
INITIAL
17 STREET NEW ADDRESS❑' 9315 CHAPEL HILL BLVD,APT Al CITY PASCO ST WA ZIP 99301 4❑ 37
18� CDL IGNITION REQUIRED IGNITION PtR-E-S1ENT MEDICAL TRANSPORTED 38
INTERLOCKYES�NO� INTERLOCK YEs I I NOF YEs t l NOF,/
19 DRIVER #
❑ ON DUTY STATUS AIRBAG 2 RESTR 9 EJECT 1 H U EET NJAU EY 1 NATURE OF INJURIES ❑ 40
LICENSE I ❑21❑ PLA E# CEE4807 TATE 41
WA VIN# 1C4RJEAG2CC103985 1
42
22❑ PLATE# STATE PLATE# STATE
23❑ UIN#. 43
TRLR RLR
'IN#.
VEH YEAR 2012 MAKE JEEP MODEL GRAND STYLE 4D VEHICLE TOWED TO BLIN TOWEDBY GOV HI 44
L4❑ DAMAGE YES NO YES NO
REGISTERED OWNER INFO AMANDA CARTER 9315 CHAPEL HILL BLVD,APT AI PASCO WA 99301 D:5094306640 VEHICLE NO.2
SHADE IN DAMAGED AREA
2 3 4
LIABILITY
INSURANCE I PORGY#ECO STATE FARM 4973456P67FIN 1U�'E""LE
❑ ,J� CITATION# CHARGE
LEGALLY YES N`L J
25 OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# JAGENCY
26
J RAYGOZA 12503 WA0171300
PART A PAGE 01 OF C7
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EE38127
COLLISION REPORT III III III III III 111
1591972 CASE# 24-00170
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.
J RAYGOZA 01-07-24 06:34 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
GREGORYBILLS 12495 11812024 1:22:44 AM
BADGE OR ID# 12503 ORI# WA0171300 TIME POLICE DISPATCHED 9:51 PM TIME POLICE ARRIVED',10:01 PM
PART I PAGE IT]OF 4�
REPORT NO. EE38127 CASE# 24-00170 OF COLLISION
01/05/24 21:44
OF CbLLI510N
NARRATIVE
RPD CASE#: 24-00170
On 01/05/2024 at approximately 2151 hours, I was dispatched to O'Reilly Auto Parts located at 307
Rainier Ave S, in the City of Renton, King County, Washington, for a report of a non-injury collision.
On arrival I located two vehicles unit 1 identified as a blue 2021 Volkswagen Jetta WA/LIC CJR0525
VIN#3VWC57BU8MM090117 and unit 2 a white 2012 Jeep Grand Cherokee WA/LIC CEE4807
VIN#1C4RJEAG2CC103985 parked on the southeast side of the building with their hazard lights on.
There were approximately seven subjects standing outside of their vehicle and when I arrived some
of the subjects started to physically push one another. I got out of my fully marked patrol vehicle and
told the subjects to separate from each other and to get into their respective vehicles.
Once all the subjects were in their respective vehicles, I spoke with the driver of unit 1 identified by
her WADOL as Ford, Jalaia Ayanna DOB (02/05/2004) and she stated the following: Jalaia was
driving westbound on S 2nd St and stopped at the intersection of Rainier Ave S and S 2nd St. Jalaia
said she had a green light to make a left turn at the intersection and as she was making a left turn to
go south of Rainier she was hit by unit 2 who collided with her vehicle damaging the front passenger's
side door. Jalaia then drove behind unit 2 and honked at her continuously until they drove into
O'Reilly's parking lot. Jalaia stated that she was not injured and provided her driver's license,
registration and valid insurance.
I spoke with the driver of unit 2 identified by her WADOL as Carter, Amanda Leah DOB (12/18/1985)
and she stated the following: Amanda said she was driving out of the drive through at McDonalds
located at 73 Rainier Ave S and was approaching Rainier Ave S from the parking lot. Amanda then
got onto Rainier Ave S and was hit by unit 1 who was driving south on Rainier Ave S. Unit 2 sustained
major damage to the driver's side door and Amanda provided valid license, registration and
insurance. Amanda said she was not injured and had a receipt from McDonalds with a receipt that
stated she was at the location at 2136 hours a few minutes prior to the collision.
When I spoke to Jalaia she stated that a witness was at the location and provided her with his name
and phone number. I called the phone number, but it went to voicemail, and I left a message.
provided Jalaia and Amanda with my business card with the case number and left the are once both
parties cleared the scene. I held off on submitting this report until Sunday to call the witness, but they
never called back or answered my phone calls. Due to both parties involved having different stories, I
am unable to confirm where the accident happened and who was the at fault driver.
I certify (declare) under penalty of perjury under the laws of the State of Washington that the
foregoing is true and correct.
Electronically signed by J. Raygoza on 01/07/2024 at 1840 hours in the City of Renton.
PAGE 3 OF 4
REPORT NO. EE38127 CASE# ' 24-00170 DATE AND TIME 01/055/24 21:44
OF COLLISION
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