HomeMy WebLinkAbout24-8964 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 1 27c
COLLISION REP FIT 1591971
SASE 24-8964 2
INTERSTATE ❑ CITY STREET FIRE ❑
RESULTED
1 STATE ROUTE OTHER STOLEN
❑ ❑ H F ❑ LOCAL AOENC 3
HIT IT&8 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# ❑
C{YLLISION OS - 1-— 2024 0505 17 ❑.= S 8 W IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓
1031 SW SUNSET BLVD BLOCK NO. e✓ 1000
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ ❑ FEET e S ❑ W e 0 2 29
UNIT 01 MOTOR CYCLE
❑ YES ]NO
MET PHONE 0 30
6❑ LAST NAME UNKNOWN FIRSTNAME MIDDLE 1 1 2 31
INITIAL
STREET ❑ CITY ST ZIP 2
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
:NTERLOCKYEs NO INTERLOCK YES No YES No
8 DRIVERS STATE SEX U D.Q O.B. 1 2 32
❑ :LICENSE# MMDDYY —=
9 ON DUTY❑ STATUS AIRBAG 9 RESTR 9 EJECT 1 H USE 9 CLAY D NATURE OF INJURIES z❑
3
LICENSE 906JDC STATE OR VIN# 1HGES16374L012272
10 9❑ pr ATF�
TRAILER STATE TRAILER STATE
11 0 0 PLATE# PLATE# FR.. ro
TRLR. TRLR 7 3 33
12 0 0 VIN#' VIN#
>; FROM TO
VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN T Y GOVT.VEHICLE 3 7 34
13FAl 2004 HOND CIVIC 4C DAMAGE YES NO �MEYERS TOWING YES[:] No✓
REGISTEREDOWNERINFO STEPHEN ANDREW 340 LAMB LNMOXEEWA98936 MOXEEWA98936 N:9999999999 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
A LIABILITY INSURANCE INSURANCE CO 4
14 ❑ UNKNOWN UNKNOWN
LI EFFECT &POLICY#VEHICL CHARGE36
LEGALLv Yes❑NO CITATION# <,IQ
15❑ STANDING 6
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT 02 VEHICLE ❑ CYCLE ❑ ❑ PROPSOWNER ❑ YES 1/ No D:4255297717
16 a
LAST NAME KENT FIRST NAME MARK MIDDLE
INITIAL
17 STREET NEW ADDRESS❑' 14007 SE 156TH CT CITY RENTON ST WA ZIP 98058 37
18� CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 38
INTERLOCK YES❑No� INTERLOCK YEs❑NOF YES
❑NOF,/
19 DRIVER # STATE WA SEX M M D.C.B. 05 _ 04 1954 El 39
CENS —NATURE OF
H USE
ET LASS 6
Y CHEST,NECK,RBACK,SHOULDER PAIN IES 40
20 ON DUTY STATUS AIRBAG,3 RESTR y EJECT 1
❑21❑ PLATE# AYS6534 TATe 41
WA YIN# 1VWBP7A30DC001303 `1
42
22❑ PLATE# STATE PLATE# STATE
23❑ UIN#. 43
TRLR RLR
'IN#.
VEH YEAR 2013 MAKE VOLK MODEL PASSAT STYLE P4 VEHICLETOWED TO BLIN TOWEDBY GOV HI 44
L4❑ DAMAGE YES NO YES NO
REGISTERED OWNER INFO KENT MARK 14007 SE 156TH CT MOXEE WA 98058 D:4255297717 VEHICLE NO.2
SHADEDAMAGEDAREA
3 4
LIABILITY
INSURANCE❑ INSU POLICY#E CO UNKNOWN UNKNOWNIN STOP 5
VEHICLE YES[:] ,.I—I CITATION# CHARGE io BOTTOM
LEGALLY N
25 0(
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
J
26
SULIASI TAMAIVENA 12788 WA0171300
PAGE 01 OF
PART A
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EF10395
COLLISION REPORT III III III III III 111
1591972 CASE# 24-8964
ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY)
NAME
(/AST 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 NJURY 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.
SULIASI TAMAIVENA 08-26-24 07:50 AM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
S.WOODWARD 11528 1 8/31/2024 11:49:12 AM
BADGE OR ID# 1Y788 OR]# j WA0171300 TIME POLICE DISPATCHED; 5:07 AM TIME POLICE ARRIVED',5:14 AM
PART I PAGE IT]OF 4�
REPORT NO. EF10395 CASE# 24-8964 OF COLLISION
08/26/24 05:05
OF CbLLI510N
NARRATIVE
On 08/26/24, at approximately 0507 hours, I was dispatched to an Accident at 1031 SW SUNSET
BLVD in the City of Renton, County of King, Washington. The dispatcher advised that they received
an accident notification saying the owner was in an accident. The dispatcher later informed us that
fire was en route, and one of the drivers entered another vehicle, leaving the scene.
As I arrived on the scene, an unknown witness told me that he saw two Asian males run into the
woods without any further descriptions. Due to the accident blocking westbound traffic and the lack of
description, 1 could not do an area check.
Unit#1 was partially described as an Asian male (no further description), and he and his passenger
were seen fleeing the scene into a wooded area. The vehicle was described as a 2004 blue Honda
Civic bearing OR plate 906JDC. There is no return with that OR plate. The Vin was run
(1 HGES163741-012272) and returned cleared and registered to ANDREW, STEPHEN—o further
return for the RO of the vehicle. It is unknown who was the driver of the vehicle. Gene Meyers Towing
towed the vehicle because it was abandoned and not drivable. The vehicle had extensive damage in
the front area. A key was still inside the ignition.
Unit#2 stated he was traveling on SW Sunset BLVD in lane #1 (lane #1 being near the middle
divider) heading westbound. While driving, he observed Unit#2 enter his traveling lane. When he
tried to cross into lane #2 to avoid being hit, Unit#1 also made the same direction of turn, causing
them to collide. He advised that he did not see who the driver was or got a description but saw two
males getting out of the car and running away from the scene. Unit 2's vehicle had extensive damage
to the front of his car. His car was unable to drive and was towed by Gene Meyers. The driver was
then transported to Valley Medical as he claimed he had neck, shoulder, back, and chest pain. A
medical form was signed.
Unit#2 wants to be a victim if the suspect is located. He was also provided with my business card
and a case number.
Photos were taken and uploaded to evidence.
This concludes my report.
I certify under penalty of perjury under the laws of the state of Washington that the foregoing is true
and correct.
Signature: Suliasi Tamaivena Date and Place: 08/26/2024 at Renton, WA
PAGE 3 OF 4
REPORT NO.! EF10395 CASE# 24-8964 DATE AND TIME 08/26/24 05:05
OF COLLISION
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PAGE 4 OF 4