HomeMy WebLinkAbout24-277 POLICETRAFF'c" III !�� I IIIllI111IN II II I REPORT NO. EE39526 170
27
COLLISION REP FIT 1591971
❑ ❑ RESULTED ❑ CASE# z4-z77 2
INTERSTATE CITY STREET FIRE
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHIr.I F ❑ LOCAL AOENC 4Y00 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 2 TOTAL#OF OBJECT 1 1 8 28
TRIBAL UNITS OZ STRUCK
RESERVATION
2
3❑ DATE of M M D D Y Y Y Y TIME(2400) COUNTY# MILES CITY# ❑
COLLISION.. 01 - 09 - 2024 0652 17 ❑.❑ N E IN S 8 W H OF e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓
S 3RD ST BLOCK NO. e✓ 200
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ 175 00 FMILES EET e S ❑ W e SHATTUCKAVES
0 4 29
UNIT VEHtOCLE CYDDAL ❑ DYESA✓NOESHOLDMET PHONE 0 1 30
6 LAST NAME ALVAREZ VEGA FIRST NAME JOSE MIDDLE L 1 2 31
INITIAL
STREET ❑ 14904 29TH AVE W APT E203 CITY LYNNWOOD ST WA 7jp, 980872480 2=
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
iNTERLOCKYEs NO INTERLOCKYEs NO YES R NO
8❑ LRIIVER # STATE WA SEX'M MI D Y' 07 - 12 - 1997 1 2 32
9 ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 H USEET ICNLJAURY 1 NATURE OF INJURIES 2❑
3
10 9❑ P1 aT�S� C31497Y sTArI WAurN# 1FTBR1Y86MKA76525
TRAILER STATE TRAILER STATE
11 2 5 PLATE# PLATE# FROM TO
TRLR. TRLR 7 1 33
12 2 5 VIN#' VIN#
>; FROM TO
VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE 7 $ 34
13 2021 FORD TRANSI DAMAGE YES NO YES[:] No✓
REGISTERED OWNER INFO CARRIER CORPORATION 4001 LEADENHALL RD MOUNT LAUREL NJ 08054 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
14 LIABILI INSURANCE INSURANCE CO SAME. 3 4
IN EFFECT &POLICY# 9TOP
VE—L' 1 5 36
LEGALLY YEs No CITATION gg0077997 CHARGE PROWIMPROPER TURN
toeorrom
15❑ STANDING 7 6
MOTOR PEDAL- '.PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT 02 VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES 1/ NO D:2066371830
16 a
LAST NAME LIAM FIRST NAME MEKAYLA MIDDLE I B
INITIAL
17❑ STREET ❑', 6901 S 123RD ST APT D171 CITY' SEATTLE ST WA ZIP 981786100 37
NEW ADDRESS ❑
18� CDL IGNITION REQUIRED IGNITION PR—E-1SENT MEDICAL TRANSPORTED 38
INTERLOCKYES�NOR INTERLOCK YEs It I NOF YES t t— l NO❑
19 DRIVER #
INJURY1 NATURE OF INJURIES 40
20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 USE CLASS ❑
21❑ LICENSE I BJF8686 TAre WA VINti 5NPDH4AE8DH391127
❑ 41
PLATE#
42
22❑ PILER LATE# STATE PLATE# STATE
23❑ UIN#. 43
TRLR RLR
'IN#.
VEH YEAR 2013 MAKE HYUN MODEL ELANTRA STYLE VEHICLE TOWED TO BLIN TOWEDBY GOV HI 44
24 DAMAGE YES NO GENE MEYER YES NO
REGISTERED OWNER INFO MEKAYLA LIAM 6901 S 123RD STAPTD171 SEATTLE WA 981786100 D:2066371830 VEHICLE NO.2
SHADE DAGED AREA
4
LIABILITY
INSURANCE INSU&PORGY#E CO ST FARM 488427OC3047IN IGQI
'E""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. EE39526
COLLISION REPORT III III III III III 111
1591972 CASE# 24-277
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
POS. 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'
2/wht sedan lane 2 1/wht van left turn from lane 1
CC
Within the city limits of Renton/King/Wa I responded to a 2 car blocking crash near the 200 block of S
3rd St.
I contacted the driver of unit 2 who told me she was east on S 3rd St in lane 2 when unit 1 made a left
turn into the side of her car. She said she honked but he still hit her car. She did not complain of
injury and damages did require a tow truck.
I contacted the driver of unit 1 ID'd by his picture WADL. He told me he was in lane 1 and did not see
unit 2 before he left turn. He did not complain of injury and damages did not require a tow truck.
I cited unit 1 driver/Vega Ref RCW 46.61.290 Improper turn from wrong lane 2 car crash 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 1/9/2024
I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT.
M.LEVERTON 01-09-24 07:36 AM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
C.JACOBS 1953 1/11/2024 2:04:21 PM
BADGE OR ID# 2517 OR]#' WA0171300 TIME POLICE DISPATCHED! 6:53 AM TIME POLICE ARRIVED 6:56 AM
PART I PAGE IT]OF 3�
REPORT NO. EE39526 CASE# ' 24-277 DATE AND TIME 01/09/24 06:52
OF COLLISION
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