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Home My WebLink About24-332 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 0 27c COLLISION REP FIT 1591971 ❑ ❑ FIRE ❑ CASE## 24-332 2 576 INTERSTATE CITY STREET ✓ RESULTED 1 STOLEN STATE ROUTE ❑ OTHER ❑ VFHIr.I F ❑ LOCAL AOENC 4200 3 HIT&RUN CODING COUNTY RD PRIVATE WAY INVOLVED 2 2 TOTAL#OF OBJECT 1 1 8 28 TRIBAL UNITS 03 STRUCK RESERVATION 2 3❑ DATE OF M M D D Y Y Y Y TIME(2400) COUNTY# MILES N E IN CITY# ❑ COLLISION.. 01 - 11 - 2024 0743 17 ❑.❑ S 8 W H OF e 1070 3 4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓ 156TH AVE SE BLOCK NO. e✓ 13000 4a❑ MILEPOST DISTANCE OF(REFERENCE OR CROSS STREET) 5❑ 1501. 00 FEET MILES e S B W e SE 132ND ST 2 0 29 MOTUNIT U1 VEHICR Z PEDAL-CLE CYCLE ElYESA,G/E NHORESHOLD MET PHONE 0 7 30 6� LAST NAME SAFARI FIRSTNAME DELARAM MIDDLE N 1 1 2 31 INITIAL STREET ❑, 360 NW DOGWOOD ST APT B104 CITY ISSAQUAH ST WA Zjp, 98059 2 NEW ADDRESS 7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3 iNTERLOCKYEs NO INTERLOCKYEs NO YES R NO 8❑ LRIIVER # ON DUTY❑ STATUS AIRBAG 3 RESTR 4 EJECT 1 H U SE ICNLJAUSSY 1 NATURE OF INJURIES 2❑ 3 LICENSE CDt8741 sTArI WAurN# 19UU62F38GA005722 10 F91 PI ATE i4 TRAILER STATE TRAILER STATE 11 3 0 PLATE# PLATE# FROM TO TRLR. YRLR. 5 1 33 12 0 0 VIN#' VIN# >; FROM TO VEH.YEAR 2016 MAKE ACUR MODEL TLX STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE 0 9 34 13 2 DAMAGE YES NO ✓ YES[:] No ✓ REGISTERED OWNER INFO MAHDI SAFARI11111 SE 144THPL RENTON INA 98059 VEHICLE NO. 1 ❑ SHADE IN DAMAGED AREA 35 14 LIABILITY INSURANCE INSURANCE CO ALLSTATE 820 314 4 LI EFFECT I SUR N# TOPVEHCLE CHARGE 36 LEGALLYYES NO CITATION# 4AO077999 INATTENTIVE DRIVING <1�3 orrom 15❑ STA"" MOTOR ❑ PEDESTRRIAN PROPERTY ❑ D OLD MET PHONE 16 aUNIT CYCLE OWNER ✓ NO 6 MIDDLE / LAST NAME BECKMAN FIRST NAME ROBIN INITIAL 17❑ STREET ❑', 125 YAKIMA AVE SE CITY RENTON ST WA ZIP 98059 37 NEW ADDRESS ❑ 18� CDL IGNITION REQUIRED IGNITION PtR—E—S1ENT MEDICAL TRANSPORTED 38 INTERLOCKYES�NOR INTERLOCK vEs I I NOF YEs t l NO❑ 19 D IVER # INJURY1 NATURE OF INJURIES 40 20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 USE CLASS ❑ 21❑ LICENSE AWE7741 TAre WA VIN# 1N4AL3AP5EC175624 ❑ 41 PLATE# 42 22❑ PLATE# STATE PLATE# STATE 23❑ UIN#. 43 TRLR RLR 'IN#. VEH YEAR 2014 MAKE NISS MODEL ALTIMA STYLE VEHICLE TOWED TO BLIN TOWEDBv GOV HI 44 24 DAMAGE YES✓ NO GENE MEYER YES NO✓ REGISTERED OWNER INFO FRANCIS BECKMAN 125 YAKIMA AVE SE RENTON WA 98059 VEHICLE NO.2 SHADEDAMAGEbAREA s Cd LIABILITY INSURANCE INSU POLICY#E CO SAME,IN 9TOP VE""LE CITATION# CHARGE 25 to BOTTOM LEGALLY YES Nu ❑ OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY J 26 M.LEVERTON 2517 WA0171300 PAGE 01 OF PART A 3000-345-159 OR 11/181 STATE OF POLICETRAFFICN CORRECTION REPORT NO. EE39528 COLLISION REPORT III III III III III 111 1591972 CASE# 24-332 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' 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 01-11-24 11:01 AM INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED APPROVED BY E DAT C.JACOBS 1953 111112024 2:01:21 PM BADGE OR ID# 2517 OR]#' WA0171300 TIME POLICE DISPATCHED 7:44 AM TIME POLICE ARRIVED',8:01 AM PART I PAGE IT]OF 5� DATE AND REPORT NO. EE39528 CASE# 24-332 OFCOLISION 01111/2407:43 OF COLLISION NARRATIVE CC Within the city limits of Renton/King/Wa I responded to a 3 car crash near the 13000 block of 156 th Ave SE. When I arrived in the area all cars had moved to the Renton Fire Station #16. Firefighters walked out and checked all the drivers. I contacted the driver of unit 3 who told me he was stopped in traffic when he was hit from behind by unit 2 who had been hit by unit 1. He did not complain of injury and damages did not require a tow truck. I contacted the driver of unit 2 who told me she was stopped in traffic when she was hit from behind by unit 1 and pushed into unit 3. She was sore, but did not complain of a specific injury. Damages did require a tow truck. I contacted the driver of unit 1 ID'd by picture WADL. She told me she didnt realize traffic was stopped in front of her. She said that rather than emergency braking she may have actually applied the accelerator instead driving into the back of unit 2, shoving him into unit 3. She did not complain of injury and damages did not require a tow truck. I cited unit 1 ref RMC 10-12-25 Driver Inattention 3 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 1/11/2024 PAGE 3 OF 5 SUPPLEMENTAL REPORT NO. EE395528 r`) POLICE TRAFFIC 1 1 8 27 COLLISION REPORT CASE# 24-332 1 COMMERCIAL MOTOR CARRIER INTERSTATE INTRASTATE G UNIT'# USDOT ICC# VEHICLE TYPE CARGO BODY ;TYPE 2 ❑ 1 28 CARRIER NAME 3 CARRIER ADDRESS ` CITY ST ZIP—1 I ' 4 ❑ NAME # PLACARD: :❑ GI PLACARD IF NO NUMBER SOURCE AXLES + 4a ❑ ADDITIONAL UNITS MOTOR PEDAL- PROPERTY DAMAGE THRESHOLD MET PHONE 5 ❑ UNIT# 3 VEHICLE tSJ CYCLE I_) PEDESTRIAN OWNER YES NO D:6147461055 OF 7 29 LAST NAME BROBERG FIRST NAME ERIC MIDDLE M INITIAL STREET 1 r:i 30 NEW AnDRFSP' 17443 158TH AVE SE CITY RENTON ST WA ZIP 98058 6 CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TANSPORTED 1 1 2 31 INTERLOCK YEs No NTERLOCK YES�NO� YEs N DRIVER'S LICENSE STATE I WA SEX M MMDDYYv 02 TO] - 1980 7 ON DUTY� STATUS AIRBAG' 2 RESTR. Q EJECT 1 HELMET I INJURY 1 1 NATURE OF INJURIES USE CLASS 8 ❑ 1 32 LICENSE BFP8683 [TAT WA VIN# 1FMCUOF71HUC81067 PLATE# 9 9] TRAILER TRAILER PLATE# STATE PLATE# STATE 10 ❑ TRLR TRLR VIN.#. VIN.#. 11 0 0 VEH.YEAR2017 MAKE FORD MODELESCAPE STYLE VEHICLE TOWS E T SABLIN TOWED BY anvi vEH1Ci P FROM TO DAMAGE YES NO YES NO REGISTERED OWNER INFOERIC BROBERG 17443158TH AVE SE RENTON WA 98058 J 9 33 12 � SHADE IN DAMAGED AREA 34 FROM TO LIABILITY INSURANCE INSURANCE CO AMICA 9404463056 GQO IN EFFECT &POLICY#VEHICLE 34 13Lecnuv YES NO❑ CITATION# CHARGE STANDING } 8 7 6 14 ❑ UNIT Tr Vd 1RE O CYDCLE 1:1OWNER YE YES AGE NOHRESHOLD MET PHONE ❑ 35 PEDESTRIAN 15 LAST NAME FIRST NAME MIDDLE INITIAL TIAL ❑ ET 16 STRETRE "F ' CITY ST ZIP NEW CDL IGNITION REdUiRED IGNITtGN PRESENT MEDICALTANSPORTED NTERLOCK YES No NTERLOCK YEs NO YEs NO El 17 37 LICENSE# STATE SEX MMDDDYBYY 18 ❑ ON DUTY� STATUS AIRBAG RESTR. ; EJECT HELMET INJURY NATURE of INJURIES 38 USE (CLASS 19 ❑ 39 LICENSE vIN# PLATE# rnr 20 ❑ TRAILER' STATE TRAILER STATE ❑ 40 PLATE#< PLATE# 21 ❑ TRLR TRLR 41 VIN# YIN#i 42 22 VEH.YEAR MAKE I MODEL STYLE I VEHICLE TO DUET SABLIN TOWED BY GOVT.VEHICLE DAMAGE YES NO YES NO 23 REGISTERED OWNER INFO SHADE IN DAMAGED 3 4 4 AREA F 43 z LIABILITY INSURANCE INSURANCE CO ' VINE EFFECT &POLICY# i 970P - 4 E:l 44 24 VEHICLE YES❑ NO❑ CITATION# CHARGE iq 60TiOM LECALLv STANDING 8 7 6 1 CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT. X LEVERTON 01-11-24 11:01 AM 25 INVESTIGATING OFFICER'S SIGNATURE OFFICER'S PHONE UNIT OR DIST DET DATED: PLACE SIGNED BADGE O#I' APPROVED 1/126 � ORID# 2517 WA0171300 ACOBS 1 PAGE F41 OF F 3000-345-013(R 11118) REPORT NO. EE39528 CASE# ' 24-332 DATE AND TIME 01/11/24 07:43 OF COLLISION t� w ,. 1� 5;7 PAGE 5 OF 5