HomeMy WebLinkAbout24-612 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 6 27c
COLLISION REP FIT 1591971
❑ ❑ RESULTED ❑ CASE 24-612 z
INTERSTATE CITY STREET FIRE
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHICI F ❑ LOCAL AOENC 4200 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 3 TOTAL#OF OBJECT 1 1 8 28
TRIBAL UNITS 02 RESERVATION STRUCK
2
3❑ DATE of M M D D Y Y Y Y TIME(2400) COUNTY# MILES CITY#
COLLISION.. 01 - 18 - 2024 0931 17 . N E IN� S 8 W H OF e 1070 3
4❑ oN (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
e✓ --- ----� ❑
N 4TH ST MILEPOST
4a❑
DISTANCE OF(REFERENCE OR CROSS STREET) BLOCK NO.
5❑ �.❑ FEET e S ❑ W e PARKAVEN
1 9 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
✓NO D:2066379497 0 11
30
LAST NAME AURELIO P DE CARVALHO FIRST NAME MARCO MIDDLE N
6 INITIAL 1 2 31
STREET ❑1 300 VUEMONT PL NE APT F202 CITY RENTON ST WA 7jp, 980564526 2
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
iNTERLOCKYEs NO INTERLOCKYEs NO YES NO
LRIIVER # STATE WA SEX'M MI MIT Y
8❑ ' 11 — 11 — 1968 1 2 32
9 ON DUTY❑ STATUS AIRBAG 2 RESTR 12 EJECT 1 H USEET ICNLJAURY 1 NATURE OF INJURIES 2❑
3
10❑ PI aT�Sil BMA1488 sTArI WAvIN# 5TDKK3DC86S111002
TRAILER STATE TRAILER STATE
11 2 5 PLATE# PLATE# FROM TO
TRLR. TRLR 3 7 33
12 3 0 VIN#' VIN#
>; FROM TO
VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE 1 $ 34
13 2 2011 TOYT SIENNA DAMAGE YES NO YES[:] No
✓
REGISTERED OWNER INFO MARCO AURELIO P DE CARVALHO 300 VUEMONT PL NE APT F202 RENTON WA 980564526 D:2066379497 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
14 LIABILI INSURANCE INSURANCE CO PROGRESSIVE 964782657 4
IN EFFECT &POLICY# 9TOP
EGALLE CHARGE 1 5 36
LEGALLY YES❑NO❑ CITATION# 4AO078001 FAIL TO OBEY TRAFFIC CONTROL
L o aorroM
15❑ NDING 8 6
MOTOR PEDAL- PROPERTY DAM THR OLD MET PHONE
UNIT 02 ❑✓ ❑ PEDESTRIAN ❑ ❑ YES,/ No D:5095670872
VEHICLE CYCLE OWNER
16 a
LAST NAME SIULAPWA FIRST NAME ARSEN MIDDLE K
INITIAL
17❑ STREET ❑', 2705 NE 6TH PL CITY RENTON ST WA ZIP 980563764 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'S 1992 STATE WA SEX M D.C... 12 �_ 07 39
LICENSE# MMDDYY
WELMET INJURY1 NATURE OF INJURIES 40
20❑ ON DUTY STATUS AIRBAG 3 RESTR 4 EJECT 1 USE CLASS ❑
21❑ LICENSE I CBE9948 TAre WA vIN# 5NPE84AC7BH169602
❑ 41
PLATE#
42
22❑ PLATE# STATE PLATE# STATE
TRLR
23❑ VIN#. N#. 43
RLR
'I
VEH YEAR 2011 MAKE HYUN MODEL SONATA STYLE VEHICLE TOWED TO BLIN TOWEDBY GOV HI 44
24❑ DAMAGE YES NO GENE MEYER YES NO
REGISTERED OWNER INFO ARSENSIULAPWA 2705NE6THPL RENTON WA 980563764 D:5095670872 VEHICLE NO.2
SHADEDAMAGEDAREA
3 4
INAEFFITY ECTNSURANCE INSU&POLICY#E CO TBA 9TOP 5
'E""LE ❑ ,J� CITATION# CHARGE to BOTTOM
LEGALLY YES Nu
25 ' e
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID#
26
M.LEVERTON 2517 [V7�ENCY
A0171300
PART A PAGE 01 OF
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EE44298
COLLISION REPORT III III III III III 111
1591972 CASE# 24-612
ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY)
NAME MIDDLE INITIAL) RANKIN PATR/STIA
(LAST FIRST,
ADDRESS&PHONE#
4253065667 SEX i U MMDOYyry 08 - 13 - 1959
----------------------------
PASSENGER SEAT AIRBAG RESTR. EJECT ' HELMET INJURY NATURE OF INJURIES
[:]WITNESS❑✓ UNIT# POS. USE CLASS
NAME
(LAST,FIRST,MIDDLE INITIAL) LI MANXL
ADDRESS&PHONE# O B
2064347488 SEx' U 4oO ,Y 05 _ 07 _ 1990
PASSENGER UNIT# SEAT AIRBAG RESTR. EJECT HELMET INJURY NATURE OF INJURIES
[]WITNESS POS. USE CLASS
NAME
(LAST FIR57 MIDDLE INITIAL)
AppRESS R PHONE#
SEX D.O.B.MMDD -❑
YYYY.
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 01-18-24 11:20 AM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY E
DAT
C.JACOBS 1953 1/25/2024 2:09:44 PM
BADGE OR ID# 2517 OR]#' WA0171300 TIME POLICE DISPATCHED 9:32 AM TIME POLICE ARRIVED',9:34 AM
PART I PAGE IT]OF 4]
REPORT NO. EE44298 CASE# 24-612 OF COLLISION
01/18/24 09:31
OF CbLLI510N
NARRATIVE
siv van 1 stop run red blue sedan sb lane 1 on green
CC
Within the city limits of Renton/King/Wa I responded to a 2 vehicle blocking crash at the intersection
of N 4th St at Park Ave N.
I contacted the driver of unit 2 who told me he was south/lane 1 on Park Ave S on his green light
when unit 1 pulled in front of him with no time to avoid contact. He was checked and released on
scene by Renton Fire. Damages required a tow truck.
I contacted the driver of unit 1 ID'd by his matching picture WADL. He said he light was red and he
stopped but then his story didnt really make sense how the collision happened. He did not complain
of injury and damages did not require a tow truck.
I contacted both listed witnesses. One witness was behind unit 1 and one behind unit 2. Both
described unit 2 was south in lane one on his green light. Unit 1 was in lane 4 westbound on N 4th st
and stopped for the red light, but then unit 1 ran the red light crossing unit 2 path causing the crash.
I cited unit 1 Ref RCW 46.61.055 FTCWTCD-red light 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 1/18/2024
**** AUTO-POPULATED SECTION ****
THE FOLLOWING ARE DESCRIPTIONS ENTERED FOR ITEMS SELECTED AS "OTHER":
Motor Vehicle Unit 1
Action Code: STOP RED WENT ON RED
**** END OF AUTO-POPULATED SECTION ****
PAGE 3 OF 4
REPORT NO. EE44298 CASE# ' 24-612 DATE AND TIME 01/18/24 09:31
OF COLLISION
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