HomeMy WebLinkAbout24-624 a ITFFi "POLCERA II IfI) 1 IlfII ('II (Illf If( fI I . 0 27c
COLLISION REP FIT 1591971
❑ RESULTED ❑ CASE 24-624 z
INTERSTATE CITY STREET FIRE
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHICI F ❑ LOCAL AOENC 4900 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 3 TOTAL#OF OBJECT 1 1 8 28
TRIBAL UNITS OZ RESERVATION STRUCK
2
3❑ DATE OF M M D D Y Y Y Y TIME(2400) COUNTY# MILES CITY# ❑
COLLISION.. 01 - 18 - 2024 1423 17 ❑.❑ N E IN S 8 W H OF e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓
NE 4TH ST BLOCK NO. e✓ 5300
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ 120 00 FEET e S ❑ W e JERICO AVE NE
0 4 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
,/No D:2064882363 0 11
30
6� LAST NAME MCLENAGHAN FIRSTNAME RACHEL MIDDLE L 1 1 2 31
INITIAL
STREET ❑, 3608 NE 14TH ST CITy RENTON ST WA 2jp, 980563351 2
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
iNTERLOCKYEs NO INTERLOCK YES NO YES No
8❑ D
RI
VERS STATE WA SEX'F MM DAY' 09 — 15 — 1992 1 2 32
9 ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 HELMETU SE CLASS 1 NATURE OF INJURIES 2❑
3
10 9❑ P1 ATE 14 AKY6849 JBTATIJ WAuN# 1C4NJPBA8DD222947
TRAILER STATE TRAILER STATE
11 3 5 PLATE# PLATE# FROM TO
TRLR. TRLR $ 7 33
12 3 5 VIN#' VIN#
>; FROM TO
❑ VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN T Y GOVT.VEHICLE 7 $ 34
13 2 2013 JEEP PATRIO DAMAGE vEs 0NO agW�MEYER ves❑ No✓
REGISTERED OWNER INFO RACHEL MCLENAGHAN 3608 NE 14TH ST RENTON WA 98056 D:2064882363 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
2 3 4
14 2 LIABILITY INSURANCE❑ INSURANCE CO
IN EFFECT &POLICY# 9TOP 5
VEHICLe CHARGE 10 BOTTOM 36
15❑ LEGALLY YES[:]NO CITATION# 4A0078002,4AO078002 FAIL YIELD PRIVATE RD MOTOR 6
"' iT 02 VE ICCLE CYCLE ❑MOTR PEDAL- PEDESTRIAN ❑ OWNER
RTY ❑ DYES✓ NO OLD MET PHONE
16 THR
a •,
LAST NAME BEDI FIRST NAME ILA MIDDLE N
INITIAL
17❑ STREET ❑', 622 NILE AVE NE CITY RENTON ST WA ZIP 980594980 37
NEW ADDRESS ❑
18� CDL IGNITION REQUIRED IGNITION PR—E-1SENT MEDICAL—T�RANSPORTED 38
INTERLOCKYES�NOR INTERLOCK YEs It I NOF YES
t l NO❑ 11
19 D IVEW #
INJURY 7 NATURE OF INJURIES 40
20� ON DUTY STATUS' AIRBAG,3 RESTR 4 EJECT 1 USE CLASS LEFTARM
21❑ LICENSE I BLR2398 TAre WA VIN# 5YJ3E1EA7JF057319
❑ 41
PLATE#
42
22❑ PLATE# STATE PLATE# STATE
TRLR
23❑ UIN#. N#.
43
RLR
'I
VEH YEAR 2018 MAKE TESL MODEL MODELS STYLE VEHICLE TOWED TO BLIN TOWEDBv GOV HI �44
24 DAMAGE YES✓ NO GENE MEYER YES NO✓
REGISTERED OWNER INFO SANDEEP SINGH 622 NILE AVE NE RENTON WA 98059 VEHICLE NO.2
SHADEDAMAGEDAREA
3 4
INAEFFITY ECTNSURANCE INSU&POLICY#E CO SAME. 9TOP 5
'E""LE ❑ Nu,J CITATION# CHARGE
LEGAL io BOTTOM
LY YES
25 ' e
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. EE44303
COLLISION REPORT III III III III III 111
1591972 CASE# 1 24-624
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 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.
M.LEVERTON 01-18-24 03:56 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY E
DAT
C.JACOBS 1953 1/25/2024 2:08:49 PM
BADGE OR ID# 2517 OR]#' WA0171300 TIME POLICE DISPATCHED! 2:23 Pry TIME POLICE ARRIVED',2:29 Pry
PART I PAGE IT]OF 4�
REPORT NO. EE44303 CASE# 24-624 OF COLLISION
01/18/24 14:23
OF CbLLI510N
NARRATIVE
blue jeep It from driveway/chucks wht sedan/2 lane 2 eb
CC
Within the city limits of Renton/King/WA I responded to a 2 car blocking crash at the 5300 block of NE
4th St.
I contacted the driver of unit 2 who told me she was eastbound on NE 4th St lane 2 when unit 1 pulled
out in front of her. She was unable to avoid unit 1 and crashed blocking both eastbound lanes. She
was checked and released by Renton Fire on scene for a complaint of injury. Her vehicle was towed
for damages.
I contacted the driver of unit 1 ID'd by her picture WADL. She told me was making a left turn out of
the Chucks Donuts parking lot when she crossed the path of unit 1 who was lawful upon the roadway.
She did not complain of injury and damages did require a tow truck. Unit 1 driver told me she did not
have insurance for her Jeep.
I cited unit 1 ref RCW 46.61.205 FTYROW from private drive 2 car crash and RCW 46.30.020 No
valid insurance 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
PAGE 3 OF 4
REPORT NO. EE44303 CASE# ' 24-624 DATE AND TIME 01/18/24 14:23
OF COLLISION
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