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HomeMy WebLinkAbout24-797 a ITFFi "POLCERA II IfI) 1 IlfII ('II (Illf If( fI I . 1 27c COLLISION REP FIT 1591971 ❑ ❑ RESULTED ❑ CASE z4as7 2 INTERSTATE CITY STREET FIRE 1 STOLEN STATE ROUTE ❑ OTHER ❑ VFHICI F ❑ LOCAL AOENC 4250 3 HIT&RUN CODING COUNTY RD PRIVATE WAY INVOLVED 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 - 1-- 2024 1808 17 ❑.= S 8 IN e 1070 3 4 4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓ RAINIER AVE N BLOCK NO. e✓ 365 4a 2❑ MILEPOST DISTANCE OF(REFERENCE OR CROSS STREET) 5❑ ❑ FEET e S ❑ W e 0 1 29 UNIT VEHICLE MOTZ PEAL-ORCYMLE. El �ESAGE NHORE✓LD MET PHONE 0 9 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 INTERLOCKYES NO INTERLOCK YES NO YES No 8❑ DRIVERS STATE SEX u MMDOBYY - 1 1 2 32 9 ON DUTY❑ STATUS AIRBAG 9 RESTR 9 EJECT 1 HELMET U E 9 CLAY 0 NATURE OF INJURIES 2❑ 3 LICENSE sTATI urN#' 10[9 PI ATE# TRAILER STATE TRAILER STATE 11 3 5 PLATE# PLATE# ROM ro rRLR. TRLR. 1 5 33 12 3 5 VIN If VIN# FROM TO ❑ VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE R T 34 13 2 DAMAGE YES NO YES❑ NO✓ REGISTERED OWNER INFO UNKNOWN VEHICLE NO. 1 SHADE IN DAMAGED AREA ❑ 35 14 LABILI INSURANCE❑ NSURANCE CO 3 4 IN EFFECT &POLICY# 9TOP VEwcLE 5 36 LECALLv Yes❑NO❑ CITATION# CHARGE 10 BOTTOM 15❑ STANDING 8 6 MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE UNIT VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES 1/ NO D:2065789369 16 a LAST NAME O'DAY FIRST NAME DANIEL MIDDLE ,I INITIAL 17❑ STREE EDTR 7 20504 SE 152ND ST CITY' RENTON ST WA ZIP 98059 37 18❑ CDL IGNITION REQUIRED IGNITION PRESENT tSENT MEDICAL TRANSPORT � 38 INTERLOCK YEs❑NoR INTERLOCK YES It1 I NOF YES l NO❑ 19 D IVEW # ❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 H EET 2 NJAURSY 1 NATURE OF INJURIES 40 ❑LICENSE I 21❑ PLA E# CAP2943 TATE WA VIN# 1FAFP55U53(3242895 41 4 42 22 [TRAILER TILER ❑ PLATE# STATE PLATE# STATE 23❑ 43 TRLR RLR UIN#. 'IN#. VEH YEAR 2003 MAKE FORD MODEL TAURUS STYLE SD VEHICLE TOWED TO BLIN TOWEDeY GOV HI 44 L4❑ DAMAGE YES NO YES NO REGISTERED OWNER INFO DANIELO'DAY20504 SE 152ND ST RENTON WA 98059 D:2065789369 VEHICLE NO.2 SHADE IN DAMAGEbAREA 2 3 Cd LIABILITY INSURANCE &POLICY#E CO GEICO 6054804262IN 1 9TOP vE""LE CITATION# CHARGE BOTTOM LEGALLY YES N� 25❑ s 7CATALAN NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY26 12007 WA0171300 PAGE 01 OF PART A 3000-345-159 OR 11/181 STATE OF POLICETRAFFICN CORRECTION REPORT No. EE44309 COLLISION REPORT III III III III III 111 1591972 CASE# 24-797 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' On January 23, 2024, at 1808 hours dispatch requested that I respond to a hit and run collision at Gerber collision and glass, 365 Rainier Ave N, In the city of Renton, county of King, Washington. Upon my arrival I spoke with the driver of unit 2. They explained they were stopped in traffic facing southbound on Rainier Avenue north when the collision occurred. The driver stated that they observed a blue Kia or Hyundai sedan driving at a high rate of speed. Unit 1, failed to come to a complete stop, driving into the back of his vehicle. The impact was substantial that his vehicle became immobile and undrivable. The driver of unit 2 also stated that the impact pushed their vehicle into unit 3 which was also stopped in front of them in the roadway. After the collision occurred, unit 1 fled the area southbound on Rainier Ave N. I then spoke with the driver of unit 3 and he explained a similar story. The driver stated he was stopped in traffic when suddenly he was struck by unit 2 from behind. Unit 3 received minor damage to their rear bumper, but unit 2 was removed by Bankers towing. Both drivers refused any medical attention, and I provided them with an exchange of information. I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT. C.CATALAN 01-24-24 09:48 AM INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED APPROVED BY DATE C.JACOBS 1953 1 1/25/2024 1:43:40 PM BADGE OR ID# 1Y007 ORI# WA0171300 TIME POLICE DISPATCHED; 6:10 PM TIME POLICE ARRIVED';6:10 PM PART I PAGE IT]OF 4] SUPPLEMENTAL REPORT No. EE44309 r`I POLICE TRAFFIC 1 1 8 27 COLLISION REPORT CASE# 24-797 1 COMMERCIAL MOTOR CARRIER INTERSTATE INTRASTATE G UNIT'# USL70r !CC# VEHICLE TYPE CARGO BODY TYPE 2 ❑ 1 28 CARRIER NAME 3 CARRIER L 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:2533251352 0 9 29 LAST NAME SAYEDI FIRST NAME : SAYED MIDDLE'.. W INITIAL STREET 30 NEW AnDRFSP' 12460 SE 299TH PL CITY AUBURN ST WA ZIP 98092 6 CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TANSPORTED 1 1 2 31 INTERLOCK YEs No zERLOCK YES[:]NO[:] YEs N DRIVER'S LICENSE STATE I WA SEX M MMDDYYv 12 - 14 - 1986 7 ON DUTY� STATUS AIRBAG' 2 RESTR. Q EJECT 1 HELMET 2 INJURY 1 1 NATURE OF INJURIES USE CLASS 8 ❑ 1 32 LICENSE I CKU9168 [TAT WA VIN# 5YFBURHE9EP140952 PLATE# 9 9] TRAILER TRAILER PLATE# STATE PLATE# STATE 10 ❑ TRLR TRLR VIN.#. VIN.#. 11 0 0 VEH.YEAR2014 MAKE TOYT MODEL COROLL STYLE SD I VEHICLE TOWS E T SABLIN TOWED BY anvi vFH1I' P FROM TO DAMAGE YES NO YES NO REGISTERED OWNER INFO SA YED SAYED112460 SE 299TH PL AUBURNWA98092 D:2533251352 SHADE IN DAMAGED AREA 9 9 33 12 z 3 FROM TO LIABILITY INSURANCE INSURANCE CO NATIONAL GENERAL 2021338187 q"i"Olx IN EFFECT &POLICY# 1 VEHICLE 34 13 2 Lecnuv YES NO❑ CITATION# CHARGE 10 BOTTUM STANDING } 8 7 6 14 ❑ UNIT Tr Vd 1 RE O FEDDAL 1:1OWNERRTY YES AGE NOHRESHOLD MET PHONE ❑ 35 El PEDESTRIAN 15 LAST NAME FIRST NAME MIDDLE INITIAL TIAL ❑ STRE 16 NEW ETETnnR"Fl CITY ST ZIP CDL IGNITION REdUiRED IGNITtGN PRESENT MEDICALTANSPORTED NTERLOCK YES No NTERLOCK YEs NO YES NO ❑ 17 4 37 LICENSE# STATE SEX MMDDDYBYY 18 ❑ ON DUTY� STATUS AIRBAG RESTR. ; EJECT HELMET INJURY NATURE of INJURIES 38 USE CLASS 19 ❑ LICENSE TAT VIN# 39 PLATE# 20 ❑ TRAILER' TRAILER El40 PLATE#< STATE PLATE# STATE 21 ❑ ❑ 41 TRLR TRLR VIN# YIN#i 42 22 VEH.YEAR MAKE I MODEL STYLE I VEHICLE TOWED DUET SABLIN TOWED BY GOVT.VEHICLE DAMAGE YES NO YES NO 23 REGISTERED OWNER INFO_ SHADE IN DAMAGED AREA 43 3 4 71 LIABILITY INSURANCE INSURANCE CO ' VINE EFFECT &POLICY# i 970P - 4 E:l 44 24 VEHICLE YES❑ NO❑ CITATION# CHARGE iq 60TiOM LEGALLv 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. C.CATALAN 01-24-24 09:48 AM 25 INVESTIGATING OFFICER'S SIGNATURE OFFICER'S PHONE UNIT OR DIST DET DATED: PLACE SIGNED APPROVED BY DATE 26 ORID# 12007 O#IL WA0171300 JACOBS 1/25/2024 PAGE F OF 4 3000-345-013(R 11118) REPORT NO. EE44309 CASE# 24-797 DATE AND TIME 01/23/2418:08 OF COLLISION t? CD a ay `1. f PAGE 4 OF 4