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Home My WebLink About24-1206 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 6 27c COLLISION REP FIT 1591971 SASE 24-1206 2 INTERSTATE ❑ CITY STREET FIRE ❑ RESULTED 1 STOLEN STATE ROUTE ❑ OTHER ❑ VFHICI 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 z 3❑ DATE of M M D D Y Y Y Y TIME(2400) COUNTY# MILES N E IN CITY# ❑ COLLISION 02 - 1-- 2024 0640 17 ❑.❑ S 8 W e IN e 1070 3 4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑ BLOCK NO. OAKESDALE AVE SW e✓ --- ----� ❑ 4a❑ MILEPOST DISTANCE OF(REFERENCE OR CROSS STREET) 5 ❑ FEET ❑ S ❑ w SW4IST ST ❑ 0 1 29 MOTUNIT O1 VEHICCLE PICYCCLE ElYYESA�NO GE THRESHOLD MET PHONE 0 11 30 LAST NAME VAZQUEZ VALENZUELA FIRST NAME HECTOR MIDDLE flq 6 INITIAL 1 1 2 31 STREET ❑ 709 9TH ST SE CITY AUBURN ST WA 2jp, 98002 z NEW ADDRESS 7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3 iNTERLOCKYEs NO INTERLOCK YES NO YES No $ D RI VER # STATE SEX'U MDMDD 05 - 24 - 1987 1 2 32 9 ON DUTY❑ STATUS AIRBAG 3 RESTR 4 EJECT 1 H USEET ICNIJAU RY 1 NATURE OF INJURIES z❑ ❑ LICENSE CGS5760 sTArI WWAurN# 1FMZU77E33UA99654 3 10 F91 PI ATE# 5 TRAILER STATE TRAILER STATE 11 2 5 PLATE# PLATE# ROM ro TRLR. TRLR 3 7 33 12 3 5 VIN#' VIN# >; FROM TO ❑ VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN T GOVT.VEHICLE 1 $ 34 13 2 2003 FORD EXPLOR DAMAGE vE5 0NO f �LII� RS vEs❑ No REGISTERED OWNER INFO ROSA GALLARDO-RUEDA 7099TH ST SE AUBURN WA 98002 VEHICLE NO. 1 ❑ SHADE IN DAMAGED AREA 35 =, , 14 2 LIABILIT INSURANCE INSURANCE COIN EFFECT &POLICY#VE—LL CHARGE 36 LEGALLY YEs No clTAnoN# gg0078011,4A0078011, FAIL STOP AT STOP15❑ STANDING MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE 16 a UNIT 02 VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES 1/ NO D:2535484105 LAST NAME HARVEY FIRST NAME MATTHEW MIDDLE IC INITIAL 17❑ STREET ❑', 16215 285TH STREET CT E CITY' GRAHAM ST WA ZIP 983388700 37 NEW ADDRESS ❑ 18� CDL ., IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED ❑ 38 IN7ERLOCKYEs�NOR INTERLOCK YEs❑NOF YES ❑NO❑ 19[ DRIVER'S STATE WA SEX M D.Q.B. 04 13 _ 1987 39 LICENSE# MMDDYY WELMET INJURY1 NATURE OF INJURIES 40 20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 USE CLASS ❑ 21❑ LICENSE 3646722 TArE/N vIN 3HSDYAPNORN210871 ❑ 41 pLATE# ❑ 42 22❑ TRAILER P908751 STATE IN TRAILER STATE PLATE# PLATE# 43 23❑ TRUR 1PNE281F6KKB36202 IN# VEH YEAR 2024 MAKE INTL MODEL 1000 STYLE VEHICLETOWED TO BLIN TOWEDBY GOV HI 44 L4❑ DAMAGE YES NO YES NO REGISTERED OWNER INFO XPO FREIGHT INC 3200 INDUSTRIES RD RICHMOND IN 473740000 VEHICLE NO.2 SHADE IN DAMAGED AREA 2 3 4 INAEFFITY ECTNSURANCE INSU&POLICY#E CO SAME. I 9TOP 5 'E""LE ❑ Nu J ,J� CITATION# CHARGE LEG 25 i o BOTTOM ALLY YES s � e OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY J 26 M.LEVERTON 2517 WA0171300 PART A PAGE 01 OF 3000-345-159 OR 11/181 STATE OF POLICETRAFFICN CORRECTION REPORT NO. EE50260 COLLISION REPORT III III III III III 111 1591972 CASE# 24-1206 ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY) NAME MIDDLE INITIAL) KOLAR GEORGE (LAST FIRST, ADDRESS&PHONE# D.O.B. 2067352047 SEX' U MMDDYYYY -❑ PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT ' HELMET INJURY NATURE OF INJURIES ❑ ❑✓ POS. USE CLASS NAME '(LAST,FIRST MIDDLE INITIAL) ADDRESS&PHONE# D O 11 SEX MMD D0 V PASSENGER ❑WITNESS❑ UNIT# SEAT AIRBAG RESTR. EJECT HELMET NJURY NATURE OF INJURIES POS. USE CLASS NAME (LAST FIR57 MIDDLE INITIAL) AppRESS&PHONE# SEX D.O.B.MMDD -❑ YYYY. PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET NJURY NATURE OF INJURIES ❑ ❑ POS. USE CLASS ----� NARRATIVE' tan truck ran stop hit semi trtr wheel then trailer wheel CC Within the city limits of Renton/King/WA I responded to a semi vs car bocking crash at the intersection of SW 41 st St at Oakesdale Ave SW. I contacted the driver of unit 2 who told me he was southbound on Oakesdale when unit 1 crashed into him. He did not complain of injury and damages did not appear to need an impound/tow truck. I contacted the driver of unit 1 ID'd by Sonora Mexico ID. A WACIC/DOL check revealed no record found. He told me he did not see the stop sign and drove directly into the side of unit 2. He did not complain of injury and damages did require a tow truck. He was unable to provide valid proof of insurance for his truck. I cited unit 1/Vasquez ref RCW 46.61.190 Fail to stop-stoop sign 2 vehicle crash, RCW 46.30.020 no insurance and RCW 46.20.015 NVOL 2nd with ID 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 2/2/2024 I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT. M.LEVERTON 02-02-24 07:38 AM INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED APPROVED BY DATE C.JACOBS 1953 2/14/2024 10:54:27 AM BADGE OR ID# 2517 OR]#' WA0171300 TIME POLICE DISPATCHED; 6:40 AM TIME POLICE ARRIVED',6:44 AM PART I PAGE IT]OF 4] SUPPLEMENTAL REPORT NO. EE550260 r` POLICE TRAFFIC 1 27 COLLISION REPORT CASE# 24-1205 1 COMMERCIAL MOTOR CARRIER INTERSTATE FVJ INTRASTATE G UNIT# 2 USDOT 241829 ICC# VEHICLE TYPE 1 4 CARGO BODY 2 ;TYPE 2 ❑ 1 28 CARRIER NAME XPO LOGISTICS ....... 3 CARRIER L ADDRESS 400 SW 34TH ST CITY RENTON ST WA ZIP'', 98057 4 ❑ NAME # PLACARD NAME IF NO NUMBER SOURCE' 1 AXLES 03 GI54000 ✓ 8 + 8 CORROSIVE 4a ❑ ADDITIONAL UNITS MOTOR PEDAL- PROPERTY DAMAGE THRESHOLD MET PHONE 5 ❑ UNIT# VEHICLE I_J CYCLE _) PEDESTRIAN � OWNER � YES NO i MIDDLE'... 29 LAST NAME FIRST NAME INITIAL STREET 30 NFW AnnRFSP CITY ST ZIP 6 � CDL GNITIttN REQUIRED GNITION PRESENT MEDICAL TANSPORTED 1 31 INTERLOCK YES No zERLOCK YES❑N0� vES N LLIICIENSE STATE I SEX M��DYRYY' 2 7 F-1 ON DUTYl STATUS AIRBAG' RESTR. EJECT HELMET INJURY NATURE OF INJURIES USE CLASS 8 ❑ ' 1 32 LICENSE+ rar VIN.# PLATE# 9 TRAILER TRAILER PLATE# STATE PLATE# STATE 10 ❑ TRLR TRLR VIN.#. VIN.#. 11 VEH.YEAR MAKE MODEL STYLE VEHICLE TOWS T SABLIN TOWED BY anvi vEHIC P FROM TO DAMAGE Y EES NO YES NO REGISTERED OWNER INFO. m 33 12 SHADE IN DAMAGED AREA FROM TO ((ABILITY INSURANCE❑ INSURANCE CO IN EFFECT &POLICY# tGQ EHILLE 34 13 ❑ LEGALLY YES[:] NO❑ CITATION# CHARGE STANDING S} MOTOR 8 7 6 14 ❑ UNIT Tr Vd 1RE O CYCLE OWNER RTY YES AGE NOHRESHOLD MET PHONE ❑ 35 PEDESTRIAN 15 LAST NAME FIRST NAME MIDDLE': INITIAL36 STREET"[—] ❑ 16 NFln+AnntxFs.� CITY'. ST 21P CDL IGNITION REdUiRED IGNITION PRESENT MEDICALTANSPORTED INTERLOCK YES No INTERLOCK 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 ❑ vIN 39 LICENSE # PLATE# rnr 20 ❑ TRAILER' TRAILER ❑ 40 PLATE# STATE PLATE# STATE 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 ' VE EFFECT &POLICY# i 970P - 4 E:l 44 24 VEHICLE YES❑ NO❑ CITATION# CHARGE iq 60TiOM C=DLv 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 02-02-24 07:38 AM 25 INVESTIGATING OFFICER'S SIGNATURE OFFICER'S PHONE UNIT OR DIST DET DATED: PLACE SIGNED BADGE O#I' APPROVED 1126 ORID# 2517 WA0171300 ACOBS 2 PAGE F OF 4 3000-345-013(R 11118) REPORT NO. EE50260 CASE# 24-1206 DATE AND TIME 02/02/24 06:40 OF COLLISION i u t ' F i1 1 n s 1 x s , PAGE 4 OF 4