HomeMy WebLinkAbout24-1445 POLICETRAFF'c" III !�� I IIIllI111IN II II I REPORT NO. EE54004 170
27
COLLISION REP FIT 1591971
CASE 24-1445 z
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 CITY# ❑
COLLISION'. 02 — 09 — 2024 1155 17 ❑.❑ N E IN S 8 W H OF e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓
S 2ND ST BLOCK e✓ 200
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ 300 00 FMILES EET e S ❑ E e RAINIER AVE S
0 4 29
UNIT MOTOR
VEHICL Z CYDDAL ElDDAMA✓NOESHOLD MET PHONE 0 1 30
6� LAST NAME KAALEKAHI FIRSTNAME RICHARD MIDDLE K 1 2 31
INITIAL
STREET ❑, 18311 108TH PL SE CITY RENTON ST WA ZIP 980556454 z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
iNTERLOCKYEs NO INTERLOCKYEs NO YES R NO
8❑ LRIIVER #
ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 H U SE
ICNLJAUSSY 1 NATURE OF INJURIES z❑
3
10 9❑ P1 aT�S� CCT4166 sTArI WAurN# 4S4WMAPD8L3467047
TRAILER STATE TRAILER STATE
11 2 5 PLATE# PLATE# FROM TO
TRLR. YRLR. 3 5 33
12 2 5 VIN#' VIN#
>; FROM TO
VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE 3 ] 34
13 2 2020 SUBA ASCENT DAMAGE YES NO YES[:] No
✓
REGISTERED OWNER INFO RICHARD KAAIEKA.120 W CASINO RD APT 30C EVERETT WA 98204 D:4252973521 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
2 3 4
14 3 LIABILITY INSURANCE❑ INSURANCE CO
IN EFFECT &POLICY# 9TOP 5
VEHlcl.e CHARGE 10 BOTTOM 36
LEGALLY YES❑NO❑ CITATION# 4AO078022,4AO078022 IMPROPER LANE USAGE,OP MOT
15❑ STANDING 8 6
MOTOR PEDAL- PROPERTY DAM THR OLD M PHONE
U�iT a2 VEHICLE CYCLE ❑ PEDESTRIAN ❑ OWNER ❑ YES V
16 NO ET D:4253939676
a
LAST NAME SURITA Ill FIRST NAME ARMANDO MIDDLE N
INITIAL
17❑ STREET ❑', 2929 NEVADA ST APT B CITY BELLINGHAM ST WA ZIP 982263532 37
NEW ADDRESS ❑
18� CDL IGNITION REQUIRED IGNITION PtR—E—S1ENT MEDICAL TRANSPORTED 38
INTERLOCKYES�NOR INTERLOCK Y�EsI I I NOF YES
t l NO❑ 11
19 D IVEW # STATE WA SEX M M D.C.B. 09 _ 14 1984 0 39
WELMET INJURY1 NATURE OF INJURIES 40
20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 USE CLASS ❑
21❑ LICENSE AGK4950 TAre WA VIN# 1FAFP33Z63W228142
❑ 41
PLATE#
42
22❑ PLATE# STATE PLATE# STATE
TRLR
23❑ UIN#. IN#.
43
RLR
'
VEH YEAR 2003 MAKE FORD MODEL FOCUS STYLE VEHICLETOWED TO BLIN TOWEDBY GOV HI 44
24❑ DAMAGE YES NO YES NO
REGISTERED OWNER INFO MARY BLEVINS 3889 SQUILCHUCK RD WENATCHEE WA 98801 VEHICLE NO.2
SHADEDAMAGEDAREA
3 4
INAEFFITY ECTNSURANCE INSU&POLICY#E CO SAME. IUL"iKOTITIfl0l�-
(PRINT)'E""LE ❑ ,J� CITATION# CHARGELEGALLYYES N`L J25 OFFICER'S NAME 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. EE54004
COLLISION REPORT III III III III III 111
1591972 CASE# 24-1445
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'
wht suv It lane 3 wht sedan In 4
CC
Within the city limits of Renton/King/Wa I responded to a 2 car crash at the 200 block of S 2nd St.
I contacted the driver of unit 2 who told me he was west on s 2nd St in lane 4 when unit 1 turned left
into his vehicle. He did not complain of injury and damages did not require a tow truck.
I contacted the driver of unit 1 ID'd by picture WADL. He was unable to provide valid proof of
insurance for his vehicle. He told me he was in lane 3 when he made a left turn towards the Safeway
parking lot striking unit 2 vehicle while crossing lane 4. He did not complain of injury and damages
did not require a tow truck.
I cited unit 1 ref RCW 46.61.140 Improper lane use/2 car crash and ref RCW 46.30.020 No valid proof
of 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 2/14/2024
I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT.
M.LEVERTON 02-14-24 08:18 AM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
C.JACOBS 1953 2/26/2024 4:56:19 PM
BADGE OR ID# 2517 OR]#' WA0171300 TIME POLICE DISPATCHED', 12:12 PM TIME POLICE ARRIVED';12:16 PM
PART I PAGE IT]OF 3�
REPORT NO. EE54004 CASE# ' 24-1445 DATE AND TIME 02/09/24 11:55
OF COLLISION
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