HomeMy WebLinkAbout24-1520 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 3 27c
COLLISION REP FIT 1591971
SASE 24-1520 2
INTERSTATE ❑ CITY STREET FIRE ❑
RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHIr.I 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 STRUCK
RESERVATION
z
3❑ DATE of M M D D Y Y Y Y TIME(2400) COUNTY# MILES N E IN CITY# ❑
COLLISION.. 02 — 11 — 2024 2030 17 ❑.❑ S 8 W H OF e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
S 3RD ST BLOCK e✓ 700 ❑
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ ❑ FEET ❑ S ❑ W❑ BURNETT AVE S
0 2 29
UNIT MOTOR
❑ PEDAL-
❑ YESA,GEE NHORESHOLD MET PHONE 0 4 30
LAST NAME CALDERON MENJIVAR FIRST NAME ROBERTO MIDDLE II
6 INITIAL 1 1 2 31
STREET ❑ 17110 120TH TER SE APT Y103 CITY RENTON ST WA ZIP' 980586234 z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
iNTERLOCKYEs NO 1/ INTERLOCKYEs NO�/ YES R No�/
8❑ LRIIVER #
ON DUTY❑ STATUS AIRBAG 3 RESTR 9 EJECT 1 HELMET
2 CLASS 1 NATURE OF INJURIES z❑
❑10❑ P1 aTES� BST0352 sTArI WWAurN# 183ES46C61D182923 3
IT STATE TRAILER STATE
11 0 0 PLATE# PLATE# ROM TO
TRLR. TRLR 7 3 33
12 2 5 VIN#' VIN#
>; FROM TO
VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE 7 1 34
13 1 2001 DODO NEON SD DAMAGE YES NO YES❑ NO✓
REGISTEREDOWNERINFO OWNEDBYDRIVER VEHICLE NO. 1
SHADE IN DAMAGED AREA 35
14 ❑ INSURANCE CO 3 4
LIABILITY INSURANCE
IN EFFECT &POLICY# 9TOP
VEwcLE CHARGE 10BOTTOM 5 36
YES No clTAnoN# 4AO189471 OP MOT VEH W/OUT INSURANCE 5
15❑ STANDING 8 7 6
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT 02 VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES 1/ NO D:2535619007
16 a
LAST NAME MARSHALL FIRST NAME LESA MIDDLE N
INITIAL
17 STREET NEW ADDRESS❑' 8916 174TH STREET CT E CITY PUYALLUP ST WA ZIP 983752495 4❑ 37
18� CDL IGNITION REQUIRED IGNITION PRESENT MEDICALTRANSPORTED 38
INTERLOCKYES�NO INTERLOCK YEs❑NOF YEs❑NOF,/
19[—] LDI IVER # STATE WA ]SEX IF MMDDW 02 _ 12 _ 1967 39
20❑ ON DUTY STATUS AIRBAG 2 RESTR 9 EJECT 1 H U EET 2 NJAURSY 1 NATURE OF INJURIES ❑ 40
❑21❑ PLATE# CHY4676 TArE WA VIN# 5XYP54CoC6RCo427102 41
1
42
22❑ PLATE# STATE PLATE# STATE
23❑ VIN#. 43
TRLR RLR
'IN#.
VEH YEAR 2024 MAKE KIA MODEL TELLURI STYLE SV VEHICLE TOWED TO BLIN TOWED BY GOV HI 44
L4❑ DAMAGE YES NO YES NO
REGISTERED OWNER INFO LESA MARSHALL 8916174TH STREET CT E PUYALLUP WA 983752495 D:2535619007 VEHICLE NO.2
SHADE IN DAMAGED AREA
2 3 4
LIABILITY
INSURANCE INSU PORGY#E CO SAFECO H2526234IN 1 9TOP 5
'E""LE ❑ N`L J
,J� CITATION# CHARGE
LEG
25 i o BOTTOM
ALLY YES s 6
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
J
26
C.ARNOLD 12509 WA0171300
PAGE 01 OF
PART A
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EE52220
COLLISION REPORT III III III III III 111
1591972 CASE# 24-1520
ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY)
NAME MIDDLE INITIAL) MARSHALL FREDERICK D
(LAST FIRST,
ADDRESS&PHONE#
8916 174TH STREET CT E PUYALLUP WA 98375 2532171865 SEX M MMDOYyry -
PASSENGER Z WITNESS❑1 UNIT# 2 PSEAT OS 3 AIRBAG 2 RESTR. 9 EJECT ? 1 HELMET INJURY NATURE OF INJURIES
USE 2 CLASS 11
NAME
(LAST,FIRST,MIDDLE INITIAL)
ADDRESS&PHONE# DOB
SEX MMDDYYYY
PASSENGER ❑WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET INJURY NATURE OF INJURIES
POS. USE CLASS
NAME
(LAST FIR57 MIDDLE INITIAL)
AppRESS&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.
C.ARNOLD 02-11-24 09:50 PM
NVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
D.MOYNIHAN 11288 1 2/21/2024 1:00:18 AM
BADGE OR ID# 112509 ORI#' WA0171300 TIME POLICE DISPATCHED' 8:35 PM TIME POLICE ARRIVED i 8:36 PM
PART I PAGE IT]OF 4]
DATE AND
REPORT NO. EE52220 CASE# 24-1520 OFCOLISION 02111/2420:30
OF COLLISION
NARRATIVE
24-1520
On 2/11/2024 at 2035 hours I was dispatched to a collision at S 3rd St and Burnett Ave S located in
the City of Renton, King County, Washington. I arrived on scene at 2036 hours and met with Drivers'
1 and 2. The following information is based off of the statements of Drivers' 1 and 2.
Unit 1 was traveling Eastbound in the number 2 lane approaching the intersection of S 3rd St and
Burnett Ave S.
Unit 2 was traveling Eastbound in the number 2 lane approaching the intersection of S 3rd St and
Burnett Ave S, preparing to make a lefthand turn to proceed North on Burnett Ave S from the
intersection.
Unit 1's driver stated that he was traveling East on S 3rd St in the number 2 lane through the
intersection when he observed Unit 2 attempt to perform a lefthand turn from the number 1 lane. The
driver of Unit 1 stated that the front passenger side bumper of Unit 1 made contact with the front
drivers side door of Unit 2.
Unit 2's driver stated that she was traveling East on S 3rd St in the number 2 lane and was preparing
to turn left at the intersection of S 3rd St and Burnett Ave S. Unit 1's driver stated that she observed
Unit 1 maneuver his vehicle left into the parking spaces on the North side of S 3rd St and proceed
through the intersection. Unit 2's drive stated that as she turned left, Unit 1's front passenger side
bumper made contact with the front drivers side door of Unit 2.
Unit 1 was disabled and was not moved prior to my arrival on scene. The final resting spot for Unit 1
was almost onto the sidewalk at the Northeast corner of S 3rd St and Burnett Ave S. Based upon this,
and my training and experience, it did not make sense that Unit 1 was in the number 2 lane when the
collision occurred as his vehicle would have remained on S 3rd St rather than being nearly onto the
corner sidewalk.
Collision description
No apparent Injuries
Unit 1 was rendered inoperable and impounded by Gene Meyers towing.
Proximate Cause:
If not for Driver 1 (CALDERON MENJIVAR) having driven his vehicle upon and area of the roadway
not marked for travel, then the collision would not have occurred.
Driver 1 stated that he did not have insurance and I advised him that he would be receiving a citation
in the mail because per RCW 46.30.020.1 No person may operate a motor vehicle subject to
registration under chapter 46.16A RCW in this state.
I certify (declare) ender penalty of perjury under the laws of the State of Washington that the
foregoing is true and correct.
Electronically signed by Officer C. Arnold #12509 at 21:33 hours on 2/11/2024, in the City of Renton,
King County, Washington.
PAGE 3 OF 4
REPORT NO. EE52220 CASE# 24-1520 DATE AND TIME 02/11/24 20:30
OF COLLISION
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PAGE 4 OF 4