HomeMy WebLinkAbout24-1867 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 1 27c
COLLISION REP FIT 1591971
SASE 24-1867 2
INTERSTATE ❑ CITY STREET FIRE ❑
RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHIr.I F ❑ LOCAL AOENC 4Y00 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 3 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 1310 17 ❑-= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
LOGAN AVE N BLOCK NO. e✓ 800 ❑
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ ❑ FEET e S ❑ VV e N 8TH ST
0 1 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
✓NO D:2062290844 0 81
30
6� LAST NAME HUYNH FIRSTNAME KHOA MIDDLE H 9 2 31
INITIAL
STREET ❑ 20117 91 TH CT S CITY RENTON ST WA 21p 98031 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 HELMET
2 CLASS 1 NATURE OF INJURIES z❑
3
10❑ P1 aT�S� ATC4617 sTArI WAvIN# 1 N4At 2AP6AN513055
TRAILER STATE TRAILER STATE
11 0 0 PLATE# PLATE# FROM TO
TRLR. A'RLR. 1 5 33
12 0 0 VIN#' VIN#
FROM TO
VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE J 9 34
13 2 2010 NISS ALTIMA SD DAMAGE YES NO YES[:] No✓
REGISTERED OWNER INFO .141JYNH.11791TH CTS RENTON WA 98031 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
14� INEFITVINSURANCEz INSURANCECOGEICO6142608899 4
LI EFFECT I SUR N# TOPVENICLE CHARGE 36
LEGALLv res❑NO❑ CITATION# <1�3
OTTOM
15❑ STANDING 7 6
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT VEHICLE ❑ CYCLE ❑ ❑ : OWNER ❑ YES 1/ NO D:2067193291
16 a
LAST NAME AUMOEUALOGO FIRST NAME JOLYNN MIDDLE N
INITIAL
17❑ STREET ❑', 55 WILLIAMS AVE S APT 402 CITY' RENTON ST WA ZIP 980572179 37
NEW ADDRESS ❑
18� CDL IGNITION REQUIRED IGNITION PtR—E—S1ENT MEDICAL TRANSPORTED ❑ 38
INTERLOCKYES�NOR INTERLOCK YEs I I NOF YEs t l NO❑
19 LICENSE# STATE WA SEX F M .O.B. 02 _ 16 _ 1955 39
HELMET {NJURY 1 NATURE OF INJURIES 40
20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 USE 2 CLASS ❑
21❑ LICENSE I BLN7274 TAre WA vIN# 7FARW2H89JE068946
❑ 41
PLATE#
42
22❑ PLATE# STATE PLATE# STATE
23❑ VIN#. 43
TRLR RLR
'IN#.
VEH YEAR 2018 MAKE HOND MODEL CRV STYLE UT VEHICLETOWED TO BLIN TOWEDBY GOV HI �44
L4❑ DAMAGE YES NO YES NO
REGISTERED OWNER INFO JOLYNN AUMOEUALOGO 55 WILLIAMS AVE S APT 402 RENTON WA 980572179 VEHICLE NO.2
SHADEDAMAGEDAREA
3 4
LIABILITY
INSURANCE I POLICY#E CO SAFECO H870192IN 9TOP 5
VE""LE CITATION If CHARGE to BOTTOM
25
LEGALLY YES Nu
❑ J e
7CA
NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY26LAN 12007 WA0171300
PART A PAGE 01 OF
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EE52802
COLLISION REPORT III III III III III 111
1591972 CASE# 24-1867
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 February 20, 2024, at 1310 hours dispatch requested that I respond to a collision that occurred at
the intersection of Logan Ave N and N 8th St. in the city of Renton, county of king, and state of
Washington. Upon my arrival I spoke with the driver of unit 2 who explained they were facing
southbound in the number one lane on Logan Ave. N. As they waited for the light to turn green at N
8th St., unit 1 struck the back of their vehicle while stopped.
I then spoke with the driver of unit 1 and they explained they were stopped behind unit 2 but were too
close. They accidentally rolled into unit 2 from behind.
Both vehicles are drivable and both drivers did not sustain any injuries.
An exchange of information were given to the involved parties.
I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT.
C.CATALAN 02-20-24 04:21 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
CO.JOHNSON 0505 1 2/22/2024 8:47:51 AM
BADGE OR ID# 12007 OR]# WA0171300 TIME POLICE DISPATCHED 1:11 PM TIME POLICE ARRIVED:1:19 PM
PART I PAGE IT]OF
REPORT NO. EE52802 CASE# ' 24-1867 DATE AND TIME 02/20/24 13:10
OF COLLISION
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