HomeMy WebLinkAbout24-1869 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 0 27c
COLLISION REP FIT 1591971
SASE 24-I869 2
INTERSTATE ❑ CITY STREET FIRE ❑
RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHICI F ❑ LOCAL AGENC 4100 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 1347 17 ❑-= S 8 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 e S ❑ w SW4IST ST
❑
0 4 29
UNIT MOTOORVECL Z CYCLE ElDDAMYESA✓NOESHOLD MET PHONE 0 11
30
6� LAST NAME FRANKLIN FIRSTNAME CHRISTOPHER MIDDLE T 1 1 2 31
INITIAL
STREET ❑ 126 VALDES CT CITY CAMANO ISLAND ST WA ZIP', 982826547 z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
iNTERLOCKYEs NO INTERLOCKYEs NO YES R NO
8❑ LRIIVERS STATE WA SEXI M MM DAY' 05 1— 18 — 1968 2 32
CENSE 9 ON DUTY❑ STATUS AIRBAG 1 RESTR 4 EJECT 1 H U SE
ICNLJAUSSY I NATURE OF INJURIES z❑
3
10 9❑ P1 aT�S� C01441D sTArI WAurN# JALE5W167F7301425
TRAILER STATE TRAILER STATE
11 3 5 PLATE# PLATE# IR.. T.
TRLR. TRLR 5 7 33
12 3 5 VIN#' VIN#
ROM TO
❑ VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE $ 34
13 2 2015 UNKN DUNE DAMAGE YES NO ✓ YES[:] NO✓
REGISTERED OWNER INFO LEATHERBACKPUBLISHING INC 6817THAVE KIRKLAND WA 98033 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
14 LIABILI INSURANCE INSURANCE CO SAME. 3 4
IN EFFECT &POLICY# 9TOP
VEHICLE 5 36
LEGALLv res❑NO❑ CITATION# CHARGE 10 BOTTOM
15❑ STAIN."' 8 6
UNIT 02 VE ICCLE CYCLE ❑ PEDESTRIAN ❑ OWNER YES
❑ DYES✓ NO OLD MET PHONE
16 a
LAST NAME HARRIS FIRST NAME BENNIE MIDDLE I L
INITIAL
17❑ STREET ❑', 4210 110TH ST SW APT 10 CITY LAKEWOOD ST WA ZIP 984997505 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 DRIVER'S STATE WA SEX M D.Q.B. 05 _ O6 _ 1978 39
LICENSE# MMDDYY
20❑ ON DUTY STATUS' AIRBAG 2 RESTR 4 EJECT 1 HELMET INJURY 7 NATURE OF INJURIES ❑ 40
USE CLASS HEAD
21❑ LICENSE I CKJ4303 TArE WA VIN1t 5YFEPRAE3LP037165
❑ 41
PLATE#
42
22❑ PLATE# STATE PLATE# STATE
23❑ VIN#. 43
TRLR RLR
'IN#.
VEH YEAR 2020 MAKE TOYT MODEL COROLL STYLE VEHICLE TOWED TO BLIN TOWEDBY GOV HI 44
24❑ DAMAGE YES✓ NO (,ENE MEYER YES NO✓
REGISTERED OWNER INFO MICHAEL VOSS 8612 BERKELEYAVE SW LAKEWOOD WA 98498 VEHICLE NO.2
SHADE IN DAMAGED AREA
2 3 4
LIABILITY INSURANCE❑ INSURANCE CO
IN EFFECT &POLICY# 9TOP 5
'E""Le Yes Nc❑ clrArloN# 4A007804Q 4A0078041 CHARGE DWLS 3RD DEGREE,OP MOT VEH ,o BOTTOM
cALLv
25 ' a
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# 777PNCY
26
M.LEVERTON 2517 0171300
PAGE 01 OF
PART A
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EE52803
COLLISION REPORT III III III III III 111
1591972 CASE# 24-1869
ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY)
NAME
(/AST 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'
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.
M.LEVERTON 02-21-24 10:59 AM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
CO.JOHNSON 0505 1
2/22/2024 8:45:58 AM
BADGE OR ID# Y517 ORI# WA0171300 TIME POLICE DISPATCHED; 1:47 Pry TIME POLICE ARRIVED i 1:51 PM
PART I PAGE IT]OF 4�
REPORT NO. EE52803 CASE# 24-1869 OF COLLISION
02/20/24 13:47
OF CbLLI510N
NARRATIVE
wht box It blue In 2
CC
On 2/20/2024 at about 1347 hours within the city limits of Renton/King/Wa I responded to a 2 car
blocking crash at the intersection of SW 41st and Oakesdale Ave SW.
I contacted the driver of unit 1 who told me he was trying to make a left turn north on Oakesdale Ave
SW to the 4050 business complex. He explained that another commercial truck was south on
Oakesdale was also going to make a left onto SW 41 st St. Unit 1 said he had checked for traffic
which he believed was clear. He said both he and the other commercial truck made left turns at
about the same time. Concealed behind the opposing turning truck was unit 2 southbound in lane 2.
Unit 1 clipped the front of unit 2. Unit 1 did not complain of injury and damages were minor.
I contacted unit 2 driver still seated in the driver seat. He told me he was hit by a a big truck and was
wincing in pain. He did not provide additional information about the crash. He told me he did not
have insurance for his vehicle and ID'd himself as Harris Bennie Lee 05-06-1978 with Wa-ID card.
He was checked by Renton Fire and later transported to VMC-ED for additional checks.
A WACIC/DOL check via IVIDC revealed Harris was driving while license suspended third degree.
(DWLS 3rd) He record showed a long history of DWLS along with other traffic violations including
fail to maintain liability insurance.
I cited Harris ref RCW 46.20.342 Driving While License Suspended 3rd Degree via Renton
Prosecutors office and ref RCW 46.30.020 No valid 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 2/21/2024
PAGE 3 OF 4
REPORT NO. EE52803 CASE# ' 24-1869 DATE AND TIME 02/20/24 13:47
OF COLLISION
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