HomeMy WebLinkAbout24-1977 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 1 27c
COLLISION REP FIT 1591971
CASE 24-1977 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 7 28
TRIBAL UNITS OZ RESERVATION STRUCK
z
3❑ DATE OF M M D D Y Y Y Y TIME(2400) COUNTY# MILES N E IN CITY#
Ct ELISION' 02 - 1-- 2024 0900 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 e S ❑ W e SWGRADYWAY
0 4 29
MOTOR PEDAL- DAM THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El YEs No ,/ D:5039535408 0 4 30
6� LAST NAME QUEEN FIRSTNAME HUNTER MIDDLE q
INITIAL 1 2 31
STREET ❑ 16504 64TH ST E CITY SUMNER ST WA ZIP' 983903003 z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
INTERLOCK YES[:]NO INTERLOCKYEs NO YES NO
8❑ LRIIVERS STATE WA SEX'M MM DAY' 06 1- 14 - 2000 2 32
CENSE 9 ON DUTY❑ STATUS AIRBAG 1 RESTR 4 EJECT 1 H USEET ICNLJAURY 1 NATURE OF INJURIES z❑
3
10❑ P1 aT�S� 2824331 sTArI IN vrN# 3AKJGEDR3LSLP1904
TRAILER HS588475 STATE OR TRAILER STATE
11 3 5 PLATE# PLATE# ROM To
nTRLR TREK 5 7 33
12 3 5 vIN# SDN16322536000644 vIN#'
ROM TO
VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE 5 7 34
13 2 2020 FRHT CONVE DAMAGE YES NO
✓ ves❑ No✓
REGISTERED OWNER INFO PENSKE LEASING CO L P 2675 MORGANTOWN RD READING PA 196070000 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
14 LIABILITY INSURANCE INSURANCE CO SAME. 3 4
IN EFFECT &POLICY#VEwcLE CHARGE 36
LEGALLvres❑NO❑ CITATION# EQ,
15❑ STAIN.D'ING 8 7 6
UNIT VEHIMOTCLE CYCLE ❑ PEDESTRIAN ❑ OWNER YES
❑ DYES,/ H OLDMET PHONE
16 a
LAST NAME MC KNIGHT FIRST NAME DANIEL MIDDLE I,/
INITIAL
17❑ STREET ❑', 32208 5TH AVE CITY' BLACK DIAMOND ST WA ZIP 980100000 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 M M D.O.B. 02 _ 05 _ 1960 El 39
WELMET INJURY1 NATURE OF INJURIES 40
20❑ ON DUTY STATUS AIRBAG 1 RESTR 4 EJECT 1 USE CLASS ❑
21❑ LICENSE D37472C rare.WA vIN1t 1FAVCWFB5NHNU2361
❑ 41
PLATE#
42
22❑ PLATE# STATE TILER PLATE# STATE
TRLR
23❑ UIN#. N#.
43
RLR
'I
VEH YEAR 2022 MAKE FRHT MODEL M2106 STYLE VEHICLETOWED TO BLIN TOWEDBY GOV HI 44
24❑ DAMAGE YES NO,� YES NO✓
REGISTERED OWNER INFO TRANSCO LEASING CO INC 750 NE COLUMBIA BLVD PORTLAND OR 97211 VEHICLE NO.2
SHADEDAMAGEDAREA
3 4
INAEFFITY ECTNSURANCE INSU&POLICY#E CO SAME. 9TOP 5
'E""LE ❑ Nu,J CITATION# CHARGE
LEG
25 to BOTTOM
ALLY YES ' e
OFFICER'S NAME(PRINT) 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. EE59093
COLLISION REPORT III III III III III 111
1591972 CASE# 24-1977
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'
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 02-23-24 01:52 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY E
DAT
C.JACOBS 1953 311412024 12:59:17 PM
BADGE OR ID# 2517 OR]#' WA0171300 TIME POLICE DISPATCHED! 9:04 AM TIME POLICE ARRIVED',9:08 AM
PART I PAGE IT]OF 5�
REPORT NO. EE59093 CASE# 24-1977 OF COLLISION
02/23/24 09:00
OF CbLLI510N
NARRATIVE
hi cude inside trct trailer outside hucube stopped for car in eb-nb Itl middle of trailer/hood
RTF
Within the city limits of Renton/King/WA I responded to a 2 truck blocking crash at the intersection of
Oaksedale Ave SW at SW Grady Way.
Both the high cube and truck/trailer pulled onto lane one westbound SW Grady Way.
I contacted the driver of unit 2 who told me he was in the inside left turn lane from south Oakesdale to
west Grady. While making his left turn there was a car that stopped proud of the stop bar left turn
lane east Grady to north Oakesdale Ave SW. He said unit 1 was in the outside left turn lane and the
middle of his trailer made contact with the front of his truck while he was stopped to avoid contact with
the unknown vehicle. He did not complain of injury and damages did not require a tow truck.
I contacted the driver of unit 1 who told me he was also making the same left turn from the outside left
turn lane. He described the same issue with the car in LTL stopping beyond the stop bar. He said
unit 2 had stopped and he made contact with unit 2 front end. He did not complain of injury and
damages were minor to his trailer.
There were no witnesses to explain lane position of either vehicle. There are not traffic cameras to
be reviewed and no debris field to locate POI showing lane position(s).
Information/Insurance only.
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 2/23/2024
PAGE 3 OF 5
SUPPLEMENTAL REPORT NO. EE559093
r`) POLICE TRAFFIC 1 27
COLLISION REPORT CASE# 24-1977
1 COMMERCIAL MOTOR CARRIER INTERSTATE ✓ INTRASTATE G
UNIT# 1 USDOT 2893904 ICC# VEHICLE TYPE 4 CARGO BODY 9
TYPE
2 ❑ 1 28
CARRIER NAME RUGBY
.......
3 CARRIER
ADDRESS 1 PILLSBURY ST#302
CITY CONCORD ST NH ZIP 03301
4 ❑ NAME # PLACARD: :❑
NAME IF NO NUMBER
SOURCE 1 AXLES 05 GI80000 +
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 AnnRFrtP. 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 vEHIG P FROM TO
DAMAGE Y EES NO YES NO
REGISTERED OWNER INFO. m 33
12 SHADE IN DAMAGED AREA
FROM TO
LIABILITY INSURANCE❑ INSURANCE CO
IN EFFECT &POLICY# tGQ
EHICLE 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
STREETIAL
❑
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 02-23-24 01:52 PM
25 INVESTIGATING OFFICER'S SIGNATURE OFFICER'S PHONE UNIT OR DIST DET DATED: PLACE SIGNED
APPROVED BY DATE
26 OR ID 2517 O#I',WA0171300 JACOBS 3/14/2024 PAGE�OF F
3000-345-013(R 11118)
REPORT NO. EE59093 CASE# 24-1977 DATE AND TIME 02/23/24 09:00
OF COLLISION
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