HomeMy WebLinkAbout24-2914 POLICETRAFF'c" III !�� I IIIllI111IN II II I REPORT NO. EE60691 170
27
COLLISION REP FIT 1591971
CASE 24-2914 z
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 1 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#
cawsloN 03 - 1-- 2024 1809 17 ❑-= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
LAKE WA BL N BLOCK NO. e ❑
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ ❑ FEET e S ❑ W e lOGAN AVE N
2 0 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
✓NO D:2063547992 0 11
30
6� LAST NAME HEFNY FIRSTNAME SABRY MIDDLE S 1 1 2 31
INITIAL
STREET ❑ 11425 SE 185TH PL CITY RENTON ST WA ZIP 98055 z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
1/ I iNTERLOCKYEs NO NTERLOCKYEs NO�/ YES R No�/
8❑ LRIIVER #
ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 HELMETU E 2 CLASS 1 NATURE OF INJURIES z❑
3
10❑ P1 aT�S� CFC4863 sTArI WAvIN# 1 V26R2CA4MC530151
TRAILER STATE TRAILER STATE
11 3 5 PLATE# PLATE# FROM ro
TRLR. TRLR. $ 7 33
vIN#
12 3 5 ' VIN#
ROM TO
VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN $ 5 TOWED BY GOVT.VEHICLE 34
13 2021 YOLK ATLAS UT DAMAGE YES NO YES[:] NO✓
REGISTERED OWNER INFOSABRY.111,121SE185THPL RENTONWA98055 D:2063547992 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
14 LIABILI INSURANCE INSURANCE CO PROGRESSIVE 932557476 4
IN EFFECT &POLICY# 9TOP
VE—LE
15❑ EC 5 36
LALLv YES❑NO❑ CITATION# CHARGE 10 BOTTOM
STANDING 8 7 6
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT VEHICLE ❑ CYCLE ❑ ❑
16 a OWNER ❑ YES 1/ NO D:2533941645
LAST NAME LUTON FIRST NAME NATASHA MIDDLE B
INITIAL
STREET
17❑ NEW ADOREss❑' 3613 MORRIS AVE S CITY RENTON ST WA ZIP 98055 37
18❑ CDL IGNITION REQUIRED IGNITION PtR-E-S1ENT MEDICAL-T�RANSPORTED � 38
INTERLOCKYES�NO INTERLOCK YEs I I NOF YEs t l NOF,/
19 DRIVER'S STATE WA ]SEX IF D.C.B. O6 _ 03 _ 1997 39
LICENSE# MMDDYY
20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 H U EET 2 NJAURSY 1 NATURE OF INJURIES ❑ 40
❑ILICENSE 21❑ PLA E# BNY4528 TArE 41
WA vIN# KNDJN2A2XF7194280 1
42
22❑ PLATE# STATE PLATE# STATE
23❑ UIN#. 43
TRLR RLR
'IN#.
VEH YEAR 2015 MAKE KJA MODEL SOUL STYLE UT VEHICLETOWED TO BLIN TOWEDBY GOV HI �44
L4❑ DAMAGE YES NO YES NO
REGISTERED OWNER INFO NATASHA LUTON 3613 MORRIS AVE S RENTON WA 98055 D:2533941654 VEHICLE NO.2
SHADE IN DAMAGED AREA
2 3 4
LIABILITY
INSURANCE INSU&PORGY#E CO ALLSTATE 817257122IN 1UR,
vE""LE ❑ ,J� CITATION# CHARGELEGALLYYES N`LJ
25 7TRADER
NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
J
26 4553 WA0171300
PART A PAGE 01 OF
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EE60691
COLLISION REPORT III III III III III 111
1591972 CASE# 24-2914
ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY)
NAME MIDDLE INITIAL) PUTTON AUDREY 0
(LAST FIRST,
ADDRESS&PHONE# D O.B. '
3613 MORRIS AVE S RENTON WA 98055 2533941645 SEXi F MMDDYyry 10 - 23 - 2016
PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT ' HELMET INJURY NATURE OF INJURIES
❑✓ ❑, 2 POS. 9 1 USE 2 CLASS ,1
NAME
(LAST,FIRST,MIDDLE INITIAL) GREEN ROBERT L
ADDRESS&PHONE# D O B
3514 N SHIRLEY ST TACOMA WA 98407 2532239410 SEX' M MM 0D:," v 04 _ 09 _ 1965
PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET NJURY NATURE OF INJURIES
❑ POS. USE CLASS
NAME
(LAST FIR57 MIDDLE INITIAL)
AppRESS&PHONE#
SEX D.O.B.MMDD -❑
YYYY.
PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET NJURY NATURE OF INJURIES
❑ ❑ POS. USE CLASS ----�
NARRATIVE'
On 03/17/2024 at approximately 1809 hours, Unit 2 was facing SB on Lake Washington BL N at
Logan AVE N waiting for the red light to change. The driver of unit 2 Luton told me she could not
make a right turn due to pedestrian traffic. She stated Unit 1 was honking his horn and got impatient
so he went around and ended up hitting the driver side of of Unit 2. Witness Green confirmed Unit 2's
account on the collision. Unit 1 was the proximate cause of the collision.
I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT.
J.TRADER 03-19-24 07:44 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
J.TRADER 4553 1 311912024 7:49:17 PM
BADGE OR ID# 4553 OR]#' I WA0171300 TIME POLICE DISPATCHED! 6:16 PM TIME POLICE ARRIVED';6:19 PM
PART I PAGE IT]OF 3�
REPORT NO. EE60691 CASE# ' 24-2914 DATE AND TIME 03/17/24 18:09
OF COLLISION
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