HomeMy WebLinkAbout24-3043 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 5 27c
COLLISION REP FIT 1591971
CASE 24-3043 z
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 2 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 1534 17 ❑.= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓
BLOCK
RAINIERAVESW ST e✓
MILEPOST 230
4a❑
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ ❑ FEET e S ❑ W e 0 4 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
✓NO D:2063709526 0 11
30
6� LAST NAME RADIUS FIRSTNAME RYAN MIDDLE N 1 1 2 31
INITIAL
STREET ❑ 3513 NE 23RD CT CITY RENTON ST WA ZIP 980562451 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 9❑ P1 aT�S� ATG6905 sTArI WAvIN# 5FRYD4H82FB012359
TRAILER STATE TRAILER STATE
11 0 0 PLATE# PLATE# FROM TO
TRLR. A'RLR. 1 3 33
12 0 0 VIN#' VIN#
>; FROM TO
VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE 5 1 34
13 2 2015 ACUR MDX DAMAGE YES NO YES[:] No✓
REGISTERED OWNER INFO RONY RADIUS 3513 NE 23RD CT RENTON WA 98056 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
14 LIABILI INSURANCE INSURANCE CO FARMERS 186126622 3 4
IN EFFECT &POLICY# 9TOP
VE—LE CHARGE 5 36
LEGALLv YES❑NO❑ CITATION# 1 o BOTTOM
15❑ STANDING 8 6
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT VEHICLE ❑ CYCLE ❑ ❑
16 a : OWNER ❑ YES 1/ NO D:9716669093
LAST NAME DIEHL FIRST NAME CARLY MIDDLE M
INITIAL
17❑ STREET ❑' 3938 PIEDMONT TER CITY' MEDFORD ST OR ZIP 97504 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 OR SEX IF I D.Q.B. 04 12 _ 1999 39
LICENSE# MMDDYY
WELMET {NJURY NATURE OF INJURIES 40
20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 USE 2 CLASS 1 ❑
21❑ LICENSE 552PDS TAre OR vIN1 JF1GV7E69CG030573
❑ 41
PLATE#
42
22❑ PILER LATE# STATE PLATE# STATE
23❑ 43
TRLR RLR
UIN#. 'IN#.
VEH YEAR 2012 MAKE SUBA MODEL ►MPREZA STYLE SD VEHICLETOWED TO BLIN TOWEDBY GOV HI 44
L4❑ DAMAGE YES NO YES NO
REGISTERED OWNER INFO CARLY DIEHL 3938 PIEDMONT TER MEDFORDOR97504 D:9716669093 VEHICLE NO.2
SHADEDAMAGEDAREA
3 4
LIABILITY
INSURANCE &POINSURGY#E CO AAA ORSS107053097IN 0( 9TOP 5
VE""LE ❑ ,J� CITATION# CHARGE io BOTTOM
LEGALLY YES N`L J
25 ' e
7CA
NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
J
26LAN 12007 WA0171300
PART A PAGE 01 OF
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT No. EE65035
COLLISION REPORT III III III III III 111
1591972 CASE# 24-3043
ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY)
NAME MIDDLE INITIAL) SHIM CHAZIN K
(LAST FIRST,
ADDRESS&PHONE# D O.B.
314 CALISTOGA ST INORTING WA 983602078 SEX M MMDDYyry 12 - 19 - 1998
PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT ' HELMET INJURY NATURE OF INJURIES
❑✓ ❑ 2 PO& 3 2 4 1 USE 2 CLASS I1
NAME
(LAST,FIRST,MIDDLE INITIAL)
ADDRESS&PHONE# D O B
SEX MMDDYYYY
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 March 20, 2024, at 1534 hours dispatch requested that I respond to a collision at Wendy's, 230
Rainier Ave S, in the city of Renton, county of King, and state of Washington.
Upon my arrival I spoke with the driver of unit 2 and they explained they were going northbound on
Rainier Ave N when the collision occurred. The driver believes unit 1 saw a gap in lane two, so he
made a left turn from the southbound lane into Wendy's, but failed to see unit 2 going northbound.
Unit 1 made a left turn in front of them, not allowing them to stop.
Unit 2 struck unit 1's passenger side fender.
I then spoke with the driver of unit 1 and he explained a similar story. He stated that another vehicle
in lane 2 stopped for him and allowed him access to the road, but he failed to see unit 2 driving
northbound in lane one. He made a left turn but was struck by unit 2 on his passenger side wheel and
fender.
An exchange of information was given to both drivers.
I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT.
C.CATALAN 03-20-24 06:37 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST.DET DATED PLACE SIGNED
APPROVED BY DATE
C.JACOSS 1953 1 4/3/2024 5:52:59 PM
BADGE OR ID# 12007 ORI# WA0171300 TIME POLICE DISPATCHED; 3:37 PM TIME POLICE ARRIVED;3:49 PM
PART I PAGE IT]OF 3�
REPORT NO. EE65035 CASE# ' 24-3043 DATE AND TIME 03/20/24 15:34
OF COLLISION
id Y
`1 3
*t
� a`irs Zu L yi
3
a v
t ,
V ki
n
}
.,,-„=,xs„. ..�;,�.�> > '�+z v ,vMu»„��;,,«:�u„ } dtt�,:: `iY.e�.;�•''t'c ::. ,'�"' .. ai c:�n�\�3�.'.s•.,:,»�: ','-� .e»,`,' t»,.;. -,;"Ps },�Y:».�,4`�," �" `y�'
PAGE 3 OF 3