HomeMy WebLinkAbout24-3100 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 6 27c
COLLISION REP FIT 1591971
CASE 24-3100 z
INTERSTATE ❑ CITY STREET FIRE ❑RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHICI F ❑ LOCAL AOENC 4150 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
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#
COLLISION.. 03 - 1-— 2024 2358 17 ❑-= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
BURNETT AVE S BLOCK NO. e✓ 300 ❑
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ �.❑ FEET e S ❑ VV e S 3RD ST
0 1 29
MOTU '�01 VEHtOCLEZ PEAL-CYMLE. El �ESAGE NHORE✓LD MET PHONE 30
6� LAST NAME UNKNOWN FIRSTNAME MIDDLE 1 1 2 31
INITIAL
STREET ❑ CITY Sr ZIP z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
iNTERLOCKYEs NO 1/ INTERLOCKYEs NO�/ YEs No�/
8❑ LIRCIENSRE# STATE SEX u MMDOBYY '❑— 32
9 ON DUTY❑ STATUS I
AIRBAG 9 RESTR 9 EJECT 1 H USEEr 9 CLAY 0 NATURE OF INJURIES z❑
3
LICENSE sTATI urN#'
10❑ PI ATE 14
TRAILER STATE TRAILER STATE
11 2 5 PLATE# PLATE# ROM ro
rRLR. TRLR. 1 5 33
12❑ VIN#' VIN#
FROM TO
❑ VEH.YEAR UNKNO MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE 3
13 34
2 HYUN 4D DAMAGE YES NO YES❑ NO✓
REGISTERED OWNER INFO UNKNOWN VEHICLE NO. 1
SHADE IN DAMAGED AREA ❑ 35
14 ABILI INSURANCE❑ NSURANCE CO 3 4
IN EFFECT &POLICY# 9TOP
vewcLE
CHARGE 5 36
LECALLv YES❑NO❑ CITATION# 10 BOTTOM
15❑ STANDING 7 6
MOTOR PEDAL- PEDESTRIAN ✓ PROPERTY DAM THR OLD MET PHONE
UNIT VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES 1/ NO D:2067355930
16 a
LAST NAME NELLIS FIRST NAME TKAUS MIDDLE J
INITIAL
17 STREET❑ NEW ADOREss❑' 3531 NE 6TH PL CITY RENTON ST WA ZIP 98056 37
18❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL—T�RANSPORTED � 38
INTERLOCK YES�NOR INTERLOCK YEs It I NO YES t l NO❑
19 DRIVER'S STATE WA SEX M D. 05 _ 31 1987 39
LICENSE# MMO.B.
20 ON DUTY STATUS 3 AIRBAG RESTR EJECT I HELMET I INJURY 7 NATURE OF INJURIES ❑ 40
USE CLASS LEFT KNEE PAIN
❑21❑ LICENSE TATE vIN# 41
`1
PLATE#
42
22 [TRAILER T
❑ PLATE# STATE PLATE#ILER STATE
23❑ 43
TRLR RLR
VIN#. IN#.
VEH YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN
TOWED BY Gov HI 44
24 1 DAMAGE YES NO YES NO
REGISTERED OWNER INFO VEHICLE NO.2
SHADE IN DAMAGED AREA
2 3 4
LIABILITY
INSURANCE❑ INSURANCE
#E CO
IN EFFECT &PO I 9TOP 5
VE""LE ❑ ,J� CITATION# CHARGE i o BOTTOM
LEGALLY YES N`L J
25 s � e
7TH
NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
26MAN 11462 WA0171300
PART A PAGE 01 OF
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EE61841
COLLISION REPORT III III III III III 111
1591972 CASE# 24-3100
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
PM 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.
J.THIELMAN 03-22-24 01:42 AM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
DESIRES SCOTT 10272 3/23/2024 4:11:42 PM
BADGE OR ID# 11462 OR]# WA0171300 TIME POLICE DISPATCHED 11:58 PM TIME POLICE ARRIVED',11:58 PM
PART Ei PAGE IT]OF 4�
DATE AND
TIME
REPORT NO. EE61841 CASE# 24-3100 OF COLLISIONO3/21/2423:58
NARRATIVE
During this incident, I was equipped with a body-worn camera, which records both audio and video.
Portions of this incident were recorded. This report is merely a summary of the incident and is not
intended to be an exact transcription of the entire investigation or what may have been captured with
the recording system. I was operating a fully marked Police Tahoe #271 which was equipped with
overhead emergency lights and sirens.
Case Number 24-3100
On 03/21/2024 at approximately 2358 hours, I was dispatched to a hit and run detail at S 3rd
ST/Burnett Ave S within the City of Renton, King County, Washington.
While en route, dispatch relayed a white sedan struck the reporting party as they were using the
crosswalk.
I arrived and contacted the reporting party/unit two, Tkaus Nellis, who informed me of the following:
Unit two was crossing on the southern side of the intersection in a clearly marked crosswalk with a
walk signal activated. Nellis was a few steps into the crosswalk moving west to east when unit one
clipped his left knee at a moderate speed. Nellis said he spun around and felt minor pain to his knee.
He also said the vehicle hit another person, but they left the scene on the own prior to my arrival.
Nellis described unit one as a white Hyundai sedan and noted he fled southbound on Burnett Ave S
from S 3rd ST. Given the minor injury to Nellis, it is unlikely the vehicle sustained any damage. Nellis
said he would be going home tonight and wasn't sure if he'd go to the hospital.
There is no further suspect information. The second victim never called 911 and their identity is
unknown.
I certify (declare) under the penalty of perjury under the laws of the State of Washington that the
foregoing is true and correct.
Electronically signed Sergeant J.Thielman/11462
03/22/2024 0023 Hours Renton, WA.
PAGE 3 OF 4
REPORT NO. EE61841 CASE# 24-3100 DATE AND TIME 03/21/24 23:58
OF COLLISION
PAGE 4 OF 4