HomeMy WebLinkAbout24-3125 POLICETRAFF'c" III !�� I IIIllI111IN II II I REPORT NO. EE61842 170
27
COLLISION REP FIT 1591971
CASE 24-3125 z
INTERSTATE ❑ CITY STREET FIRE ❑RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHIl.I F ❑ LOCAL AOENC 4Y00 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 3 TOTAL#OF OBJECT 1 1 8 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#
COLLISION.. 03 - 1-- 2024 2245 17 ❑-= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
N 30TH ST BLOCK e✓ 900 ❑
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ �,❑ FEET e S ❑ W e /405
0 4 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
,/No D:4255337686 0 81
30
6� LAST NAME KOPP FIRSTNAME ROLAND MIDDLE N 1 2 31
INITIAL
STREET ❑ 4218 NE 9TH CIR CITY RENTON ST WA 21p 980594570 z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
INTERLOCK YES[:]NO 1/ INTERLOCKYEs NO�/ YES R No�/
8❑ LRIIVER #
ON DUTY❑ STATUS AIRBAG 2 RESTR 9 EJECT 1 HELMET U E 2 1 CLASS NATURE OF INJURIES z❑
3
10 2❑ P1 ATE 14 BfD5022 STATE WA VIN#' JN8AE2KP8G9155885
TRAILER STATE TRAILER STATE
11 3 5 PLATE# PLATE# FROM To
TRLR. TRLR. 1 3 33
12 0 0 VIN#' VIN#
>; FROM TO
VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED By GOVT.VEHICLE J 9 34
13 4 2016 NISS QUEST VN DAMAGE YES NO YYES[:] NO✓
REGISTERED OWNER INFO OWNEDBYDRIVER VEHICLE NO. 1
❑
SHADE IN DAMAGED AREA 35
4 INSURANCE CO 3 4
14 IN EF IT INSURANCE❑ TRAVELERS 6001175462032
IN EFFECT &POLICY# 9TOP
VEHlcl.e CHARGE 10BOTTOM 5 36
LEGALLY YES❑NO❑ CITATION# 4AO245819 OP MOT VEH W/OUT INSURANCE 5
15❑ STANDING 7 6
MOTOR PEDAL-: PROPERTY DAM THR OLD MET PHONE
UNIT 02 VEHICLE CYCLE ❑ PEDESTRIAN ❑ OWNER ❑ YES 1/ NO DD 2065910422
16 a
LAST NAME HAILE FIRST NAME DESI MIDDLE I F
INITIAL
17❑ STREET Is❑' 9618 56TH AVE S CITY' SEATTLE ST WA ZIP 981185713 4❑ 37
NEW ADDREs
18❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED � 38
INERLOCKYEs❑No� INTERLOCK ves No� YES
NOF
19 LICENSE# STATE WA SEX M I D.MMDDYY O6 _ 16 _ 1996 39
20❑ ON DUTY STATUS AIRBAG 2 RESTR g EJECT 1 H U EET 2 NJAURSY 1 NATURE OF INJURIES ❑ 40
LICENSE I ❑21❑ PLA E# CHA1798 TATE 41
WA VIN# 1FADP3F23FL348766 1
42
22❑ PLATE# STATE PLATE# STATE
TRLR
23❑ VIN#. IN#. 43
RLR
'
GoI
VEH YEAR 2015 MAKE FORD MODEL FOCUS STYLE $D DAMAGE TOWED NOO✓ BLIN TOWED BY v HyES NO 1/ 44
24❑ ES
REGISTERED OWNER INFO OWNED SY DRIVER VEHICLE N0.2
SHADE IN DAMAGED AREA
2 3 4
LIABILITY
INSURANCE &POINSURGY#E CO pROGRESSIVE 975456299IN STOP 5
'E""LE CITATION# CHARGE i o BOTTOM
LEGALLY YES Nu I 1 0(25❑ J a
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
26
C.ARNOLD 12509 WA0171300
PAGE 01 OF
PART A
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EE61842
COLLISION REPORT III III III III III 111
1591972 CASE# 24-3125
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'
24-3125
On 3/22/2024 at 2245 hours I was dispatched to a collision at the 900 block of N 30th St located in
the City of Renton, King County, Washington. I arrived on scene at 2252 hours and met with Drivers'
1 and 2. The following information is based off of the statements of Drivers' 1 and 2.
Unit 1 had stopped at the stop sign exiting i405 South and was preparing to make a lefthand turn to
proceed East on N 30th St at around the 900 block.
Unit 2 was stopped at the stop sign facing West at the intersection of N 30th St and the i405 off-ramp
at around the 900 block. Unit 2 was in the number 2 lane which is a lefthand turn lane, preparing to
make a lefthand turn to proceed South on i405 South.
Unit 1 performed a lefthand turn and miscalculated the turn, resulting in the front bumper of Unit 1
colliding with the front bumper of Unit 2
Unit 2 remained stopped at the stop sign during this incident.
Collision description:
Neither party complained of injuries.
Vehicle dispositions (Not Towed)
Driver 1 was unable to provide me with valid insurance. Driver 1 provided a policy number and
company but was unable to provide insurance with an expiration date that would render his insurance
in effect, in violation of RCW 46.30.020. Driver 1 was cited with SECTOR citation #4A0245819 for not
having valid insurance
I certify (declare) ender penalty of perjury under the laws of the State of Washington that the
foregoing is true and correct.
Electronically signed by Officer C. Arnold #12509 at 23:22 hours on 3/22/2024, in the City of Renton,
King County, Washington.
I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT.
C.ARNOLD 03-22-24 11:39 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
DESIRES SCOTT 10272 1 3/23/2024 4:11:35 PM
BADGE OR ID# 12509 OR]#+ " WA0171300 TIME POLICE DISPATCHED! 10:47 PM TIME POLICE ARRIVED 10:52 PM
PART I PAGE IT]OF
REPORT NO. EE61842 CASE# 24-3125 DATE AND TIME 03/22/24 22:45
OF COLLISION
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