HomeMy WebLinkAbout24-3145 POLICETRAFF'c" III !�� I IIIllI111IN II II I REPORT NO. EE64748 170
27
COLLISION REP FIT 1591971
CASE 24-3145 z
INTERSTATE ❑ CITY STREET FIRE ❑RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHIC;I F ❑ LOCAL AOENC 4Y00 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#
cowsloN 03 - 1-- 2024 1144 17 ❑-= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
SE 128TH ST BLOCK NO. e ❑
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ ❑ FEET e S ❑ VV e 160THAVE SE
0 4 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
,/No D:4252738811 0 11
30
6❑ LAST NAME WEAVER FIRSTNAME COLE MIDDLE A 1 2 31
INITIAL
STREET ❑ 16216 SE 140TH ST CITY RENTON ST WA ZIP 980597516 z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
1/ I INTERLOCK YES[:]NO NTERLOCKYEs NO�/ YES R No�/
8❑ LDRIVER # STATE WA SEX'M MID
LOB 07 1— 30 — 2007 2 32
9 ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 HELMETU E 2 CLASS 1 NATURE OF INJURIES z❑
3
10 9❑ P1 aT�S� CGJ8970 sTArI WAurN# 1 FADP3K25DL 174914
TRAILER STATE TRAILER STATE
11 3 5 PLATE# PLATE# FROM TO
TRLR. TRLR $ 7 33
12 3 5 VIN#' VIN#'
>; FROM TO
VEH.YEAR 2013 MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE 7 3 34
13 4 FORD FOCUS SD DAMAGE YES NO YES[:] NO✓
REGISTERED OWNER INFO NORMAN WEAVER 17726 SE 58TH PL BELLEVUE WA 98006 VEHICLE NO. 1
❑ ❑
SHADE IN DAMAGED AREA 35
14 LIABILITY INSURANCE Z INSURANCE CO GENERAL ASSURANCE CORP 53-WA 6632143 3 4
IN EFFECT &POLICY# 9TOP
vEHICLE CHARGE 5 36
ECALLY YEs No clTAnoN# 4A0332252 FAIL STOP AT STOP o eorrom
15❑ STANDING 8 7 6
MOTOR PEDAL- 'PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT 02 VEHICLE ❑ CYCLE' ❑ ❑ OWNER ❑ YES 1/ NO D:4252698858
16 a
LAST NAME RD LINGER FIRST NAME RUDOLPH MIDDLE I P
INITIAL
17 STREET I❑ 11449 RAINIER AVE S UPPR CITY SEATTLE ST WA ZIP 981783954 37
NEW ADOREss❑'
18❑ CDL IGNITION REQUIRED IGNITION PtR—E—S1ENT MEDICAL—T�RANSPORTED � 38
INTERLOCK YEs❑No� INTERLOCK YEs I I NOF YEs t l NOF,/
19 LDIIVER # STATE WA SEX M M .C.B. 09 _ 25 _ 1948 39
20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 H U EET 2 NJAURSY 1 NATURE OF INJURIES ❑ 40
❑ILICENSE 21❑ PLA E# BFS1721 TArE 41
WA VIN# 3FARP15J2RR125028 1
42
22❑ PLATE# STATE PLATE# STATE
TRLR
23❑ UIN#. IN#.
43
RLR
'
VEH YEAR 1994 MAKE FORD MODEL ESCORT STYLE HB VEHICLETOWED TO BLIN TOWEDBY GOV HI �44
L4❑ DAMAGE YES NO YES NO
REGISTERED OWNER INFO DEBORAH NATELSON 11449 RAINIER AVE S SEATTLE WA 98178 VEHICLE NO.2
SHADEDAMAGEDAREA
3 4
LIABILITY
INSURANCE 8 POINSURGY#E CO PROGRESSIVE 944608959IN STOP 5
VEHICLE ❑ ,.I—I CITATION# CHARGE to BOTTOM
LEGALLY YES N`LJ
25 s a
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# JAGENCY
26
KEITH PETTY 12809 WA0171300
PAGE 01 OF
PART A
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EE64748
COLLISION REPORT III III III III III 111
1591972 CASE# 24-3145
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'
TRAFFIC COLLISION
Cole A Weaver (07/30/2007) was driving his gray ford focus (Unit 1) and, Rudolph P Rollinger (DOB
09/25/1948) was driving his green Ford Escort (Unit 2). Both drivers were identified by their WADL.
Unit 1 was turning westbound onto SE 128th St from 160th Ave SE. As Unit 1 entered into the
intersection he stated that another vehicle to his right swerved towards him before turning Eastbound
onto Se 128th. Unit 1 swerve out of the way. Unit 1 pulled out into lane 1 of SE 128th St eastbound
in front of Unit 2.
Unit 1 pulled out in front of unit 2 which was a contributing factor in the collision.
I cited unit 1 with (RCW 46.61.190) Vehicle entering stop or yielding intersection.
I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT.
KEITH PETTY 03-23-24 05:05 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
P.KORDEL 9676 1 41212024 12:28:51 PM
BADGE OR ID# 1Y809 OR]# WA0171300 TIME POLICE DISPATCHED 11:49 AM TIME POLICE ARRIVED]12:02 PM
PART I PAGE IT]OF 3�
REPORT NO. EE64748 CASE# ' 24-3145 DATE AND TIME 03/23/24 11:44
OF COLLISION
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NOT
TO, SCALE
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