HomeMy WebLinkAbout24-3663 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 0 27c
COLLISION REP FIT 1591971
CASE 24-3663 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 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.. 04 - 1-— 2024 1030 17 ❑.= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
BLOCK
EASTVALLEYRD ST e✓
MILEPOST 4300 ❑
4a❑
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ ❑ S ❑❑ FEET VV❑ SW 43RD ST
0 1 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
,/No D:3162959614 0 11
30
6❑ LAST NAME LANDRETH FIRSTNAME AUSTIN MIDDLE L 1 2 31
INITIAL
STREET ❑ 9728 S 239TH PL CITY KENT ST WA ZIP 98031 z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION : PRESENT MEDICAL TRANSPORTED 3
iNTERLOCKYEs NO 1/ INTERLOCKYEs NO�/ YES R No�/
8❑ LDRIVER # STATE WA SEX'M MID
LOB 06 1— 17 — 1992 2 32
9 ON DUTY❑ STATUS' AIRBAG 3 RESTR 9 EJECT 1 1 I [NATURE OF INJURIES
H U EET 2 1 INJURY CLASS ju CUT ON LEFT HAND z❑
❑
10 1❑ PI ATE 14 A7119021 sTAr WA u N#' 1 FM5K8F83DGA26290 3
0 TRAILER STATE TRAILER STATE
11 0 0 PLATE# PLATE# FROM TO
TRLR. YRLR. 5 1 33
12 0 0 VIN#' VIN#
>; FROM TO
❑ VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TR Y GOVT.VEHICLE 3 7 34
13 4 2013 FORD EXPLOR SD DAMAGE YES NO �MEYERS YES❑ No✓
REGISTERED OWNER INFO OWNEDBYDRIVER VEHICLE NO. 1
SHADE IN DAMAGED AREA ❑ 35
14 LIABILITY INSURANCE❑ INSURANCE CO <53 4
IN EFFECT &POLICY# TOPVEIF" CHARGE 36
LEGALLY YEs❑NO CITATION# 4AO181376 OP MOT VEH W/OUT INSURANCEorrom
15❑ STANDING 6
MOTOR PEDAL-: 'PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT U2 VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES 1/ NO D:4256239975
16 a
LAST NAME LE FIRST NAME ' HO1 MIDDLE V
INITIAL
17 STREET I9TH ST CITY' RENTON ST WA ZIP 98056 4❑ 37
NEW ADDREs�' 3407 NE
18� CDL IGNITION REQUIRED IGNITION PRESENT MEDICALTRANSPORTED 38
INTERLOCK YEs❑No� INTERLOCK YEs❑NOF YEs❑NOF,/
19 DIVE
❑ ON DUTY STATUS AIRBAG 2 RESTR 9 EJECT 1 H U EET 2 NJAURSY 1 NATURE OF INJURIES ❑ 40
❑ 41
21❑ ILICENSE PLA E# AON6024 TArE WA VINE 1HGCT2888EA001807 1
42
22❑ PILER LATE# STATE PLATE# STATE
TRLR
23❑ VIN#. IN#. 43
RLR
'
TOWED BY Gov HI 44
VEH YEAR 2014 MAKE HOND MODEL ACCORD STYLE $D DAMAGE TOWED TOO✓ BLIN YES NO 1/
24❑ REGISTERED OWNER INFO OWNED SY DRIVER VEHICLE N0.2
SHADE IN DAMAGED AREA
2 3 4
LIABILITY
INSURANCE INSU PORGY#ECO STATE FARM 5288297-A13-47BIN STOP 5
VEHICLE ❑ C[:] CITATION# CHARGE i o BOTTOM
LEGALLY YES N
25 ' a
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
26
MICAH BATTLE 12049 WA0171300
PAGE 01 OF
PART A
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EE68019
COLLISION REPORT III III III III III 111
1591972 CASE# 24-3663
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'
24-3663
On 4/4/24 at 1045 hours, I was dispatched to a vehicle collision at 4300 East Valley Rd, City of
Renton, County of King, Washington.
Upon arrival I contacted Unit 1 who was identified as Austin L. Landreth (6/17/92) who was driving
WA-A7119021. He stated he was traveling northbound on East Valley Rd going thru the intersection
of SW 43rd ST. He was following behind a semi-truck who was turning onto SW 43rd ST. U2 pulled
into the intersection in front of him causing him to strike Unit 2 on the driver's side with his front end.
I contacted Unit 2 who was identified as Hoi V. Le (9/26/64) who was driving WA-AON6024. He
stated he was driving westbound on SW 43rd St passing thru the East Valley Rd intersection with a
green light when Unit 1 struck his front driver's side quarter panel.
I observed moderate damage to Unit 1's front end, and Unit 2's front driver's side quarter panel. Unit
1 was towed out of the roadway; Unit 2 was able to driver out of the roadway.
Unit 1 reported minor laceration to his left hand but refused medical attention.
Unit 1 could not provide proof of insurance and was cited for operating a motor vehicle without
insurance.
I certify (declare) under penalty of perjury under the laws of the State of Washington that the
foregoing is true and correct.
Electronically Signed, M. Battle 12049, 4/4/24, 1347
I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT.
MICAH BATTLE 04-04-24 01:48 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
G.BARFIELD 6476 1 411412024 2:47:55 PM
BADGE OR ID# 12049 ORI# WA0171300 TIME POLICE DISPATCHED; 10:35 AM TIME POLICE ARRIVED',10:53 AM
PART I PAGE IT]OF
REPORT NCV EE68019 CASE# ' 240663 DATE AND TIME 04/04/24 10:30
OF COLLISION
*No,t drawn to scale
AD
Text
LIJ
PAGE 3 OF 3