HomeMy WebLinkAbout24-4379 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 1 27c
COLLISION REP FIT 1591971
CASE 24-4379 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 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#
COLLISION' 04 - 1-- 2024 1206 17 ❑-= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
LOGAN AVE N BLOCK NO. e✓ 600 ❑
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ ❑ FEET e S ❑ W e N 6TH ST
2 0 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
No ,/ I D:2533829441 0 11
30
LAST NAME GONZALEZ HERNANDEZ FIRST NAME FELIPE MIDDLE
6 INITIAL 1 2 31
STREET ❑ 13904 SE 200TH ST CITY KENT ST I WA Zjp, 980423058 z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION : PRESENT MEDICAL TRANSPORTED 3
INTERLOCK YES[:]NO,/ INTERLOCKYEs NO Z/ YES R No�/
8❑ LRIIVER #
ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 HELMET U E 2 CLASS 1 NATURE OF INJURIES z❑
3
LICENSE C61864T sTArI WAurN# 3C6JR6DGXKG507109
10❑ PI ATE 14
TRAILER STATE TRAILER STATE
11 0 0 PLATE# PLATE# FROM TO
TRLR. A'RLR. 1 5 33
12 0 0 VIN#' VIN#'
FROM TO
VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED By GOVT.VEHICLE 1 $ 34
13 2 2019 RAM SWEEP DAMAGE YES NO YES[:] No
✓
REGISTERED OWNER INFO A C MOATE INDUSTRIES INC 2118 A STSE AUBURN WA 98002 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
14 LIABILITY INSURANCE INSURANCE CO PROPEL INSURANCE CPP127188002 3 4
IN EFFECT &POLICY# 9TOP
VEF" 1 5 36
LEGALLv Yes❑NO❑ CITATION# CHARGE 10 BOTTOM
15❑ STANDING 8 7 6
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT VEHICLE ❑ CYCLE ❑ ❑
16 a : OWNER ❑ YES,/ NO D:2068300797
LAST NAME AHMED FIRST NAME MUNA MIDDLE I A
INITIAL
17 STREET I8TH AVE S CITY TUKWILA ST WA ZIP 981783424 4❑ 37
NEW ADDREs�' 12227 4
18� CDL IGNITION REQUIRED IGNITION PR-E-1SENT MEDICAL TRANSPORTED 38
INTERLOCKYES�NO� INTERLOCK yEs It I NOF YES
t l NOF,/
19 DRIVER'S STATE WA ]SEX IF D.C... 09 _ O6 _ 1996 39
LICENSE# MMDDYY
20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 H U EET 2 NJAURSY 1 NATURE OF INJURIES ❑ 40
❑ILICENSE 21❑ PLA E# AFL3289 TArE 41
WA VIN# 4T1BF3EK88U744259 1
42
22❑ PLATE# STATE PLATE# STATE
TRLR
23❑ UIN#. IN#.
43
RLR
'
GI
VEH YEAR 2011 MAKE 7'Dy7' MODEL CAMRY STYLE 4D DAMAGE TOWED NOO✓ BLIN TOWED BY OV HyES NO,/ 44
24❑ YES
REGISTERED OWNER INFO OWNED SY DRIVER VEHICLE N0.2
SHADEDAMAGED AREA
3 4
LIABILITY
INSURANCE INSU&PORGY#E CO PROGRESSIVE 980074992IN STOP 5
VEHICLE ❑ C[:] CITATION# CHARGE
25 to BOTTOM
LEGALLY YES N
a
7,L
CER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
LI M RIDGEWAY 12500 WA0171300
A
26
PART A PAGE 01 OF C7
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EE71744
COLLISION REPORT III III III III III 111
1591972 CASE# 24-4379
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.
W/LLIAM RIDGEWAY 04-22-24 03:13 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
S.WOODWARD 11528 4/26/2024 1:16:34 PM
BADGE OR ID# 12500 OR]4f WA0171300 TIME POLICE DISPATCHED; 12:06 PM TIME POLICE ARRIVED',12:16 PM
PART I PAGE IT]OF 4�
REPORT NO. EE71744 CASE# 24-4379 OF COLLISION
04/22/24 12:06
OF CbLLI510N
NARRATIVE
At about 1208 hours on 04/22/2024, 1 was dispatched to a blocking accident that occurred at the
intersection of Logan Ave N and N 6th St in the City of Renton, King County, Washington.
Upon arrival, I confirmed no injuries for all involved. All were told they would be recorded.
Unit 1 was a White Dodge Street Sweeper (C61864T/WA). The driver was: Felipe Gonzalez
Hernandez (DOB:05/01/1971 -verified by WADL photo).
Unit 2 was a black Toyota Camry (AFL3289/WA). The driver/owner was: Muna A. Ahmed
(DOB:09/06/1996-verified by WADL photo).
I spoke to Unit 1, who said they were traveling southbound on Logan Ave N, wanting to turn right onto
N. 6th St. Unit 1 said they were in the lane closest to the middle (lane #2), and signaled to turn right,
into lane #1 / N. 6th St. Unit 1 said he was pretty much stopped, after waiting about 8 cars to go by
and then turned right and was hit by Unit 2. Unit 1 was wearing their seatbelt with no passengers.
Unit 1 said Unit 2 was behind him.
Unit 2 said they were traveling behind Unit 1 in lane #2 southbound Logan Ave N, approaching N. 6th
St. Unit 2 changed lanes into lane #1, when Unit 1 turned into lane #1, hitting Unit 2 on the front
driver's side fender, causing moderate front end damage. Unit 2 did not remember if Unit 1 had a turn
signal on. Unit 2 said they were traveling less than 20mph. Unit 2 had no passengers and was
wearing their seatbelts.
I did not observe any damage to Unit 1. Photos of all the damage were taken and uploaded to the
case. I provided both with an exchange of information sheet and a business card with case number.
This concludes my involvement in this case.
I declare under penalty of perjury under the laws of the State of Washington that the foregoing is true
and correct.
Electronically signed by W. Ridgeway#12500 on 04/22/2024 at 1512 hours in Renton, Washington.
PAGE 3 OF 4
REPORT NO. EE71744 CASE# 24-4379 DATE AND TIME 04/22/2412:06
OF COLLISION
PAGE 4 OF 4