No preview available
HomeMy WebLinkAbout24-9110 STATE OF II I l�� I III llI 111�111I IN II II I REPORT NO. EF10941 170 27 COLLISION REP FIT 1591971 CASE 24-9110 z INTERSTATE ❑ CITY STREET FIRE ❑RESULTED 1 STOLEN STATE ROUTE ❑ OTHER ❑ VFHICI F ❑ LOCAL AGENC 4100 3 HIT&RUN CODING COUNTY RD PRIVATE WAY INVOLVED 2❑ TOTAL#TRIBAL OF 02 OBJECT 1 1 8 28 UNITS RESERVATION I STRUCK z 3 DATE OF M M D D Y Y Y Y TIME(2400) COUNTY# MILES N E IN CITY# CowsloN 08 - 1-- 2024 1328 17 ❑.= S IN 1070 3 4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑ AIRPORT WAY BLOCK NO. e✓ --- ----� ❑ 4a❑ MILEPOST DISTANCE OF(REFERENCE OR CROSS STREET) 5❑ MILES�,❑ FEET e S ❑ W e SHATTUCKAVES 0 4 29 MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE UNIT 01 VEHICLE ❑ CYCLE El �/No F I D:2062457540 0 11 30 6 LAST NAME COINS FIRSTNAME JALAYIAH MIDDLE J 1 1 2 31 INITIAL STREET ❑ 9061 SEWARD PARK AVE S APT 10 CITy SEATTLE ST WA ZIP 981185150 z 'NEW ADDRESS 7❑ ODL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3 INTERLOCK YES[:]NO INTERLOCKYEs NO YES NO 8❑ LDRIVER # STATE WA SEX'F MID .O B 01 - 01 - 2001 1 2 32 9❑ ON DUTY❑ STATUS' AIRBAG 6 RESTR 4 EJECT 1 H U EET CLASS 7 I UNKRE OF INJURIES 2❑ 3 10❑ P1 aT�S� CBP4385 sTAT� WAurN# 1HGCM567X5A107451 TRAILER STATE TRAILER STATE 11 3 0 PLATE# PLATE# FROM TO TRLR. TRLR. 3 5 33 12 3 0 VIN#' VIN# >; FROM TO VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN T Y GOVT.VEHICLE 7 3 34 13 2005 HOND ACCOR DAMAGE YES NO � �MEYER YES❑ No✓ REGISTERED OWNER INFO JALAY/AH GO/NS 9061 SEWARD PARK AVE S APT 10 SEATTLE WA 981185150 D:2062457540 VEHICLE NO. 1 ❑ SHADE IN DAMAGED AREA 35 3 4 14 2 LIABILITY INSURANCE❑ INSURANCE CO IN EFFECT M: POLICY# Q vewcLE CHARGE 15 36 LE ALLv YES No CITATION# 4A0652640,4A0652640, FAIL YIELD LEFT TURN MOTOR 15❑ STANDING 6 UNIT 02 VEHICCLE CYCLE ❑ PEDESTRIAN ❑ OWNERMOTO ❑TY DYES✓ NO OLD MET PHONE 16 a LAST NAME FILIGA FIRST NAME CAROLYN MIDDLE G INITIAL 17❑ STREET ❑', 5205 66TH ST W APT 2 CITY UNIVERSITY PLACE ST WA ZIP 984673303 37 NEW ADDRESS ❑ 18� CDL IGNITION REQUIRED IGNITION PtR-E-S1ENT MEDICAL TRANSPORTED ❑ 38 INTERLOCKYES�NOR INTERLOCK Y�EsI I I NOF YEs t l NO❑ 19 D IVEW # STATE WA ]SEX IF M.C.B. 03 _ 13 _ 1983 0 39 WELMET INJURY 6 NATURE OF INJURIES 40 20❑ ON DUTY STATUS AIRBAG,6 RESTR 4 EJECT 1 USE CLASS HAND FACE 21❑ LICENSE I CKX7422 TATe WA VIN# 1N46L4DVXNN397973 ❑ 41 PLATE# 42 22❑ PLATE# STATE PLATE# STATE 23❑ UIN#. 43 TRLR RLR 'IN#. VEH YEAR 2022 MAKE /HISS MODEL ALTIMA STYLE VEHICLE TOWED TO BLIN TOWEDBY GOV HI 44 24❑ DAMAGE YES✓ NO GENE MEYER YES NO✓ REGISTERED OWNER INFO JOHN RUMOON 520566TH ST WAPT2 UNIVERSITY PLACE WA 98467 VEHICLE NO.2 SHADEd DAMAGEDAREA 4� 3 4 INAEFFITY ECTNSURANCE INSU&POLICY#E CO TBA 9TOP 5 VE""LE ❑ ,J� CITATION# CHARGE 1oBOTTOM LEGALLY YES N`L J 25 ' e OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY 26 M.LEVERTON 2517 WA0171300 PART A PAGE 01 OF C7 3000-345-159 OR 11/181 STATE OF POLICE TRAFFICN CORRECTION REPORT NO. ER 0941 COLLISION REPORT III III III III III 111 1591972 CASE# 24-9110 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. M.LEVERTON 08-30-24 02:47 PM INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED APPROVED BY E DAT C.JACOBS 1953 9/2/2024 12:23:53 PM BADGE OR ID# 2517 OR]#' WA0171300 TIME POLICE DISPATCHED! 1:29 Pry TIME POLICE ARRIVED',1:32 PM PART B PAGE IT]OF 4� AND REPORT NO. EF10941 CASE# 24-9110 OFCOLLISION 08/30/24 13:28 OF COLLISION�isi©�u NARRATIVE gry2 lane 1 eb slv 2 left turn CC Within the city limits of Renton/King/WA I responded to a 2 car blocking crash at the intersection of Airport Way at Shattuck Ave S. Both vehicles were facing east blocking lane one of Airport Way. I contacted the driver of unit 2 who told me she was on her solid green in lane one eastbound when unit 1 crossed in front of her path. She complained of injury and was checked and released on scene by Renton Fire. Damages to her car required a tow truck/Gene Meyer. I contacted the driver of unit ID'd by her picture WADL. She told me she was westbound and attempting a left turn across three lanes of traffic. She told me lane 3 and 2 were stopped so she proceeded, but did not see unit 2 and crashed with her. She was up and ambulatory and did not seem upset or hurt. She did request Fire check her young female passenger whose name was not given. Later Renton Fire said that unit 1 driver complained of a headache and wanted to be transported to the hospital. After learning it was thousands of dollars for Tri-Med she declined and would have her mother take her later. Unit 2 told me she did not have valid proof of insurance on her vehicle. Her tabs showed 04-2022. A WACIC/DOL check via Dispatch and MDC revealed her tabs were expired 04-01-2023. Damages to her vehicle required a tow truck/Gene Meyer. I cited unit 1 via complaint Ref RCW 46.61.185 FTYROW-Left Turn 2 car injury, ref RCW 46.30.020 No valid proof of insurance and ref RCW 46.16A.030 expired vehicle registration more than 2 months. I certify (declare) under penalty of perjury under the laws of the State of Washington that the foregoing is true and correct. M.Leverton/2517 City of Renton/King/Wa 8/30/2024 PAGE 3 OF 4 REPORTNO. EF10941 CASE# 24-9110 DATE AND TIME 08/30/2413:28 OF COLLISION ti ?yy PAGE 4 OF 4