HomeMy WebLinkAbout24-9236 a OLICETRAFFic" II I f I) 11I1ll(111(111l If( f 11 REPORT NO. EF14459 170
27
COLLISION REP FIT 1591971
CASE 24-9236 z
INTERSTATE ❑ CITY STREET FIRE ❑RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHICI F ❑ LOCAL AOENC 4Y00 3
HIT&RUN CODING'
COUNTY RD PRIVATE WAY INVOLVED
2 2 TOTAL#OF OBJECT 1 1 8 28
TRIBAL UNITS 02 RESERVATION STRUCK
z
3 DATE OF M M D D Y Y Y Y TIME(2400) COUNTY# MILES N E IN CITY#
CowsloN 09 - 1-- 2024 0748 17 ❑.= S IN 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
MAPLE VALLEY HWY
BLOCK NO. e✓ --- ----� ❑
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5 MILES❑ �,❑ FEET e S ❑ W e MAPLEWOOD AVE SE
0 4 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
�/No D:2068565551 0 1 30
6 LAST NAME VERES FIRSTNAME AMY MIDDLE N 1 1 2 31
INITIAL
STREET ❑ 19628 SE 264TH CT CITY COVINGTON ST WA ZIP 980425034 z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
INTERLOCK YES[:]NO INTERLOCKYEs NO YES R NO
8❑ LDRIVER # STATE WA SEX'F MID
.O B 11 - 26 - 1996 1 2 32
9❑ ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 H USEET ICNLJAURY 1 NATURE OF INJURIES z❑
3
10 9❑ P1 ATNFS14 BQX4347 STATE WA u N# 5TDKK3DC1 GS708175
TRAILER STATE TRAILER STATE
11 2 5 PLATE# PLATE# FROM ro
TRLR. YRLR. 1 3 33
12 4 0 VIN#' VIN#
:: FROM TO
❑ VEH.YEAR MAKE TOYT SIENNA MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE 3 7 34
13 2 2016 DAMAGE vEsNo vEs❑ No
REGISTEREDOWNERINFO VIORELPOLOCOSER17124NE29THPL BELLEVUEWA98008 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
14 rI LIABILITY INSURANCE U INSURANCE CO SAME. <1�3 4
IN EFFECT &POLICY# TOPVEHICLE CHARGE 36
LE ALLv YEs No clTAnoN# 4A0652644 FAIL YIELD LEFT TURN MOTOR orroM
15❑ IG�USTA
NIT 02 MOTOR PEDAL. ❑ PEDESTRIAN ❑ PROPERTY ❑ DAM THR OLDMET PHONE
16 a VEHICLE CYCLE OWNER YES�/ NO
LAST NAME SO FIRST NAME JOHNNY MIDDLE N
INITIAL
17❑ STREET ❑', 9308 S 203RD PL CITY KENT ST WA ZIP 980311422 37
NEW ADDRESS ❑
18� CDL IGNITION REQUIRED IGNITION PtR-E-S1ENT MEDICAL TRANSPORTED ❑ 38
INTERLOCKYES�NOR INTERLOCK YEs I I NOF YEs t l NO❑
19 DRIVER'S STATE WA SEX M D.Q.B. 07 O6 _ 1967 39
LICENSE# MMDDYY
WELMET INJURY1 NATURE OF INJURIES 40
20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 USE CLASS ❑
21❑ LICENSE 67639D TATE WA VIN# 1GCHSBEA1L1162230
❑ 41
PLATE#
42
22❑ PLATE# STATE PLATE# STATE
23❑ VIN#. 43
TRLR RLR
'IN#.
24❑ DVEH YEAR 2020 MAKE CHEV MODEL COLORA STYLE VEHICLE TOWED TO BLIN TOWED ev GOV!TN-
REGISTERED 44
AMAGE YES NO BANKERS YES
OWNER INFO CITY OF RENTON 3555 NE 2ND ST RENTON WA 98056 D:4254307400 VEHICLE NO.2
SHADE J4 DAGAAGE$AREA
INAEFFIECTNSURANCE INSU&POLICY#E CO SAME. I 4� L3� �d5
VEwcLE ❑ ,J� CITATION# CHARGE GQ
LEGALLY YES N`L J
25 s � a
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
J
26
M.LEVERTON 2517 WA0171300
PART A PAGE 01 OF C7
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT No. EF14459
COLLISION REPORT III III III III III 111
1591972 CASE# 24-9236
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'
red/2 rt In gry/1 left turn
CC
Within the city limits of Renton/King/WA I responded to a 2 vehicle crash at Olympia Ave SE at Maple
Valley Hwy.
I contacted the driver of unit 2 who had his car stopped in the grass and sidewalk area just west of he
intersection. He told me he was west in lane 1 MVH when unit 1 made a left turn into the side of his
work truck. He did not complain of injury and damages required a tow truck.
I contacted the driver of unit 1 ID'd by picture WADL. She told me she was attempting to make a left
into the merge lane and crashed into the side of unit 2. She did not complain of injury and damages
did not require a tow truck.
I cited unit 1 ref RCW 46.61.185 FTYROW-Left Turn 2 car crash via complaint.
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 9/3/2024
I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT.
M.LEVERTON 09-03-24 03:49 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY E
DAT
C.JACOSS 1953 9/12/2024 3:50:55 PM
BADGE OR ID# 2517 OR]# WA0171300 TIME POLICE DISPATCHED 7:50 AM TIME POLICE ARRIVED 8:06 AM
PART B PAGE IT]OF 3�
REPORT NO. EF14459 CASE# 24-9236 DATE AND TIME 09/03/24 07:48
OF COLLISION
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