No preview available
HomeMy WebLinkAbout24-10794 ITFF' "POLCERA 1�1 . 1 27c I II COLLISION REP FIT 1591971 CASE 24-10794 z INTERSTATE ❑ CITY STREET FIRE ❑ RESULTED 1 STOLEN STATE ROUTE ❑ OTHER ❑ VFHICI F ❑ LOCAL AGENCI 4900 3 HIT&RUN CODING COUNTY RD PRIVATE WAY INVOLVED 2 TOTAL#OF OBJECT 6 0 2$ TRIBAL 1 02 STRUCK RESERVATION z 3 DATE OF M M D D Y Y Y Y TIME(2400) COUNTY# MILES N E IN CITY# ❑ GawsloN 10 - 16 - 2024 1841 17 ❑.❑ S IN 1070 3 4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓ SW 7TH ST BLOCK NO. e✓ 100 4a❑ MILEPOST DISTANCE OF(REFERENCE OR CROSS STREET) 5❑ 205 00 FMILES N EET e S ❑ E e HARDIEAVESW OF,1 29 MOTOR PEDAL- DAMETHSHO PHONE UNIT 01 VEHICLE ❑ CYCLE ElYES AG✓NORE LD MET D:2069818936 30 6 LAST NAME RIVEL FIRSTNAME XAJJA MIDDLE R 1 1 2 31 INITIAL STREET ❑1 33020 10TH AVE SW UNIT X302 CITY FEDERAL WAY ST WA ZIP 980235701 z NEW ADDRESS 7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3 :NTERLOCKYEs NO INTERLOCK YES NO YES No 8❑ LDRIVER # STATE WA SEX'F MMDDYY 05 - O6 - 1996 32 9 ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 H U SE ICNLJAUSSY 1 NATURE OF INJURIES z❑ 3 10 9❑ P1 ATNES# CDJ6905 sTAr WAvN# 1HGCV1F31NA048454 5 TRAILER STATE TRAILER STATE 11 3 5 PLATE# PLATE# FROM TO TRLR. TRLR 3 7 33 12❑ vIN#' VIN# :: FROM TO ❑ VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE 5 1 34 13 4 2022 HOND ACCOR 4D DAMAGE vesNo ✓ ves❑ No✓ REGISTERED OWNER INFO XAJJA RIVEL 3302010THAVE SW UNITX302 FEDERAL WAY WA 98023 VEHICLE NO. 1 ❑ SHADE IN DAMAGED AREA 35 14 LIABILITY INSURANCE NPOLICY E CO PROGRESSIVE 948189374 4 LI EFFECT &POLICY# TOPVEHICLE CHARGE36 LEGALLv YEs❑NO CITATION# <1�3 OTTOM 15❑ STANDING 7 6 UNIT 02 VEHICLE ❑ CYCLE ❑ PEDESTRIAN ❑MOTOR ✓ OWNER YES ❑ DYES✓ OLD MET NO PHONE 16 a LAST NAME BESSETTE FIRST NAME JACOB MIDDLE lH INITIAL 17❑ STREET ❑' 224 S WA ST.APT 607 CITY SEDRO WOOLLEY ST WA ZIP 98104 37 NEW ADDRESS ❑ 18� CDL IGNITION REQUIRED IGNITION PR-E-1SENT MEDICAL-T�RANSPORTED 38 INTERLOCKYES�NOR INTERLOCK vEs It I NOF YES t l NO❑ 19 DRIVE # STATE SEX M M D.O.B. 05 _ 11 _ 1989 39 ON DUTY STATUS 3 AIRBAG RESTR EJECT HELMET I INJURY 5 NATURE OF INJURIES 40 USE CLASS BROKEN PELVIS ❑21❑ LICENSE TArE VIN# 41 PLATE# 42 22❑ PLATE# STATE PLATE# STATE TRLR 23❑ VIN#. N#. 43 RLR 'I VEH YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED By Gov HI 44 L4 Q 6 DAMAGE YES NO YES NO REGISTERED OWNER INFO VEHICLE NO.2 SHADE IN DAMAGED AREA 2 3 4 LIABILITY INSURANCE❑ INSURANCE #E CO IN EFFECT &PO I 9TOP 5 VE""LE ❑ ,J� CITATION# CHARGE i o BOTTOM LEGALLY YES N J 25 s e =UGENT (PRINT) OFFICER PHONE BADGE OR ID# AGENCY 26 11498 WA0171300 PAGE 01 OF PART A 3000-345-159 OR 11/181 STATE OF POLICETRAFFICN CORRECTION REPORT NO. EF2771 1 COLLISION REPORT III III III III III 111 1591972 CASE# 24-10794 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. MATTHEW NUGENT 10-17-24 04:01 PM INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED APPROVED BY DATE CO.JOHNSON 0505 1 1012312024 9:05:37 AM BADGE OR ID# 11498 ORI# WA0171300 TIME POLICE DISPATCHED! 6:42 PM TIME POLICE ARRIVED',6:43 PM PART B PAGE IT]OF 4� REPORT NO. EF27711 CASE# 24-10794 DATEAND aE dF coyL� 10/16/24 18:41 LISIO isi©�u NARRATIVE 2024 -10794 On 10/16/2024 at approximately 1842 hours, I was dispatched to a vehicle verse pedestrian collision with reports of injury just west of the intersection at Hardie Ave SW and SW 7th St, in the City Limits of Renton, County of King, State of Washington. Upon arrival, the Renton Regional Fire Authority (RRFA) was administrating aid to the pedestrian who was hit. I collected the involved drivers driving documents and their recollection of events leading up to the collision. RRFA confirmed that the pedestrian had a broken pelvis, likely did not sustain life threatening injuries at this time and would be transported to Valley Medical Center for care. Another officer on scene gathered the pedestrian's identification. The driver of Unit#1 (Rivel) said she was the sole occupant of her vehicle and was traveling westbound in about the 100 block of SW 7th St, just west of Hardie Ave SW in lane 1 of 2. She stated she had a green light and traveling approximately 35-40 MPH per the posted speed limit. After traveling past the crosswalk, a pedestrian crossed in front of her path of driving. The pedestrian landed on the hood of her vehicle causing damage to the front windshield and hood. Rivel stated she was unable to stop in time and did not see the pedestrian until he landed on her vehicle hood. Rivel stated she had just come from dinner at Feast Buffet (located at 485 Renton Center Way SW) and was headed to Walmart. She did not exhibit any signs of intoxication but did agree to perform voluntary field sobriety tests as a form of cooperation towards the investigation. Field Sobriety Tests: I asked Rivel if she would be willing to conduct voluntary Standardized Field Sobriety Tests (SFSTs) to determine if she had consumed alcohol prior to the collisions. Rivel stated she would conduct voluntary SFSTs. I then conducted the NHTSA Field Sobriety Tests. Following the tests, Rivel did not display any signs of intoxication. Rivel also agreed to conduct a voluntary Preliminary Breath Test (PBT) which revealed 0.00 alcohol content. Based on the above statements, I determined that Rivel is not the proximate cause for this collision. Rivel was not injured and was able to leave the scene in her vehicle. Electronically signed by Officer R. Smith #12986 10/17/2024 3:45 PM Renton, King County, WA. PAGE 3 OF 4 REPORT NO. EF27711 CASE# 24-10794 DATE AND TIME 10/16/2418:41 OF COLLISION t �s Y r ^ r t i t � ¢ r lat rt3 � r e � h It rr t �t }F t. it 5, S 1 xtnw fi i� 4r t k w I v ,t r t PAGE 4 OF 4