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HomeMy WebLinkAbout24-11194 a ITFFi "POLCERA II IfI) 1 IlfII ('II (Illf If( fI I . 1 27c COLLISION REP FIT 1591971 CASE 24-11194 z INTERSTATE ❑ CITY STREET FIRE ❑RESULTED 1 STOLEN STATE ROUTE ❑ OTHER ❑ VFHICI F ❑ LOCAL AGENC 4900 3 HIT&RUN CODING COUNTY RD PRIVATE WAY INVOLVED 2 TOTAL#TRIBAL OF 02 OBJECT 1 0 5 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# ❑ COLLISION' 10 - 1-- 2024 1822 17 ❑.❑ S IN 1070 3 4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓ NE 4TH ST BLOCK NO. e✓ 4000 4a❑ MILEPOST DISTANCE OF(REFERENCE OR CROSS STREET) 5❑ 40 00 FMILES N EET e S ❑ E e UNION AVE NE 0 1 29 MOTOR PEDAL- DAMTHSHOLD MET PHONE UNIT 01 VEHICLE ❑ CYCLE El AGENoRE,/ D:4254953988 30 6❑ LAST NAME JOHNSON FIRSTNAME SCOTT MIDDLE R 1 1 2 31 INITIAL STREET ❑, 4324 NE 10TH PL CITY RENTON ST WA 2jp, 98059 z NEW ADDRESS 7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3 iNTERLOCKYEs NoWINTERLOCKYEs NO�/ YES R NO 8❑ LDRIVER # STATE WA SEX'M M D-O B 10 — 02 — 1949 32 9 ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 HELMET 2 CLASS 1 NATURE OF INJURIES z❑ 3 10❑ Pi aT�S� ANA2327 sTATe WAvrN# 1J4GZ58SOWC323876 TRAILER STATE TRAILER STATE 11 0 0 PLATE# PLATE# FROM TO TRLR. TRLR 7 3 33 12❑ vIN#' UIN# :: FROM TO VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE 5 1 34 13 4 1998 JEEP GRAND 4D DAMAGE YES NO YES[:] No✓ REGISTEREDOWNERINFO OWNEDBYDRIVER VEHICLE NO. 1 SHADE IN DAMAGED AREA ❑ 35 14 LIABILI INSURANCE INSURANCE CO PEMCO 1225995 3 4 IN EFFECT &POLICY# 9TOP VEHICLE CHARGE 5 36 LEcnLLv YES❑NO❑ CITATION# 10 BOTTOM 15❑ STANDING 8 6 MOTOR PEDAL- PEDESTRIAN ✓ PROPERTY DAM THR OLD MET PHONE UNIT 02 VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES 1/ NO D:4782832232 16 a LAST NAME BROOKS FIRST NAME ESSENCE MIDDLE N INITIAL 17 STREET I❑ 9714 121ST ST SW CITY' LAKEWOOD ST WA ZIP 98498 37 NEW ADOREss❑' 18❑ CDL IGNITION REQUIRED IGNITION PR—E-1SENT MEDICAL—T�RANSPORTED � 38 INTERLOCKYES�NOR INTERLOCK YEs It I NOF YES t l NO❑ 19 DRIVER'S STATE WA SEX F D.O.B. 02 _ 01 2005 39 LICENSE# MMDDYY 20 ON DUTY STATUS 3 AIRBAG RESTR EJECT HELMET 2 INJURY 6 NATURE N INJURIES 40 USE CLASS HEAD AND BACK PAIN ❑21❑ TATE 41 IN#LICENSE V 1 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 INAEFFITY ECTNSURANCE❑ &POINSULICY#E CO I VE."Le ❑ ,J� CITATION# CHARGE 25 GQ LEGALLY YES N J s � e OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY 26 JASON TURNER 12650 WA0171300 PART A PAGE 01 OF 3000-345-159 OR 11/181 STATE OF POLICETRAFFICN CORRECTION REPORT NO. EF29483 COLLISION REPORT III III III III III 111 1591972 CASE# 24-11194 ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY) NAME MIDDLE INITIAL) W/LSON JCLEB (LAST FIRST, ADDRESS&PHONE# UN/ON AVE NE NE 4TH ST RENTON WA 98058 4783964175 SEX i M MMDOYyry 08 - 09 - 2004 PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT ' HELMET INJURY NATURE OF INJURIES POS. I USE CLASS NAME '(LAST,FIRST,MIDDLE INITIAL) ADDRESS&PHONE# DOB SEX' MMDDYYYY PASSENGER ❑WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET NJURY NATURE OF INJURIES POS. USE CLASS NAME (LAST FIR57 MIDDLE INITIAL) AppRESS&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. JASON TURNER 10-29-24 02:21 AM INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED APPROVED BY DATE J.CHRISTIANSEN 10437 1 1012912024 2:38:51 AM BADGE OR ID# 12650 ORI# WA0171300 TIME POLICE DISPATCHED 6:24 PM TIME POLICE ARRIVED',6:24 PM PART PAGE IT]OF 4� TIM REPORT NO. EF29483 CASE# 24-11194 OFC LNaoy L isI©�ON 10/28/24 18:22 F cu NARRATIVE Unit 2 was driving eastbound on NE 4th ST approaching Union Ave NE in the number 1 lane. Unit 2 merged left into the northbound turn lane approaching Union Ave NE. Unit 1 was on the sidewalk located at the westside of the intersection at approximately the 4000 block of NE 4th ST. Unit 1 began to cross the roadway from south to north without using a designated crosswalk. Unit 1 began crossing the roadway and was walking in the northbound turn lane of NE 4th ST while Unit 2 had began driving in the northbound turn lane. Unit 2 struck Unit 1, causing unit 1 to fly approximately 10 feet and strike the blacktop of the roadway. Unit 1 appeared to have minor-significant injuries. They were evaluated by the fire department and transported to Valley Medical Center. They complained of head pain and back pain at the scene, there were no visible injuries. Unit 1 was wearing dark clothing, dark pants and a dark top. Unit 2 had minor damage to the hood of their vehicle, no reported injuries and was able to leave the scene under their own power. The weather was dry and the sun had just begun to set. I find that the proximate cause of the collision is unit 1's failure to utilize a designated crosswalk and cross the roadway when safe. Additionally the sun had just begun setting and Unit 1 was wearing dark clothing. I declare under penalty of perjury under the laws of the State of Washington that the foregoing is true and correct. Electronically signed by J. Turner 12650 on 10/29/2024 at 0212 hours. PAGE 3 OF 4 REPORT NO. EF29483 CASE# 24-11194 DATE AND TIME 10/28/2418:22 OF COLLISION }tkk, r x �z a t` } PAGE 4 OF 4