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HomeMy WebLinkAbout24-2246 ITFF' "POLCERA II I !�� I III I III I IIII III II I . $ 27c COLLISION REP FIT 1591971 CASE 24-2246 z INTERSTATE ❑ CITY STREET FIRE ❑RESULTED 1 STOLEN STATE ROUTE ❑ OTHER ❑ VFHIC;I F ❑ LOCAL AOENC 4Y00 3 HIT&RUN CODING COUNTY RD PRIVATE WAY INVOLVED 2 3 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.. 02 - 1-- 2024 1503 17 ❑.= S 8 IN e 1070 3 4❑ oN (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓ HARDIE AVE SW BLOCK NO. e✓ 450 4a❑ MILEPOST DISTANCE OF(REFERENCE OR CROSS STREET) 5❑ ❑ FEET e S ❑ W e 0 4 29 MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE UNIT 01 VEHICLE ❑ CYCLE El NO ✓ I D:2069108176 0 11 30 6� LAST NAME ROBEY FIRSTNAME SETH MIDDLE G 1 2 31 INITIAL STREET ❑ 15825 40TH PL S CITY TUKWILA ST WA 21p 98188 z= NEW ADDRESS 7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3 iNTERLOCKYEs NO INTERLOCKYEs NO YES R NO 8❑ LRIIVER # ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 HELMET 2 CLASS 1 NATURE OF INJURIES z❑ 3 LICENSE CDN8878 sTArI WAvIN# 1G1ZJ57B38F260533 10 F91 PI ATE# TRAILER STATE TRAILER STATE 11 0 0 PLATE# PLATE# FROM ro TRLR. TRLR 3 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 2008 CHEV MAL/BU SD DAMAGE YES NO ✓ YES[:] NO✓ REGISTERED OWNER INFO SETH ROBEY 101028TH AVE S APT G59 SEATTLE WA 98168 VEHICLE NO. 1 ❑ SHADE IN DAMAGED AREA 35 14 LIABILITY INSURANCE❑ INSURANCE CO eq�T3 4 IN EFFECT &POLICY# 9TOP VEwcLE CHARGE 5 36 LEGALLY Ye6❑NO❑ CITATION# 1 o BOTTOM 15❑ STANDING 8 7 6 MOTOR ✓ PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE UNIT U2 VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES NO ✓ D:2533979860 16 a LAST NAME MARIFOSQUE FIRST NAME JEROME MIDDLE C INITIAL 17❑ STREET ❑', 24207 130TH AVE SE CITY KENT ST WA ZIP 980309208 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.C.B. O6 _ 26 _ 1987 39 LICENSE# MMDDYY HELMET INJURY 0 NATURE OF INJURIES 40 20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 USE 5 CLASS ❑ 21❑ LICENSE 263Y66 TAre WA VIN# 5FNYF185488054373 ❑ 41 PLATE# 42 22❑ PLATE# STATE PLATE# STATE 23❑ VIN#. 43 TRLR RLR 'IN#. VEH YEAR 2008 MAKE HOND MODEL PILOT EX STYLE UT VEHICLE TOWED TO BLIN TOWED eY GOV HI 44 L4❑ DAMAGE YES NO✓ YES NO✓ REGISTERED OWNER INFO JEROME MARIFOSQUE 24027130TH AVE SE KENTWA98030 VEHICLE NO.2 SHADE IN DAMAGED AREA 2 3 4 LIABILITY INSURANCE I PORGY#ECO CONNECT INSURANCE A104103839IN 1GQVE""LE ❑ ,J� CITATION# CHARGE LEGALLY YES N`L J 25 s 7 6 7CA NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY J 26LAN 12007 WA0171300 PART A PAGE 01 OF 3000-345-159 OR 11/181 STATE OF POLICETRAFFICN CORRECTION REPORT NO. EE60145 COLLISION REPORT III III III III III 111 1591972 CASE# 24-2246 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' On February 29, 2024, at 1503 hours dispatch requested that I respond to a collision at the intersection of Hardie Ave SW and SW 7th St, in the city Renton, county of king, and state of Washington. Upon my arrival I spoke with the driver of unit 1 and he explained that he was making a left turn from behind the Fred Meyer to Hardie Ave SW when the collision occurred. While waiting, the driver stated he looked both ways on Hardie Ave SW. He proceeded forward but failed to notice unit 2 driving southbound on Hardie. Unit 1 struck unit 2's drivers side doors. I then spoke with the driver of unit 2 and he explained that he had made a right turn from SW 5th PI to Hardie Ave SW when the collision occurred. The driver said that after making his right turn, he proceeded to south on Hardie Ave SW. As he drove past the rear entrance of Fred Meyer, unit 1 failed to see him, striking his driver's side doors. The two drivers refused any medical attention, and their vehicles were considered drivable. I provided the involved parties with an exchange of information. I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT. C.CATALAN 03-12-24 06:56 PM INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED APPROVED BY DATE C.JACOBS 1953 1 311812024 11:59:53 AM BADGE OR ID# 1Y007 OR]#' ' WA0171300 TIME POLICE DISPATCHED 3:07 Pry TIME POLICE ARRIVED',3:22 PM PART I PAGE IT]OF 3� REPORT NO. EE60145 CASE# ' 24-2246 DATE AND TIME 02/29/24 15:03 OF COLLISION nit I NTS PAGE 3 OF 3