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HomeMy WebLinkAbout24-4625 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 0 27c
COLLISION REP FIT 1591971
CASE 24-4625 z
INTERSTATE ❑ CITY STREET FIRE ❑RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHIr.I F ❑ LOCAL AOENC 4200 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 1 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' 04 - 1-- 2024 1906 17 ❑.❑ S 8 W e IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓
BLOCK
NE SUNSET BLVD MILEPOST ST e✓ 3100
4a❑
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 D:2108579203 0 11
30
6� LAST NAME RODRIGUEZ FIRSTNAME DALTON MIDDLE W 1 1 2 31
INITIAL
STREET ❑✓ 4311 NE 5TH ST F104 CITY RENTON ST WA 2jp, 98056 z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
iNTERLOCKYEs NO 1/ INTERLOCKYEs NO�/ YEs No�/
8❑ DRIVERS
# STATE WA SEX'M I D-MIDI Y' 08 - 18 - 1994 1 2 32
9 ON DUTY❑ STATUS AIRBAG 2 RESTR 9 EJECT 1 H USE CLASS 2 CLASS 1 NATURE OF INJURIES 2❑
3
10 99 P1 ATES# BLX7721 sTAT WAv N# 5YFBURHEOFP360045
5 TRAILER STATE TRAILER STATE
11 3 5 PLATE# PLATE# FROM To
TRLR. TRLR 7 1 33
12 3 5 VIN#' VIN#
FROM TO
VEH.YEAR 2015 MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE 3 7 34
13 4 TOYT COROL SD DAMAGE YES NO YES[:] No
✓
REGISTERED OWNER INFO JESSICA DELA CRUZ4311 NE5TH STAPTF104 RENTON WA 98059 VEHICLE NO. 1
❑
SHADE IN DAMAGED AREA 35
4 INSURANCE CO 3 4
14 LIABILITY INSURANCE z PROGRESSIVE 971280101
IN EFFECT &POLICY# STOP
36
LLE to BOTTOM 5
VEGAH'C Y YES❑NO❑ CITATION# 4A0359583 CHARGE FAIL YIELD LEFT TURN MOTOR 5
15❑ NDING 8 6
MOTOR PEDAL-: PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT 02 VEHICLE ❑ CYCLE' ❑ ❑ OWNER ❑ YES 1/ NO D:4252606973
16 a
LAST NAME NCIS FIRST NAME KELLY MIDDLE E
INITIAL
17 STREET I❑ NEW ADDRESS❑' 1712 HARRINGTON AVE NE CITY RENTON ST WA ZIP 98056 4❑ 37
18❑ CDL IGNITION REQUIRED IGNITION PR-E-1SENT MEDICAL-T�RANSPORTED � 38
INTERLOCK YEs❑No� INTERLOCK YEs It I NOF YES
t l NOF,/
19 D IVEW #
❑ ON DUTY STATUS I
AIRBAG 3 RESTR 9 EJECT 1 H U EET 2 NJAURSY 1 NATURE OF INJURIES 40
❑21❑ PLATE# BYP1471 TATE 41
WA VIN1 5XYRGDLC6M0008698 1
42
22❑ PILER LATE# STATE PLATE# STATE
23❑ UIN#. 43
TRLR RLR
'IN#.
VEH YEAR 2029 MAKE KIA MODEL SORENT STYLE SI/ VEHICLE TOWED TO BLIN TOWEDBY GOV HI 44
L4❑ DAMAGE YES NO YES NO
REGISTERED OWNER INFO DAVID FRANCIS 1712 HARRINGTON AVE NE RENTON WA 98056 VEHICLE NO.2
SHADE IN DAMAGED AREA
2 3 4
LIABILITY
INSURANCE INSU PORGY#E CO PROGRESSIVE 909646251IN CQ'E""LE
❑ ,J� CITATION# CHARGE i o
LEGALLY YES N`L J
25
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
J
26
C.ARNOLD 12509 WA0171300
PART A PAGE 01 OF C7
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EE74263
COLLISION REPORT III III III III III 111
1591972 CASE# 24-4625
ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY)
NAME MIDDLE INITIAL) FRANCS EMMA L
(LAST FIRST,
ADDRESS&PHONE# D O.B. '
1712 HARRINGTON AVE NE RENTON WA 98056 4256528576 SEXi F MMDOYyry 09 - 19 - 2006
PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT ' HELMET INJURY NATURE OF INJURIES
❑✓ ❑ 2 POS, 3 3 9 1 USE 2 CLASS 1
NAME
'(LAST,FIRST MIDDLE INITIAL)
ADDRESS&PHONE# DOB
SEX MMDDYVYV
PASSENGER ❑WITNESS❑ UNIT# SEAT AIRBAG RESTR. EJECT HELMET NJURY NATURE OF INJURIES
POS. USE CLASS
NAME
(LAST FIR57 MIDDLE INITIAL)
AppRESS R PHONE#
SEX D.O.B.MMDD -❑
YYYY.
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.
C.ARNOLD 04-29-24 08:51 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
D.MOYNIHAN 1128E 1 51512024 6:55:03 PM
BADGE OR ID# 112509 ORI#' WA0171300 TIME POLICE DISPATCHED 7:15 PM TIME POLICE ARRIVED',7:17 PM
PART I PAGE IT]OF 4�
REPORT NO. EE74263 CASE# 24-4625 OF COLLISION
04/29/24 19:06
OF CbLLI510N
NARRATIVE
On 04/29/2024 at 1915 hours I was dispatched to a non-injury collision near the 3100 block of NE
Sunset Blvd.
Unit 1 was traveling East on NE Sunset Blvd and entered the two-way center turn lane to turn left into
a parking lot at around the 3100 block.
Unit 2 was traveling West in the number 1 lane approaching the 3100 block.
Unit 1 stated that he attempted to perform a lefthand turn into the parking lot, and did not see that Unit
2 was traveling towards him due to traffic being backed up. Unit 1's driver stated that the front bumper
of Unit 2 made contact with the right front tire/wheel well of Unit 1.
Unit 2's driver stated that she was traveling in the number 1 lane approaching the 3100 block and saw
that traffic was backed up in the number 2 lane. Unit 2's driver stated that as she approached the
3100 block, Unit 1 attempted to perform a lefthand turn into the parking lot near the 3100 block. Unit
2's driver stated that she did not have time to come to a stop to avoid the collision and the front
bumper of Unit 2 made contact with the passenger side wheel well/tire of Unit 1.
I was able to see scuff marks on the roadway indicating where Unit 1 was at when it was struck. It
should be noted that there is no traffic control devices/signs at the area in which this collision
occurred. The roadway markings coincided with the story that was provided by both Unit 1 and Unit
2's drivers.
All parties involved refused medical treatment/assessment.
Unit 2's front and passenger side airbags deployed.
Unit 1's front right tire was bent inwards and was rendered inoperable/unsafe to drive. Unit 1 was
towed at the owners request from the private property where it stopped at.
Proximate cause:
If Unit 1 had yielded to the right of way of oncoming traffic, then this collision would not have
occurred. Driver 1 was cited for failing to yield to the right of way.
PAGE 3 OF 4
REPORT NO. EE74263 CASE# ' 24-4625 DATE AND TIME 04/29/24 19:06
OF COLLISION
AN
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PAGE 4 OF 4