HomeMy WebLinkAbout24-4966 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 5 27c
COLLISION REP FIT 1591971
SASE 24-4966 2
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 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 CITY#
COLLISION'. 05 — 09 — 2024 1124 17 . N E IN� S 8 W H OF e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
e✓ --- ----� ❑
S 2ND ST MILEPOST
4a❑
DISTANCE OF(REFERENCE OR CROSS STREET) BLOCK NO.
5❑ ❑ FEET e S ❑ W e WELL AVE S
0 4 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
✓NO D:5092006115 0 11
30
6� LAST NAME HOORI FIRSTNAME NOELLE MIDDLE H 1 2 31
INITIAL
STREET ❑ 6504 CRESTFIELDS RD CITY YAKIMA ST WA 2jp, 989032400 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
10❑ PI ATE
S� AUZ9695 sTArI WAvIN# 5TDKK3DC5FS597662
TRAILER STATE TRAILER STATE
11 0 0 PLATE# PLATE# FROM TO
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 3 ] 34
13 2015 TOYT SIENNA VN DAMAGE YES NO YES[:] NO✓
REGISTERED OWNER INFO NOELLE HOORI 282414TH AVENUE NORTHWEST,P PUYALLUP WA 98371 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
14 LIABILI INSURANCE INSURANCE CO ALL STAATE 820 688 988 3 4
IN EFFECT &POLICY# 9TOP
vErIICLE CHARGE 5 36
LEGALLv Yes❑NO❑ CITATION# 10 BOTTOM
15❑ STANDING 6
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT 02 VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES 1/ NO D:3373157832
16 2
LAST NAME THIBODEAUX FIRST NAME ALEXANDER MIDDLE A
INITIAL
17❑ STREET �' 13503 8OTH AVE S CITY' SEATTLE ST' WA ZIP 98178 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 D IVEW #
{NJURY 1 NATURE OF INJURIES 40
20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 USE 2 CLASS ❑
21❑ LICENSE I CKX5074 TAre WA YIN# KNDJ23AU6R7906112
❑ 41
PLATE#
42
22❑ PLATE# STATE PLATE# STATE
23❑ UIN#. 43
TRLR RLR
'IN#.
TOWED BY Gov HI 44
VEH YEAR 2024 MAKE I(I/� MODEL SOUL STYLE 4T DAMAGE TOWED TOO✓ BLIN YES HI
24❑ REGISTERED OWNER INFO OWNED SY DRIVER VEHICLE N0.2
SHADE DAGED AREA
4
LIABILITY INSURANCE INSU&PORGY#E CO PACIFIC STAR INSURANCE 5553289 IGQ
5
IN EFFECT
VE""LE ❑ ,J� CITATION# CHARGE
LEGALLY YES N`L J
25 s � e
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. EE83088
COLLISION REPORT III III III III III 111
1591972 CASE# 24-4966
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 May 9, 2024, at 1124 hours dispatch requested that I respond to a collision that occurred at the
intersection of Well Ave S and S 2nd St, in the Renton.
Upon my arrival I saw two vehicles stopped in the middle of the intersection. I saw a Toyota Sienna
that appeared to have made a left turn, and a Kia Soul that was going straight through the
intersection. The Toyota Sienna was in the number 2 lane, making a left turn. The Kia Soul was in the
number 3 lane, going straight through.
As parked, the vehicles moved to a nearby parking lot. I then spoke with the driver of unit 1, a 2015
Toyota Sienna bearing Washington plates AUZ9695. The driver explained she was making a left turn
at the intersection. The driver said she was confused because she was still processing what
happened. The driver said they made a left turn and then was struck by the Kia Soul.
I then spoke with the driver of unit 2, a 2024 Kia Soul. The driver explained he was in the number 3
lane going through the intersection, when unit 1 made a left turn. The driver of unit 1 made a left turn
from the number two lane.
Unit 1 struck unit 2's right front wheel.
No one complained of any injuries and no vehicle were towed from the location. An exchange of
information was given to both drivers.
I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT.
C.CATALAN 05-09-24 05:33 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
C.JACOBS 1953 1 6/3/2024 11:34:07 AM
BADGE OR ID# 1Y007 ORI# WA0171300 TIME POLICE DISPATCHED 11:26 AM TIME POLICE ARRIVED'11:30 AM
PART I PAGE IT]OF 3�
REPORT NO. EE83088 CASE# ' 24-4966 DATE AND TIME 05/09/24 11:24
OF COLLISION
e'
F,
i
r
i
PAGE 3 OF 3
