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HomeMy WebLinkAbout24-4930 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 1 27c
COLLISION REP FIT 1591971
CASE 24-4930 z
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 - 08 - 2024 1407 17 ❑.❑ N E IN S 8 W H OF e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓
SW 27TH ST BLOCK NO. e✓ 800
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 D:5084091405 0 11
30
6� LAST NAME SEANG FIRSTNAME LINDA MIDDLE N 1 1 2 31
INITIAL
STREET El 17650 134TH AVE SE APT S102 CITY RENTON ST WA 2jp, 980587875 z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
INTERLOCK YES[:]NO INTERLOCKYEs NO YEs NO
LRIIVER # STATE WA SEX'F MM D Y' 07
8❑ — 04 — 1976 1 2 32
9 ON DUTY❑ STATUS AIRBAG 6 RESTR 4 EJECT 1 HELMET USE 2 CLASS 1 NATURE OF INJURIES 2❑
3
10 9❑ PI ATE SH18683 sTArI WAVIN#' 2T2BK1BAOACO26955
Fj0 TRAILER STATE TRAILER STATE
11 0 PLATE# I I I PLATE# I FROM To
TRLR. TRLR 1 3 33
12 0 0 VIN#' VIN#'
;.... FROM TO
VEH.YEAR 2010 MAKE LEXS MODEL RX STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE 3 ] 34
13 2 DAMAGE YES NO YES[:] No
✓
REGISTERED OWNER INFO SAM TEK 18401111THAVE SE RENTON WA 98058 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
14 LIABILITY INSURANCE INSURANCE CO GEICO 4570-74.36.94 3 4
IN EFFECT &POLICY# 9TOP
VEHCLE CHARGE 5 36
LEGALLY YES❑NO❑ CITATION# 10 BOTTOM
15❑ STANDING 8
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES 1/ NO D:2532039006
16 2
LAST NAME SOPKE FIRST NAME DAVID MIDDLE M
INITIAL
17❑ STREET ❑', 7721 182ND AVE E CITY BONNEY LAKE ST WA ZIP 983917116 37
NEW ADDRESS ❑
18� CDL IGNITION REQUIRED IGNITION PR—E-1SENT MEDICAL TRANSPORTED 38
INTERLOCKYES�NOR INTERLOCK YEs It I NOF YES
t t— l NO❑
19[—] DRIVER'S STATE WA SEX M D.C... 04 25 _ 1977 El 39
LICENSE# MMDDYY
HELMET {NJURY 1 NATURE OF INJURIES 40
20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 USE 2 CLASS ❑
21❑ LICENSE I C66128U TAre WA VIN# 1FTRX14W26FA56633
❑ 41
PLATE#
42
22❑ PLATE# STATE PLATE# STATE
23❑ VIN#. 43
TRLR RLR
'IN#.
VEH YEAR 2006 MAKE FORD MODEL F150 STYLE TR VEHICLETOWED TO BLIN TOWEDBY GOV HI 44
24❑ DAMAGE YES NO YES NO✓
REGISTERED OWNER INFO THE FITNESS TECH 7721182ND AVE E BONNEY LAKE WA 98321 VEHICLE NO.2
SHADE IN DAMAGED AREA
2 3 4
LIABILITY INSURANCE INSU&PORGY#E CO ARTISAN AND TRUCKERS 976732491 STOP 5
IN EFFECT0(
VE""LE ❑ ,J� CITATION# CHARGE i o BOTTOM
LEGALLY YES N`L J
25 ' a
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. EE83090
COLLISION REPORT III III III III III 111
1591972 CASE# 24-4930
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 8, 2024, at 2407 hours dispatch requested that I respond to a collision that occurred at 800
SW 27th St, in the City of Renton.
Upon my arrival I spoke with the driver of unit 2 and they explained they were leaving the parking lot
and attempting to make a left turn on SW 27th St to go eastbound. The driver failed to see unit 2
going westbound and crossed in front of them. Unit 2 was struck their driver's side door.
I then spoke with the driver of unit 2 and they explained they were going westbound on s 27th St,
when unit 1 exited the parking lot and entered the roadway in front of them. Unit 2 was unable to stop,
striking the vehicles drivers side door.
Both vehicles needed to be towed away, so Gene Meyers towing arrived later and removed the
vehicles.
Both drivers were checked by Renton Fire.
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 05-13-24 10:49 AM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
C.JACOBS 1953 1 6/3/2024 11:33:30 AM
BADGE OR ID# 1Y007 ORI# WA0171300 TIME POLICE DISPATCHED 2:10 PM TIME POLICE ARRIVED f 2:20 PM
PART I PAGE IT]OF 3�
REPORT NO. EE83090 CASE# 24'4030 DATE AND TIME 05/08/2414:07