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HomeMy WebLinkAbout24-5170 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 0 27c COLLISION REP FIT 1591971 CASE 24-5170 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 2 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# ❑ cawsloN 05 - 1-- 2024 1428 17 ❑.= S 8 IN e 1070 3 4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓ RAINIER AVE S BLOCK NO. e✓ 073 4a❑ MILEPOST DISTANCE OF(REFERENCE OR CROSS STREET) 5❑ 125 00 FEET MILES e S B W e AIRPORT WAY 1 9 29 UNIT VEHtOCLE CYDDAL ❑ DYESA✓NOESHOLDMET PHONE Q 1 30 6� LAST NAME JONES FIRSTNAME EMILY MIDDLE D 1 2 31 INITIAL STREET ❑, 3100 HYDRANGEA AVE CITY K/LLEEN ST TX 2jp', 765490000 z NEW ADDRESS 7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3 iNTERLOCKYEs NO INTERLOCKYEs NO YES NO ❑ DRIVER'S' STATE TX SEX'F MM ovY' 07 - 13 - 1989 1 2 32 8 LICENSE# 9 ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 HELM USEET INJUR 5Y NA 1 TURE OF INJURIES 2❑ 3 10 9❑ PI ATE 14 CDH7213 STATE WA VIN# 3G1BE6SM2JS649220 TRAILER STATE TRAILER STATE 11 3 5 PLATE# PLATE# FROM To TRLR. TRLR 7 3 33 12 3 5 VIN#' VIN#' FROM TO VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE 5 1 34 13 2 2018 CHEV CRUZE DAMAGE YES NO YES❑ NO✓ REGISTERED OWNER INFO EMILYJONES 8862 SHEPARD WAYNE OLYMPIA WA 98516 D:3608107438 VEHICLE NO. 1 ❑ SHADE IN DAMAGED AREA 35 14 LIABILITY INSURANCE INSURANCE CO SAME. IN EFFECT &POLICY# 9TOP VE—LE CHARGE 5 36 LEGALLv YES[:]NO❑ CITATION# 1 o BOTTOM 15❑ STANDING 8 6 MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE �NiT VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES 1/ NO D:2159190264 16 a LAST NAME WOLF FIRST NAME NATHANIEL MIDDLE I/ INITIAL 17❑ STREET ❑', 7172 MARSHALL AVE SE APT 206 CITY AUBURN ST WA ZIP 980928764 37 NEW ADDRESS ❑ 18� CDL IGNITION REQUIRED IGNITION PtR-E-S1ENT MEDICALt-T�RANSPORTED 38 INTERLOCKYES�NOR INTERLOCK YEs I I NoF YES t l NO❑ 19[� LDI IVEW # STATE WA SEX M M MD D. 01 12 _ 2003 El 39 HELMET I INJURY NATURE OF INJURIES 40 20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 USE CLASS 1 ❑ 21❑ LICENSE I CLD4190 TATe WA VIN1 1LNHM97V92Y699867 ❑ 41 PLATE# 42 22❑ PLATE# STATE PLATE# STATE 23❑ 43 TRLR RLR UIN#. 'IN#. VEH YEAR 2002 MAKE LINO MODEL CONTINE STYLE VEHICLETOWED TO BLIN TOWEDBY GOV HI 44 24❑ DAMAGE YES NO YES NO✓ REGISTERED OWNER INFO NATHANIEL WOLF 7172 MARSHALL AVE SE APT 206 AUBURN WA 980928764 VEHICLE NO.2 SHADE IN DAMAGED AREA 2 3 4 LIABILITY INSURANCE 8 POINSURGY#E CO DYER WNP 316391RIN CQVE""LE ❑ ,J� CITATION# CHARGE i o LEGALLY YES N`L J 25 OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY J 26 M.LEVERTON 2517 WA0171300 PART A PAGE 01 OF C7 3000-345-159 OR 11/181 STATE OF POLICETRAFFICN CORRECTION REPORT NO. EE83094 COLLISION REPORT III III III III III 111 1591972 CASE# 24-5170 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' 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. M.LEVERTON 05-15-24 07:13 AM INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED APPROVED BY E DAT C.JACOSS 1953 6/3/2024 11:30:55 AM BADGE OR ID# 2517 OR]#' WA0171300 TIME POLICE DISPATCHED! 2:28 Pry TIME POLICE ARRIVED]2:41 PM PART I PAGE IT]OF 4] REPORT NO. EE83094 CASE# 24-5170 OF COLLISION 05/14/24 14:28 OF CbLLI510N NARRATIVE red sedan from me to banner/1 wht lic/2 RTF Within the city limits of Renton/King/Wa I responded to a 2 car crash at about the 073 block of Rainier Ave S. I contacted the driver of unit 2 who told me he was northbound Rainier Ave S, lane 1, when unit 1 crossed in front of him, contacting his vehicle. He did not complain of injury and damages did not require a tow truck. I contacted the driver of unit 1 who told me she was in the parking lot of Mcdonalds and wanted to cross all lanes of Rainier Ave S to the Banner Bank parking lot, 54 Rainier Ave S. She said it appeared all lanes of traffic both direction were stopped and there was an opening between cars where she felt she could make it. She said another driver even waved her through but no one observed unit 2 northbound. Unit 1 crossed the path of unit 2 where they made contact. She did not complain of injury and although it appeared she needed a tow truck she denied needing one. Information/insurance only I certify (declare) under penalty of perjury under the laws of the State of Washington that the foregoing is true and correct. M.Leverton/2517 City of Renton/King/Wa 05/15/2024 **** AUTO-POPULATED SECTION **** THE FOLLOWING ARE DESCRIPTIONS ENTERED FOR ITEMS SELECTED AS "OTHER": Motor Vehicle Unit 1 Action Code: CROSSING TRAFFIC **** END OF AUTO-POPULATED SECTION **** PAGE 3 OF 4 REPORT NO. EE83094 CASE# ' 24-5170 DATE AND TIME 05/14/24 14:28 OF COLLISION x 'r r ?t i PAGE 4 OF 4