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HomeMy WebLinkAbout24-5219 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 1 27c COLLISION REP FIT 1591971 CASE 24-5219 z INTERSTATE ❑ CITY STREET FIRE ❑RESULTED 1 STOLEN STATE ROUTE ❑ OTHER ❑ VFHICI F ❑ LOCAL AOENC 4250 3 HIT&RUN ✓ CODING COUNTY RD PRIVATE WAY INVOLVED 2 TOTAL#OF OBJECT 1 O 7 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# ❑ CowsloN 05 - 1-- 2024 2208 17 ❑.= S 8 IN e 1070 3 4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓ DUVALL AV NE BLOCK NO. e✓ 1600 4a❑ MILEPOST DISTANCE OF(REFERENCE OR CROSS STREET) 5❑ 50 00 FMILES EET e S B W e NE SUNSET BLVD 0 1 29 MOTOR PEDAL- DAMAGE THRESHOLDHONE UNIT 01 VEHICLE ❑ CYCLE El MET P YES �/No D:2064460497 0 11 30 6� LAST NAME NONU FIRSTNAME JOSEPH MIDDLE M 1 2 31 INITIAL STREET ❑ 12909 158TH AVE SE CITY RENTON ST WA ZIP 98059 z NEW ADDRESS 7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3 iNTERLOCKYEs No✓ INTERLOCKYEs NO✓ YEs No✓ 8❑ LRIIVER # ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 H USEET ICNLJAURY 1 NATURE OF INJURIES 2❑ 3 10 9❑ P1 ATE 14 BTS0017 STATE WA u N# 1 FAFP55263G167817 TRAILER STATE TRAILER STATE 11 3 5 PLATE# PLATE# ROM ro FT -R TPILF1 1 5 33 12 3 5 VIN#j VIN# :: FROM TO VEH.YEAR 2003 MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE 1 5 34 13 4 FORD TAURUS SD DAMAGE YES NO ✓ YES[:] No ✓ REGISTERED OWNER INFO AISAKENONU 12111158THAVE SE RENTON WA 98059 VEHICLE NO. 1 ❑ ❑ SHADE IN DAMAGED AREA 35 4 INSURANCE CO 2 3 14 ❑LIABILITY INSURANCE IN PEMCO CA1914577 IN EFFECT &POLICY# � 9TOP VEHICL' CHARGE 36 LEGALLY, YES❑NO❑ CITATION# 10 BOTTOM 15❑ STAIN.D" 8 UNIT a2 VE ICCLE CYCLE ❑ PEDESTRIAN ❑ OWN ARTY ❑ DYES✓ NO OLD MET PHONE 16 a LAST NAME UNKNOWN FIRST NAME MIDDLE INITIAL STREET CITY RENTON ST ZIP 17❑ NEW ADDRESS ❑ 37 18❑ CDL IGNITION REQUIRED IGNITION PR-E-1SENT MEDICAL-T�RANSPORTED ❑ 38 INTERLOCKYES�NO� INTERLOCK YEs It I NOF YES t l NOF,/ 19 LLIICENS # STATE SEX U MMDDYY 39 WELMET 1NJURY NATURE OF INJURIES 40 20❑ ON DUTY STATUS' AIRBAG 9 RESTR 9 EJECT ''9 USE 9 CLASS 0 ❑ ❑21❑ LICENSE UNKNOWN TATE VIN# 41 pLATE# 42 22❑ PLATE# STATE PLATE# STATE 23❑ TRLR R 43 LR VIN#. N I #. VEH YEAR MAKE UNKN MODEL UNKNOW STYLE VEHICLETOWED TO BLIN TOWEDBY GOV HI �44 24❑ DAMAGE YES NO✓ YES NO✓ REGISTERED OWNER INFO UNKNOWN RENTON VEHICLE NO.2 SHADEDAMAGED AREA 3 4 INAEFFITY ECTNSURANCE❑ &POINSULICY#E CO 9TOP 5 "'LLE ❑ Nu,J CITATION# CHARGE 25 to BOTTOM LEGALLY YES ' e =HSU AME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY J 26 12651 WA0171300 PART A PAGE 01 OF C7 3000-345-159 OR 11/181 STATE OF POLICETRAFFICN CORRECTION REPORT NO. EE79667 COLLISION REPORT III III III III III 111 1591972 CASE# 24-5219 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' Unit 1 and 2 both traveling south on Duvall Av NE approaching NE Sunset Blvd. Unit 2 rear ends Unit 1 causing major disabling reportable rear end damage to Unit 1 and major reportable front end damage to Unit 2. Unit 2 does not remain on scene and leaves the area, westbound along NE Sunset Blvd. No injuries reported. A passerby reported that Unit 2 may have been a black SUV, possibly a Yukon. Driver of Unit 2 may have also been a Hispanic male. No witnesses or driver of Unit 1 could identify hit and run driver. No actionable leads to locate Unit 2. Area check negative. I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT. HANSEN HSU 05-16-24 11:18 PM INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED APPROVED BY DATE P.SUMMERS 8887 5/23/2024 8:43:57 AM BADGE OR ID# ! 12651 ORI#' WA0171300 TIME POLICE DISPATCHED 10:26 PM TIME POLICE ARRIVED 10:31 PM PART I PAGE IT]OF 3� REPORT NO. EE79667 CASE# 24-5219 DATE AND TIME 05/15/24 22:08 OF COLLISION u PAGE 3 OF 3