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HomeMy WebLinkAbout24-5440 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 0 27c COLLISION REP FIT 1591971 CASE 24-5440 z INTERSTATE ❑ CITY STREET FIRE ❑RESULTED 1 STOLEN STATE ROUTE ❑ OTHER ❑ VFHIr.I F ❑ LOCAL AOENC 4Y00 3 HIT 8 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'. 05 - 1-— 2024 1316 17 ❑.= S 8 W IN e 1070 3 4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓ WILLIAMS AVE S BLOCK NO. e✓ 220 4a❑ MILEPOST DISTANCE OF(REFERENCE OR CROSS STREET) 5❑ �,❑ FEET e S ❑ W e 0 1 29 MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE UNIT 01 VEHICLE ❑ CYCLE El NO ✓ I D:8016788299 0 11 30 6� LAST NAME WEISSMANN FIRSTNAME HANNAH MIDDLE K 1 1 2 31 INITIAL STREET ❑, 1864 21ST AVE SE CITY OLYMPIA ST WA 2jp, 985018904 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 H USE 2 1 CLASS NATURE OF INJURIES 2❑ 3 10 9❑ P1 ATNES# RWM0444 sTAT TX vN# JN16J1CR5HW139669 TRAILER STATE TRAILER STATE 11 0 0 PLATE# PLATE# FROM ro TRLR. TRLR. 3 7 33 12 0 0 VIN#' VIN# FROM TO VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE 1 $ 34 13 2 2017 NISS ROGUE UT DAMAGE YES NO ✓ YES[:] No ✓ REGISTERED OWNER INFO HANNAH WEISSMANN 186421STAVE SE OLYMPIA WA 985018904 D:8016788299 VEHICLE NO. 1 ❑ SHADE IN DAMAGED AREA 35 14 LIABILITY INSURANCE z INSURANCE CO PROGRESSIVE 981466516 4 LI EFFECT I POLICY# TOPVEHICLE CHARGE 36 LEGALLv res❑NO❑ CITATION# <1�3 OTTOM 15❑ NDING 7 6 MOTOR ✓ PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE UNIT 02 VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES NO ✓ D:4253066593 16 2 LAST NAME DAWSON FIRST NAME REBECCA MIDDLE M INITIAL 17❑ STREET ❑', 1517 SHATTUCK AVE S CITY RENTON ST WA ZIP 980553325 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 LDIIVEW # STATE WA ]SEX IF M .O.B. 11 10 _ 1962 0 39 WELMET {NJURY NATURE OF INJURIES 40 20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT '1 USE 2 CLASS 1 ❑ 21❑ LICENSE BUX1100 rare WA vIN1 2GNFLNEKOC6274648 ❑ 41 PLATE# 42 22❑ PILER LATE# STATE PLATE# STATE 23❑ 43 TRLR RLR UIN#. 'IN#. VEH YEAR 2012 MAKE CHEV MODEL EQUINOX STYLE UT VEHICLETOWED TO BLIN TOWEDBY GOV HI �44 L4❑ DAMAGE YES NO✓ YES NO✓ REGISTERED OWNER INFO REBECCA DAWSON 1517 SHATTUCK AVE S RENTON WA 98055 VEHICLE NO.2 SHADE IN DAMAGED AREA 2 3 4 LIABILITY INSURANCE 8 POINSURGY#E CO GEIC04437867528IN 1 9TOP 5 VEwCLE ❑ N`L J ,J� CITATION# CHARGE 25 i o BOTTOM LEGALLY YES $ 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. EE83093 COLLISION REPORT III III III III III 111 1591972 CASE# 1 24-5440 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 22nd, 2024, at 1316 hours dispatch requested that I respond to a collision the current at 220 Williams Ave. S, in the city of Renton. Upon my arrival I spoke with the driver of unit 2 and she explained that she was driving southbound on Williams Ave S when she observed unit 1 exit a parking lot from 220 Williams S. Unit 2 had already passed the exit, when unit 1 struck her rear left wheel. I then spoke with the driver of unit 1 and she explained she was exiting 220 Williams S when the collision occurred. She looked at northbound traffic but failed to look towards southbound traffic. She proceeded forward and struck unit 2 which was on Williams Ave S going southbound. Both vehicles sustained minor damage, so I provided the two drivers an exchange of information. I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT. C.CATALAN 05-31-24 10:05 AM INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED APPROVED BY DATE C.JACOBS 1953 1 6/3/2024 11:10:23 AM BADGE OR ID# 1Y007 ORI# WA0171300 TIME POLICE DISPATCHED 4:99 pry TIME POLICE ARRIVED 1:27 pry PART I PAGE IT]OF 3� REPORT NO. EE83093 CASE# ' 24-5440 DATE AND TIME 05/22/24 13:16 OF COLLISION Su p Am f , n I'1 e � sw i w PAGE 3 OF 3