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HomeMy WebLinkAbout24-5477 ITFF' "POLCERA II I !�� I III I III I IIII III II I . $ 27c COLLISION REP FIT 1591971 ❑ ❑ FIRE ❑ CASE# 24-$477 2 6 0 INTERSTATE CITY STREET RESULTED 1 STOLEN STATE ROUTE ❑ OTHER ❑ VFHICI 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 2 3❑ DATE OF M M D D Y Y Y Y TIME(2400) COUNTY# MILES N E IN CITY# cowsloN 05 - 1-- 2024 1120 17 ❑-= S 8 IN e 1070 3 4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑ LOGAN AVE N BLOCK NO. e✓ --- ----� ❑ 4a❑ MILEPOST DISTANCE OF(REFERENCE OR CROSS STREET) 5❑ ❑ FEET e S ❑ W e N 4TH ST 0 1 29 MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE UNIT 01 VEHICLE ❑ CYCLE El �/No D:2533206306 0 4 30 6� LAST NAME JALBA FIRSTNAME ADIEL MIDDLE A 1 1 2 31 INITIAL STREET ❑ 9219 FAWCETT AVE CITY TACOMA ST WA 71p 984446250 2 NEW ADDRESS 7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3 INTERLOCK YES[:]NO INTERLOCKYEs NO YES R NO 8❑ LRIIVERS STATE WA SEX'M MM DAY' 08 1- 26 - 2001 2 32 CENSE 9 ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 H USEET ICNLJAURY 1 NATURE OF INJURIES 2❑ 3 10 1❑ P1 ATE 14 C71338E STATE WA u N# 3N6CMOKNXFK710032 TRAILER STATE TRAILER STATE 11 3 0 PLATE# PLATE# FROM ro TRLR. A'RLR. 1 5 33 12 3 0 VIN#' VIN# :: FROM TO VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE 3 $ 34 13 2 201$ NISS NV200 DAMAGE YES NO YES[:] NO✓ REGISTERED OWNER INFO INNOVATIVE COMFORTINC 3302 TAYLOR RD OAK HARBOR WA 98277 VEHICLE NO. 1 ❑ SHADE IN DAMAGED AREA 35 14 LIABILITY INSURANCE INSURANCE CO SAME. 3 4 IN EFFECT &POLICY# 9TOP VE'CLE CHARGE 1 5 36 LE�ALLv YEs No clTAnoN# 4A0361505 FAIL TO OBEY TRAFFIC CONTROL o aorroM 15❑ STANDING 8 MOTOR PEDAL-: 'PEDESTRIAN PROPERTY DAM THR OLD MET PHONE U 1/NIT U2 VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES NO D:4252078994 16 a LAST NAME ARMSTEAD FIRST NAME MARY MIDDLE I F INITIAL 17❑ STREET ❑', 201 UNION AVE SE UNIT 82 CITY RENTON ST WA ZIP 980595179 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 LDIIVEW # STATE WA ]SEX IF M .C.B. 02 _ 01 1948 39 WELMET INJURY1 NATURE OF INJURIES 40 20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 USE CLASS ❑ 21❑ LICENSE ARX5100 TATE WA VIN# 1(B11E$SA6DF285419 ❑ 41 PLATE# 42 22❑ PLATE# STATE PLATE# STATE 23❑ VIN#. 43 TRLR RLR 'IN#. VEH YEAR 2013 MAKE CHEV MODEL MALIBU STYLE VEHICLETOWED TO BLIN TOWEDBY GOV HI 44 L4❑ DAMAGE YES NO YES NO REGISTERED OWNER INFO MARYARMSTEAD 201 UNION AVE SE UNIT 82 RENTON WA 98059 VEHICLE NO.2 SHADEDAMAGEDAREA 3 4 INAEFFITY ECTNSURANCE� &POINSULICY#E CO SAME. IUL"iKOTITIfl0l�- (PRINT)VE""LE ❑ ,J� CITATION# CHARGELEGALLYYES N`L J25 OFFICER'S NAME 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. EE83091 COLLISION REPORT III III III III III 111 1591972 CASE# 24-5477 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' wht van/1 red light sb gray suv It outside lane CC Within the city limits of Renton/King/WA I responded to a 2 vehicle crash at the intersection of Logan Ave N at N 4th St. I contacted the driver of unit 2 who told me she was making a left turn from the outside turn lane from N 4th to SB Logan Ave N when she was hit by unit 1. She did not complain of injury and damages did not require a tow truck. I contacted the driver of unit 1 ID'd by matching picture WADL. He told me he was southbound on Logan Ave N, distracted plugging in his cell phone and ran a red light striking unit 2 at n 4th St. He did not complain of injury and damages did not require a tow truck. I cited unit 1 ref RCW 46.61.055 FTCWTCD-red light 2 vehicle crash via complaint. 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 5/23/2024 I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT. M.LEVERTON 05-23-24 11:55 AM INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED APPROVED BY E DAT C.JACOBS 1953 6/3/2024 11:30:11 AM BADGE OR ID# 2517 OR]#' WA0171300 TIME POLICE DISPATCHED 11:21 AM TIME POLICE ARRIVED]11:26 AM PART I PAGE IT]OF 3� REPORT NO. EE83091 CASE# ' 24-5477 DATE AND TIME 05/23/24 11:20 OF COLLISION t �t ht i4 S PAGE 3 OF 3