HomeMy WebLinkAbout24-5484 (2) POLICETRAFF'c" III !�� I IIIllI111IN II II I REPORT NO. EE80523 170
27
COLLISION REP FIT 1591971
CASE 24-5484 z
INTERSTATE ❑ CITY STREET FIRE ❑RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHICI F ❑ LOCAL AOENC 4150 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 N E IN CITY# ❑
cowsloN 05 - 1-- 2024 1847 17 ❑.= S 8 IN e 1070 3
4❑ oN (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
HARDIE AVE SW BLOCK NO. e ❑
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ �,❑ FEET e S ❑ VV a SW SUNSET BLVD
0 4 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
,/No D:4252364236 0 11
30
6� INITIAL
LAST NAME BOWSER-WALTON FIRSTNAME XSAUN MIDDLE T 1 1 2 31
STREET ❑ 201 TAYLOR AVE NW APT 201 CITY RENTON ST I WA 2jp, 98057 z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
INTERLOCK YES[:]NO 1/ INTERLOCKYEs NO Z/ YES R No�/
8❑ LDRIVER # STATE WA SEX'M MID
LOB 11 1- 29 - 2005 2 32
_l [NATURE OF
9 ON DUTY❑ STATUS' AIRBAG 6 RESTR 4 . EJECT 1 HELMETU E 2 CLASS'NJURy7 I LEG PAIN INJURIES z❑
3
10❑ PI aT�Slt CLX8337 sTAr� WA #' JT8BF28G2Y0245980
IT STATE TRAILER STATE
11 0 0 PLATE# I PLATE# I I FROM TO
rRLR TRLR 1 3 33
12 0 0 VIN#' VIN#
>;. FROM TO
VEH.YEAR 2000 LEXS ES 250 SD MAKE MODEL STYLE VEHICLE TOWED TO BLIN T GOVT.VEHICLE 5 1 34
13 DAMAGE YES NO �LII� RS YES[:] No✓
REGISTERED OWNER INFO XlAUN BOWSER-WALTON 201 TAYLOR AVE NW APT 201 RENTON WA 98057 D:4252364236 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
14 ❑ INSURANCE �3g
4
LIABILITV INSURANCEIN EFFECTI SUR N#❑ VEwcLE CHARGE 5 36
15 2 srANoLN res No CITATION# 4AO415183,4AO415183 OP MOT VEH W/OUT INSURANCE, e
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT U2 VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES 1/ No D:2063561514
16 a
LAST NAME SCHWAB FIRST NAME BRIANNA MIDDLE M
INITIAL
17 NEW EETREs7' 11028 CRESTWOOD DR CITY SEATTLE ST' WA ZIP 98178 4❑ 37
18� CDL IGNITION REQUIRED IGNITION PRESENT MEDICALTRANSPORTED 38
INTERLOCKYEs❑No� INTERLOCK yEsF_j No� YEs NoF
19 DRIVER'S STATE WA ]SEX IF D.C... 04 09 _ 2003 39
LICENSE# MMDDYY
20❑ ON DUTY STATUS AIRBAG 6 RESTR 4 EJECT 1 HELMET 2 INJURY 7 NATURE OF INJURIES ❑ 40
USE CLASS GENERAL PAIN
❑ 41
21❑ PLATE# CGD9901 TArE WA VIN# 1HGCV1F33NA106421 1
42
22❑ PLATE# STATE PLATE# STATE
TRLR
23❑ UIN#. IN#.
43
RLR
'
TOWED BV Gov HI 44
VEH YEAR 2022 MAKE HOND MODEL ACCORD STYLE $D _7EHICLE
TOWED✓ NOO BLIN BANKERS YES No�/
24❑ REGISTERED OWNER INFO OWNED SY DRIVER VEHICLE N0.2
SHADE IN DAMAGED AREA
2 3 4
LIABILITY INSURANCE INSU8 PORGY#E CO STATE FARM 531 5223-A09-47-001 1 9TOP 5
IN EFFECT
l I
VE."LE ❑ ,J� CITATION# CHARGE i o BOTTOM
LEGALLY YES N J
25 =TURNER
NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
J
26 12650 WA0171300
PART A PAGE 01 OF C7
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EE80523
COLLISION REPORT III III III III III 111
1591972 CASE# 1 24-5484
ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY)
NAME MIDDLE INITIAL) ASHFORD-THOMAS AR/AH J
(I.P.ST FIRST,
ADDRESS&PHONE# D O.B.
201 TAYLOR AVE NW APT 201 RENTON WA 98057 2068562964 SEX F MMDDYyry 08 - 04 - 2005
{� SEAT HELMET INJURY NATURE OF INJURIES
PASSENGER Z WITNESS❑ UNIT# 1 POS j 3 AIRBAG 6 RESTR. 4 EJECT 1 USE 2 1 CLASS 7 GENERAL PAIN
NAME
(LAST,FIRST,MIDDLE INITIAL}
ADDRESS&PHONE# D O
SEXI MMDDVYE4
YV
PASSENGER ❑WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET NJURY NATURE OF INJURIES
POS. USE CLASS
NAME
(LAST FIR57 MIDDLE INITIAL)
AppRESS&PHONE#
SEX D.O.B.
MMDDYYYY.
PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET NJURY NATURE OF INJURIES
❑ ❑ POS. USE CLASS ----�
NARRATIVE'
Unit 1 was traveling southbound on Hardie Ave SW approaching the intersection of Sunset Blvd SW,
Unit 1 had a solid green light and was attempting to make a left turn to travel east bound on Sunset
Blvd SW.
Unit 2 was traveling northbound on Hardie Ave SW approaching the intersection of Sunset Blvd SW,
Unit 2 had a solid green light and was attempting to travel northbound on Hardie Ave SW.
Unit 1 failed to yield to Unit 2 while making their left turn, this resulted in the two vehicles colliding.
Unit 1's front bumper collided with the driver's side bumper of Unit 2. Both vehicles were not driveable
and towed by Bankers towing. The driver of Unit 1 had leg pain, front passenger of unit 1 had chest
pain. The driver of Unit 2 stated that they had general pain all over their body. All invovled were
checked out by the fire department.
The driver of Unit 1 did not have insurance on the vehicle and only had an Identification card.
The driver of Unit 1 was cited for No Insurance and Failure to Yield.
I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT.
JASON TURNER 05-23-24 08:46 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
DESIRES SCOTT 10272 1 5/26/2024 9:46:21 AM
BADGE OR ID# 12650 OR]# WA0171300 TIME POLICE DISPATCHED 6:50 PM TIME POLICE ARRIVED 6:54 PM
PART Ei PAGE IT]OF
REPORT NO. EE80523 CASE# ' 24-5484 DATE AND TIME 05/23/24 18:47
OF COLLISION
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