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HomeMy WebLinkAbout24-5569 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 0 27c
COLLISION REP FIT 1591971
SASE 24-5569 2
INTERSTATE ❑ CITY STREET FIRE ❑
RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHICI F ❑ LOCAL AOENC 4200 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# ❑
COLLISION'. 05 - 1-— 2024 1113 17 ❑.= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓
SW GRADY WAY BLOCK NO. e✓ 300
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5 MILES❑ ❑ FEET e S ❑ W e MAPLE AVE SW
0 4 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
✓NO D:2066180422 0 11
30
6� LAST NAME LUNA-COVARRUBIAS FIRSTNAME CAROLINA MIDDLE 1 2 31
INITIAL
STREET ❑, 2057 S 116TH ST CITY SEATTLE ST WA 21p, 98168 z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED I IGNITION PRESENT MEDICAL TRANSPORTED 3
iNTERLOCKYEs NO INTERLOCKYEs NO YEs NO
8❑ LRIIVER #
ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 H USEET 2 CLASS 1 NATURE OF INJURIES z❑
3
,OF
Pi ATNES# BZL8643 sTAr WAv N# 7FARW2H70ME020389
TRAILER STATE TRAILER STATE
11 0 0 PLATE# PLATE# FROM TO
TRLR. TRLR 7 1 33
12 0 0 VIN#' VIN#'
>; FROM TO
VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE 3 7 34
13 r 2021 HOND CRV UT DAMAGE YES NO YES[:] No✓
REGISTERED OWNER INFO CAROLINA LUNA-COVARRUBIAS 2057 S 116TH ST SEATTLE WA 98168 D:2066180422 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
14 LIABILI INSURANCE INSURANCE CO SAFECO H2486079 3 4
IN EFFECT &POLICY# 9TOP
VEHICLE 5 36
LEGALLv res❑NO❑ CITATION# CHARGE 1 o BOTTOM
15❑ STANDING 8 7 6
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT VEHICLE ❑ CYCLE ❑ ❑
16 a : OWNER ❑ YES 1/ NO D:3124783848
LAST NAME RENGE CASTILLO FIRST NAME VALERIA MIDDLE p
INITIAL
17❑ STREET ❑', 1133 LAKE WASHINGTON BLVD N E309 CITY RENTON ST WA ZIP 98056 37
NEW ADDRESS ❑
18� CDL IGNITION REQUIRED IGNITION PtR—E—S1ENT MEDICAL TRANSPORTED 38
INTERLOCKYES�NOR INTERLOCK YEs I I NOF YEs t l NO❑
19 DRIVER'S STATE IL ]SEX IF I D.C.B. 03 _ 10 _ 2024 39
LICENSE# MMDDYY
HELMET {NJURY 1 NATURE OF INJURIES 40
20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT '1 USE 2 CLASS ❑
21❑ LICENSE EL55320 TAre 41
IL vIN1t USE
❑
PLATE#
42
22❑ PLATE# STATE PLATE# STATE
23❑ UIN#. 43
TRLR RLR
'IN#.
VEH YEAR 2015 MAKE TOYT MODEL PRIUS STYLE 4H VEHICLETOWED TO BLIN TOWEDBY GOV HI 44
L4❑ DAMAGE YES NO YES NO
REGISTERED OWNER INFO VALERIA RENGE CASTILLO 5600 N SHERIDAN RD CHICAGO 1L 60660 D:3124783848 VEHICLE NO.2
SHADEDAMAGEDAREA
3 4
INAEFFITY ECTNSURANCE❑ &POINSULICY#E CO 9TOP 5
VE""LE ❑ ,J� CITATION# CHARGE to BOTTOM
LEGALLY YES N J
25 e
7CA
NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
26LAN 12007 WA0171300
PART A PAGE 01 OF
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EE83095
COLLISION REPORT III III III III III 111
1591972 CASE# 24-5569
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 29, 2024, at 1113 hours dispatch requested that I respond to a collision at the intersection of
Maple Ave SW and SW Grady Way, in the city of Renton, county of King, and state of Washington.
Upon my arrival I spoke with the driver of unit 2. The driver explained that while going westbound on
SW Grady Way she observed unit 1 make a left turn from the eastbound center turn lane. She
believes that unit 1 failed to notice her vehicle because the other driver decided to cross the
westbound lanes as she approached the intersection. When unit 1 crossed westbound lanes, she
was unable to slow her vehicle down. Unit 2 struck unit 1 passenger side front bumper.
I then spoke with the driver unit 1 and she explained a similar story. She was in the eastbound center
turn lane attempting to make a left turn into Walmart when the collision occurred. She explained there
was heavy traffic going westbound, butt one vehicle in the number 2 westbound lane created a gap
for her to cross. She decided cross but failed to notice unit 2 driving in lane one. As she entered lane
one, she was struck by unit 2 who was going westbound on southwest Grady way.
After speaking with involved drivers, 1 provided them with an exchange of information.
No one complained of any injuries, and no vehicles were towed from the scene.
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 08:53 AM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
C.JACOBS 1953 1 6/3/2024 11:11:03 AM
BADGE OR ID# 12007 ORI# WA0171300 TIME POLICE DISPATCHED 11:19 AM TIME POLICE ARRIVED;11:21 AM
PART I PAGE IT]OF 3�
REPORT NO. EE83095 CASE# ' 24-5569 DATE AND TIME 05/29/24 11:13
OF COLLISION
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