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HomeMy WebLinkAbout24-5664 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 0 27c COLLISION REP FIT 1591971 SASE 24-5664 2 INTERSTATE ❑ CITY STREET FIRE ❑ RESULTED 1 STOLEN STATE ROUTE ❑ OTHER ❑ VFHIr.I F ❑ LOCAL AOENC 4Y00 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 0825 17 ❑.= S 8 IN e 1070 3 4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓ SUNSET BLVD N BLOCK NO. e✓ 352 4a❑ MILEPOST DISTANCE OF(REFERENCE OR CROSS STREET) 5❑ ❑ FEET e S ❑ W e 0 4 29 MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE UNIT 01 VEHICLE ❑ CYCLE El ,/No D:4253996678 0 11 30 6� LAST NAME URIBE FIRSTNAME ELISEO MIDDLE 1 2 31 INITIAL STREET ❑ 703 S 17TH ST TON WA NEW ADDRESS ST zIP', 98055 2 CITY REN 7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3 INTERLOCK YES[:]NO INTERLOCKYEs NO YES R NO 8❑ LRIIVER # ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 HELMET 2 CLASS 1 NATURE OF INJURIES z❑ 3 10 9❑ Pi aT�S� BV60189 sTArI WAurN# NMOtS7E27L1438486 TRAILER STATE TRAILERSTATE FROM ro 11 0 0 PLATE# PLATE# TRLR. TRLR 3 5 33 12 0 0 VIN#' VIN# >; FROM TO VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED By GOVT.VEHICLE 5 1 34 13 2 2020 FORD TRANSI VN DAMAGE YES NO YES[:] No✓ REGISTERED OWNER INFO OWNEDBYDRIVER VEHICLE NO. 1 SHADE IN DAMAGED AREA ❑ 35 14 LIABILITY INSURANCE INSURANCE CO PROGRESSIVE 01044615.1 <�3 4 LI EFFECT I SUR N#VEHCLE CHARGE 36 LEGALLY YES❑NO❑ CITATION# TTOM 15❑ STANDING 6 MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE UNIT VEHICLE ❑ CYCLE ❑ ❑ : OWNER ❑ YES 1/ NO D:5098592283 16 a LAST NAME SPAHN FIRST NAME COLTON MIDDLE lH INITIAL 17❑ STREET ❑', 286 SWIGERT RD CITY' MOSSYROCK ST WA ZIP 98564 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[—] LICENSE# STATE WA SEX M M D.C.B. 09 _ 24 1985 39 HELMET {NJURY 1 NATURE OF INJURIES 40 20❑ ON DUTY STATUS AIRBAG 6 RESTR 4 EJECT 1 USE 2 CLASS ❑ 21❑ LICENSE I CEF7803 TAre WA VIN1t 3W887AX1NM115181 ❑ 41 PLATE# 42 22❑ PILER LATE# STATE PLATE# STATE 23❑ VIN#. 43 TRLR RLR 'IN#. GoI VEH YEAR 2022 MAKE VOLK MODEL TIGUAN S STYLE UT DEHICLE AMAGE TOWED NOO✓ BLIN TOWED BY vHyES NO 44 24❑ ES REGISTERED OWNER INFO OWNED SY DRIVER VEHICLE N0.2 SHADE DAGED AREA 4 LIABILITY INSURANCE INSU PORGY#ECO ALLSTATE820476299IN CQl VE""LE ❑ ,J� CITATION# CHARGE to LEGALLY YES N`L J 25 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. EE83096 COLLISION REPORT III III III III III 111 1591972 CASE# 24-5664 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 0825 hours dispatch requested that I respond to a collision that occurred at 404 Sunset Blvd N, in the city of Renton, county of King, and state of Washington. Upon my arrival I spoke with the driver of unit 1 and he explained he was exiting the parking lot of Miller Paint when the collision occurred. Traffic was heavy and people in lanes 1 and 2 made a gap for him to proceed. As he crossed the road, he failed to clear the 3rd lane where unit 2 was driving northbound. Unit 1 struck unit 2's right passenger doors. This caused unit 2 to deploy a combination of airbags. I then spoke with the driver of unit 2 and he mentioned a similar story. He was driving northbound on Sunset Blvd N when he was struck by unit 1 on his driver's side door. Unit 2 was in the number 3 lane, when unit 2 crossed and struck his vehicle. I provided both drivers with an exchange of information and unit 2 was removed from the location by Gene Meyers Towing. I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT. C.CATALAN 05-29-24 10:49 AM INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED APPROVED BY DATE C.JACOBS 1953 1 6/3/2024 11:17:46 AM BADGE OR ID# 1Y007 ORI# WA0171300 TIME POLICE DISPATCHED 8:29 AM TIME POLICE ARRIVED:8:43 AM PART I PAGE IT]OF 3� REPORT NO. EE83096 CASE# 24-5664 DATE AND TIME 05/29/24 08:25 OF COLLISION � w 4 w � �rr y b <s r w y 4; n. Y Y PAGE 3 OF 3