HomeMy WebLinkAbout24-5766 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 1 27c COLLISION REP FIT 1591971 SASE 24-5766 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 5 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 1547 17 ❑-= S 8 IN e 1070 3 4❑ oN (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑ BRONSON WAY BLOCK NO. e✓ --- ----� ❑ 4a❑ MILEPOST DISTANCE OF(REFERENCE OR CROSS STREET) 5❑ ❑ FEET e S ❑ VV a MAIN AVE S 1 2 29 MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE UNIT 01 VEHICLE ❑ CYCLE El ✓NO D:9852860079 0 11 30 6 LAST NAME SOLORIO FIRSTNAME JULIE MIDDLE B 1 1 2 31 INITIAL STREET ❑ 615 27TH ST CITY HOQUTAM WA NEW ADDRESS ST 2jp 985504104 z 7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3 iNTERLOCKYEs NO INTERLOCKYEs NO YEs NO 8❑ LRIIVER # ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 HELMET USE 2 CLASS 1 NATURE OF INJURIES 2❑ 3 10❑ P1 aT�S� CDW5351 sTArI WAvIN# 1C4PJMBXOKD131244 TRAILER STATE TRAILER STATE 11 0 0 PLATE# PLATE# FR.. ro TRLR. A'RLR. 1 5 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 2019 JEEP CHERO DAMAGE YES NO YES❑ NO✓ REGISTERED OWNER INFO JULIE SOLORIO 61527TH ST HOQUTAM WA 985504104 VEHICLE NO. 1 ❑ SHADE IN DAMAGED AREA 35 14 LIABILITY INSURANCE INSURANCE CO NATIONAL GENERAL 2023047687 IN EFFECT &POLICY#POLICY 9TOP CHA VEwcLE RGE 5 35 LECALLv res❑NO❑ CITATION# 1 o BOTTOM ❑ STANDING 15 8 6 MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE UNIT VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YEs No ,/ D:206445270 16 a 5 LAST NAME PHOUSOUVANH FIRST NAME SOUPHY MIDDLE N INITIAL 17❑ STREET ❑', 1221 LYONS AVE NE CITY' RENTON ST WA ZIP 980596041 37 NEW ADDRESS ❑ 18� CDL IGNITION REQUIRED IGNITION PtR—E—S1ENT MEDICAL TRANSPORTED ❑ 38 INTERLOCKYES�NOR INTERLOCK Y�EsI I I NOF YES t l NO❑ 19 DRIVER'S STATE WA SEX M D.C.B. 03 _ 25 _ 1979 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 I C27334G TAre WA YIN# 1FTNX21S8YEE31780 ❑ 41 PLATE# 42 22❑ PLATE# STATE TILER PLATE# STATE 23❑ UIN#. 43 TRLR RLR 'IN#. VEH YEAR 2000 MAKE FORD MODEL F250 STYLE UT VEHICLETOWED TO BLIN TOWEDBY GOV HI 44 L4❑ DAMAGE YES NO YES NO REGISTERED OWNER INFO SOUPHYPHOUSOUVANH 1221 LYONS AVE NE RENTON WA 980596041 VEHICLE NO.2 SHADEDAMAGEDAREA 3 4 LIABILITY INSURANCE INSU8 PORGY#E CO AMERICAN FAMILY INSURANCE BX10075666 STOP 5 IN EFFECT0( 'E""LE ❑ ,J� CITATION# CHARGE io BOTTOM LEGALLY YES N`L J 25 ' a 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. EE83102 COLLISION REPORT III III III III III 111 1591972 CASE# 24-5766 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 31, 2024, at 1547 hours dispatch requested that I respond to a collision at the intersection of Main Ave S and S 2nd St, in Renton. Upon my arrival I spoke with the driver of unit 2 and he explained that while driving southbound on Main Ave S from S 2nd St, the vehicle beside him slowly began to merge into his lane. His wheels began to rub against the passenger side door of unit 1. Eventually he slowed his vehicle down, but unit 2 swung in front of his vehicle. I then spoke with the driver of unit 1 and she explained that her vehicle struck unit 2 damaging her passenger side doors. The driver of unit 2 was unsure on how the collision occurred, but both vehicles sustained moderate damage. I provided the two drivers with 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 05:18 PM INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED APPROVED BY DATE C.JACOBS 1953 1 6/3/2024 11:06:34 AM BADGE OR ID# 1Y007 ORI# WA0171300 TIME POLICE DISPATCHED 4:08 Pry TIME POLICE ARRIVED 4:08 Pry PART I PAGE IT]OF 3� REPORT NO. EE83102 CASE# 24-5766 DATE AND TIME 05/31/2415:47 OF COLLISION i r, s k i PAGE 3 OF 3