HomeMy WebLinkAbout25-299 a POLICETRAFFic" II I f I) 11I1ll(111(111l If( f 11 REPORT NO. EF58436 170
27
COLLISION REP FIT 1591971
❑ ❑ RESULTED ❑ CASE zs-zss 2
INTERSTATE CITY STREET FIRE
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHIl.I F ❑ LOCAL AOENC 4200 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 5 TOTAL#OF OBJECT 1 1 8 28
TRIBAL UNITS 02 RESERVATION STRUCK
2
3❑ DATE of M M D D Y Y Y Y TIME(2400) COUNTY# MILES CITY#
Ct ELISION' 01 - 09 - 2025 1421 17 . N E IN� S 8 W H OF e 1070 3
4❑ oN (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
BLOCK NO. e✓ --- ----� ❑
L1ND AVE SW MILEPOST
4a❑
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ ❑ FEET e S ❑ W e SW 43RD ST
2 0 29
MOTOR PEDAL- DAMAGE THRESHOLDHONE
UNIT 01 VEHICLE ❑ CYCLE El MET P
YES
�/No D:6822563759 0 11
30
6� LAST NAME AZIZ FIRSTNAME ZOHRA MIDDLE N 1 2 31
INITIAL
STREET ❑ 22416 88TH AVE S APT G205 CITY KENT ST WA Zjp, 980311844 2
NEW ADDRESS
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 H USEET ICNLJAURY 1 NATURE OF INJURIES 2❑
3
10[1 P1 ATE 14 HAMZA sTAT WAu N#' JTJHY7AXOK4292127
5 TRAILER STATE TRAILER STATE
11
3-LATE# PLATE# FROM ro
TRLR. TRLR 5 1 33
12 3 5 VIN#' VIN#
>; FROM TO
VEH.YEAR 2019 MAKE LEXS MODEL LX STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE 5 1 34
13 2 DAMAGE YES NO YES[:] No
✓
REGISTERED OWNER INFO ZOHRA AZIZ 2241688TH AVE S APT G205 KENT WA 980311844 D:6822563759 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
14 LIABILITY INSURANCE INSURANCE CO GEICO 6076-39.74.02 3 4
IN EFFECT &POLICY# 9TOP
vewcLe CHARGE 1 5 36
EGHALLY YES❑NO❑ CITATION# 5AO151247 IMPROPER LANE USAGE o eorrom
15❑ STANDING 7 6
MOTOR PEDAL- pROpERTY DAM THR OLD MET PHONE
UNIT 02 VEHICLE CYCLE ❑ PEDESTRIAN ❑ OWNER ❑ YES 1/ No D:2533478309
16 a
LAST NAME BRATCHER FIRST NAME CRESENCIA MIDDLE I S
INITIAL
17❑ STREET ❑', 730 ELLINGSON RD CITY PACIFIC ST WA ZIP 980471257 37
NEW ADDRESS ❑
18� CDL IGNITION REQUIRED IGNITION PR-E-1SENT MEDICAL TRANSPORTED ❑ 38
INTERLOCKYES�NOR INTERLOCK vEs It I NOF YES
t t- l NO❑
19 DRIVER #
INJURY1 NATURE OF INJURIES 40
20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 USE CLASS ❑
21❑ LICENSE BUZ7746 TATE WA VIN# 2HGEJ6612YH502894
❑ 41
PLATE#
42
22❑ PLATE# STATE PLATE# STATE
TRLR
23❑ UIN#. N#.
43
RLR
'I
VEH YEAR 2000 MAKE HOND MODEL CIVIC STYLE VEHICLETOWED TO BLIN TOWEDBY GOV HI 44
L4❑ DAMAGE YES NO YES NO
REGISTERED OWNER INFO CRESENCIA BRATCHER 730 ELLINGSON RD PACIFIC WA 980471257 D:2533478309 VEHICLE NO.2
SHADE DAGED AREA
4
LIABILITY
INSURANCE INSU&PORGY#E CO FARMERS 187784381IN IGQI
'E""LE ❑ ,J� CITATION# CHARGE
LEGALLY YES N`L J
25
OFFICER'S NAME(PRINT) 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. EF58436
COLLISION REPORT III III III III III 111
1591972 CASE# 25-299
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
PM 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'
Please see subsequent narrative pages
I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT.
M.LEVERTON 01-10-25 01:59 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY E
DAT
C.JACOBS 1953 112212025 11:09:13 AM
BADGE OR ID# 2517 OR]#' WA0171300 TIME POLICE DISPATCHED! 2:22 Pry TIME POLICE ARRIVED',2:26 PM
PART I PAGE IT]OF 4�
REPORT NO. EF58436 CASE# 25_299 O OFF CbLL COLLOTINIEI510N 01/09/25 14:21
NARRATIVE
blu/2 lane 2 blk/1 lane one lane change for tanker
CC
Within the city limits of Renton/King/Wa I responded to a 2 vehicle blocking crash near the
intersection of SW 43rd St at Lind Ave SW.
I contacted the driver of unit 2 who told me she was in lane 2 southbound when unit 1 crossed into
her lane contacting her vehicle. She did not complain of injury and damages did not require a tow
truck.
I contacted the driver of unit 1 ID'd by her matching picture WADL. She told me she was going to
make a lane change to go around a blocking semi truck and thought it was clear to change lanes from
southbound lane 1 into lane 2. However, it was occupied by unit 2 and unit 1 made contact with unit
2. She did not complain of injury and damages did not require a tow truck.
I cited unit 1 ref RCW 46.61.140 Improper lane use 2 vehicle crash/non injury 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 1/10/2025
PAGE 3 OF 4
REPORT NO. EF58436 CASE# ' 25-299 DATE AND TIME 01/09/25 14:21
OF COLLISION
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PAGE 4 OF 4