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HomeMy WebLinkAbout24-6030 POLICETRAFF'c" III !�� I IIIllI111IN II II I REPORT NO. EE91676 170
27
COLLISION REP FIT 1591971
CASE 24-6030 z
INTERSTATE ❑ CITY STREET FIRE ❑RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHIC;I F ❑ LOCAL AOENC 4150 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 TOTAL#TRIBAL OF OZ OBJECT 1 1 8 28
UNITS
RESERVATION I I
STRUCK
z
3❑ DATE of M M D D Y Y Y Y TIME(2400) COUNTY# MILES N E IN CITY# ❑
cawsloN 06 - 1-- 2024 1548 17 ❑.= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓
TALBOT RD S BLOCK NO. e✓ 3800
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ ❑ FEET e S ❑ W e 1 2 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
NO F,/ I D:3109820225 0 11
30
6❑ LAST NAME MEHERALLY FIRSTNAME NAHID MIDDLE S 1 1 2 31
INITIAL
STREET 01 717 S 26TH P! TON WA
NEW ADDRESS ST zlp', 98055 2 CITY REN
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
1/ I iNTERLOCKYEs NO NTERLOCKYEs NO�/ YES R No�/
8❑ LDRIVER # STATE WA SEX'F MID
.O B 08 1— 14 — 1955 2 32
9 ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 HELMET
2 CLASS 1 NATURE OF INJURIES z❑
3
10 9❑ P1 aTES� BRW4069 sTArI WAVIN# 5NMS5CAA2LH163482
TRAILER STATE TRAILER STATE
11 0 0 PLATE# PLATE# FROM TO
TRLR. TRLR 7 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 4 2020 HYUN SONATA SD DAMAGE YES YES[:] NO
❑
REGISTERED OWNER INFO OWNEDBYDRIVER VEHICLE NO. 1
SHADE IN DAMAGED AREA ❑ 35
14� LIABILI INSURANCE INSURANCE GO ALLSTATE 807 820 524 3 4
IN EFFECT &POLICY# 9TOP
EEGALLYrIICLE Yes CHARGE 5 36
L ❑NO❑ CITATION# 1 o BOTTOM
15❑ v STANDING 8 7 6
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT 02 VEHICLE ❑ CYCLE ❑ ❑ OWNER [:]EA.
YES 1/ NO D:2063071604
16 a
LAST NAME LEFT FIRST NAME CHRISTOPHER MIDDLE C
INITIAL
17 NEW STREETREs7' 537 UNION AVE NE CITY RENTON ST WA ZIP 98059 37
18� CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 38
INTERLOCK YEs❑NO� INTERLOCK YEs I I NOF YEs t l NOF,/
19 LDI IVE STATE WA SEX M M D.O.B. 09 _ 13 _ 1985 39
20 ON DUTY STATUS AIRBAG,6 RESTR 4 EJECT 1 H EET 2 NJAU SY 7 [NATURE OF INJURIES MINOR CUTS ON RIGHT HAND 40
❑21❑ PLATE# BYS9654 TArE WA VIN 41
ML32A3HJ9KH015060 1
42
22❑ PILER LATE# STATE PLATE# STATE
23❑ 43
TRLR RLR
VIN#. IN#.
TOWED eY Gov HI 44
VEH YEAR 2019 MAKE �lijJ'j-$ MODEL MIRAGE STYLE $D DAMAGE TOWED✓ NOO BLIN BANKERS YES NO�/
24❑ REGISTERED OWNER INFO OWNED SY DRIVER VEHICLE N0.2
SHADE IN DAMAGEbAREA
2 3 Cd
LIABILITY
INSURANCE &POINSURGY#E CO STATE FARM 448 2829-FOI-47A
IN ®TOP
VEHICLE ❑ ,.I—I CITATION# CHARGE
25 i o BOTTOM
LEGALLY YES N
s a
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
26
MICAH BATTLE 12049 WA0171300
PAGE 01 OF
PART A
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EE91676
COLLISION REPORT III III III III III 111
1591972 CASE# 24-6030
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'
Unit 1 was identified as Nahid S. Meherally (8/14/55) who was driving WA-BRW4069.
Unit 2 was identified as Christopher C. feet (9/13/85) who was driving WA-BYS9654.
Unit 1 stated she was at the stop sign preparing to enter Talbot Rd S from S 38th ST. turned left onto
Talbot Rd S when she struck Unit 2 with her front end.
Unit 2 stated he was traveling northbound on Talbot Rd S when he was suddenly struck on his rear
passenger side. He stated he over corrected and in combination of being struck and overturning he
flipped his compact car onto its roof.
I observed substantial damage to Unit 2 roof and windshield, 1 also observed paint transfer marks on
the rear passenger quarter panel of Unit 2. Unit 2's vehicle was towed by Banker's towing. Unit 1 had
minor damage to their front end.
Unit 2 had minor cuts on his right hand, he was medically evaluated by the Renton Fire Authority and
transported to Valley Medical Hospital as a precaution.
I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT.
MICAH BATTLE 06-08-24 08:33 AM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
G.BARFIELD 6476 1 71112024 8:21:16 AM
BADGE OR ID# 12049 ORI# i WA0171300 TIME POLICE DISPATCHED; 3:49 PM TIME POLICE ARRIVED',3:53 PM
PART I PAGE IT]OF
REPORT NO. EE91676 CASE# ' 24-6030 DATE AND TIME 06/07/24 15:48
OF COLLISION
*Not drawn to scale
co
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