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HomeMy WebLinkAbout24-6235 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 1 27c
COLLISION REP FIT 1591971
INTERSTATE ❑ CITY STREET ❑ FIRE ❑
CASE#r` 24-6235 2
RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHIC;I F ❑ LOCAL AGENC 4200 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 TOTAL#TRIBAL OF OZ OBJECT 1 1 8 28
UNITS
RESERVATION I I
STRUCK
2
3❑ DATE OF M M D D Y Y Y Y TIME(2400) COUNTY# MILES N E IN CITY# ❑
COLLISION'. 06 - 1-- 2024 1709 17 ❑.= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓
715 N LANDING WAY
BLOCK NO. e✓ --- ----�
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5 100 00 FEET MILES e S ❑ W e LOGAN AVE N
0 1 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
✓NO D:2066986180 1 51
30
6� LAST NAME PALESTINO FIRSTNAME JAVIER MIDDLE 1 2 31
INITIAL
STREET ❑, 15040 MACADAM RD S APT F1 CITY TUKWILA ST WA 2jp, 98188 2
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
1/ I iNTERLOCKYEs NO NTERLOCKYEs NO�/ YES R No�/
8❑ LRIIVER #
ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 HELMETU E 2 CLASS 1 NATURE OF INJURIES 2❑
3
10 9❑ Pi aT�S� CGY0624 sTAr1 WAvIN# 1N46t4CW8PN343343
TRAILER STATE TRAILER STATE
11 0 0 PLATE# PLATE# FROM TO
TRLR. TRLR 7 3 33
12 0 0 VIN#' VIN#
>; FROM TO
VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE 7 O 34
13 2 2023 NISS ALTIMA SD DAMAGE YES NO YES[:] NO✓
REGISTERED OWNER INFO OWNEDBYDRIVER VEHICLE NO. 1
SHADE IN DAMAGED AREA ❑ 35
14 LIABILITY INSURANCE INSURANCE CO ALLSTATE 820309594 3 4
IN EFFECT &POLICY# 9TOP
VE"'CLE CHARGE 5 36
LEGALLY YES❑NO❑ CITATION# BOTTOM
15❑ STANDING 8
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT VEHICLE ❑ CYCLE ❑ ❑ : OWNER ❑ YES 1/ NO D:8175013073
16 2
LAST NAME AKINBORO FIRST NAME AKINBOBOLA MIDDLE /
INITIAL
17❑ STREET NEW ADDREs7 9308 57TH AVE S CITY SEATTLE ST WA ZIP 98118 37
18� CDL IGNITION REQUIRED IGNITION PRESENT MEDICALTRANSPORTED 38
INERLOCKYEs❑No� INTERLOCK YEsF-j No� YES
NDF
19 D IVERI # STATE WA SEX M MMDDYY 02 _ 04 1993 39
20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 H U EET 2 NJAURSY 1 NATURE OF INJURIES 40
LICENSE ❑21❑ PLA E# CKV9451 TArE WA VIN# 41
SALWR2RUOKA868216 1
42
22❑ PLATE# STATE TILER PLATE# STATE
TRLR
23❑ VIN#. IN#. 43
RLR
'
VEH YEAR 2019 MAKE LRV MODEL RANG STYLE SD VEHICLETOWED TO BLIN TOWEDBY GOV HI 44
24❑ DAMAGE YES NO YES NO
REGISTERED OWNER INFO AKINBOBOLA AKINBORO 930857TH AVE S SEATTLE WA 98118 D:8175013073 VEHICLE NO.2
SHADE IN DAMAGEbAREA
2 3 Cd
LIABILITY
INSURANCE INSU&PORGY#E CO PROGRESSIVE 942523644IN I STOP
VEHICLE ❑ C[ CITATION# CHARGE i o BOTTOM
LEGALLY YES N
25 s a
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# JAGENCY
26
KEV/N PETERSON 12808 WA0171300
PAGE 01 OF
PART A
3000-345-159 fR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EE92201
COLLISION REPORT III III III III III 111
1591972 CASE# 24-6235
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'
I was dispatched to a collision on 06/13/24 at 1715 hours at 715 N Landing Way , in city Renton, King
County WA.
Unit 1 CGY0624 Driver: Javier Palestino (DOB 02/18/2004)
Unit 2 CKV9451 Driver: Akinbobola L. Akinboro (02/04/1993)
Unit 2 stated he was driving North on N Landing Way when he slightly turned left to back into a
parking stall at LA Fitness. As he went to back into the parking space Unit 1 then drove around the
back of his vehicle and the parking stall and both vehicles collided. Unit 1 stated they both were
traveling North on N Landing Way when Unit 2 appeared to be pulling into a parking spot in one of the
West side of N Landing way. Unit 1 then pulled to the back side of Unit 2 to go around him, and Unit 2
backed into the driver side of the vehicle.
I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT.
KEVIN PETERSON 06-14-24 12:56 AM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
P.SUMMERS 888 1 71212024 4:47.03 PM
BADGE OR ID# ! 9Y808 ORI#' WA0171300 TIME POLICE DISPATCHED 5:15 PM TIME POLICE ARRIVED 5:21 PM
PART I PAGE IT]OF 3�
REPORT NO. EE92201 CASE# ' 24-6235 DATE AND TIME 06/13/24 17:09
OF COLLISION
� 4
Unit 1
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