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HomeMy WebLinkAbout24-6392 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 0 27c
COLLISION REP FIT 1591971
CASE 24-6392 z
INTERSTATE ❑ CITY STREET FIRE ❑RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHIl.I F ❑ LOCAL AOENC 4Y00 3
HIT 8 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#
COLLISION'. 06 - 18 - 2024 0836 17 ❑-= S 8 IN e 1070 3
4❑ oN (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
BLOCK NO. e✓ --- ----� ❑
S 132ND ST MILEPOST
4a❑
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ ❑ FEET e S ❑ W e RENTON AVE S
0 4 29
MOTOR PEDAL- DAMAGE THRESHOLDHONE
UNIT 01 VEHICLE ❑ CYCLE El MET P
YES
�/No D:2539510175 0 11
30
6� LAST NAME GARZA FIRSTNAME JAYDEN MIDDLE M 1 1 2 31
INITIAL
STREET ❑ 1400 LAKE WASHINGTON BLVD N CITy RENTON ST WA ZIP' 980562599 z
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 HELMET
2 CLASS 1 NATURE OF INJURIES z❑
3
10 9❑ PI ATE CNB1475 sTArI WAurN#' JT8BF12G1T0165890
IT STATE TRAILER STATE
11 0 0 PLATE# PLATE# ROM TO
rRLR TRLR 3 5 33
12 0 0 VIN#' VIN#
;. FROM TO
VEH.YEAR 1996 MAKE LEXS MODEL ES STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE 7 $ 34
13 3 DAMAGE YES NO YES[:] NO✓
REGISTERED OWNER INFO ,JAYDEN GA.1400 LAKE WASHINGTON BLVD N A RENTON WA 98056 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
14 LIABILITYINSURANCE INSURANCE CO PATRIOT INSURANCE 114 094 869 29 3
IN EFFECT &POLICY# 9TOP
vewcLE CHARGE 5 36
LECALLv YES❑NO❑ CITATION# 10 BOTTOM
15❑ STANDING 8 7 6UNIT
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES 1/ No D:4252745108
16 a
LAST NAME PIRIS FIRST NAME CHRISTOPHER MIDDLE I J
INITIAL
17❑ STREET ❑', 11302 205TH AVE E CITY BONNEY LAKE ST WA ZIP 983917718 37
NEW ADDRESS ❑
18� CDL IGNITION REQUIRED IGNITION PtR—E—S1ENT MEDICAL TRANSPORTED ❑ 38
INTERLOCKYES�NOR INTERLOCK YEs I I NOF YEs t l NO❑
19 DRIVER'S STATE WA SEX M D.O.B. 10 _ 26 _ 1978 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 B34750Y TAre WA VIN# 4TAVL52N9WZ174328
❑ 41
PLATE#
42
22❑ PLATE# STATE PLATE# STATE
23❑ 43
TRLR 'I RLR
UIN#. N#.
VEH YEAR 1998 MAKE TOYT MODEL TACOMA STYLE VEHICLETOWED TO BLIN TOWEDBY GOV HI �44
24❑ DAMAGE YES NO YES NO
REGISTERED OWNER INFO DESIGN WEST MANAGEMENT LLC 2900 S KING ST APT B SEATTLEWA98144 VEHICLE NO.2
SHADEDAMAGEDAREA
3 4
LIABILITY
INSURANCE INSU8 PORGY#E CO TRAVELERS BA-9172L636-24-SELIN STOP 5
VE""LE ❑ ,J CITATION# CHARGE io BOTTOM
LEGALLY YES Nu
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. EE89712
COLLISION REPORT III III III III III 111
1591972 CASE# 24-6392
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 June 18, 2024 at 0836 hours dispatch requested that I respond to a collision at Renton Ave S and
S 132nd St, in Renton.
Upon my arrival I spoke with the driver of unit 2 and he explained that he was going eastbound on S
132nd St. As he approached Renton Ave S, he witnessed unit 1 make a left turn Renton Ave S to S
132nd St. Unit 1 made a left turn without yielding, causing unit 2 to strike unit 1's rear right wheel.
Unit 2 sustained moderate damage and needed to be towed away by Bankers Towing.
I then spoke with the driver of unit 1 and he explained he made a left turn in front of unit 2. He said he
was going westbound on Renton Ave S and attempted to make a left turn onto S 132nd St. He said it
was his fault.
An exchange of information was given to both drivers.
I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT.
C.CATALAN 06-18-24 10:49 AM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
C.JACOBS 1953 1 6/24/2024 12:17:26 PM
BADGE OR ID# 1Y007 OR]#' ' WA0171300 TIME POLICE DISPATCHED! 8:41 AM TIME POLICE ARRIVED',9:02 AM
PART I PAGE IT]OF 3�
REPORT NO. EE89712 CASE# 24-6392 DATE AND TIME 06/18/24 08:36
OF COLLISION
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