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HomeMy WebLinkAbout24-6477 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 0 27c COLLISION REP FIT 1591971 CASE 24-6477 z 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 1 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# ❑ cawsloN 06 - 1-- 2024 0623 17 ❑.❑ S 8 W e IN e 1070 3 4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓ BENSON DR S BLOCK NO. e✓ 3000 4a❑ MILEPOST DISTANCE OF(REFERENCE OR CROSS STREET) 5❑ 900 00 FEET MILES e S B W e SE 172ND ST 0 1 29 MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE UNIT 01 VEHICLE ❑ CYCLE El ✓NO D:2064260927 0 7 30 6� LAST NAME SCHMIDT FIRSTNAME NICHOLAS MIDDLE R 1 1 2 31 INITIAL STREET ❑ 33050 38TH AVE S CITY FEDERAL WAY ST WA 2jp, 980019666 z= NEW ADDRESS 7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3 iNTERLOCKYEs NO INTERLOCKYEs NO YES R NO 8❑ LRIIVER # ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 H U SE ICNLJAUSSY 1 NATURE OF INJURIES z❑ 3 10 9❑ P1 aT�S� BTY4660 sTArI WAvIN# 1GNDT13W5Y2110368 TRAILER STATE TRAILER STATE 11 4 0 PLATE# PLATE# ROM ro TRLR. YRLR. 5 1 33 12 0 0 VIN#' VIN# >; FROM TO VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN T /g[ GOVT.VEHICLE J 9 34 13 2000 CHEV BLAZER DAMAGE YES NO � '` RS YES❑ No✓ REGISTERED OWNER INFO NICHOLASSCHMIDT 3305038TH AVE S FEDERAL WAY WA 980019666 D:2064260927 VEHICLE NO. 1 ❑ SHADE IN DAMAGED AREA 35 14 LIABILI INSURANCE INSURANCE CO GEICO 4563-25.87.99 4 IN EFFECT &POLICY# TOPVEHCLE CHARGE 36 LEGALLY YES❑NO❑ CITATION# <1�3 OTTOM 15❑ STANDING 7 6 MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE UNIT VEHICLE ❑ CYCLE ❑ ❑ : OWNER ❑ YES 1/ NO D:2539516391 16 2 LAST NAME CISNEROS MARTINEZ FIRST NAME ANTONIO MIDDLE N INITIAL 17❑ STREET ❑', 13904 SE 200TH STREET CITY KENT ST WA ZIP 980420000 37 NEW ADDRESS ❑ 18� CDL IGNITION REQUIRED IGNITION PR—E-1SENT MEDICAL TRANSPORTED 38 INTERLOCKYES�NOR INTERLOCK YEs It I NOF YES t t— l NO❑ 19 DRIVER'S STATE WA SEX M D.C.B. O6 _ 25 _ 1977 0 39 LICENSE# MMDDYY WELMET INJURY1 NATURE OF INJURIES 40 20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 USE CLASS ❑ 21❑ LICENSE I CGT5794 TAre WA VIN1t JN8AT2MV7GW137896 ❑ 41 PLATE# 42 22❑ PLATE# STATE PLATE# STATE 23❑ VIN#. 43 TRLR RLR 'IN#. VEH YEAR 2016 MAKE NIS5 MODEL ROGUE STYLE VEHICLETOWED TO BLIN TOWEDBY GOV HI 44 L4❑ DAMAGE YES NO YES NO REGISTERED OWNER INFO ANTONIO CISNEROS MARTINEZ 13904 SE 200TH STREET KENT WA 980420000 D:2539516391 VEHICLE NO.2 SHADE IN DAMAGEbAREA 2 3 Cd LIABILITY INSURANCE &POINSURGY#E CO NAT GENERAL 2016828969IN 1 9TOP VE""LE CITATION# CHARGE LEG 25 i o BOTTOM ALLY YES NEI ❑ s OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY J 26 M.LEVERTON 2517 WA0171300 PAGE 01 OF PART A 3000-345-159 OR 11/181 STATE OF POLICETRAFFICN CORRECTION REPORT NO. EE89716 COLLISION REPORT III III III III III 111 1591972 CASE# 24-6477 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' maroon /2 lane 1 stop wht suv rear RTF Within the city limits of Renton/King/WA I happened upon a two car blocking crash at about the 3000 block of north bound Benson Dr S lane 1. I contacted the driver of unit 2 who told me he was stopped for traffic when he was hit in the back end by unit 1. He did not complain of injury and damages did not require a tow. I contacted the driver of unit 1 who told me he was watching me conducting a traffic stop southbound on Benson Dr S. He said he was looking in his mirror and did not realized traffic was stopped in front of him. He rear ended unit 2. He did not complain of injury and damages required a tow truck. Information/Insurance only. 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 6/20/2024 I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT. M.LEVERTON 06-20-24 07:38 AM INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED APPROVED BY E DAT C.JACOBS 1953 6/24/2024 12:29:43 PM BADGE OR ID# 2517 OR]#' WA0171300 TIME POLICE DISPATCHED; 6:23 AM TIME POLICE ARRIVED'6:23 AM PART I PAGE IT]OF 3� REPORT NO. EE89716 CASE# 24-6477 DATE AND TIME 06/20/24 06:23 OF COLLISION i z; w-; f l \ f uti' �s 4 PAGE 3 OF 3