HomeMy WebLinkAbout24-6486 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 5 27c
COLLISION REP FIT 1591971
INTERSTATE ❑ CITY STREET FIRE ❑
CASE 24-sass 2
RESULTED
1 STATE ROUTE OTHER STOLEN
❑ ❑ HFHIC;I F ❑ LOCAL AOENC 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# ❑
COLLISION: 06 - 1-- 2024 1055 17 ❑. S 8 W Li OF e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
BLOCK NO. e✓ --- ----�
NE 3RD ST MILEPOST
4a❑
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ �.❑ FEET e S ❑ W e JEFFERSON AVE NE
0 1 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
,/NO D:2067376969 0 81
30
6� LAST NAME LANGFORD FIRSTNAME KINETA MIDDLE C 1 1 2 31
INITIAL
STREET ✓ 201 UNION AVE SE CITY RENTON ST WA Zlp 98059 z
NEW ADDRESS
]❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
1/ I iNTERLOCKYEs NO NTERLOCKYEs NO Z/ YES R No�/
8❑ LRIIVER #
ON DUTY❑ STATUS AIRBAG 3 RESTR 9 EJECT 1 HELMET USE 2 CLASS 1 NATURE OF INJURIES 2❑
3
10❑ P1 aTES� ABB8429 sTAr� WAVIN# WDBJF65J4Y8131308
TRAILER STATE TRAILER STATE
11 3 5 PLATE# PLATE# FR.. ro
TRLR. TRLR 7 3 33
12 3 5 VIN#' VIN#
>; FROM TO
VEH.YEAR 2000 MERZ E320 4D D MAKE MODEL STYLE VEHICLE TOWED TO BLIN T ��] GOVT.VEHICLE
13 4 AMA GE YES NO �AWkkRS YES❑ J 9 34
NO
REGISTERED OWNER INFO KINETA LANGFORD 201 ON AVE SE RENTON WA 98059 D:2067376969 VEHICLE NO. 1
❑ ❑
SHADE IN DAMAGED AREA 35
4 LIABILITY INSURANCE INSURANCE CO 14 USAA 00918 36 42C
IN EFFECT &POLICY#VEHCLE CHARGE 36
LEGALLY YES❑NO❑ CITATION# <14,
15❑ STANDNG
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT 02 VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES NO ,/ D:2067650261
16 a
LAST NAME ARKANIT FIRST NAME AIIDEN MIDDLE T
INITIAL
17❑ STREET Is�' 17968 48TH AVE S CITY' SEATAC ST WA ZIP 981884607 4❑ 37
NEW ADDREs
18❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED � 38
INTERLOCK YEs❑NO� INTERLOCK YEs❑NOF YES
❑NOF,/
19 DRIVER'S STATE WA SEX M D.C... 02 _ 09 _ 2003 39
LICENSE# MMDDYY
20❑ ON DUTY STATUS AIRBAG 2 RESTR 9 EJECT 1 H U EET 2 NJAURSY 1 NATURE OF INJURIES 40
❑21❑ PLATE# C433976 TArE 41
WA VIN 1 STFRT54117X009631 1
42
22❑ PLATE# STATE PLATE# STATE
23❑ UIN#. 43
TRLR RLR
'IN#.
TOWED BY GOV HI 44
VEH YEAR 2007 MAKE 7'Oy7- MODEL TUNDRA STYLE PK DAMAGE TOWED NOO✓ BLIN YES
NO 1/
24❑ REGISTERED OWNER INFO OWNED SY DRIVER VEHICLE N0.2
SHADE IN DAMAGEbAREA
2 3 Cd
LIABILITY INSURANCE INSU&PORGY#E CO AMERICAN FAMILY 41073-55918-03 1 STOP
IN EFFECT
—e E YES❑ N,J� CITATION# CHARGE i o BOTTOM
LEGALLY
25 $ '
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
26
MI 1AAM LONG 7 12790 WA0171300
PAGE 01 OF
PART A
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EE88593
COLLISION REPORT III III III III III 111
1591972 CASE# 24-6486
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'
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.
MIRIAM LONG 06-20-24 02:43 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
P.KORDEL 9676 6/20/2024 5:32:37 PM
BADGE OR ID# 12790 OR]# WA0171300 TIME POLICE DISPATCHED 10:57 AM TIME POLICE ARRIVED 11:00 AM
PART I PAGE IT]OF 4�
REPORT NO. EE88593 CASE# 24-6486 OF COLLISION
06/20/24 10:55
OF CbLLI510N
NARRATIVE
On 6/20/2024 at approximately 1057 hours, while working as a commissioned police officer for the
City of Renton, I was dispatched to an injury accident that took place at Jefferson Ave NE/NE 3rd St.
Upon arrival, Renton Fire Department was on scene evaluating the drivers. I observed a vehicle
(WA/ABB8429) facing east on NE 3rd St, just west of Jefferson Ave NE, with significant front-end
damage and airbag deployment. The vehicle was pushed into the rear bumper of the second vehicle
(WA/C43397B) that was at the light at Jefferson Ave NE also facing eastbound. Neither driver
appeared to have obvious injuries.
Renton Fire Department medically cleared both drivers and they declined being transported for
further evaluation.
I contacted the driver of the unit one, identified by WA DOL photo as Kineta C Langford (DOB
11/1/1970), who appeared shaken up from the incident. She stated that she does not know what
happened, just said she did not see the vehicle stopped in front of her and applied her breaks too
late.
I contacted the driver of the unit two, identified by WA DOL photo as Aiiden T Arkanit (DOB 2/9/2003).
Aiiden said he was driving east on NE 3rd St in lane two when he observed the other driver change
lanes behind him from lane one. He told me the light at Jefferson Ave NE turned red, so he
proceeded to stop at the red light. He said when he was stopped, the other driver struck the back of
his vehicle.
Due to airbag deployment and sigficant damage, Bankers Towing responded to the scene and towed
unit one.
Both Aiiden and Kineta provided their WA DOL identification, registration, and proof of insurance.
I took photos of the vehicles and uploaded them to Axon.
I provided all involved parties with the exchange of information and the case number.
No further information.
My involvement in this case was captured on my department-issued Axon body camera. This report is
a summary of events that occurred and is not an exact sequencing of events. Statements have been
paraphrased and summarized.
I certify (declare) under penalty of perjury under the laws of the state of Washington that the foregoing
is true and correct.
Electronically signed by M Long#12790 on 6/20/2024 @ 1245 hours in Renton WA.
PAGE 3 OF 4
REPORT NO. EE88593 CASE# ' 24-6486 DATE AND TIME 06/20/24 10:55
OF COLLISION
1„
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PAGE 4 OF 4
