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HomeMy WebLinkAbout24-6643 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 0 27c COLLISION REP FIT 1591971 CASE 24-6643 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 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 - 1-— 2024 1338 17 ❑.= S 8 IN e 1070 3 4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓ BLOCK NE SUNSET BLVD M4100 4a❑ MILEPOST DISTANCE OF(REFERENCE OR CROSS STREET) 6 MILES❑ 30 00 FEET e S ❑ W e UNION AVE NE 0 1 29 MOTOR PEDAL- DAM THRESHOLD MET PHONE UNIT 01 VEHICLE ❑ CYCLE El YES NO ✓ D:2066178220 0 7 30 6� LAST NAME ALYN FIRSTNAME CHLOE MIDDLE 1 2 31 INITIAL STREET ❑✓ 2607 JONES AVE NE CITY RENTON ST WA 21p 98056 z NEW ADDRESS 7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3 ✓ I iNTERLOCKYEs No NTERLOCKYEs NO✓ YES R No 8❑ LRIIVER # ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 H USEET ICNLJAURY 1 NATURE OF INJURIES z❑ 3 10❑ P1 aT�S� E38829E sTAr� WAvIN# 1 GTR9CEK4NZ123487 TRAILER STATE TRAILER STATE11 3 5 PLATE# PLATE# FR.. To TRLR. TRLR 3 7 33 12 3 5 VIN#' VIN# >; FROM TO ❑ VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GO VT.VEHICLE J 9 34 13 4 2022 GMC SIERRA PK DAMAGE YES NO ✓ YES ❑ NO✓ REGISTERED OWNER INFO OWNEDBYDRIVER VEHICLE NO. 1 SHADE IN DAMAGED AREA ❑ 35 14 LIABILITY INSURANCE INSURANCE CO SAFECO H2567524 3 4 IN EFFECT &POLICY# 9TOP VEwc� CHARGE 1 5 36 LEGALLv YES No CITATION# 4AO435205 FOLLOW VEHICLE TOO CLOSELY Io BOTTOM 15❑ STANDING 8 6 MOTOR ✓ PEDAL-: PEDESTRIAN PROPERTY DAM THR OLD MET PHONE UNIT 02 VEHICLE ❑ CYCLE' ❑ ❑ OWNER ❑ YES✓ NO D:2062491157 16 a LAST NAME GUTIERREZ GUZMAN FIRST NAME EDER MIDDLE A INITIAL 17❑ STREET ❑', 3901 PARK AVE N CITY RENTON ST WA ZIP 98056 37 NEW ADDRESS ❑ 18� CDL IGNITION REQUIRED IGNITION PtR—E—S1ENT MEDICAL TRANSPORTED 38 INTERLOCK YEs❑No� INTERLOCK vEs I I NOF YEs t l NOF,/ 19 STATEWSEXM .C.. _ El 39 LICENSE# M . WELMET INJURY1 NATURE OF INJURIES 40 20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 USE CLASS ❑ 21❑ LICENSE ACH4857 TAre WA VIN# JM1BK323641106920 ❑ 41 PLATE# 42 22❑ PLATE# STATE PLATE# STATE TRLR 23❑ VIN#. N#. 43 RLR 'I VEH YEAR 2004 MAKE MAZp MODEL 323S STYLE Qp VEHICLETOWED TO BLIN TOWEDBY GOV HI �44 L4❑ DAMAGE YES NO✓ YES NO✓ REGISTERED OWNER INFO LISA DIERCKINS 152929TH AVE BE PUYALLUP WA 98374 VEHICLE NO.2 SHADE IN DAMAGED AREA 2 3 4 LIABILITY INSURANCE❑ INSURANCE CO IN EFFECT &POLICY# 1 STOP °E YES NEI CITATION# 4AO559428 CHARGE OP MOT VEH W/OUT INSURANCE o BOTTOM �Ecn��r 25 -RA s � a OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY 26 R.ON/SHl 5738 WA0171300 PAGE 01 OF PART A 3000-345-159 OR 11/181 STATE OF POLICETRAFFICN CORRECTION REPORT NO. EE89472 COLLISION REPORT III III III III III 111 1591972 CASE# 24-6643 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' Driver 2 Gutierrez Guzman was stopped, third car in line westbound on NE Sunset Blvd stopped for red traffic signal at Union Ave NE in curb lane. Driver 1 Alyn was behind Gutierrez Guzman. When light changed, both started moving. Gutierrez Guzman stated that the BMW in front of him started a right turn, then braked abruptly. Gutierrez Guzman braked, but Alyn's GMC truck struck the back of Gutierrez Guzman's Mazda 3 from behind. Alyn stated that Gutierrez Guzman started moving and had his phone in his hand, then abruptly braked causing her to hit him from behind. Gutierrez Guzman denied having phone in hand, saying that his car is a manual transmission and he had both hands free to operate it. Minor bumper damage to Gutierrez Guzman's rear bumper. Gutierrez Guzman told me that he had purchased the Mazda a week ago, and had no insurance because he did not have money to register the car in his name, and didn't know that he needed to have insurance coverage until he put the car in his name. Issued NOI to Alyn for following too closely, NOI to Gutierrez Guzman for no insurance. I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT. R.ONISHI 06-23-24 03:04 PM INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED APPROVED BY DATE D.SKELTON 9139 1 6/24/2024 3:50:54 AM BADGE OR ID# 5738 ORI# WA0171300 TIME POLICE DISPATCHED! ?:4Y PM TIME POLICE ARRIVED]1:47 PM PART I PAGE IT]OF 3� REPORT NO. EE89472 CASE# ' 24-6643 DATE AND TIME 06/23/24 13:38 OF COLLISION 3 i snit �I r PAGE 3 OF 3