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HomeMy WebLinkAbout24-6790 POLICETRAFF'c" III !�� I IIIllI111IN II II I REPORT NO. EE92149 170 27 COLLISION REP FIT 1591971 CASE 24-6790 z INTERSTATE ❑ CITY STREET FIRE ❑RESULTED 1 STOLEN STATE ROUTE ❑ OTHER ❑ VFHIl.I F ❑ LOCAL AOENC 4Y00 3 HIT&RUN CODING COUNTY RD PRIVATE WAY INVOLVED 2 2 TOTAL#OF OBJECT 1 1 8 28 TRIBAL UNITS OZ RESERVATION STRUCK z 3❑ DATE of M M D D Y Y Y Y TIME(2400) COUNTY# MILES N E IN CITY# cowsloN 06 - 1-- 2024 1524 17 ❑-= S 8 IN e 1070 3 4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑ BURNETT AVE S BLOCK NO. e✓ --- ----� ❑ 4a❑ MILEPOST DISTANCE OF(REFERENCE OR CROSS STREET) 5❑ ❑ FEET e S ❑ W e S 4TH ST 0 4 29 MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE UNIT 01 VEHICLE ❑ CYCLE El ✓NO D:2063693709 0 11 30 6� LAST NAME SURRIDGE FIRSTNAME DANIEL MIDDLE C 1 2 31 INITIAL STREET ❑, 22424 SE 243RD ST CITY MAPLE VALLEY ST WA 2jp, 980387913 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 USEET ICNLJAURY 1 NATURE OF INJURIES z❑ 3 LICENSE CLG3379 sTAr WAvN# 1G1PC5SHOC7275586 10 1❑ PI ATE it 11[-j- TRAILER STATE TRAILER STATE 11 2 5 PLATE# PLATE# ROM ro rRLR. TRLR. 1 3 33 12 2 5 VIN#j VIN# :: FROM TO VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE 5 1 34 13 2 2012 CHEV CRUZE DAMAGE YES NO YES[:] No✓ REGISTERED OWNER INFO DANIEL SURRIDGE 22424 SE 243RD ST MAPLE VALLEY WA 980387913 D:2063693709 VEHICLE NO. 1 ❑ SHADE IN DAMAGED AREA 35 14 LIABILITY INSURANCE INSURANCE CO PROGRESSIVE 975439229 3 4 IN EFFECT &POLICY# 9TOP VEHICLe CHARGE 1 5 36 LEGALLv YES No CITATION# 4A0361529 FAIL YIELD LEFT TURN MOTOR o aorrom 15❑ NDING 6 MOTOR PEDAL-: PEDESTRIAN PROPERTY DAM1/ THR OLD MET PHONE UNIT 02 VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES NO D:2067241790 16 a LAST NAME MADISON FIRST NAME ROBERT MIDDLE I L INITIAL 17❑ STREET ❑', 14901 INTERURBAN AVE S APT 10 CITY TUKWILA ST WA ZIP 981684628 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 LDIIVER # STATE WA SEX M M .O.B. 12 _ 30 _ 1952 39 WELMET INJURY1 NATURE OF INJURIES 40 20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 USE CLASS ❑ 21❑ LICENSE BTC0889 TAre WA vIN# 1J4GZ58SOWC106716 ❑ 41 PLATE# 42 22❑ PLATE# STATE PLATE# STATE TRLR 23❑ VIN#. N#. 43 RLR % 'I VEH YEAR 1998 MAKE JEEP MODEL GRAND STYLE VEHICLETOWED TO BLIN TOWEDBY GOV HI �44 L4❑ DAMAGE YES NO YES NO REGISTERED OWNER INFO ROBERT MADISON 14901 INTERURBAN AVE S APT IO TUKWILA WA981684628 D:2067241790 VEHICLE NO.2 SHADE IN DAMAGED AREA 2 3 4 LIABILITY INSURANCE &POINSURGY#E CO ST FARM 413 3086 F2147IN I STOP 5 'E""LE ❑ Nu,J CITATION# CHARGE LEG 25 i o BOTTOM ALLY YES s a 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. EE92149 COLLISION REPORT III III III III III 111 1591972 CASE# 24-6790 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' blu/1 sedan It yellow maroon/jeep 2 straight CC Within the city limits of Renton/King/WA I responded to a 2 car blocking crash at the intersection of S 4th St at Burnett Ave S. I contacted the driver of unit 2 who told me he was on Burnett Ave S northbound and proceeded through the intersection on his fresh yellow light when he was hit by unit 1. He did not complain of injury and damages did not require a tow truck. I contacted the driver of unit 1 ID'd by his picture WADL/Surridge. Unit 1 told me he believed he had the right of way while making a left turn during his yellow light. He told me he made a left turn and was hit by unit 2. 1 told unit 1 its required to yield to on coming traffic before making a left turn. He did not complain of injury and damages did not require a tow truck. I cited unit 1 ref RCW 46.61.185 FTYROW-Left Turn 2 car crash via complaint. 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 6/28/2024 I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT. M.LEVERTON 06-28-24 07:25 AM INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED APPROVED BY DATE CO.JOHNSON 0505 7/2/2024 2:40:39 PM BADGE OR ID# 2517 ORI# WA0171300 TIME POLICE DISPATCHED; 3:27 Pry TIME POLICE ARRIVED',3:33 PM PART I PAGE IT]OF REPORT NO. EE92149 CASE# ' 24-6790 DATE AND TIME 06/27/24 15:24 OF COLLISION .. l �t: n � p 1 4 SS i Y # daMg ( a it�ye s ti t 5 s PAGE 3 OF 3