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HomeMy WebLinkAbout24-6851 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 1 27c COLLISION REP FIT 1591971 SASE 24-6851 z INTERSTATE ❑ CITY STREET FIRE ❑ RESULTED 1 STOLEN STATE ROUTE ❑ OTHER ❑ VFHIC;I F ❑ LOCAL AGENCI 4150 3 HIT 8 RUN CODING COUNTY RD PRIVATE WAY INVOLVED 2 TOTAL#OF OBJECT 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 2330 17 ❑-= S 8 IN e 1070 3 4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑ SE CARR RD BLOCK NO. e ❑ 4a❑ MILEPOST DISTANCE OF(REFERENCE OR CROSS STREET) 5❑ ❑ FEET e S ❑ W e 106TH PL SE 0 1 29 UNIT 01 MOTOR CYCLE ❑ YES ]NO MET PHONE 0 30 6� LAST NAME UNKNOWN FIRSTNAME MIDDLE 1 1 2 31 INITIAL STREET ❑ CITY ST ZIP 2 NEW ADDRESS 7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3 iNTERLOCKYEs NO INTERLOCK YES No YES No 8❑ LIRCIENSRE# STA fE I SEX u MMDOBYY '❑- 1 1 2 32 9 ON DUTY❑ STATUS I AIRBAG 9 RESTR 9 EJECT 1 H U EEr 9 CLAY 0 NATURE OF INJURIES z❑ 3 LICENSE srATI urN#' 10❑ PI ATE 14 TRAILER STATE TRAILER STATE 11 0 0 PLATE# PLATE# ROM ro TRLR. TRLR m 33 12 3 5 VIN#' VIN# FROM TO VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE R T 34 13❑ DAMAGE YES NO YES❑ NO✓ REGISTERED OWNER INFO UNKNOWN VEHICLE NO. 1 SHADE IN DAMAGED AREA ❑ 35 14 LIABILITY INSURANCE❑ INSURANCE CO 3 4 IN EFFECT &POLICY# 9TOP VEF" 5 36 LECALLv YES❑NO❑ CITATION# CHARGE 10 BOTTOM 15❑ STANDING 8 6 MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE UNIT 02 VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES 1/ NO D:4256529549 16 a LAST NAME UNDERWOOD FIRST NAME AZZIEM MIDDLE H INITIAL 17 NEW STREETR 7' 14600 SE 176TH ST UNIT P1 CITY RENTON ST WA ZIP 98058 37 18� CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL t-T�RANSPORTED 38 INTERLOCK YEs❑No� INTERLOCK YES It1 I NoF t l YES NO 19 DRIVER'S STATE WA SEX U I D.C.B. O6 _ 24 1960 39 LICENSE# MMDDYY 20❑ ON DUTY STATUS AIRBAG 3 RESTR 4 EJECT 1 HELMET 2 INJURY 7 NATURE OF INJURIES ❑ 40 USE CLASS LEFT HAND PAIN LICENSE I ❑21❑ PLATE# MEIZZA TATE 41 WA VIN# 1YVHZ8DH005M38137 `1 42 22 [TRAILER TILER ❑ PLATE# STATE PLATE# STATE TRLR 23❑ UIN#. IN#. 43 RLR ' TOWED eY Gov HI 44 VEH YEAR 2012 MAKE MAZp MODEL MZ5 STYLE SD DAMAGE TOWED✓ NOO BLIN BANKERS YES No 24❑ REGISTERED OWNER INFO OWNED SY DRIVER VEHICLE N0.2 SHADEDAMAGEDAREA 3 4 LIABILITY INSURANCE INSURANCE #E CO PEMCO CA0825257IN STOP 5 VEHICLE ❑ ,.I—I CITATION# CHARGE 25 io BOTTOM LEGALLY YES N e 7B- S NAME(PRINT) OFFICER PHONE BADGE OR ID# [AGENCY 26 MIN FLICK 12825 WA0171300 PART A PAGE 01 OF 3000-345-159 OR 11/181 STATE OF POLICETRAFFICN CORRECTION REPORT NO. EE92589 COLLISION REPORT III III III III III 111 1591972 CASE# 24-6851 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. BENJAMIN FLICK 06-30-24 12:51 AM INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED APPROVED BY DATE J.TRADER 4553 7/3/2024 11:45:17 PM BADGE OR ID# 12825 OR]# WA0171300 TIME POLICE DISPATCHED! 11:36 PM TIME POLICE ARRIVED',11:38 PM PART I PAGE IT]OF 4� REPORT NO. EE92589 CASE# 24-6851 OF COLLISION 06/29/24 23:30 OF CbLLI510N NARRATIVE 24-6851 On 06-29-2024 at approximately 2336 hours I was working a Renton Police Department patrol in full uniform in the city of Renton, King County, Washington. I responded to a motor vehicle collision at the intersection of 106th PL SE and SE Carr Rd. Prior to my arrival, the suspect vehicle driver failed to provide any information and then drove away from the scene. The victim/reporting party met me in the parking lot of the US Bank at 108th AVE SE and SE Petrovitsky RD. The victim/reporting party of unit 02 was as follows: Unit 2: (WA/MEIZZA) driver Azziem H. Underwood (DOB: 06-24-1960 via WADL) The suspect vehicle was as follows: A grey sedan. Unknown further. Driver Underwood was driving eastbound on SE Carr RD and was proceeding through a green light on 106th PL SE when the suspect vehicle proceeded north through a red light from the Fred Meyer Parking lot. The suspect vehicle collided with the victim vehicle and then fled the scene immediately, driving westbound in the eastbound lanes of SE Carr RD. Victim Underwood was able to limp his vehicle to the nearby parking lot, but the airbag had deployed and there was significant front end damage. Victim Underwood's glasses were broken/bent from the airbag. I provided Underwood with a business card which contained the case number. An area check for the suspect vehicle had negative results. Underwood told me that his left hand hurt as a result of the collision. I asked him if he wanted medical attention, he told me he did not. I believed that there was PC for felony hit and run for the unidentified driver of the suspect vehicle, since victim Underwood complained of pain in his hand. At the time this report was written, the suspect and suspect vehicle had not been located, nor identified. I declare under penalty of perjury under the laws of the State of Washington that the foregoing is true and correct. Electronically signed by B. Flick 12825 on 06-30-2024 in Renton, WA. PAGE 3 OF 4 REPORT NO. EE92589 CASE# 24-6851 DATE AND TIME 06/29/24 23:30 OF COLLISION ANSE Carr, not to scale � 1 e 1 I i PAGE 4 OF 4