HomeMy WebLinkAbout24-5910 IT si " II IIIII III IIIII II IIII IIIII I . 27c REPORT NO EE85812OLCERA COLLISION REPORT 1591971 CASE�# 24-5910 2 INTERSTATE CITY STREET FIRE ❑RESULTED 1 STOLEN STATE ROUTE ❑ OTHER ❑ VEHICLE ❑ LOCAL CO A`NG 4200 3[--� COUNTY RD INVOLVED CODING PRIVATE WAY TOTAL 1 2❑ TRIBAL UNITS#OF 02 SO BJECT TRUCK 1 8 28 RESERVATION 2 3� M M D D Y Y Y Y TIME(2400) COUNTY# MILES CITY# DATE OF'. N E coulsloN' 06 - 04 - 2024 1006 17 =.= S 8 W e IN OF M 1070 a 4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION �✓ NON INTERSECTION ❑ BLOCK NO. SW GRADY WAY 4a❑ MILE POST DISTANCE OF(REFERENCE OR CROSS STREET) 5❑ C------�. FEET e S 8 W e LIND AVE SW 0 1 29 MOTtlR PEDAL- DAM AG THRESHOLD MET PHONE UNIT 01 VEHICLE ❑ CYCLE' ❑ YES ✓NO D:2068509664 0 8 30 5 LAST NAME MAYER FIRST NAME BRANDON MIDDLE R 1 1 2 31 INITIAL STREET ❑ 805 TOLE LAKE RD S CITY TACOMA ST WA ZIP 984443503 2 NEW ADDRESS 7 CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3 INTERLOCKYEs NO INTERLOCkvEs Na YEs NOFJ 8❑ LICENSE# STATE WA SEX'M MMOCSYY' 04 1 2 32 9 ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 N USEET INJURY CLASS 1 NAruRE of INJURIES 2 LICENSE, CJU5178 STATE WA VN# 1C3CDZAB7CN231141 3 10[9� PI ATF# 11[-j- TRAILER STATE TRAILER ,STATE ROM TO 11 3 5 PLATE# PLATE# TRLR TRLR 7 3 33 12 0 0 VIN# VIN# ( FROM TO VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED By GOVT VEHICLE 9 9 34 13 2 2012 DODG AVENGE DAMAGE Yes�No ✓� Yes❑ No� REGISTERED OWNER INFO BRANDON MAYER 805 TULE LAKE RD S TACOMA WA 984443503 D:2068509664 VEHICLE NO. 1 SHADE IN DAMAGED AREA 35 14❑ El NSURANCE CO 3 4 LIABILITY INSURANCE ❑ IN EFFECT &POLICY# 4TOP vEnic�E CHARGE 70 BOTTOM 5 36 15 s ALLYc yes❑NO❑ CITATION# 4A0361513,4A0361513 INATTENTIVE DRIVING,OP MOT VEH 7 e MOTOR PEDAL- PEDESTRIAN PROPERTY DAM TO OLD MET PHONE UNIT VEHICLE CYCLE' ❑ ❑ nWNFR YEs�/ No D:4253262345 16� LAST NAME POPLAVSKYI FIRST NAME MAKSYM MIDDLE N INITIAL 17 STREET'❑ ❑3528 138TH PL SW CITY LYNNWOOD ST, W 37 q ZIP 980875211 NEW AbbRESS 1 g❑ CDL IGNITION REQUIRED IGNTION PRESENT MEDICAL TRANSPORTED' ❑ 38 INTERLOCKYEs NO INTERLOCK YES Nt YEs NO 19� DRIVER'S STATE WA SEX M I D.O.B. 05 14 1983 39 LICENSE# MMDDYY — HELMET INJURY' NATURE OF INJURIES 40 20❑ ON DUTY STATUS' AIRBAG 2 RESTR 4 EJECT 1 USE CLASS 1 ❑ 21 LICENSLATE E CLY6663 TATE WA VIN# WD3PE7CD5JP631997 � 41 22❑ PLATE# STATE PATE# STATE ❑ 42 23 TRLR kRLR 43 UIN#. 'IN#. VEH.YEAR 201$ MAKE MERZ MODEL SPR/NTE STYLE VEHICLE TOWED TO BLIN TOWED BY GOV HI 44 24 DAMAGE YES NO YES NO REGISTERED OWNER INFO MAKSYMPOPLAVSKY73528138TNPLSW L..ODWA980875211 D:4253262345 VEHICLE NO.2 SHADE IN DAMAGE$AREA 2 3 �4 LIABILITY INSURANCE INSURANCE CO PROGRESSIVE 971391987 IN EFFECT &POLICY# I 9TOP veeicLe ,J—I CITATION# CHARGE tO BOTTOM Lecntty YES N`[ 25 s 7 e OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY 26 M.LEVERTON 2517 WA0171300 PAGE 01 OF PART A 3000-345-159(R 11/18) POLIICFETRAFFICN CORRECTION REPORT NO. EE85812 COLLISION REPORT III III III III III 111 1591972 CASE# 24-5910 ADDITIONAL PERSONS INVOLVED(PASSENGERS AND/OR WITNESSES ONLY) 'NAME (LAST,FIRST MIDDLE INTTIAL) ADDRESS&PHONE# SEX' D.O.B. - [----------� MMDDYYYY PASSENGER F-1 WITNESS Ej UNIT# SEAT AIRBAG RESTR. EJECT HELMET INJURY NATURE OF INJURIES--� POS. USE CLASS 'NAME (LAST FIRS,MIDDLE INITIAL) ADDRESS&PHONE# SEX' D.O.B. - L----------� MMDDYYYY PASSENGER DWITNESSD UNIT# SEAT AIRBAG RESTR. EJECT HELMET NJURY NATURE OF INJURIES POS. : USE CLASS ----� '.NAME (LAST,FIRST,MIDDLE INITIAL) ADDRESS&PHONE# SEX D.O.B. - L----------� MMDDYYYY PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET INJURY NATURE OF INJURIES ❑ Q POS. USE CLASS �____ ----j 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. M.LEVERTON 06-04-24 11:07 AM INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST.DET DATED PLACE SIGNED APPROVED BY DATE C.JACOBS 1953 611012024 6:51:34 AM BADGE OR ID# 2517 ORI# ( WA0171300 TIME POLICE DISPATCHED'; 10:10 AM TIME POLICE ARRIVED 10:19 AM PART B 3 Do-3mx-,ao(Burls) PAGE 27 OF 47 REPORT NO.` EE85812 CASE# 24-5910 O COLLI COLLISION TIME OF 06/04/24 10:06 COLLI NARRATIVE lane 2 lind eb rear blue van gray sedan CC Within the city limits of Renton/King/WA I responded to a 2 car non blocking crash at Lind Ave SW at SW Grady Way. I contacted the driver of unit 2 who told me he was stopped EB on SW Grady at Lind Ave SW when he was hit from behind by unit 1. He did not complain of injury and damages did not require a tow truck. The crash did knock his rear bumper/metal step clear off his vehicle. I contacted the driver of unit 1 ID'd by picture WADL. He told me he just didnt get stopped in time even though unit 2 was clearly stopped. I asked unit 1 if he had good tires/brakes and he said yes. Was just human error. He did not complain of injury and damages did not require a tow truck. He told me he did not have valid proof of insurance of his vehicle or had a policy from a previous vehicle. I cited unit 1 Mayer ref RCW 46.30.020 No Insurance and Ref RMC 10-12-25 Driver Inattention 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 6/4/2024 PAGE 3 OF 4 REPORT NO. EE85812 CASE# 24-5910 DATE AND TIME i 06/04/24 10:06 OF COLLISION r +y z , 4 � t A m, b 1 ,fir r soh r r r r� rn , t 4 PAGE 4 OF 4