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HomeMy WebLinkAbout24-5974 iiTFiNII IIIII III IIIII II IIII IIIII I . 27c REPORT NO EE84171oc� RA COLLISION REPORT 1591971 CASE# 24-5974 2 INTERSTATE CITY STREET FIRE ❑RESULTED 1 STATE ROUTE OTHER STOLEN ❑ VEHICLE ❑ LOCAL AGENCY 3 HIT&RUN ✓ CODING COUNTY RD PRIVATE WAY INVOLVED Lm- 2❑ TOTAL OBJECT 1 TRIBAL UNITS#OF 02 STRUCK 1 8 28 RESERVATION 2 3� M M D D Y Y Y Y TIME(2400) COUNTY# MILES CITY# DATE OF'. N E COLLISION' 06 - 05 - 2024 1805 17 =.= S 8 W e IN OF e 1070 s 4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION �✓ NON INTERSECTION ❑ BLOCK NO. e .� 4a S 3RD ST MILE POST ❑ DISTANCE OF(REFERENCE OR CROSS STREET) 5❑ C------�. FEET e S 8 W e LOGAN AVE S 0 1 29 MOTtlR PEDAL- DAM AG THRESHOLD MET PHONE UNIT 01 VEHICLE ❑ CYCLE' ❑ YES NO Q $ 30 6❑ LAST NAME UNKNOWN FIRST NAME MIDDLE 1 2 31 INITIAL STREET ❑ CITY ST ZIP' 2 NEW ADDRESS 7 CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3 INTERLOCKYES No I INTEPLOCKYESD NO 0 YES F No LCEENSE# STATE SEX U MMDDYY' —=— 1 2 32 8❑ VERS 9 ON DUTY STATUS AIRBAG 9 RESTR 9 EJECT 1 HELM USEET 9 CLASS 0 NATURE OF INJURIES 2 LICENSE, 6JIS689 STATE CA VIN# JTDKN3DU2A0038727 3 10 PI ATP rt TRAILER STATE TRAILER ,STATE 11 0 0 PLATE# PLATE# FROM TO rRLR rRLR, 7 3 33 1 Q Q VIN# 1.] N# ( FROM TO 2 VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED By GOVT VEHICLE 9 9 34 13 1 2010 TOYT PR1US $D DAMAGE YES NO YES❑ NO REGISTERED OWNER INFO gVENDANO SEPULVEDA CRIST1AN 745 V10ENTE ST SAN FRANCISCO CA 94116 VEHICLE NO. 1 ❑ SHADE IN DAMAGED AREA 35 14❑ LIABILITY INSURANCE❑ NSURANCE CO 3 4 IN EFFECT &POLICY# 4TOP vEnic�E 5 36 LEGALLY YES[:]NO[:] CITATION# CHARGE 7 o BOTTOM 15❑ sTANowG 7 e III MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE UNIT VEHICLE CYCLE r1wNFR YES)/ NO D:3607060392 16� LAST NAME LEE FIRST NAME DAKOTA MIDDLE L 17 F1 STREET INITIAL 37 ❑ '❑ 695 PETERSON RD UN/T 204 CITY I BURL/NGTON ST, WA ZIP 98233 g NEW ADDRESS 18❑ CDL IGNITION REQUIRED fGNITION PRESENT MEDICAL TRANSPORTED; 38 INTERLOCKYEs No (NTERLOCKYEs No ves No 19 DRIVER'S STATE WA SEY F I D.C.B. 02 18 1999 39 LICENSE# MMDDYY — 20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 HELMET 2 INJURY 6 NATURE A INJURIES 40 USE CLASS NECK PAIN 21 LICENLATE SE CMHO398 rarE WA vIN# 1FADP3K23EL145946 41 22❑ [TILER AILER PLATE# STATE PATE# STATE ❑ 42 23 TRLR kRLR 43 UIN#. 'IN#. VEH.YEAR 2014 MAKE FORD MODEL FOCUS STYLE $D VEHICLE TOWED TO BLIN TOWED BY GOV HI 44 24 DAMAGE YES NO YES NO REGISTERED OWNER INFO EVANMCCR .1332192ND ST SE UNIT 41 80THELL WA 98012 VEHICLE NO.2 SHADE IN DAMAGAREA 2 3 LIABILITY INSURANCE INSURANCE CO NONE IN EFFECT &POLICY# t 9TOP vewaE ,.I—I CITATION# CHARGE tO BOTTOM EEGnEEv YES N`.LJ 25 OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY J 26 E.EDMUNDS 12576 WA0171300 PAGE 01 OF 1 PART A 3000-345-159(R 11/18) POLIICFETRAFFICN CORRECTION REPORT NO. EE84171 COLLISION REPORT III III III III III 111 1591972 CASE# 24-5974 ADDITIONAL PERSONS INVOLVED(PASSENGERS AND/OR WITNESSES ONLY) NAME MCCRACKIN EVANJ (LAST,FIRST MIDDLE INITIAL} ADDRESS&PHONE# D(� 1332 192ND ST SE UNIT 41 BOTHELL WA 98012 SEX' M MMDDYYYv O6 — 05 — 1996 PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET INJURY NATURE OF INJURIES El UNIT 2 POS. 3 2 4 1 USE CLASS ;1 'NAME (LAST FIRS,MIDDLE INITIAL) ADDRESS&PHONE# ' D.O.B. SEX MMDD —F L----------� YYYY PASSENGER F]WITNESSD UNIT# SEAT AIRBAG RESTR. EJECT HELMET NJURY NATURE OF INJURIES POS. : USE CLASS ----� '.NAME (LAST,FIRST,MIDDLE INITIAL) ADDRESS&PHONE# SEX' D.O.B.M -T L----------� MDDYYYY PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET INJURY NATURE OF INJURIES ❑ Q POS. USE CLASS �____ ----� NARRATIVE Vehicle #1 rear ended Vehicle #2 on S 3rd St at the intersection with Logan Ave S. Vehicle # 2 (driven by Dakota L Lee 02/18/1999) pulled into a nearby parking lot. Vehicle #1 pulled in behind and the driver, an unknown hispanic male approached Lee on the driver's side. Lee stated the male spoke Spanish and broken English. Lee stated the man asked her not to call 911 and stated the vehicle did not belong to him. When the male saw that Lee's passenger (Evan J McCrackin 06/05/1996) was calling 911, he returned to his vehicle and drove away. Firefighters responded to the scene and evaluated Lee for injury. Lee was transported to Valley Medical Center for neck pain. McCrackin, the vehicle's registered owner, did not require medical attention. The damage to McCrackin's vehicle appeared to exceed $1000, however the vehicle was drivable. McCracking stated he did not have insurance. This concluded my involvement with the case. 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 E. Edmunds/12576 at 1913 hours on 06/05/2024 in the City of Renton, WA. I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT. E.EDMUNDS 06-06-24 02:11 AM INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST.DET DATED PLACE SIGNED APPROVED BY DATE 6/6/2024 1:53:44 PM J.CHRISTIANSEN 10437 BADGE OR ID# 12576 ORI# ( WA0171300 TIME POLICE DISPATCHED'; 6:10 PM TIME POLICE ARRIVED 6:16 PM PART B 3aaa-345-,aa(R11Y1s) PAGE 27OF 37 REPORT NO. EE84171 CASE# 24-5974 DATE AND TIME 06/05/24 18:05 OF COLLISION fz jz 4 { 1� ~•n,, a� »,,q,.t,.,t*xi, ,"�*��,. sua«¢wa�c'.at�xxv�.x:,,. )'z �uit.�d`�Y�i`ca S Yi�3"w•;,ua i � ,. .:.:.� h*:, 7..t� :� �� ..~'�, °+� 3., rye�t,>•,a�v`auamm�.��a�4a„.«�,aa. ,� ,�.,.,,km.a�e��,,,.�rs�a,u y�,.,:.., as��sm,�a,�a �m Mz� �����" PAGE 3 OF 3