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HomeMy WebLinkAbout24-6202 IT si " II IIIII III IIIII II IIII IIIII I . 27c REPORT NO EE92197OLCERA COLLISION REPORT 1591971 CASE# 24-6202 2 INTERSTATE CITY STREET FIRE ❑ RESULTED 1 STOLEN STATE ROUTE ❑ OTHER ❑ VEHICLE ❑ LOCCO A`GENC'Y 4200 3[--� COUNTY RD INVOLVED CODING 2 PRIVATE WAY ❑ TRIBAL TOTAL 1 UNITS#OF 02 SdBJECT 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 - 12 - 2024 2128 17 =.= S 8 W e IN OF M 1070 a 4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION �✓ NON INTERSECTION ❑ HOUSER WAY BLOCK NO. e 1500 .� 4a❑ MILE POST ❑ DISTANCE OF(REFERENCE OR CROSS STREET) 5 FEET e S 8 W e BRONSONWAYN 1 5 29 MOTtlR PEDAL- DAMAG THRESHOLD MET PHON UNIT 01 E VEHICLE ❑ CYCLE' ❑ YES NO �/ D:2062479836 Q 7 30 5 LAST NAME YEUNG FIRST NAME KAYLEE MIDDLE I W 1 1 2 31 INITIAL STREET ❑ 300 GLENNWOOD CT SE CITY RENTON ST WA ZIP 98056 2 NEW ADDRESS 7 CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3 INTERLOCKYES NO�/ INTERLOCKYES NO�/ YES No�/ 8❑ DCIENSE# STATE WA SEX U MMOCSYY' 11 1 2 32 9 ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 HELM USEET CLASS 1 NAruRE of INJURIES 2 10 1❑ as ENSrtEI BMV8349 STATE WA VN# JTHKD5BH6E2187865 3 TRAILER STATE TRAILER ,STATE 11 3 0 PLATE# PLATE# ROM TO TRLR TRLR Q Q 33 1 3 ( FROM TO 2 Q VIN# VIN# VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED By GOVT VEHICLE 9 9 34 13 a 2014 LEXS CT200H $D DAMAGE YES�NO� YES❑ NO REGISTERED OWNER INFO MARCUS YEUNG 300 GLENNWOOD CTSE RENTON WA 98056 VEHICLE NO. 1 ❑ SHADE IN DAMAGED AREA 35 4 LIABILITY INSURANCE INSURANCE CO 2 3 14 ALLSTATE 064151763 IN EFFECT &POLICY# 4TOP VEHICLE CHARGE t S 36 Lemur YES❑NO❑ CITATION# 7 o BOTTOM 15❑ sTnNowc B 7 e rL� MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE UNIT VEHICLE CYCLE' ❑ ❑ nWNFR D:2064740563 16� LAST NAME GUYA FIRST NAME WYCLIF MIDDLE' p INITIAL STREET ❑ 17 ' 9 ❑ 20 296TH PL CITY FEDERAL WAY ST, WA ZIP 98003 37 NEW ADDRESS 18 CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED' 38 INTERLOCKYES ND INTERLOCK YES No vES No 19[ DRIVER'S STATE WA SEX U D.CLB. 06 27 1987 ❑ 39 LICENSE# MM06YY - HELMET INJURY' NATURE OF INJURIES 40 20❑ ON DUTY❑ STATUS' AIRBAG 2 RESTR 4 EJECT 1 USE CLASS 1 ❑ 21 LICENSLATE E CCM1412 TATE WA VIN# 4S4BP61CO563335341 41 22❑ PLATE# STATE PATE# STATE ❑ 42 23 TRLR kRLR 43 UIN#. 'IN#. VEH.YEAR 2005 MAKE $(JBp MODEL LEG STYLE GA VEHICLE TOWED TO BLIN TOWED BY GOV HI 44 24 DAMAGE YES NO YES NO REGISTERED OWNER INFO OWNEDBYDRIVER VEHICLE NO,2 SHADE IN DAMAGED AREA 2 3 4 LIABILITY INSURANCE INSURANCECO STATE FARM 5556622241700 IN EFFECT &POLICY# 9TOP vewae ,.I—I CITATION11 CHARGE tO BOTTOM ALLr YESZ N J 25 a 7 a OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY 26 HANSEN HSU 12651 WA0171300 PAGE 01 OF PART A 3000-345-159(R 11/18) POLIICFETRAFFICN CORRECTION REPORT NO. EE92197 COLLISION REPORT III III III III III 111 1591972 CASE# 24-6202 ADDITIONAL PERSONS INVOLVED(PASSENGERS AND/OR WITNESSES ONLY) 'NAME (LAST,FIRST MIDDLE INITIAL) ADDRESS&PHONE# SEX' D.O.B. — [----------� MMDDYYYY PASSENGER F-1 WITNESS El 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 Both Units 1 and 2 heading north along Houser Way N at the intersection of Bronson Way N. Unit 1 backs up at intersection and causes collision to Unit 2, causing non reportable non disabling damage to the rear of Unit 1 and no observable damage to Unit 2. No injuries. Proximate cause of collision was driver of Unit 1 improperly backing due to surrounding traffic into Unit 2. I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT. HANSEN HSU 06-13-24 12:24 AM INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST.DET DATED PLACE SIGNED APPROVED BY DATE P.SUMMERS 8887 7/2/2024 4:47:13 PM BADGE OR ID# 12651 ORI# ( WA0171300 TIME POLICE DISPATCHED'; 9:31 Pry TIME POLICE ARRIVED 9:37 PM PART B 3 Da-3m5-,aa(R11ras) PAGE 27 OF 37 REPORT NO. EE92197 CASE# 24-6202 DATE AND TIME 06/12/24 21:28 OF COLLISION �r 21 At Mm , n PAGE 3 OF 3