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HomeMy WebLinkAbout24-7315 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 0 27c COLLISION REP FIT 1591971 CASE 24-7315 z INTERSTATE ❑ CITY STREET FIRE ❑RESULTED 1 STOLEN STATE ROUTE ❑ OTHER ❑ VFHICI F ❑ LOCAL AOENC 4900 3 HIT&RUN CODING COUNTY RD PRIVATE WAY INVOLVED 2 1 TOTAL#OF OBJECT 1 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# cowsloN 07 - 1-- 2024 1246 17 ❑-= S 8 IN e 1070 3 4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑ SE CARR RD BLOCK NO. e✓ 10300 ❑ 4a❑ MILEPOST DISTANCE OF(REFERENCE OR CROSS STREET) 5❑ ❑ FEET e S ❑ VV a 103RD AVE SE 0 3 29 MOTOR PEDAL- DAMAGE THRESHOLDPHONE UNIT 01 VEHICLE ❑ CYCLE El MET YES �/No D:6315528346 0 11 30 6� LAST NAME LI FIRSTNAME GUANGBI MIDDLE 1 2 31 INITIAL STREET ❑1 3315 S EDDY CT CITY SEATTLE ST WA 2jp, 981183139 z NEW ADDRESS 7❑ CDL IGNITION REQUIRED IGNITIt)N PRESENT MEDICAL TRANSPORTED 3 iNTERLOCKYEs NO 1/ INTERLOCK YES No Z YE. No�/ 8❑ LICIENSE# STATE yyq SEX'F MM DAY' 04 — 08 — 1974 1 2 32 9 ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 H USE CLASS 2 CLASS 1 NATURE OF INJURIES z❑ 3 LICENSE CHW2648 sTArI WAurN# JTJHA31 U940047131 10[ PI ATE# 5 TRAILER STATE TRAILER STATE 11 2 5 PLATE# PLATE# FROM TO TRLR. RLR 1 7 33 12 3 5 VIN#' VIN# >; FROM TO ❑ VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TR y GOVT.VEHICLE 3 ] 34 13 2 2004 LEXS RX DAMAGE YES NO �MEYER YES : NO✓ REGISTERED OWNER INFO JEFFREY FROST 53011 38TH ST TACOMA WA 98407 VEHICLE NO. 1 ❑ SHADE IN DAMAGED AREA 35 14 ABILI V INSURANCE INSURANCE CO FARMERS 561 4446A04.498 3 4 IN EFFECT &POLICY# 9TOP VEHCLE CHARGE 5 36 LEGALLY YES❑NO❑ CITATION# 4A0212085 FAIL TO YEILD RIGHT OF WAY )o eorrom 15❑ STANDING 7 6 MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE UNIT 02 VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES 1/ NO D.2062099140 16 a LAST NAME LEON NAJERA FIRST NAME ELI MIDDLE INITIAL 17❑ STREET ❑', 17712 98TH AVE S CITY RENTON ST WA ZIP 980555735 37 NEW ADDRESS ❑ 18� CDL IGNITION REQUIRED IGNITION PR—E-1SENT MEDICAL TRANSPORTED ❑ 38 INTERLOCK YEs❑NO� INTERLOCK YEs It I NOF YES t l NOF,/ 19 DRIVER'S STATE I WA SEX M D.C.B. 10 _ 05 _ 1976 39 LICENSE# MMDDYY —NATURE OF INJURIES W USE EET LASSY SORE LEFT SHOULDER AND UPPER BACK ❑ 40 20❑ ON DUTY STATUS AIRBAG,2 RESTR 4 EJECT 1 2 6 21❑ LICENSE B60333Y TAre I WA vIN# 1D7HA18D15S111767 ❑ 41 PLATE# 42 22❑ PLATE# STATE PLATE# STATE TRLR 23❑ UIN#. IN#. 43 RLR ' GI VEH YEAR 2005 MAKE DODG MODEL RAM 1500 STYLE PK DAMAGE TOWED NOO✓ BLIN TOWED BY ov HyES NO 1/ 44 24❑ ES REGISTERED OWNER INFO OWNED SY DRIVER VEHICLE N0.2 SHADE IN DAGED AREA 2 4 LIABILITY INSURANCE INSU&PORGY#E CO PROGRESSIVE 71175 038IN IGQ'E""LE ❑ ,J� CITATION# CHARGE LEGALLY YES N`L J 25 OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# JAGENCY 26 C.STEED 8770 WA0171300 PART A PAGE 01 OF C7 3000-345-159 OR 11/181 STATE OF POLICETRAFFICN CORRECTION REPORT No. EE95376 COLLISION REPORT III III III III III 111 1591972 CASE# 24-7315 ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY) NAME MIDDLE INITIAL) MUNDO KAYLEE L (IAST FIRST, ADDRESS&PHONE# 17434 SE 244TH PL KENT WA 98032 2064469861 SEXi F MMDDYyry 02 - 25 - 2009 PASSENGER Z WITNESS❑ UNIT# 2 POS 9 AIRBAG 2 RESTR. 4 EJECT ? 1 HELMET NJURY NATURE OF INJURIES USE 2 'CLASS 11 NAME (LAST,FIRST,MIDDLE INITIAL) ADDRESS&PHONE# DOB SEX' MMDDYYYY PASSENGER ❑WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET NJURY 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' On 07/13/24 at about 1302 hrs I arrived at SE Carr Rd and 103rd Ave SE for an Injury Collision, in the City of Renton, County of King, and State of Washington. Both drivers were identified by their WADL. Unit#2 was traveling WB on SE Carr Rd and had the right of way. Unit#1 was traveling SB on 103rd Ave SE and had a stop sign before entering SE Carr Rd. The driver of Unit#1 said she stopped at the stop sign but when she entered SE Carr Rd, she collided with the middle passenger side of Unit#2 who was traveling in the inside lane. The driver of Unit#1 advised she was not injured. The driver of Unit#2 said his left shoulder and his left upper back were sore from the collision. Unit#1 was missing the front bumper and the front driver's side tire was rubbing so it was towed by Gene Meyer Towing. Unit#1's driver was issued an infraction for failing to yield to the right of way of Unit#2. This incident was captured on my body worn video camera. This report is a summary of events that occurred and is not an exact sequencing of events. Statements have been paraphrased and summarized. The video was uploaded to evidence.com. 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 Officer Steed on 07/13/24 1427 hrs, Renton Washington Cassidy Steed/8770 I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT. C.STEED 07-13-24 02:33 PM INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED APPROVED BY E DAT D.SKELTON 9139 711312024 3:41:09 PM BADGE OR ID# 8770 OR]# ! WA0171300 TIME POLICE DISPATCHED! 12:51 PM TIME POLICE ARRIVED?:0Y Pry] PART I PAGE IT]OF 3� REPORT NO. EE95376 CASE# ' 24-7315 DATE AND TIME 07/13/24 12:46 OF COLLISION t „4 r j} 4 � i PAGE 3 OF 3