HomeMy WebLinkAbout24-7409 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 2 27c
COLLISION REP FIT 1591971
SASE 24aaos 2
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#
cawsloN 07 - 1-- 2024 1725 17 ❑-= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
SW 7TH ST BLOCK NO. e✓ 1000 ❑
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ �.❑ FEET e S ❑ W e POWELL AVE SW
0 4 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
NO ✓ I D:8082762869 30
6 LAST NAME FLETCHER FIRSTNAME CURTIS MIDDLE B 1 1 2 31
INITIAL
STREET ❑✓ 833 SW SUNSET BLVD#M58 CITY RENTON ST WA ZIP 98057 z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
INTERLOCK YES No✓ I INTERLOCK YES NO✓ YES R NO
8❑ LICENSE# STATE WA SEX'M I ELMMDDYY 11 — 16 — 1994 32
9 ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 H USE CLASS 2 CLASS 1 NATURE OF INJURIES z❑
3
10 9❑ P1 aT�S� C86658N sTArI WAvIN# 1 FTFW1 EFODFA07755
TRAILER STATE TRAILER STATE11 3 5 PLATE# PLATE# FROM To
TRLR. TRLR 3 5 33
12❑ VIN#j VIN#
FROM TO
VEH.YEAR 2013 MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE 7 3 34
13 4 FORD F150 PK DAMAGE YES NO ✓ YYES[:] NO✓
REGISTERED OWNER INFO OWNEDBYDRIVER VEHICLE NO. 1
❑
SHADE IN DAMAGED AREA 35
14 LIABILITY INSURANCE INSURANCE CO USAA 03581 72 85G 3 4
IN EFFECT &POLICY# STOP
VEHICLE CHARGE 1 5 36
LEGALLY YES❑NO❑ CITATION# 10 BOTTOM
15❑ STAIN.D'ING 7 6
UNIT 02 VE ICCLE ❑ CYCLE PEDESTRIAN ❑ OWNERMOTO PEDAL RTY ❑ DYES✓ NO OLD MET PHONE
16 a
LAST NAME MCINTOSH FIRST NAME ADRON MIDDLE D
INITIAL
17❑ NEW STREETR 16221 S
7 E 173RD PL CITY RENTON ST WA ZIP 98058 37
18❑ CDL IGNITION REQUIRED IGNITION PtR—E—S1ENT MEDICAL—T�RANSPORTED � 38
INTERLOCKYES�NOR INTERLOCK YEs I I NOF YEs t l NO❑
19 LICENSE# STATE SEX M M .C.B. O6 _ O6 _ 1974 39
20 ON DUTY STATUS 1 AIRBAG RESTR EJECT 2 WEB SET 7 INJURY6 [NATURE OF INJURIES
CLASS ABRASION R/ELBOWAND BACK ALONG SPINE ❑ 40
❑21❑ TArE LICENSE vIN1 41
1
PLATE#
42
22❑ PLATE# STATE PLATE# STATE
23❑ 43
TRLR RLR
VIN#. IN#.
VEH YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN
TOWED BY Gov HI 44
24❑ DAMAGE YES NO YES NO
REGISTERED OWNER INFO VEHICLE NO.2
SHADE IN DAMAGED AREA
2 3 4
LIABILITY
INSURANCE❑ INSURANCE
#E CO
IN EFFECT &PO I STOP 5
'E""LE ❑ ,J� CITATION# CHARGE i o BOTTOM
LEGALLY YES N J
25 s e
=ORAJEWSKI
PRINT) OFFICER PHONE BADGE OR ID# AGENCY
26 5 0 12399 WA0171300
PART A PAGE 01 OF
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EF00750
COLLISION REPORT III III III III III 111
1591972 CASE# 24-7409
ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY)
NAME MIDDLE INITIAL) KAESTNER MADELENE F
(LAST FIRST,
ADDRESS&PHONE# D O.B.
833 SW SUNSET BLVD#M58 RENTON WA 98057 4253086185 SEXi F MMDOYyry 02 - 20 - 1997
PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT ' HELMET INJURY NATURE OF INJURIES
❑✓ ❑ 1 POS. 7 2 4 1 USE 1 2 CLASS 11
NAME
(LAST,FIRST,MIDDLE INITIAL) FLETCHER CHELSIE N
ADDRESS&PHONE# DOB
3626 LWR HONOAPIILANI RD F315 LAHAINA H/96761 8087279890 SEX IF MMDDYvvv 01 _ 29 _ 1990
SEAT HELMET INJURY NATURE OF INJURIES
PASSENGER WITNESS❑ UNIT# 1 PGS 9 AIRBAG 2 RESTR. 4 EJECT 1 USE 1 2 CLASS 1
NAME
(LAST FIRST,MIDDLE INITIAL) FLETCHER SHELLIE D
AooREss PHONE# 91 IKAIKA PL LAHAINA H/96761 8082763037 SEX F D•O•B. 09 13_ _ 1964
MMDDYYYY
PASSENGER WITNESS UNIT# ! 1 SEAT 3 AIRBAG 2 RESTR. 4 EJECT 1 HELMET 2 NJURY 1 NATURE OF INJURIES
❑ POS. USE GLASS
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.
RAYMOND GORAJEWSKI 07-16-24 11:09 AM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
CO.JOHNSON 0505 1 713112024 8:10:57 AM
BADGE OR ID# 1Y399 ORI# WA0171300 TIME POLICE DISPATCHED! 5:29 PM TIME POLICE ARRIVED i 5:31 PM
PART I PAGE 2�OF❑
REPORT NO. EF00750 CASE# 24-7409 OF COLLISION
07/15/24 17:25
OF CbLLI510N
NARRATIVE
ASSIGNMENT/ARRIVAL
On 07/16/2024 at approximately 1729 hours, I was dispatched to an injury collision of a vehicle with a
bicyclist at the intersection of Powell Avenue SW and SW 7th Street in the city of Renton, King
County, Washington.
I arrived at approximately 1731 hours.
BICYCLIST: MCINTOSH, ADRON D.
Upon arrival I observed the bicyclist laying in the planter near the sidewalk/roadway edge of SW 7th
Street just east of Powell Avenue SW. I identified the bicyclist as Adron D. McIntosh (DOB:
06/06/1974) by his valid Washington Driver License. I established McIntosh as the bicyclist by the
involved driver's admission.
McIntosh was being treated by the Renton Fire Authority. McIntosh didn't speak the entire time I was
with him, but he was conscious (he was blinking and moving his face). I saw an abrasion to
McIntosh's right elbow and an abrasion along the length of his spine from his shoulders to his lower
back. I did not observe any other injury. I was unable to examine McIntosh for other injury because he
was being immobilized by medical personnel for spinal injury precautions.
I saw a white bicycle helmet with a DOT sticker on the back laying near McIntosh. The outer foam
near the back was damaged. I was unable to tell if the damage was pre-existing or caused from the
collision.
BICYCLE
McIntosh's bicycle was laying in the planter near him. It had been moved from its point of rest. The
rear tire was bent out of shape. The bicycle was a silver, "Juiced" model "Cross Current X" electric-
assisted bicycle (Serial #LB112020060647).
The Renton Fire Authority took the bicycle to store for McIntosh. I had no way to transport the bicycle
in my patrol vehicle.
VEHICLE 1: FORD F-150
I located the involved vehicle, a black Ford F-150 (WA/ C86658N), in the east parking lot of 700
Powell Avenue SW. Vehicle 1 had been moved from its point of rest prior to my arrival. There were no
mechanical defects claimed or observed.
I saw what looked like a rub mark from a tire near Vehicle 1's front, passenger bumper. The height of
the rub mark was consistent with that of McIntosh's bicycle tire.
DRIVER 1: FLETCHER, CURTIS B.
I contacted Curtis B. Fletcher (DOB: 11/16/1994) standing near McIntosh when I arrived. I identified
Curtis by his valid Washington Driver License. Curtis was not injured from the collision. I established
Curtis as the driver of Vehicle 1 by his admission.
PASSENGERS
I contacted several passengers that were in Vehicle 1 at the time of the collision. Madelene F.
Kaestner (DOB: 02/20/1997) was the left, rear passenger, Shellie D. Fletcher (DOB: 09/13/1964) was
the right, front passenger, and Chelsie N. Fletcher (DOB: 01/29/1990), was the right, rear passenger.
No passenger was injured from the collision.
STATEMENT: DRIVER 1
1 spoke with Curtis about the collision. The following is a summary of our conversation:
Curtis drove Vehicle 1 west on SW 7th Street toward Powell Avenue SW at approximately 25 to 30
miles per hour. Curtis intended to turn left (south) onto Powell Avenue SW from SW 7th Street. Curtis
activated Vehicle 1's left turn indicator, slowed for the turn, and checked for on-coming vehicles.
Curtis didn't see any hazard to make the turn, so he turned Vehicle 1 left (south) toward Powell
PAGE 3 OF 5
REPORT NO. EF00750 CASE# 24-7409 OF COLLISION
07/15/24 17:25
OF CbLLI510N
NARRATIVE
Avenue SW. As he was turning, Curtis suddenly saw McIntosh riding his bicycle in the unmarked
crosswalk, crossing Powell Avenue SW from west to east along the south sidewalk of SW 7th Street.
Curtis didn't have time to stop, and Vehicle 1's front bumper collided with the bicycle's rear tire.
McIntosh was ejected from the bicycle and "rolled" across the pavement.
This concluded my conversation with Curtis.
PHOTOGRAPHS
I took photographs of McIntosh's injury, Vehicle 1, and the bicycle with my department issued cell
phone. I uploaded the photographs to Axon's Evidence.com.
DISPOSITION
This concluded my involvement in this case.
I declare under penalty of perjury under the laws of the State of Washington that the foregoing is true
and correct.
Electronically signed by Officer R. Gorajewski, #12399, on 07/16/2024 at 0913 hours in Renton,
Washington.
PAGE 4 OF 5
REPORT NO. EF00750 CASE# ' 24-7409 DATE AND TIME 07/15/24 17:25
OF COLLISION
SW 7th Street
.0
Ncvt to
cafe
Powell Ave SW
PAGE 5 OF 5