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HomeMy WebLinkAbout24-7506 POLICETRAFF'c" III !�� I IIIllI111IN II II I REPORT NO. EE99214 170
27
COLLISION REP FIT 1591971
SASE 24asos 2
INTERSTATE ❑ CITY STREET FIRE ❑
RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHIr.I F ❑ LOCAL AOENC 4Y00 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 1 TOTAL#OF OBJECT 1 1 8 28
TRIBAL UNITS 02 STRUCK
RESERVATION
z
3❑ DATE OF M M D D Y Y Y Y TIME(2400) COUNTY# MILES CITY#
cawsloN 07 - 18 - 2024 1010 17 . N E IN� S 8 W H OF e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
SW 43RD ST BLOCK NO. e✓ 1200 ❑
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ �.❑ FEET e S ❑ W e OAKESDALE AVE SW
1 2 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
NO D:2069798807 0 11
30
6� LASTNAME I PALMQUIST FIRSTNAME KENNETH MIDDLE M 1 1 2 31
INITIAL
STREET ❑ 3815 37TH AVE SW CITY SEATTLE ST WA 2jp, 981262426 z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
iNTERLOCKYEs NO INTERLOCKYEs NO YES NO
LRIIVER # STATE WA SEX'M MMDDYY
8❑ ' 11 — 20 — 1953 1 2 32
9 ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 H USE 2 1 CLASS NATURE OF INJURIES z❑
3
10 1❑ PI ATE 14 C82625 W STATE WA u N# 1 GCCS19X4V8120843
11[-j- TRAILER STATE TRAILER STATE
11 3 5 PLATE# PLATE# IR.. ro
TRLR. TRLR 3 7 33
12 0 0 VIN#j VIN#
:: FROM TO
❑ VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN T GOVT.VEHICLE 3 7 34
13 2 1997 CHEV S DAMAGE vEs 0NO f �LAWkkRS TOWING vEs❑ No
REGISTERED OWNER INFO KENNETH PALMQUIST381537THAVE SW SEATTLE WA 98126 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
3 4
14 LIABILITY INSURANCE INSURANCE CO SAFECO H2383185
IN EFFECT &POLICY# 9TOP
VEHCLE CHARGE 5 36
LEGALLY YES❑NO❑ CITATION# 10 BOTTOM
15❑ STANDING 7 6
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES 1/ NO D:2063766288
16 a
LAST NAME BROWN FIRST NAME ARIELLE MIDDLE T
INITIAL
17❑ STREET ❑', 1208 N 26TH ST CITY' RENTON ST WA ZIP 98056 37
NEW ADDRESS ❑
18� CDL IGNITION REQUIRED IGNITION PR—E-1SENT MEDICAL TRANSPORTED ❑ 38
INTERLOCKYES�NOR INTERLOCK YEs It I NOF YES
t t— l NO❑
19 LDIIVER # STATE WA ]SEX IF MMDDW 04 05 _ 2006 39
HELMET {NJURY 1 NATURE OF INJURIES 40
20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 USE 2 CLASS ❑
21❑ LICENSE I CLZ2625 TATe WA VIN# 1N4AL24E39C128117
❑ 41
pLATE#
42
22❑ PLATE# STATE PLATE# STATE
TRLR
23❑ VIN#. IN#. 43
RLR
'
VEH YEAR 2009 MAKE NISS MODEL ALTIMA STYLE VEHICLE TOWED TO BLIN TOWEDBY GOV HI 44
24❑ DAMAGE YES✓ NO BANKERS TOWING YES NO
REGISTERED OWNER INFO ARIELLE BROWN 1208 N 26TH ST RENTON WA 98056 VEHICLE NO.2
SHADE DAGED AREA
4
LIABILITY
INSURANCE INSU&PORGY#E CO ALLSTATE 18845 7653IN 1GQI
'E""LE ❑ ,J� CITATION# CHARGE
LEGALLY YES N`L J
25
7CA
NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
J
26LAN 12007 WA0171300
PART A PAGE 01 OF
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EE99214
COLLISION REPORT III III III III III 111
1591972 CASE# 24-7506
ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY)
NAME MIDDLE INITIAL) RANSOM DEVANTE C
(LAST FIRST,
ADDRESS&PHONE# D O.B. '
32115 20TH LN SW FEDERAL WAY WA 98023 2063908695 SEX M MMDDYyry 11 - 08 - 1997
PASSENGER WITNESS SEAT AIRBAG RESTR. EJECT ' HELMET INJURY NATURE OF INJURIES
Z UNIT# POS. USE CLASS
NAME
(LAST,FIRST,MIDDLE INITIAL)
ADDRESS&PHONE# DOB
SEX MMDDYVYV
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.0.8.
MMDDYYYY. -
PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET NJURY NATURE OF INJURIES
❑ ❑ POS. USE CLASS ----�
NARRATIVE'
On July 18, 2024, at 1010 hours dispatch requested that I respond to a collision that occurred at SW
43rd St and Oakesdale Ave SW, in Renton.
Upon my arrival I spoke with the driver of unit 1 and he explained he was going westbound on SW
43rd St but did not know how the collision occurred.
I was then approached by a witness who stated that unit 1 merged left from lane 1, striking unit 2 who
was driving westbound on SW 43rd St in lane 2.
1 then spoke with the driver of unit 2 and they explained they were going westbound on SW 43rd St
and approaching Oakesdale Ave SW when the collision occurred. They explained they were in the
number 2 lane when unit 1 merged left into them.
After speaking with all the involved parties, I believe unit 1 merged improperly.
I provided the drivers with a copy of the exchange of information and both vehicles were removed by
Bankers Towing.
I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT.
C.CATALAN 07-19-24 12:18 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
CO.JOHNSON 0505 7/25/2024 3:41:53 PM
BADGE OR ID# 12007 OR]# WA0171300 TIME POLICE DISPATCHED 10:13 AM TIME POLICE ARRIVED 10:26 AM
PART I PAGE IT]OF
REPORT NO. EE99214 CASE# ' 24-7506 DATE AND TIME 07/18/24 10:10
OF COLLISION
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