HomeMy WebLinkAbout24-7509 POLICETRAFF'c" III !�� I IIIllI111IN II II I REPORT NO. EE97378 170
27
COLLISION REP FIT 1591971
SASE 24asos 2
INTERSTATE ❑ CITY STREET FIRE ❑
RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHICI F ❑ LOCAL AOENC 4200 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# ❑
cowsloN 07 - 18 - 2024 1240 17 ❑.❑ N E IN S 8 W H OF e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓
S 3RD ST BLOCK e✓ 200
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ 150 00 FMILES EET e S ❑ E e RAINIER AVE S
0 4 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
NO F,/ I D:2064204712 0 11
30
6� LAST NAME BELLAL FIRSTNAME KARIM MIDDLE 1 2 31
INITIAL
STREET 01 18225 1ST AVE S APT 112 CITY NORMANDY PARK ST WA ZIP 98148 z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
:NTERLOCKYEs NO INTERLOCK YES NO YES No
8❑ DRIVERS
# STATE WA SEX'U I D-MIDI Y' 01 — 24 — 1963 1 2 32
9 ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 H U SE
ICNLJAUSSY 1 NATURE OF INJURIES z❑
3
10 9❑ P1 ATNES# A G W6469 sTAr WAv N# 1 D4GP25R956186147
TRAILER STATE TRAILER STATE
11 2 5 PLATE# I PLATE# I I FROM TO
TRLR. TRLR 7 1 33
12 2 5 VIN#' VIN#
>; FROM TO
❑ VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE 7 $ 34
13 1 2005 DODG CAVAN DAMAGE YES NO ✓ YES❑ No✓
REGISTERED OWNER INFO R.BELLAL 182251STAVE SAPT 112 NORMANDYPARK WA 98148 D:2064204712 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
14 LIABILI INSURANCE INSURANCE CO SAME. 3 4
IN EFFECT &POLICY# 9TOP
VE—L' CHARGE 1 5 36
LEGALLY re5 No CITATION# 4A0361547 IMPROPER LANE USAGEMOT I o eorrom
15❑ STAIN.D'ING 7 6
UNIT VEHICLE CYCLE ❑ PEDESTRIAN ❑ OWNER RTY ❑ DYES✓ NO OLDMET PHONE
16 a
LAST NAME WOULF FIRST NAME KIMBERLY MIDDLE A
INITIAL
17❑ STREET ❑', 13022 SE MAY CREEK PARK DR CITY NEWCASTLE ST WA ZIP 980562683 37
NEW ADDRESS ❑
18� CDL IGNITION REQUIRED IGNITION PtR—E—S1ENT MEDICAL—T�RANSPORTED 38
INTERLOCKYES�NOR INTERLOCK YEs I I NOF YEs t l NO❑
19 DRIVER # STATE WA SEX F MMDDW 11 15 _ 1960 39
WELMET INJURY1 NATURE OF INJURIES 40
20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 USE CLASS ❑
21❑ LICENSE AOG7666 TAre WA VIN1 1GIPE5SB7E7310035
❑ 41
PLATE#
42
22❑ PILER LATE# STATE PLATE# STATE
23❑ VIN#. 43
TRLR RLR
'IN#.
VEH YEAR 2014 MAKE CHEV MODEL CRUZE STYLE VEHICLETOWED TO BLIN TOWEDBY GOV HI 44
24❑ DAMAGE YES NO✓ YES NO✓
REGISTERED OWNER INFO WAYNE WOULF 13022 SE MAY CREEK PARK DR NEWCASTLE WA 98056 VEHICLE NO.2
SHADE IN DAGELLAREA
z Cdd
LIABILITY
INSURANCE INSU&POLICY#E CO SAFECO H2465878IN IGQ'E""LE
❑ ,J� CITATION# CHARGE
LEGALLY YES N`L J
25
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
J
26
M.LEVERTON 2517 WA0171300
PART A PAGE 01 OF C7
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EE97378
COLLISION REPORT III III III III III 111
1591972 CASE# 24-7509
ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY)
NAME(LAST FIRST,MIDDLE INITIAL) UNK .
ADDRESS&PHONE# D O.B.
SEX' U MMDDYYYY -❑
PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT ' HELMET INJURY NATURE OF INJURIES
❑ �' PM USE CLASS
NAME
'(LAST,FIRST MIDDLE INITIAL)
ADDRESS&PHONE# D O B
SEX' MMDDYYYY
PASSENGER ❑WITNESS❑ UNIT# SEAT AIRBAG RESTR. EJECT HELMET INJURY NATURE OF INJURIES
POS. USE CLASS
NAME
(LAST FIR57 MIDDLE INITIAL)
AppRESS R PHONE#
SEX D.O.B.MMDD -❑
YYYY.
PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET NJURY NATURE OF INJURIES
❑ ❑ POS. USE CLASS ----�
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.
M.LEVERTON 07-18-24 03:04 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
CO.JOHNSON 0505 1
711912024 3:36:34 PM
BADGE OR ID# 2517 ORI# WA0171300 TIME POLICE DISPATCHED; 12:41 PM TIME POLICE ARRIVED',12:45 PM
PART I PAGE IT]OF 4]
REPORT NO. EE97378 CASE# 24-7509 OF COLLISION
07/18/24 12:40
OF CbLLI510N
NARRATIVE
blu minivan It from lane 1 into blk sedan/2
CC
Within the city limits of Renton/King/WA I responded to a 2 car blocking crash at the 200 block of S
3rd St.
Both vehicles were able to clear the roadway and pull into the Safeway parking lot. An unknown male
walked over and told me unit 2 was in lane 2 while unit 1 in lane one attempted a left turn towards the
Safeway parking lot and hit unit 2.
1 contacted the driver of unit 2 who told me she was eastbound S 3rd St in lane 2 when unit 1 made a
left turn into the side of her car. She did not complain of injury and damages did not require a tow
truck.
I contacted the driver of unit 1 ID'd by picture WADL. He told me vaguely about where he was and he
was attempting to turn left into the parking lot but was hit by unit 2. He did not complain of injury and
damages did not require a tow truck.
Unit 2 would have had to be driving in the parking stalls on the north side of S 3rd St. After hearing
the Wit tell me what happened, unit 2 account and unit 1 vaguely explaining I believe unit 1 made an
improper turn/lane use causing a 2 car non injury crash.
I cited unit 1 via complaint ref RCW 46.61.140 improper lane use.
I certify (declare) under penalty of perjury under the laws of the State of Washington that the
foregoing is true and correct.
M.Leverton/2517 City of Renton/King/Wa 7/18/2024
PAGE 3 OF 4
REPORT NO. EE97378 CASE# ' 24-7509 DATE AND TIME 07/18/24 12:40
OF COLLISION
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PAGE 4 OF 4
