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HomeMy WebLinkAbout24-7611 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 1 27c COLLISION REP FIT 1591971 CASE 24-7611 z INTERSTATE ❑ CITY STREET FIRE ❑RESULTED 1 STOLEN STATE ROUTE ❑ OTHER ❑ VFHICI F ❑ LOCAL AOENC 4Y00 3 HIT&RUN CODING COUNTY RD PRIVATE WAY INVOLVED 2 1 TOTAL#OF OBJECT 1 1 7 28 TRIBAL UNITS OZ STRUCK RESERVATION z 3❑ DATE OF M M D D Y Y Y Y TIME(2400) COUNTY# MILES CITY# COLLISION' 07 - 19 - 2024 1007 17 . N E IN� S 8 W H OF e 1070 3 4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑ RAINIER AVE S BLOCK NO. e✓ --- ----� ❑ 4a❑ MILEPOST DISTANCE OF(REFERENCE OR CROSS STREET) 5❑ ❑ FEET e S ❑ W e AIRPORT WAY 0 3 29 UNIT MOTOOR Z CYDDAL ❑ DYESA✓NOESHOLDMET PHONE 0 3 30 6� LAST NAME WINSTON FIRSTNAME VIVIAN MIDDLE K 1 2 31 INITIAL STREET ❑ 17901 105TH PL SE APT N310 CITY RENTON ST WA ZIP' 980556433 z NEW ADDRESS 7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3 iNTERLOCKYEs NO INTERLOCKYEs NO YES R NO 8❑ LRIIVER # ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 H USEET ICNLJAURY 1 NATURE OF INJURIES z❑ 3 10 1❑ P1 ATE 14 CMC7059 STATE WA uN# 1C4PJLCB8KD444653 TRAILER STATE TRAILER STATE 11 3 5 PLATE# PLATE# FROM To TREK. YRLR. 5 3 33 12 3 5 VIN#j VIN# FROM TO VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE 5 3 34 13 2 2019 JEEP CHERO DAMAGE YES NO YES[:] No✓ REGISTERED OWNER INFO VIVIAN WINSTON 11101105TH PL SEAPTN310 RENTON WA 98055 D:4255241597 VEHICLE NO. 1 ❑ SHADE IN DAMAGED AREA 35 14 LIABILI INSURANCE INSURANCE CO SAME. 4 IN EFFECT &POLICY# 9TOP VEHICLE CHARGE 5 36 LECALLv YES❑NO❑ CITATION# 10 BOTTOM 15❑ STANDING 8 6 MOTOR PEDAL- PEDESTRIAN 16 a PROPERTY DAM THR OLD MET PHONE UNiT VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES 1/ NO D:2533320392 LAST NAME KREISSL FIRST NAME CHRISTIAN MIDDLE N INITIAL 17❑ STREET ❑', 29617 114TH AVE SE CITY AUBURN ST WA ZIP 980922564 37 NEW ADDRESS ❑ 18� CDL IGNITION REQUIRED IGNITION PtR-E-S1ENT MEDICAL TRANSPORTED ❑ 38 INTERLOCKYES�NOR INTERLOCK YEs I I NOF YEs t l NO❑ 19 LICENSE# STATE WA SEX M MMDDW 07 10 _ 1964 39 WELMET INJURY1 NATURE OF INJURIES 40 20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 USE CLASS ❑ 21❑ LICENSE I CLS4685 TATE WA vIN# 3WFB7AX9RM032191 ❑ 41 PLATE# 42 22❑ PLATE# STATE PLATE# STATE TRLR 23❑ UIN#. IN#. 43 RLR ' VEH YEAR 2024 MAKE VOLK MODEL TIGUAN STYLE VEHICLETOWED TO BLIN TOWEDBY GOV HI 44 L4❑ DAMAGE YES NO YES NO REGISTERED OWNER INFO L RECARO AIRCRAFT SEATING AMER]2275 EAGLE PKWY FORT WORTH TX 76177 VEHICLE NO.2 SHADE IN DAMAGED AREA 2 3 4 INAEFFITY ECTNSURANCE INSU&POLICY#E CO SAME. IUQ'E""LE ❑ ,J� CITATION# CHARGELEGALLYYES N`L J25 OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY J 26 M.LEVERTON 2517 WA0171300 PAGE 01 OF PART A 3000-345-159 OR 11/181 STATE OF POLICETRAFFICN CORRECTION REPORT NO. EE97379 COLLISION REPORT III III III III III 111 1591972 CASE# 24-7611 ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY) NAME (LAST FIRST,MIDDLE INITIAL)_ ADDRESS&PHONE# SEX D.O.B. - - MMDDYYYY. PASSENGER❑WITNESS UNIT# SEAT AIRBAG RESTR. EJECT ' HELMET INJURY NATURE OF INJURIES POS. USE CLASS NAME '(LAST,FIRST MIDDLE INITIAL) ADDRESS&PHONE# D D 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. MMDDYYYY. - PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET NJURY NATURE OF INJURIES ❑ ❑ POS. USE CLASS ----� NARRATIVE' slv suv2 blk suv 1 rt vs lane change RTF Within the city limits of Renton/King/WA I responded to a 2 car crash near the intersection of Rainier Ave S at Airport Way. I contacted the driver of unit 1 who told me she had just turned from Rainier onto Airport when unit 2 changed lanes and contacted her vehicle causing some damage on the passenger side. She did not complain of injury and damages did not require a tow truck. I contacted the driver of unit 2 who told me he was in the right turn lane of Rainier Ave S and as he was making his turn onto Airport Way unit 1 crowded his lane with her vehicle contacted her vehicle. He did not complain of injury and damages did not require a tow truck. Information/insurance only 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 7/19/2024 I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT. M.LEVERTON 07-19-24 10:50 AM INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED APPROVED BY DATE CO.JOHNSON 0505 7/19/2024 3:37:47 PM BADGE OR ID# 2517 ORI# WA0171300 TIME POLICE DISPATCHED; 10:10 AM TIME POLICE ARRIVED',10:15 AM PART I PAGE IT]OF REPORT NO. EE97379 CASE# ' 24-7611 DATE AND TIME 07/19/24 10:07 OF COLLISION i { z t 4 $ a u .,C E.. �.,.. mot.•S .4.. .., .,nl w:.7 �,..,'� �ir n{ ')n�v../�,w .�......, ��,b.....��t PAGE 3 OF 3