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HomeMy WebLinkAbout24-7654 a POLICETRAFFic" II I f I) 11I1ll(111(111l If( f 11 REPORT NO. EF00344 170
27
COLLISION REP FIT 1591971
CASE 24-7654 z
INTERSTATE ❑ CITY STREET FIRE ❑RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHIr.I F ❑ LOCAL AOENC 4Y00 3
HIT 8 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 N E IN CITY# ❑
cowsloN 07 - 1-- 2024 1320 17 ❑.= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓
DUVALL AVE NE BLOCK NO. e✓ 800
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ ❑ FEET e S ❑ W e 2 0 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
,/No D:2063315372 0 11
30
6� LAST NAME TRAN FIRSTNAME TAN MIDDLE 1 2 31
INITIAL
STREET ❑, 627 RACHAEL PL CITY KENT ST 2jp, 98032 z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
INTERLOCK YES[:]NO INTERLOCKYEs NO YES R NO
8❑ LRIIVER #
ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 H U SE
ICNLJAUSSY 1 NATURE OF INJURIES z❑
3
10� P1 aT�S� BYX0777 sTATI WAurN# 3CZRU6H14MM741874
TRAILER STATE TRAILER STATE
11 3 5 PLATE# PLATE# FROM TO
TRLR. A'RLR. 1 5 33
12 3 5 VIN#j VIN#'
FROM TO
VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED By GOVT.VEHICLE 1 $ 34
13 4 2021 HOND HR-V UT DAMAGE YES NO YES[:] NO✓
REGISTERED OWNER INFO OWNEDBYDRIVER VEHICLE NO. 1
❑
SHADE IN DAMAGED AREA ❑ 35
14 LIABILI INSURANCE❑ INSURANCE CO 3 4
IN EFFECT &POLICY# 9TOP
VEHICLE CHARGE 1 5 36
LEGALLY YES❑NO❑ CITATION# 10 BOTTOM
15❑ STANDING 8
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT 02 VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES 1/ NO D:4258025305
16 a
LAST NAME QUAN FIRST NAME ADRIENNE MIDDLE Y
INITIAL
17❑ STREET ❑', 4825 225TH AVE NE CITY REDMOND ST WA ZIP 98053 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[—] LDI IVEW # STATE WA SEX F MMDDW 05 _ 10 _ 2001 0 39
WELMET INJURY1 NATURE OF INJURIES 40
20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 USE CLASS ❑
21❑ LICENSE AJW7888 TATe WA VIN# JTDKDT637C1020010
❑ 41
PLATE#
42
22❑ PLATE# STATE PLATE# STATE
23❑ VIN#. 43
TRLR RLR
'IN#.
GoI
VEH YEAR 2012 MAKE 7'Dy7' MODEL pRIUS C STYLE 4H —FEHICLE
TOWED NOO✓ BLIN TOWED BY v HyES NO 44
24❑ fj
REGISTERED OWNER INFO OWNED SY DRIVER VEHICLE N0.2
SHADE DAGED AREA
4
LIABILITY
INSURANCE I POLICY#E CO PEMCO CA1889648IN IGQ'E""LE
❑ ,J� CITATION# CHARGE
LEGALLY YES N`L J
25
=Kl
(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
J
26 12598 WA0171300
PART A PAGE 01 OF C7
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EF00344
COLLISION REPORT III III III III III 111
1591972 CASE# 24-7654
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'
On Saturday, July 20, 2024 at 1324 hours, I was dispatched to a two-vehicle collision in the area of
the Duvall Ave NE and NE 7th St.
The following occurred within the City of Renton, King County; Unit 1 - WA/ BYX0777was being
driven by Tan Tran and headed south on Duvall Ave NE in the 800 block. Unit 2 - WA/AJW7888 was
driven by Adrienne Quan and was traveling southbound on Duvall Ave NE in the 800 block.
Tan stated he was driving southbound on Duvall Ave NE when he changed lanes and was struck by
Unit 2. When asked for proof of vehicle insurance Tan was unable to provided proof of any kind at the
time of the collision.
Unit 2 was driving south in lane 2 when she observed the vehicle in front of Unit 1 slow to turn then
Unit 1 swerved into lane 2 from lane 1 and collided with the front passenger side fender causing
significant damage to both Unit 1 and Unit 2.
Both involved sustained significant damage but, neither vehicle needed to be towed.
I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT.
J.WISNIEWSKI 07-20-24 03:07 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
PHILIP DAVIS 12018 7/30/2024 4:37:47 AM
BADGE OR ID# 12598 ORI# WA0171300 TIME POLICE DISPATCHED! 1i24 PM TIME POLICE ARRIVED f 1:30 PM
PART I PAGE IT]OF 3�
REPORT NO. EF00344 CASE# ' 24-7654 DATE AND TIME 07/20/24 13:20
OF COLLISION
i
t
gg� )
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