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HomeMy WebLinkAbout24-7758 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 1 27c
COLLISION REP FIT 1591971
CASE 24-7758 z
INTERSTATE ❑ CITY STREET ❑ FIRE ❑RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ HIT F ❑ LOCAL AOENC 4200 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 N E IN CITY# ❑
cawsloN 07 - 1-- 2024 1356 17 ❑.= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓
BLOCK
EASTVALLEYRD M101
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ 190 00 FEET MILES e S B W e SW41ST ST
0 3 29
MOTUNIT O1 VEHICR Z PEDAL-CLE CYCLE ElYYESA�NO THRESHOLD MET PHONE 0 3 30
6� LAST NAME ISSAH FIRSTNAME ABUBAKAR MIDDLE S 1 1 2 31
INITIAL
STREET ❑, 815 S 216TH ST UNIT 304 CITY DES MOINES ST WA 2jp, 981986332 z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
:NTERLOCKYEs NO INTERLOCK YES NO YES No
8❑ DRIVERS
# STATE WA SEX'M MIDI 04 — 10 — 1983 1 2 32
9 ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 HELMETU SE CLASS 1 NATURE OF INJURIES z❑
3
10 9❑ P1 aT�S� CDL4031 sTAr1 WAurN# JTMRJREV2JD211305
TRAILER STATE TRAILER STATE
11 3 5 PLATE# PLATE# FROM To
TRLR. TRLR. 7 5 33
12 3 5 VIN#' VIN#'
>; FROM TO
❑ VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN T GOVT.VEHICLE ] 4 34
13 2 2018 TOYT RAV4 DAMAGE vEs 0NO f �AWkkRS vEs❑ No
REGISTERED OWNER INFO ABUBAKAR ISSAH 815 S 216TH ST UNIT304 DES MOINES WA 981986332 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
3 4
14 LIABILITY INSURANCE INSURANCE CO PROGRESSIVE 981856034
IN EFFECT &POLICY# 9TOP
VEH" CHARGE I 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 [:]EA.
YES NO ,/ D:2063257921
16 a
LAST NAME MURRAY FIRST NAME MARC MIDDLE M
INITIAL
17❑ STREET ❑', 1429 25TH AVE CITY SEATTLE ST WA ZIP 981223015 37
NEW ADDRESS ❑
18� CDL IGNITION REQUIRED IGNITION PR—E-1SENT MEDICAL—T�RANSPORTED 38
INTERLOCKYES�NOR INTERLOCK YEs It I NOF YES
t l NO❑
19 LICENSE# STATE WA SEX M M D.O.B. 04 11 1968 0 39
WELMET INJURY1 NATURE OF INJURIES 40
20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 USE CLASS ❑
21❑ LICENSE I C11824Y TAre WA vIN# 5PVNJ8JV2H4S63221
❑ 41
PLATE#
42
22❑ PLATE# STATE PLATE# STATE
23❑ UIN#. 43
TRLR RLR
'IN#.
VEH YEAR 2017 MAKE HIND MODEL 2581268 STYLE VEHICLETOWED TO BLIN TOWEDBY GOV HI 44
24❑ DAMAGE YES NO YES NO
REGISTERED OWNER INFO CRAM ENTERPRISE LLC 142925TH AVE SEATTLE WA 98122 VEHICLE NO.2
SHADE IN DAMAGEbAREA
2 3 Cd
INAEFFITY ECTNSURANCE INSU&POLICY#E CO SAME. 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.tEVERTON 2517 WA0171300
PART A PAGE 01 OF C7
3000-345-159 fR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EE99218
COLLISION REPORT III III III III III 111
1591972 CASE# 24-7758
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'
both turning right from same driveway
RTF
Within the city limits of Renton/King/WA I responded to a 2 vehicle blocking crash about the 4050
block of East Valley Rd.
I contacted the driver of unit 1 who told me a large white box truck was stopped in the driveway on the
east side of the road, no signal just sitting. He said as he began to make his right turn so did the
truck, basically colliding in the private drive. He did not complain of injury and damaged required a
tow truck.
I contacted the driver of unit 2 who told me he had moved his truck towards the left to make swing
room as he made his right hand turn onto East Valley Rd. He claimed his signal was active. I
observed his signal to be operatable. He said the driveway was clear with no cars in sight as he
proceeded when suddenly contact was made with unit 1. He did not complain of injury and damages
were unremarkable.
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 7/23/2024
I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT.
M.LEVERTON 07-23-24 02:53 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
CO.JOHNSON 0505 7/25/2024 3:38:49 PM
BADGE OR ID# 2517 OR]#' [ WA0171300 TIME POLICE DISPATCHED; 2:08 Pry TIME POLICE ARRIVED',Y:06 PM
PART I PAGE IT]OF
REPORT NO. EE99218 CASE# ' 24-7758 DATE AND TIME 07/23/24 13:56
OF COLLISION
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