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HomeMy WebLinkAbout24-10097 POLICETRAFF'c" III !�� I IIIllI111IN II II I REPORT NO. EF22170 170
27
COLLISION REP FIT 1591971
SASE 24-10097 2
INTERSTATE ❑ CITY STREET ❑ FIRE ❑
RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHIC;I F ❑ LOCAL AOENC 4200 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 2 TOTAL#OF OBJECT 1 1 8 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# ❑
COLLISION 09 - 1-- 2024 2023 17 ❑.❑ S 8 W e IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓
S CARR RD BLOCK NO. e✓ 1100
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ 100 00 FEET MILES e S B W e MI!!AVE S
2 0 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
No ,/ I D:2064659835 0 11
30
6� LAST NAME LAWHON FIRSTNAME RONALD MIDDLE R 1 1 2 31
INITIAL
STREET ❑ 17806 142ND AVE SE CITY RENTON ST WA 21p 980589206 z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
INTERLOCK YES[:]NO,/ INTERLOCKYEs NO Z/ YES R No�/
8❑ LRIIVER #
ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 HELMET USE 2 CLASS 1 NATURE OF INJURIES 2❑
3
LICENSE C64903R sTArr WAurN# 1GTV2NEC1JZ200608
10 F91 PI ATE#
TRAILER STATE TRAILER STATE
11 3 5 PLATE# PLATE# FROM TO
TRLR. TRLR 6 2 33
12 3 5 VIN#' VIN#
>; FROM TO
VEH.YEAR 2018 MAKE MODEL STYLE VEHICLE TOWED TO BLIN 6 2 TOWED BY GOVT.VEHICLE 34
13 4 GMC SIERRA PK DAMAGE YES NO YES[:] NO✓
REGISTERED OWNER INFO RONALD LAWHON 17806142ND AVE SE RENTON WA 98058 D:2064659835 VEHICLE NO. 1
❑ ❑
SHADE IN DAMAGED AREA 35
14 LIABILITY INSURANCE INSURANCE CO AMERICAN FAMILYBX13393081 3 4
IN EFFECT &POLICY# 9TOP
ve'Cle CHARGE 1 5 36
LEGALLv Yes❑NO❑ CITATION# 10 BOTTOM
15❑ STANDING 8
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES,/ NO D:2064465038
16 a
LAST NAME OKOT-OKIDI FIRST NAME HOLLY MIDDLE A
INITIAL
17❑ STREET ❑', 15742 SE 167TH PL CITY' RENTON ST WA ZIP 980588284 37
NEW ADDRESS ❑
18� CDL IGNITION REQUIRED IGNITION PtR-E-S1ENT MEDICAL TRANSPORTED 38
INTERLOCK YES❑No� INTERLOCK YEs I I NOF YEs t l NOF,/
19 LDIIVEW # STATE WA ]SEX IF M .C... 04 12 _ 1991 El 39
HELMET {NJURY 1 NATURE OF INJURIES 40
20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 USE 2 CLASS ❑
21❑ LICENSE BTZ7946 TAre WA VIN# 5J6RM3H56EL037535
❑ 41
PLATE#
42
22❑ PLATE# STATE PLATE# STATE
TRLR
23❑ VIN#. IN#. 43
RLR
'
VEH YEAR 2014 MAKE HOND MODEL CR-V STYLE UT VEHICLETOWED TO BLIN TOWEDBY GOV HI 44
24❑ DAMAGE YES NO,/ YES NO✓
REGISTERED OWNER INFO HOLLY OKOT-OKIDI 15742 SE 167TH PL RENTONWA98058 VEHICLE NO.2
SHADEDAMAGEDAREA
3 4
LIABILITY
INSURANCE &POINSURGY#E CO PROGRESSIVE 960334972IN STOP 5
'E""LE ❑ ,J� CITATION# CHARGE io BOTTOM
LEGALLY YES N`L J
25 ' e
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
J
26
C.PAGET 8660 WA0171300
PART A PAGE 01 OF C7
3000-345-159 fR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EF22170
COLLISION REPORT III III III III III 111
1591972 CASE# 24-10097
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
PM 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'
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.
C.PAGET 09-26-24 09:50 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
DESIRES SCOTT 10272 1 101712024 11:33:38 AM
BADGE OR ID# 8660 OR]# WA0171300 TIME POLICE DISPATCHED! 8:25 Pry TIME POLICE ARRIVED',8:Y9 Pry
PART Ei PAGE IT]OF 4�
REPORT NO. EF22170 CASE# 24-10097 OF COLLISION
09/26/24 20:23
OF CbLLI510N
NARRATIVE
24-10097 non-injury, non-blocking collision
Axon:
Axon body cam available
Narrative:
On 09.26.2024 at 2029 hours, I arrived at the 7-Eleven located at 17615 108 AVE SE to contact two
drivers who pulled into the lot after a collision. The collision occurred at 2023 hours in the 1100 block
of S Carr RD. (Described as being near the New Horizon School at 1111 S Carr Rd). This is within
the city limits of Renton, County of King, WA. The ground was damp as it had rained this evening.
When I arrived, I found a Gray 2018 GMC Sierra pickup WA/C64903R parked in a parking stall. The
front bumper of a white 2014 Honda CRV WA/BTZ7946 attached the driver's side rear bumper of the
truck. Both drivers were standing near the truck.
I advised both drivers that our contact was recorded.
Ronald R Lawhon DOB/07.19.1956 is the registered and legal owner of the Gray 2018 GMC Sierra
Pickup WA/C64903R. Lawhon was identified by photo WADL and his DOL status is valid. Lawhon
provided proof of insurance. Lawhon told me that he was headed up the hill (eastbound) on S Carr
RD. Lawhon signaled to change lanes, but White Honda CRV was in his blind spot. Lawhon was in
the curb lane and the white Honda was in the center lane. Lawhon didn't see the white Honda and
struck the vehicle as he changed lanes. Lawhon had no injuries.
I loaned Lawhon a tool and he was able to remove the Honda bumper from his bumper and return it
to Orot-Okidi.
I spopke with Holly A Okot-Okidi DOB/04.12.1991. Okot-Okidi was identified by photo WADL and her
DOL status is valid. Okot-Okidi is the registered owner of the white 2014 Honda CRV WA/BTZ7946.
Okot-Okidi provided proof of insurance. Okot-Okidi was headed eastbound in the center lane when
Lawhon's gray GMC Sierra Pickup changed lanes and struck her vehicle. Okot-Okidi is uninjured.
If not for the actions of Lawhon, the collision would not have occurred.
No citations issued.
I certify (or declare) under penalty of perjury under the laws of the State of Washington that the
foregoing is true and correct.
Electronically signed by Officer C. Paget/8660 9/26/2024 9:18 PM Renton, King County, WA.
PAGE 3 OF 4
REPORT NO. EF22170 CASE# 24-10097 DATE AND TIME 09/26/24 20:23
OF COLLISION
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PAGE 4 OF 4