HomeMy WebLinkAbout24-10162 iiTFiNII IIIII III IIIII II IIII IIIII I . 27c REPORT NO EF19931oc� RA COLLISION REPORT 1591971 CASE# 24-10162 2 INTERSTATE CITY STREET FIRE I RESULTEDSTOLENSTATE ROUTE OTHER VEHICLE LdCAI-A`NG 4100 3 HIT&RUN CODING COUNTY RD PRIVATE WAY INVOLVED 2 TOTAL#OF OBJECT 1 s 28 TRIBAL UNITS 02 STRUCK RESERVATION : 1 1 2 3� M M D D Y Y Y Y TIME(2400) COUNTY# MILES CITY# eaCL s on' 09 - 28 - 2024 1847 17 =.[� S 8 W e OF IN e 1070 3 4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓ BLOCK NO. e .� 4a S 2ND ST MILE POST ❑ ❑ DISTANCE OF(REFERENCE OR CROSS STREET) 5 3001.1 00 FEET e✓ S 8 W e✓ LAKE AVE S 0 4 29 MOTOR PEDAL- DAMAG THRESHOLD MET PHONE UNIT 01 VEHICLE ❑ CYCLE ❑ YES No �/ D:5095717722 0 1 30 5 LAST NAME HAMMERMEISTER FIRST NAME ABIGALE MIDDLE B 1 1 2 31 INITIAL STREET ❑ 2000 RESERVOIR LOOP RD CITY; SELAH ST I WA ZIP; 98942 2 NEW ADDRESS 7 CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3 INTERLOCKYEs NO�/ INTERLOCKVES N©�/ YEs NO;�/ 8 DRIVER # STATE WA SEXI F MMDDYY' 09 - 29 - 2003 1 2 32 9 ON DUTY STATUS' AIRBAG 2 RESTR 4 EJECT 1 N USEET 2 CLASSY 1 NATURE of INJURIES 2= 10 PI ENSttEI BZA2798 STATE WA V 1HGCVIF45JA099216 3 TRAILER STATE TRAILER STATE 11 3 0 PLATE# PLATE# 1ROM To TRLR zRLR 3 1 5 33 12 3 0 UIN#' VIN# FROM TO VEH.YEAR 2018 MAKE yOND MODEL ACCOR STYLE SD VEHICLE TOWED[n TO ZBLIN TOWEDBY GOVT VEHICLE 3 7 34 13� DAMAGE YES II_II NO YESII_I) NO REGISTERED OWNER INFO ABIGALE HAMMERMEISTER 2000 RESERVOIR LOOP RD SELAH WA 98942 D:5095717722 VEHICLE NO. 1 SHADE IN DAMAGED AREA 35 1 LIABILITY INSURANCE INSURANCE CO 2 3 4 14 ALLSTATE 17749 IN EFFECT &POLICY# 4TOP VEn" CHARGE t 5 36 Lec Ly YES❑NO❑ CITATION# 70 80TTOM 15❑ STM ING e MOTCYR PEDAL- PEDESTRIAN PROPERTY DAM OLD MET PHONE UNIT 02 VEHICLE CYCLE nWNFR YES�/ THR NO D:2065077013 16� LAST NAME CONSTANTINO FIRST NAME KENDALL MIDDLE G INITIAL STREET ❑ 17 ❑ 12828 84TH AVE S CITY SEATTLE ST, WA ZIP 98178 q 37 NEW ADORE SS 18❑ CDL IGNITION REtQUIRED IGNITION PRESENT MEDICAL TRANSPCRTED'. 38 INTERLOCKYES No INTERLOCK YES NO YES NO 19 DRIVER'S MMIDDYYJ I — 20❑ ON DUTY❑ STATUS AIRBAG 2 RESTR 13 EJECT 2 HELMET 5 INJURY 6 NATURE OF INJURIES 40 USE CLASS BROKEN ARM 21 LICENSEPLATE# A 7703362 rare WA vIN# CB360106199 41 22❑ [TILER TAILER PLATE# STATE PLATE# STATE 42 23 TRLR r RLR 43 UIN#. 'IN# TOWED BY GOV HI 44 VEH.YEAR 9974 MAKE HOND MODEL CB$60 STYLE MB VEHICLE TOWED✓ No BLIN BANKERS 24 REGISTERED OWNER INFO KENDALL CONSTANTIN01282884TH AVES SEATTLE WA 98178 D:2065077013 VEHICLE NQ.2 SHADFjy DAMAGED AREA 3 4 LIABILITY INSURANCE❑ INSURANCE CO IN EFFECT &POLICY#1-1— YES❑ NIL] CITATION11 CHARGEUR 25 OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY 26 KEVIN PETERSON 12808 WA0171300 PART A PAGE 01 OF 1 3000-348-189(R 11/181 STATE OF POLICETRAFFICN CORRECTION REPORT NO. EF19931 COLLISION REPORT III III III III III 111 1591972 CASE# 24-10162 E NA ADDITIONAL PERSONS INVOLVED(PASSENGERS AND/OR WITNESSES ONLY) M (LAST,FIRST,MIDDLE INITIAL) VENCES-MOSCOT DANIELA ADDRESS&PHONE# 2000 WEST LINCON AVE APT 22 YAKIMA WA 98902 SEXi F MM DD'yyy 09 - 03 1- 2003 PASSENGER Z WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET INJURY NATURE OF INJURIES �I 1 POS. 3 2 4 1 USE 2 CLASS 1 ----� :NAME Lnsr EIRST,MIDDLE INITIAL) FLOWERS KALENA A ADDRESS&PHONE# 8958 N TORREY LN HAYDEN ID 83835 SEX' F D.O.B. 06 _ 17 _ 2004 MMDDYYYY SJURY NATURE OF INJURIES PASSENGER a WITNESS UNIT# EAT HELMET 1 SOS. ' 9 AIRBAG 2 RESTR. 4 EJECT 1 USE 2 CNLASS 1 ----� :NAME (LOST,FIRST,MIDDLE INITIAL) ADDRESS&PHONE# SEX/ MMDDYY D.O.B. YY PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET NJURY NATURE OF INJURIES —1 1POS. I USE CLASS NARRATIVE I was dispatched to a collision on 09/28/24 at 1848 hours at S 2nd St and Lake Ave S, in city Renton, King County WA. Unit 1 BZA2798 Driver: Abigale B. Hammermeister (DOB 09/29/2003) Unit 1 A7703362 Driver: Kendall G. Constantino (DOB 03/07/1999) Unit 2 stated he was traveling in lane 2 driving West on S 2nd St. As he was approaching the safeway parking lot entrance Unit 2 who he stated was traveling in lane 3 then turned left in front of him causing him to hit them. Unit 1 stated that she was traveling in lane 2 on S 2nd St heading West when she went to turn left into Safeway parking lot and did not see the bike in her blind spot causing her to cross over his lane and Unit 2 crashing into her. Medic evaluated Unit 2 and transported him to Valley Medical Center. Unit 1 and her passengers stated there was no injury. Both Units were given the case number as reference. I certify (declare) under penalty of perjury under the laws of the State of Washington that the foregoing is true and correct. Electronically signed: Officer Kevin L. Peterson Date and Place: 09/28/2024, 2254 hours at Renton, WA I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT. KEVIN PETERSON 09-28-24 11:46 PM INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST.DET DATED PLACE SIGNED APPROVED BY DATE P.SUMMERS 8887 913012024 11:55:08 AM BADGE OR ID# 12808 ORI# WA0171300 TIME POLICE DISPATCHED 1 6:48 PM TIME POLICE ARRIVED i 6:50 PM (PART B 3 Da-3mx-attar(t 1Mff) PAGE 2�OF F3 REPORTNO. EF19931 CASE# 24-10162 DATE AND TIME 09/28/2418:47 OF COLLISION d PAGE 3 OF 3