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HomeMy WebLinkAbout24-10213 IT si " II IIIII III IIIII II IIII IIIII I . 27c REPORT NO EF21738OLCERA COLLISION REPORT 1591971 CASE# 24-10213 2 INTERSTATE CITY STREET FIRE ❑ RESULTED 1 STOLEN STATE ROUTE ❑ OTHER ❑ VEHICLE ❑ LOCAI-A`NG 4200 3 HIT&RUN CODING COUNTY RD PRIVATE WAY INVOLVED 2 TOTAL#OF OBJECT 5 1 28 TRIBAL UNITS 02 STRUCK RESERVATION : 1 1 2 3� M M D D Y Y Y Y TIME(2400) COUNTY# MILES CITY# eaCLson' 09 - 30 - 2024 0857 17 =.= S 8 W e IN e 1070 s 4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓ RAINIER AVE S BLOCK NO. e 800 .� 4a❑ MILE POST ❑ DISTANCE OF(REFERENCE OR CROSS STREET) 5 1001.1 00-] MILES N FEET e✓ S 8✓ E e SGRADYWAY 0 1 29 MOTOR PEDAL- DAMAG THRESHOLD MET PHONE UNIT 01 VEHICLE ❑ CYCLE ❑ YES No �/ D:2066183050 2 0 30 5❑ LAST NAME CALLOWAY FIRST NAME DERRICK MIDDLE D 1 2 31 INITIAL STREET ❑✓ 13117142ND AVE NW CITY; GIG HARBOR ST I WA ZIP; 98329 2 NEW ADDRESS 7 CDL IGNITION REQUIRED IGNITION PRESENT MEDIQAL TRANSPORTED 3 INTERLOCKYES NO✓ INTERLOCKYES NO✓ YES F NO✓ DRIVER # STATE SEX I M MM0,13. 04 - 03 - 2000 t 1 2 32 $❑ 9 ON DUTY STATUS' AIRBAG 2 RESTR 9 EJECT 1 N USE ET CLASSY 1 NAruRE of INJURIES 2 LICENSE, SSA175 STATE HI V 1N4AL3AP2FC443658 3 10� PI ATE# IN# TRAILER STATE TRAILER STATE 11 3 5 PLATE# PLATE# FROM To TRLR rRLR 5 1 33 12 3 5 VIN# vIN# FROM TO VEH.YEAR 2015 MAKE NI$$ MODEL UNKNO STYLE 4D VEHICLE TOWED[n TO ZBLIN TOWEDBY GOVT VEHICLE g 1 34 13� DAMAGE YES II_II NO YESII_I) NO✓ REGISTERED OWNER INFO DERRICK CALLOWAY 13117142ND AVE NW GIG HARBOR WA 98329 D:2066183050 VEHICLE NO. 1 SHADE IN DAMAGED AREA 35 14 LIABILITY INSURANCE NSURANCE CO THE GENERAL WA8069092 4 IN EFFECT &POLICY#VEHICLE 9TOP _ srgNOLNG ❑NO❑ CITATION# 4A0638899 CHARGE NO VALID OPER LICENSE WITH s o Qorrofi 36 Yes 15 MOTOR ✓ PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE UNIT VEHICLE CYCLE nWNFR D:9079523686 16� LAST NAME DOLAN FIRST NAME MATHEW MIDDLE' B INITIAL 17 F1 STREET ❑ ❑ 19306 SE 31 ST DR CITY CAMAS ST, WA ZIP 98607 37 NEW ADDRESS 18❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICALTRANSPORTED' 38 INTERLOCKYEs ND✓ INTERLOCK YES No R yEs ND✓ 19 DRIVERS STATE WA SEX M DO B' 02 11 1982 � 39 LICENSE# MMDDYY — HELMET INJURY: NATURE OF INJURIES 40 20❑ ON DUTY STATUS AIRBAG 2 RESTR g EJECT 1 USE CLASS 1 ❑ 21 LICENSE I PATE# BGX1259 TATE WA I El VIN# 3N1 CN7AP7EL809589 41 22❑ PLAILER TE# STATE PLATE# STATE 42 23 TRLR RLR 43 UIN#. 'IN# VEH.YEAR 2014 MAKE NJ$$ MODEL VERSA STYLE qp VEHICLE TOWED TO BLIN TOWED BY GOV HI 44 24 DAMAGE YES NO✓ VES NO✓ REGISTERED OWNER INFO MATHEW DOLAN 19306 SE 31ST DR CAMASWA98607 D:9079523686 VEHICLE NO.2 SHADE IN DAMAGED AREA 2 3 4 LIABILITY INSURANCE INSURANCE CO ALL STATE 907785427 IN EFFECT &POLICY# I STOP L,EILY YES❑ NJ—I, CITATION# CHARGE to BOTTOM LEGALL 25 s e OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY 26 SHAWN CROW 12618 WA0171300 PAGE 01 OF PART A 3000-348-189(R 11/18) STATE OF POLICETRAFFICN CORRECTION REPORT NO. EF21738 COLLISION REPORT III III III III III 111 1591972 CASE# 24-10213 ADDITIONAL PERSONS INVOLVED(PASSENGERS AND/OR WITNESSES ONLY) '.NAME (LAST,FIRST,MIDDLE INITIAL) ADDRESS&PHONE SEXi D.O.B. — MMDDYYYY PASSENGERQ WITNESS� UNIT SEAT AIRBAG RESTR. EJECT ; HELMET INJURY NATURE OF INJURIES POS. ' USE CLASS 1 ----� :NAME (LAST FIRST MIDDLE INITIAL) ADDRESS&PHONE# SEX D.O.B. — MMDDYYYY PASSENGER❑WITNESS UNIT# : SEAT AIRBAG RESTR. EJECT HELMET INJURY: NATURECFINJURIES POS. USE 0,SS ----� :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 POS. I 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. SHAWN CROW 10-05-24 02:35 PM INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST.DET DATED PLAGE SIGNED APPROVED BY DATE D.SKELTON 9139 10/6/2024 3:45:38 AM BADGE OR ID# 12618 ORI# WA0171300 TIME POLICE DISPATCHED 9:01 AM TIME POLICE ARRIVED i 9:10 AM PAST B 3 Do-3mx—attar(t 1Mff) PAGE 2�OF 4 REPORT NO. EF21738 CASE# 24-10213 OF DATE AND r�N + 09/30/24 08:57 O�COLLISION NARRATIVE On 09/30/2024 at about 0902 hours I was dispatched to a non-injury motor vehicle collision that occurred on Rainier Ave S just south of the intersection at Rainier Ave S/S Grady Way within the city limits of Renton, King County, Washington. Dispatch advised that both drivers would move their vehicles to a nearby parking lot to meet with police. Neither driver was injured, and both vehicles were able to be driven from the scene with minor damage to the exterior mirrors on both cars. I began to assist both drivers with exchanging information, but I soon discovered that Derrick D. Calloway was driving without a valid driver's license. When asked about the collision Derrick (driver of Unit 1-2014 Nissan with Hawaii stated license plate SSA175) explained he was headed northbound on Rainier Ave S when the other vehicle (Unit 2-2014 Nissan Versa with Washington state license plate BGX1259) changed lanes and collided into Derrick's car. The driver of Unit 2 (Mathew B. Dolan) said he was changing lanes (to his left) when Unit 1 quickly drove up from behind Unit 2 striking it. Unit 1 had damage to the passenger side exterior mirror, and Unit 2 had damage to the driver side exterior mirror. Derrick claimed the other driver struck him as he changed lanes, but Mathew claimed the other driver drove up on him quickly striking his car suggesting Unit 1 was driving at a high rate of speed. No other witnesses came forward, and I could not rule out speed as being a factor in this collision, and I was unable to determine who was at fault for this collision. I informed Derrick that I would be citing him for driving without a valid driver's license with ID. Derrick had a Washington state photo ID card, and mentioned he recently moved to Washington state from Hawaii. Derrick's ID card was issued on 07/02/2024, and that appears to be plenty of time to acquire a Washington state driver's license since moving to the state of Washington. I completed the infraction (4A0638899) and sent it to the prosecutor's office. I gave each driver a Renton PD business card with the case number. I certify (declare) under penalty of perjury under the laws of the State of Washington that the foregoing is true and correct. Signature: Shawn Crow Date and Place: 09/30/2024 at Renton, WA PAGE 3 OF 4 REPORT NO. EF21738 CASE# 24-10213 DATE AND TIME 09/30/24 08:57 OF COLLISION now r CL At s sk s s� }s i s i4,i i ti } 3 i i 4 l Q Y �S v� %t PAGE 4 OF 4