HomeMy WebLinkAbout24-7962 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 1 27c
COLLISION REP FIT 1591971
CASE 24-7962 z
INTERSTATE ❑ CITY STREET FIRE ❑RESULTED
1 STATE ROUTE OTHER STOLEN
❑ ❑ vFFIIC;I F ❑ LOCAL AGENC 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
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# ❑
C{YLLISION O7 - 1-— 2024 1147 17 ❑.= S 8 W IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
N 3RD ST BLOCK NO. e
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ ❑ FEET e S ❑ W e BURNETT AVE N
0 1 29
UNIT 01 MOTOOR � PEDDAL ❑ YESAGE NHORE✓LDMET PHONE 0 1 30
6❑ LAST NAME UNKNOWN FIRSTNAME MIDDLE 1 2 31
INITIAL
STREET ❑ CITY RENTON ST ZIP 2
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
:NTERLOCKYES NO INTERLOCK YES NO YES No
8 DRIVERS STATE SEX U D.O.B. 1 2 32
❑ LICENSE# MMDDYY -�
9 ON DUTY❑ STATUS AIRBAG 9 RESTR 9 EJECT 1 HELMET USE 9 CLAY 0 NATURE OF INJURIES 2❑
3
10 9❑ Pi ATE 14 BMA5031 sTAr WAu N# 4S3GTAB69J3751014
IT STATE TRAILER STATE
11 2 5 PLATE# I PLATE# I I FRom To
TRLR. YRLR. 5 1 33
12 2 5 VIN#' VIN#
1 FROM TO
VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE 7 $ 34
13 2 2018 SUBA IMPREZ SD DAMAGE YES NO YES❑ NO✓
REGISTERED OWNER INFO HARRYATLAS 5530 S 129TH ST SEATTLE WA 98178 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
14 LIABILITY INSURANCE❑ INSURANCE CO 3 4
IN EFFECT &POLICY# 9TOP
VEwcle CHARGE 1 5 36
LEGALLv res❑NO❑ CITATION# 10 BOTTOM
15❑ STANDING 8 6
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES NO ,/ D:2069605865
16 a
LAST NAME RODRIGUEZ 77771 FIRST NAME CARLICIA MIDDLE L
INITIAL
17❑ STREET IS❑' 4415 NE 5TH ST B302 CITY' RENTON ST WA ZIP 98059 37
NEW ADDRES
18❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED ❑ 38
INTERLOCK YEs❑NO� INTERLOCK YEs❑NOF YEs❑NOF,/
19 DRIVER'S STATE WA ]SEX IF D.O.B. 10 _ 23 _ 1995 El
39
LICENSE# MMDDYY
WELMET INJURY1 NATURE OF INJURIES 40
20❑ ON DUTY STATUS AIRBAG 2 RESTR 9 EJECT 1 USE CLASS ❑
❑21❑ PLATE# CDC4837 TAre WA VIN 1t 2C3CDXBG4MH671410 41
4
42
22❑ PILER LATE# STATE PLATE# STATE
TRLR
23❑ UIN#. N#.
43
RLR
'I
VEH YEAR 2021 MAKE DODG MODEL CHARGE STYLE 4D VEHICLETOWED TO BLIN TOWEDBY GOV HI 44
L4❑ DAMAGE YES NO,/ YES NO
REGISTERED OWNER INFO CARLICIA RODRIGUEZ 4415 NE 5TH STB302 RENTON WA 98059 D:2069605865 VEHICLE NO.2
SHADE IN DAMAGED AREA
2 3 4
INAEFFITY ECTNSURANCE❑ &POINSULICY#E CO IUQ,
—e E ❑ , CITATION# CHARGEES N 25
7SHA
NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
26 CROW 12618 WA0171300
PART A PAGE 01 OF
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EF08331
COLLISION REPORT III III III III III 111
1591972 CASE# 24-7962
ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY)
NAME MIDDLE INITIAL) UNKNOWN CARTER
(LAST FIRST,
ADDRESS&PHONE#
2064509884 SEX' F MMDDYYYY -❑
---------------------------
PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT ' HELMET NJURY NATURE OF INJURIES
❑ O' POS. USE 'CLASS '
NAME
(LAST,FIRST,MIDDLE INITIAL)
ADDRESS&PHONE# D O E4
SEX MMDDVVYY
PASSENGER ❑WITNESS❑ UNIT# SEAT AIRBAG RESTR. EJECT HELMET NJURY
POS. NATURE OF INJURIES
USE CLASS
NAME
(LAST FIR57 MIDDLE INITIAL)
AppRESS&PHONE#
SEX D.O.B.MMDD -❑
YYYY.
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.
SHAWN CROW 08-01-24 03:18 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
QUINT TIBEAU 07691 1 8/25/2024 1:09:09 PM
BADGE OR ID# ( 12618 OR]# WA0171300 TIME POLICE DISPATCHED 12:00 PM TIME POLICE ARRIVED]12:17 PM
FART I PAGE IT]OF 4�
REPORT NO. EF08331 CASE# 24-7962 OF COLLISION
07/29/24 11:47
OF CbLLI510N
NARRATIVE
On 07/29/2024 at about 1147 hours a hit and run collision occurred between two vehicles at the
intersection of N 3rd St/Burnett Ave N. Vehicle 1 was last seen headed northbound on N 3rd St, and
Vehicle 2 remained in the area. When I arrived I spoke to Carlicia L. Rodriguez who was the driver of
Vehicle 2. There were no injuries and Vehicle 2 was driveable. The driver of Vehicle 1 was
unknown.
Carlicia was traveling eastbound on N 3rd St approaching Burnett Ave N when she noticed Vehicle 1
traveling north onto N 3rd St from Burnett Ave N. Vehicle 1 had a visible stop sign posted for
northbound traffic, but Vehicle 2 did not have any traffic signals or stop signs for the eastbound traffic.
Carlicia had to swerve to her left to avoid colliding into Vehicle 1 which caused Vehicle 2 to spin
before coming to a stop near the intersection. The front driver side fender and wheel of Vehicle 2
collided into Vehicle 1 as Carlicia tried to avoid the collision. Vehicle 1 drove away northbound
without stopping to contact Carlicia. Carlicia was not injured. Vehicle 2 had damage to the front
driver side fender and wheel, but it was able to be driven from the scene. The damage to Vehicle 1 is
unknown.
A pedestrian, only identified as Carter, was walking in the area and witnessed the collision. Carter
approached Carlicia and told her that she saw Vehicle 1 strike Vehicle 2. Carter provided her phone
number to Carlicia. I attempted to call Carter several times, but no one answered.
Carlicia described Vehicle 1 as a blue colored car with Washington state license plate BMA5031.
The license plate returned to a 2018 Subaru Impreza registered to Harry A. Atlas (DOB: 05/28/1947)
out of Seattle, Washington. Carlicia did not get a look at the driver of Vehicle 1, and she was unable
to describe the driver. The identity of the driver of Vehicle 1 is unknown. I took photos of Vehicle 2
using my department issued cellphone and uploaded those photos to Axon.
I gave Carlicia a Renton PD business card with the case number.
PAGE 3 OF 4
REPORT NO. EF08331 CASE# ' 24-7962 DATE AND TIME 07/29/24 11:47
OF COLLISION
Fawn to sca
PAGE 4 OF 4
