HomeMy WebLinkAbout24-7979 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 0 27c
COLLISION REP FIT 1591971
INTERSTATE ❑ CITY STREET ❑ FIRE ❑
CASE#r` 24-7979 2
RESULTED
1 STOLEN
STATE ROUTE � OTHER ❑ VFHIC;I F ❑ LOCAL AGENC 4200 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 3 TOTAL#OF OBJECT 1 1 8 28
TRIBAL UNITS OZ RESERVATION STRUCK
2
3❑ DATE of M M D D Y Y Y Y TIME(2400) COUNTY# MILES N E IN CITY# ❑
COLLISION.. O7 - 1-- 2024 1818 17 ❑.❑ S 8 W e IN e 1070 3
4❑ oN (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓
MAPLE VALLEY HIGHWAY BLOCK NO. e✓ 15100
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ 250 00 FMILES EET e S ❑ E e SE 149TH ST
0 1 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
,/No D:4255108574 0 11
30
6� LAST NAME COLYVAS FIRSTNAME NORBERT MIDDLE J 1 1 2 31
INITIAL
STREET ❑, 11417163RD AVE SE CITY RENTON ST WA 2jp, 98059 2
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
iNTERLOCKYEs NO 1/ INTERLOCKYEs NO�/ YEs No�/
8❑ DRIVERS
# STATE WA SEX'M I ELMIDI Y' 06 - 01 - 1997 1 2 32
9 ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 H USE 2 CLASS 1 NATURE OF INJURIES 2❑
3
10 99 P1 ATE 4 CKX8346 sTAT WAu N#' 2HGF62F54CH571172
0 TRAILER STATE TRAILER STATE
11 5 0 PLATE# PLATE# FROM TO
TRLR. TRLR 3 7 33
12 5 0 VIN#' VIN#
>; FROM TO
VEH.YEAR 2012 MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED By GOVT.VEHICLE 3 7 34
13 4 HOND CIVIC P4 DAMAGE YES NO YES[:] No
✓
REGISTERED OWNER INFO MAlAEH COLLlNS 11417163RD AVE SE RENTON WA 98059 VEHICLE NO. 1
❑ ❑
SHADE IN DAMAGED AREA 35
14 LIABILITY INSURANCE❑ INSURANCE CO 3 4
IN EFFECT &POLICY# 9TOP
VEHICLE CHARGE 5 36
LEGALLv YFS❑NO❑ CITATION# 1 o BOTTOM
15❑ STANDING 7 6
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT U2 VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES 1/ No D:2535498025
16 a
LAST NAME MAHER 777771 FIRST NAME DIEDRA MIDDLE R
INITIAL
17 STREET NEW ADOREs7 708 50TH ST SE CITY AUBURN ST WA ZIP 98092 37
18� CDL IGNITION REQUIRED IGNITION PR-E-1SENT MEDICAL-T�RANSPORTED 38
INTERLOCKYES�NO� INTERLOCK yEs It I NOF YES
t l NOF,/
19 DRIVER'S STATE WA SEX F D.O.B. 04 09 _ 1992 39
LICENSE# MMDDYY
20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 H U EET 2 NJAURSY 1 NATURE OF INJURIES 40
LICENSE I ❑21❑ PLA E# CED0402 TATe 41
WA VIN# JF2GPAKC9G8238983 1
42
22❑ PLATE# STATE PLATE# STATE
23❑ VIN#. 43
TRLR RLR
'IN#.
GI
VEH YEAR 2016 MAKE S(JB�Q MODEL CRO$S7' STYLE P4 DAMAGE TOWED NOO✓ BLIN TOWED BY ov HyES NO 44
24❑ ES
REGISTERED OWNER INFO OWNED SY DRIVER VEHICLE N0.2
SHADE IN DAMAGEbAREA
2 3 Cd
LIABILITY
INSURANCE &POINSURGY#E CO ALLSTATE 976549464IN 1 9TOP
VE""LE ❑ N`L J
,J� CITATION# CHARGE
LEG
25 i o BOTTOM
ALLY YES $ '
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
J
26
D.NELSON 12421 WA0171300
PART A PAGE 01 OF C7
3000-345-159 fR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EF02478
COLLISION REPORT III III III III III 111
1591972 CASE# 24-7979
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 NJURY 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'
24-7979
On 7/29/2024 1 was working as a uniformed patrol officer and driving a marked patrol vehicle for the
City of Renton. I was dispatched to a report of a non-injury and non-blocking collision in the 14900
block of Maple Valley Highway Renton/King/WA. An involved party was calling to report the collision
and advised they had pulled off Maple Valley Highway onto SE 149th St.
I arrived on scene and located both vehicles on the side of the road, a blue 2012 Honda Civic
WA/CKX8346 had extensive damage to the front end. The driver, identified by his WADL as Norbert J
Colyvas DOB: 6/1/1997, was not injured. He advised he had rear-ended the other vehicle. The Civic
was not drivable so I used my patrol vehicle to push it out of the roadway so Norbert could call a tow.
The driver of the 2016 Subaru Crosstrek WA/CED0402, identified by her WADL as Diedra R Maher
DOB: 4/9/1992, advised she was rear-ended by the Civic while travelling west on Maple Valley
Highway. The damage was to the rear bumper on the Crosstrek, which was still drivable. Diedra
advised she was not injured.
Provided both parties with a case number and left the scene.
Nothing further.
I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT.
D.NELSON 07-29-24 07:28 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
P.SUMMERS 888 1 81512024 2:27.19 PM
BADGE OR ID# ! 12421 ORI#' WA0171300 TIME POLICE DISPATCHED 6:22 Pry TIME POLICE ARRIVED 6:43 PM
PART I PAGE IT]OF 3�
REPORT NO. EF02478 CASE# ' 24-7979 DATE AND TIME 07/29/24 18:18
OF COLLISION
1
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