Press Alt + R to read the document text or Alt + P to download or print.
This document contains no pages.
HomeMy WebLinkAbout24-8339 a POLICETRAFFic" II I f I) 11I1ll(111(111l If( f 11 REPORT NO. EF05649 170
27
COLLISION REP FIT 1591971
CASE 24-8339 z
INTERSTATE ❑ CITY STREET FIRE ❑RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHIl.I F ❑ LOCAL AOENC 4900 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 2 TOTAL#OF OBJECT 1 1 8 28
TRIBAL UNITS OZ RESERVATION STRUCK
z
3❑ DATE OF M M D D Y Y Y Y TIME(2400) COUNTY# MILES CITY#
COLLISION'. O8 — 08 — 2024 1342 17 . N E IN� S 8 W H OF e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
BLOCK NO. e✓ --- ----� ❑
SW 7TH ST MILEPOST
4a❑
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ �.❑ FEET e S ❑ W e POWELL AVE SW
0 4 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
,/No D:4252717785 0 11
30
6� LAST NAME ROEN►CKE FIRSTNAME WILLIAM MIDDLE L 1 1 2 31
INITIAL
STREET ❑ 3112 SE 18TH ST CITy RENTON ST WA 2jp, 980583803 z
NEW ADDRESS
]❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
INTERLOCK YES[:]NO INTERLOCKYEs NO YES NO
8❑ LRIIVER #
ON DUTY❑ STATUS AIRBAG 1 RESTR 4 EJECT 1 H USEET ICNLJAURY 1 NATURE OF INJURIES z❑
3
10 9❑ p)aT�S1t AME7797 sTAr� WA urN# 1G3AJ54N5t6348057
TRAILER STATE TRAILER STATE
11 2 5 PLATE# PLATE# FR.. ro
TRLR. TRLR 5 7 33
12 3 0 VIN#' VIN#
>; FROM TO
❑ VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN T GOVT.VEHICLE ] $ 34
13 2 1990 OLDS CUTLAS DAMAGE vE6 0NO f �LII� RS vEs❑ No
REGISTERED OWNER INFO WILLIAM ROENICKE 3112 SE 18TH ST RENTON WA 980583803 D:4252717785 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
14 LIABILITY INSURANCE INSURANCE CO HARTFORD 55PHL125238 3 4
IN EFFECT &POLICY# 9TOP
LVEHICLe CHARGE 1 5 36
LEGALLY res�No� CITATION# 4A0652622 FAIL YIELD LEFT TURN MOTOR io sorroM
15❑ STANDING 8 6
MOTOR PEDAL-: ❑ .PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
16 a UNIT 02 VEHICLE ❑ CYCLE' ❑ OWNER ❑ YES 1/ NO D:2538317519
LAST NAME LAWRENCE FIRST NAME MONIQUE MIDDLE I L
INITIAL
17❑ STREET ❑', 27902 PACIFIC HWY S APT 232 CITY' FEDERAL WAY ST WA ZIP 980039216 37
NEW ADDRESS ❑
18� CDL IGNITION REQUIRED IGNITION PtR—E—S1ENT MEDICAL TRANSPORTED ❑ 38
INTERLOCKYES�NOR INTERLOCK YEs I I NOF YEs t l NO❑
19 LDI IVEW # STATE WA SEX F M .C... 07 27 1980 El 39
20❑ ON DUTY STATUS AIRBAG,2 RESTR 4 EJECT 1 HELMET INJURY 6 NATURE OF INJURIES ❑ 40
USE CLASS BACK
21❑ LICENSE I CGT4231 TArE WA VIN# 1FADP3M21HL225201
❑ 41
PLATE#
42
22❑ PLATE# STATE PLATE# STATE
TRLR
23❑ UIN#. N#.
43
RLR
'I
VEH YEAR 2017 MAKE FORD MODEL FOCUS STYLE VEHICLE TOWED TO BLIN TOWEDBY GOV HI 44
24❑ DAMAGE YES NO BANKERS YES NO
REGISTERED OWNER INFO MONIQUE LAWRENCE 27902 PACIFIC HWY S APT 232 FEDERAL WAY WA 980039216 D:2538317519 VEHICLE NO.2
SHADE DAGELLAREA
LIABILITY
INSURANCE INSU&PORGY#E CO AM FAM 410916325273IN 1GQ'E""LE
❑ ,J� CITATION# CHARGE
LEGALLY YES N`L J
25
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
J
26
M.LEVERTON 2517 WA0171300
PART A PAGE 01 OF C7
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EF05649
COLLISION REPORT III III III III III 111
1591972 CASE# 24-8339
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 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.
M.LEVERTON 08-09-24 10:48 AM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
CO.JOHNSON 0505 8/16/2024 11:40:48 AM
BADGE OR ID# 2517 ORI# WA0171300 TIME POLICE DISPATCHED 1:43 PM TIME POLICE ARRIVED',1:44 PM
PART I PAGE IT]OF 4�
REPORT NO. EF05649 CASE# 24-8339 OF COLLISION
08/08/24 13:42
OF CbLLI510N
NARRATIVE
slv/1 It blk/2 lane 2
CC
Within the city limits of Renton/King/Wa I responded to a 2 vehicle blocking unknown if injury crash at
the intersection of SW 7th St at Powell Ave SW.
I contacted the driver of unit 2 who told me she was eastbound lane 2 SW 7th St when unit 1 made a
left turn into the side of her car. She spun out facing the opposite direction. She complained of
injury. Renton Fire responded and treated her on scene for injury's. She was later transported by Tri-
Med to VMC for additional care. Her car was towed for damages.
I contacted the driver of unit 1 ID'd by his picture WADL. He told me he was northbound on Powell
Ave SW and preparing to make a left turn. He said he was distracted by a truck nearby and when he
pulled out making his left turn he did not see unit 2 until it was too late when he crashed into the side
of her car. He did not complain of injury and damages required a tow truck.
I cited Unit 1 ref RCW 46.61.185 FTYROW-Left Turn 2 car injury crash via complaint.
I certify (declare) under penalty of perjury under the laws of the State of Washington that the
foregoing is true and correct.
M.Leverton/2517 City of Renton/King/Wa 8/9/2024
PAGE 3 OF 4
REPORT NO. EF05649 CASE# 24-8339 DATE AND TIME 08/08/24 13:42
OF COLLISION
x a"
�.
,
t
,
3
A
�t
Y
"':'':.?',..
PAGE 4 OF 4