HomeMy WebLinkAbout24-8652 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 5 27c
COLLISION REP FIT 1591971
SASE 24-8652 2
INTERSTATE ❑ CITY STREET FIRE ❑
RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHICI F ❑ LOCAL AGENCI 4Y00 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2� TOTAL#OF OBJECT 1 �2$
TRIBAL UNITS 01 STRUCK
RESERVATION
z
3❑ DATE OF M M D D Y Y Y Y TIME(2400) COUNTY# MILES N E IN CITY# ❑
CowsloN 08 - 1-- 2024 0404 17 ❑.= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓
600 OAKESDALE AVE SW BLOCK NO. e✓ 600
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ ❑ FEET e S ❑ W e 0 1 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
,/No D:4255472240 30
6� LAST NAME MILLER FIRSTNAME JOEY MIDDLE 1 2 31
INITIAL
STREET ❑, 51 BURNETT AVE S APT 317 CITY RENTON ST WA 2jp, 98057 z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
1/ I INTERLOCK YES[:]NO NTERLOCKYEs NO�/ YES R No�/
8❑ LRIIVER #
ON DUTY❑ STATUS AIRBAG 6 RESTR 4 EJECT 1 HELMET USE 2 1 CLASS NATURE OF INJURIES 2❑
3
10❑ PI ATNE 14 CJC4598 sTAr WAvN# 1N4AL11E35C317987
TRAILER STATE TRAILER STATE
11 3 5 PLATE# PLATE# FROM TO
TRLR. TRLR 3 7 33
12❑ VIN#j UIN#
FROM
34
❑ VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN T /g[ GOVT.VEHICLE
13 $ 2005 NISS ALTIMA SD DAMAGE YES NOBS YES[:] No✓
REGISTERED OWNER INFO DERRICKHUTTLESTON 15815 CRESCENT VALLEYDR NW GIG HARBOR WA 98332 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
14❑ LIABILI INSURANCE❑ INSURANCE CO NO INSURANCE N/A 4
IN EFFECT &POLICY#
VEHCLE CHARGE 5 ❑ 36
LEGALLY YES❑NO❑ CITATION# BOTTOM
15❑ STAIN.D'ING 6
UNIT VE IOOR El CYCLEPEDAL- ❑ PEDESTRIAN ❑ PROPRRTY ❑ DYES H OLD MET PHONE
16❑
LAST NAME FIRST NAME MIDDLE
INITIAL
STREET
CITY' ST ZIP 4❑ 37
17❑ NEW ADDRES7
18❑ CDL IGNITION REQUIRED IGNITION PtR—E—S1ENT MEDICAL—T�RANSPORTED ❑ 38
INTERLOCKYES�NOR INTERLOCK YEs I I NOF YEs t l NO❑
19 LLIICENS # STATE SEX MMDDYY —�_ 39
HELMET INJURY NATURE OF INJURIES 40
20❑ ON DUTY STATUS' AIRBAG RESTR EJECT USE CLASS ❑
❑21❑ TArE 41
IN#LICENSE V 1
PLATE#
42
22❑ PLATE# STATE PLATE# STATE
23❑ 43
TRLR RLR
VIN#. IN#.
VEH YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN
TOWED BY Gov HI 44
L4❑ DAMAGE YES NO YES NO
REGISTERED OWNER INFO VEHICLE NO.2
SHADE IN DAMAGED AREA
2 3 4
INAEFFIECTTY NSURANCE❑ &POINSULICY#E CO I 9TOP 5
VE."LE YES❑ N J
,J� CITATION# CHARGE i o BOTTOM
LEGALLY
25 s � e
7MICAELA
NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
26 CASTAIN 7 12573 WA0171300
PAGE 01 OF
PART A
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EF09255
COLLISION REPORT III III III III III 111
1591972 CASE# 24-8652
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'
On 08-17-2024 at approximately 0404 hours I was dispatched to an unknown injury accident at 600
block of Oakesdale Ave SW, in the City of Renton, King County, WA.
While in route, dispatched advised there was a vehicle that collided into a pole.
Upon arrival, there was a black Nissan Altima (WA/CJC4598) stopped facing south, in the eastbound
lanes. The Nissan was unoccupied. The Nissan had heavy front-end damage.
The driver, Joey Miller (DOB 09/29/1984), arrived back on scene. Miller advised he went to find help
to tow his vehicle. Miller advised that he was traveling westbound at the above location and struck the
middle barrier curb, which sent him into oncoming lanes. Miller advised that he was traveling
approximately 35 MPH upon sticking the curb.
Miller advised he did not want medical aid.
Bankers impounded Miller's vehicle upon his request.
I provided Miller with my business card and case number.
This report is for documentation purposes.
I certify (or declare) under penalty of perjury under the laws of the State of Washington that the
foregoing is true and correct.
Electronically signed by Officer M. Castain #12573 8/17/2024 Renton, WA
I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT.
MICAELA CASTAIN 08-17-24 08:19 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
J.THIELMAN 11462 1 8/28/2024 12:36:08 AM
BADGE OR ID# 12573 ORI#' i WA0171300 TIME POLICE DISPATCHED; 4:05 AM TIME POLICE ARRIVED',4:08 AM
PART I PAGE IT]OF
REPORT NO. EF09255 CASE# ' 24-8652 DATE AND TIME 08/17/24 04:04
OF COLLISION
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