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HomeMy WebLinkAbout24-887 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 6 27c COLLISION REP FIT 1591971 ❑ ❑ RESULTED ❑ CASE# z4-ss7 2 INTERSTATE CITY STREET FIRE 1 STOLEN STATE ROUTE ❑ OTHER ❑ VFHIr.I F ❑ LOCAL AOENC 4Y00 3 HIT&RUN CODING COUNTY RD PRIVATE WAY INVOLVED 2 2 TOTAL#OF OBJECT 1 1 8 28 TRIBAL UNITS OZ STRUCK RESERVATION 2 3❑ DATE OF M M D D Y Y Y Y TIME(2400) COUNTY# MILES N E IN CITY# COLLISION'. OS - 1-- 2024 0539 17 ❑-= S 8 IN e 1070 3 4 4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑ RAINIER AVE S BLOCK NO. e✓ 200 ❑ 4a 3❑ MILEPOST DISTANCE OF(REFERENCE OR CROSS STREET) 5❑ ❑ FEET e S ❑ VV e S 2ND ST 0 1 29 MOTOR PEDAL- DAM THRESHOLD MET PHONE UNIT 01 VEHICLE ❑ CYCLE El YEs No ,/ D:2536785114 0 4 30 6� LAST NAME NGATCHA FIRSTNAME JEAN MIDDLE J 1 1 2 31 INITIAL STREET ❑ 21207125TH AVE SE CITY KENT ST I WA 7jp, 980312266 2 NEW ADDRESS 7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3 ,/ I INTERLOCK YES[:]NO NTERLOCKYEs NO Z/ YES R No�/ 8❑ LRIIVER # ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 HELMET USE 2 CLASS 1 NATURE OF INJURIES 2❑ 3 10❑ PI ATE D15881E sTArI WA urN#' 2GBHG31K9M4120876 TRAILER STATE TRAILER STATE 11 3 5 PLATE# PLATE# FROM TO FTRL-R TPILF1 1 5 33 12 2 5 VIN#j VIN# FROM TO VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE 3 5 34 13 4 1991 CHEV G30 CG DAMAGE YES NO YES[:] No ✓ REGISTERED OWNER INFO JEAN NGATCHA 21201125THAVE SE KENT WA 98031 VEHICLE NO. 1 ❑ ❑ SHADE IN DAMAGED AREA 35 14 LIABILITY INSURANCE INSURANCE CO PROGRESSIVE 980540711 3 4 IN EFFECT &POLICY# 9TOP ve'CLe CHARGE 1 5 36 LEGALLv Ye6❑NO❑ CITATION# 10 BOTTOM 15❑ STANDING 8 6 MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE UNIT 02 VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES,/ NO D:2067780411 16 a LAST NAME HARRIS FIRST NAME SAVOYA MIDDLE IT INITIAL 17❑ STREET ❑', 15205 140TH WAY SE APT B203 CITY' RENTON ST WA ZIP 980587851 37 NEW ADDRESS ❑ 18� CDL ., IGNITION REQUIRED IGNITION PtR-E-S1ENT MEDICAL t-TRANSPORTED ❑ 38 INTERLOCK YEs❑No� INTERLOCK YEs I I NOF YES t l NOF,/ 19[ DRIVER # USE EET LAU SY COMPLAINT OF PAIN IN LEFT ARM ❑F—NATURE OF INJURIES 40 20❑ ON DUTY STATUS AIRBAG,2 RESTR 2 EJECT 1 2 7 21❑ LICENSE I CDX2466 TAre I WA VIN# 1N4AA6DV1LC386320 ❑ 41 PLATE# 42 22❑ PLATE# STATE PLATE# STATE TRLR 23❑ VIN#. IN#. 43 RLR ' VEH YEAR 2020 MAKE NIS6 MODEL MAXIMA STYLE P4 VEHICLETOWED TO BLIN TOWEDBY GOV HI 44 24❑ DAMAGE YES NO,/ YES NO✓ REGISTERED OWNER INFO SAVOYA HARRIS 600 SW5TH CTAPTJ206 RENTONWA98057 VEHICLE NO.2 SHADE DAGED AREA 4 LIABILITY INSURANCE INSU&PORGY#E CO GEIC04563950346IN 1 9TOP 5 VEHICLE ❑ C[ CITATION# CHARGE 25 io BOTTOM LEGALLY YES N s e OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY J 26 QU/NT TIBEAU 07691 WA0171300 PAGE 01 OF PART A 3000-345-159 OR 11/181 STATE OF POLICETRAFFICN CORRECTION REPORT NO. EF08337 COLLISION REPORT III III III III III 111 1591972 CASE# 24-887 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 PM 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. QUINT TIBEAU 08-23-24 06:57 AM INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED APPROVED BY DATE QUINT TIBEAU 07691 1 8/25/2024 2:00:47 PM BADGE OR ID# ( 07691 OR]# WA0171300 TIME POLICE DISPATCHED 5:41 AM TIME POLICE ARRIVED',5:46 AM FART I PAGE IT]OF 4� REPORT NO. EF08337 CASE# 24-887 OF COLLISION 08/23/24 05:39 OF CbLLI510N NARRATIVE 24-8871 Narrative The following occurred in the City of Renton, County of King, State of Washington. On 08/23/2024 at about 0541 hours I was dispatched to a two vehicle non injury, non-blocking collision near 275 Rainier Ave S. 1 arrived at about 0546 hours and contacted the driver of vehicle #1, who identified himself as the registered owner Jean Ngatcha with his WADL. Ngatcha stated that he was traveling south bound in the #2 lane of Rainier Ave S. He stated that his light was green, or possibly turned yellow at S 2nd St. He was proceeding through the intersection and was past it when his vehicle was struck from the side by vehicle #2. The driver of vehicle #2 identified herself as the registered owner Savoya Harris with her WADL. She stated that she was making a left turn from west bound S 2nd St onto Rainier Ave S with a fresh green light, when vehicle #2 ran the red light and struck the front corner of her vehicle. She complained of pain to her left arm. She was examined by Renton Regional Fire Authority and stated she would later seek medical attention at a hospital. This incident was captured on my Axon body worn video camera. This report is a summary of events that occurred and is not an exact sequencing of events. Statements have been paraphrased and summarized. Nothing further at this time. I certify (declare) under penalty of perjury under the laws of the State of Washington that the foregoing is true and correct. Electronically signed by Q. Tibeau #07691 08/23/2024 0640 hours, Renton, WA. PAGE 3 OF 4 REPORT NO. EF08337 CASE# 24-887 DATE AND TIME 08/23/24 05:39 OF COLLISION w � R t 1 �a. 4 � �1 6 � 1 }h S zt- S PAGE 4 OF 4