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HomeMy WebLinkAbout24-8893 POLICETRAFF'c" III !�� I IIIllI111IN II II I REPORT NO. EF07888 170 27 COLLISION REP FIT 1591971 ❑ ❑ FIRE ❑ CASE# 24-sss3 2 5 0 INTERSTATE CITY STREET RESULTED 1 STATE ROUTE OTHER STOLEN ❑ ❑ H F ❑ LOCAL AOENC 3 HIT IT&8 RUN CODING COUNTY RD � PRIVATE WAY � INVOLVED 2� 1 1 8 28 TOTAL#OF OBJECT TRIBAL UNITS 02 STRUCK' TRAFFIC SIGNAL POLE RESERVATION 2 3❑ DATE OF M M D D Y Y Y Y TIME(2400) COUNTY# MILES N E IN CITY# ❑ C{YLLISION O8 - 1-- 2024 1603 17 ❑.= S 8 W IN e 1070 3 4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑ 300 PARK AVE N BLOCK NO. e✓ 300 4a❑ MILEPOST DISTANCE OF(REFERENCE OR CROSS STREET) 5❑ ❑ FEET e S ❑ W e N 3RD ST 0 4 29 MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE UNIT 01 VEHICLE ❑ CYCLE El ,/No D:2063937052 0 11 30 6❑ LAST NAME TAYLOR FIRSTNAME JOVANI MIDDLE A 1 1 2 31 INITIAL STREET ❑, 15710 124TH AVE NE CITY WOODINVILLE ST WA ZIP, 980727903 2 NEW ADDRESS ]❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3 1/ I INTERLOCK YES[:]NO NTERLOCKYEs NO�/ YES R No�/ 8 LDRIVER # STATE WA SEX'M MID -O B 08 1- 03 - 2003 2 32 9 ON DUTY❑ STATUS AIRBAG 3 RESTR 9 EJECT 1 H U SE ICNLJAUSSY 1 NATURE OF INJURIES 2❑ 3 LICENSE CCT1001 sTArr WAurN# 1C4SDJCT4CC238011 10❑ PI ATE 14 IT STATE TRAILER STATE 11 0 0 PLATE# PLATE# ROM ro TRLR. TRLR $ 7 33 12 0 0 VIN#' VIN#' >; FROM TO VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE 1 $ 34 13 A 2012 DODG DURAN DAMAGE YES NO YES[:] NO✓ REGISTEREDOWNERINFO OWNEDBYDRIVER VEHICLE NO. 1 SHADE IN DAMAGED AREA ❑ 35 14[Al LIABILITY INSURANCE INSURANCE CO PROGRESSIVE 970693609 4 LI EFFECT &POLICY# TOPVEHICLE CHARGE36 LEGALLY YES❑NO CITATION# <1�3 OTTOM 15❑ STANDING 6 MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE UNIT VEHICLE ❑ CYCLE ❑ ❑ : OWNER ❑ YES 1/ NO D:2065915039 16 a LAST NAME CABANSAG FIRST NAME IRENE MIDDLE M INITIAL 17❑ STREET ❑', 1750 FERNDALE AVE SE CITY RENTON ST WA ZIP 980584607 37 NEW ADDRESS ❑ 18� CDL IGNITION REQUIRED IGNITION PRESENT MEDICALTRANSPORTED 38 INTERLOCK YES❑NO INTERLOCK YEs❑NOF YEs❑NOF,/ 19[-] DRIVER # INJURY1 NATURE OF INJURIES 40 20❑ ON DUTY[:I] STATUS AIRBAG 3 RESTR 9 EJECT ''1 USE CLASS ❑ 21❑ LICENSE I CHD3615 TArE I WA vIN# 4T1BF1FK8HU620343 ❑ 41 PLATE# 42 22❑ PLATE# STATE PLATE# STATE TRLR 23❑ VIN#. N#. 43 RLR 'I VEH YEAR 2017 MAKE TOYT MODEL CAMRY STYLE P4 VEHICLE TOWED TO BLIN TOWEDBY GOV HI 44 24= DAMAGE YES NO BANKERS TOWING YES No�/ REGISTERED OWNER INFO IRENE CABANSAG 1750 FERNDALE AVE SE RENTON WA 980584607 D:2065915039 VEHICLE NO.2 SHADEDAMAGEDAREA 3 4 LIABILITY INSURANCE INSU PORGY#E CO PROGRESSIVE 957-135-176IN STOP 5 VEHICLE ❑ ,.I—I CITATION# CHARGE io BOTTOM LEGALLY YES N 25 a OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY J 26 SULIASI TAMAIVENA 12788 WA0171300 PART A PAGE 01 OF C7 3000-345-159 OR 11/181 STATE OF POLICETRAFFICN CORRECTION REPORT NO. EF07888 COLLISION REPORT III III III III III 111 1591972 CASE# 24-8893 ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY) NAME MIDDLE INITIAL) DAVID JANELLE C (LAST FIRST, ADDRESS&PHONE# 13025 SE 159TH PL RENTON WA 980585527 2063795045 SEXi F MMDOYyry 09 - 07 - 2004 PASSENGER WITNESS UNIT# 2 POS $ AIRBAG 3 RESTR. 9 EJECT ? 1 HELMET LASS NATURE OF INJURIES USE CLASS i1 NAME (LAST,FIRST,MIDDLE INITIAL) ADDRESS&PHONE# DOB 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' 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. SULIASI TAMA/VENA 08-23-24 07:00 PM INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED APPROVED BY DATE P.SUMMERS 8887 1 8/23/2024 7:30:39 PM BADGE OR ID# ! 1Y788 OR]# WA0171300 TIME POLICE DISPATCHED! 4:05 PM TIME POLICE ARRIVED',4:05 PM PART I PAGE IT]OF 4� REPORT NO. EF07888 CASE# 24-8893 OF COLLISION 08/23/24 16:03 OF CbLLI510N NARRATIVE On 08/23/2024, at approximately 1605 hours, I viewed an accident in the 300 block of Park Ave N in the City of Renton, County of King, Washington. The driver for Unit#1 was identified by his WADL photo as Jovani A. Taylor (DOB 08/03/2003). His vehicle was described as a black-colored 2012 Dodge Durango bearing WA plate CCT1001 registered to Jovani. Unit#1 stated he was traveling north on the 300 block of Park Ave N in lane #1 (lane #1 near the divider). As he got to N Third St, he said he thought it was N Fourth St and made a left turn. North 3rd St is a one-way for cars to travel East. With this in mind, Unit#1 was turning into oncoming traffic. As he turned, he was then hit by Unit#2; his right front bumper and her front bumper collided, causing his vehicle to turn southbound. His vehicle had crucial damage in the front area of his car. The vehicle was not drivable, and it was towed by Bankers Towing. He also claimed no injuries. The driver for Unit#2 was identified by her WADL photo as Irene M. Cabansag (DOB 02/25/2005). Her vehicle was described as a red-colored 2017 Toyota Camry bearing WA plate CHD3615 registered to Irene. Unit#2 stated she was traveling south in lane #2 on the 300 block of Park Ave N. As she was passing N Third St, she said Unit#1's vehicle turned in front of her, causing her to hit his car. The force of the hit caused her vehicle to swerve into an electric box. This caused the intersection lights to shut off. She had crucial damage in the front area of his car. The vehicle was not drivable, and it was towed by Bankers Towing. She also claimed no injuries. Unit#2's passenger, who sat in the front right seat, was identified by her WADL photo as Janelle C. David (DOB 09/07/2004). Her statement was the same as Unit#2. She also claimed no injuries. Both units had green lights when the accident occurred. I gave both a copy of their information (exchanged information). They also received my business card with a case number. The City of Renton was notified about the traffic light and will be en route. This concludes my report. 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 S. Tamaivena #12788 on 08/23/2024 @1855 hours in Renton, WA PAGE 3 OF 4 REPORT NO. EF07888 CASE# ' 24-8893 DATE AND TIME 08/23/24 16:03 OF COLLISION { v { �t a., PAGE 4 OF 4