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HomeMy WebLinkAbout24-8895 POLICETRAFF'c" III !�� I IIIllI111IN II II I REPORT NO. EF09964 170 27 COLLISION REP FIT 1591971 CASE 24-8895 z INTERSTATE ❑ CITY STREET FIRE ❑RESULTED 1 STATE ROUTE OTHER STOLEN ❑ ❑ HIT& F ❑ LOCAL AOENC 3 HIT&RUN CODING COUNTY RD PRIVATE WAY INVOLVED 2 3 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 N E IN CITY# ❑ COLLISION OS - 1-— 2024 1613 17 ❑-= S 8 IN e 1070 3 4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑ BLOCK NO. OAKESDALE AVE S e✓ --- ----� 4a❑ MILEPOST DISTANCE OF(REFERENCE OR CROSS STREET) 5❑ ❑ FEET e S ❑ W e SW41ST ST 0 4 29 MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE UNIT 01 VEHICLE ❑ CYCLE El NO D:2064121977 0 11 30 6❑ LAST NAME ARKHIPCHUK FIRSTNAME VITALIY MIDDLE S 1 2 31 INITIAL STREET ❑, 1210 M ST SE APT 6 CITY AUBURN ST WA ZIP 98002 z NEW ADDRESS 7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3 iNTERLOCKYEs NO 1/ INTERLOCKYEs NO�/ YES R No�/ 8❑ LDRIVER # STATE WA SEX'M MID -O B 06 1— 12 — 1974 2 32 9 ON DUTY❑ STATUS AIRBAG 6 RESTR 4 EJECT 1 HELMET 2 CLASS 1 NATURE OF INJURIES z❑ 3 LICENSE CLM7858 sTArI WAVIN# JTDKB20U773276850 10 F91 PI ATE# IT STATE TRAILER STATE 11 0 0 PLATE# PLATE# ROM ro TRLR. YRLR. 3 5 33 12 0 0 VIN#' VIN# >; FROM TO ❑ VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN T GOVT.VEHICLE 5 1 34 13 2 2007 TOYT PRIUS SD DAMAGE vEs 0NO f �AWkkRS TOWING vEs❑ No REGISTERED OWNER INFO OWNEDBYDRIVER VEHICLE NO. 1 SHADE IN DAMAGED AREA ❑ 14 LIABILITY INSURANCE Z INSURANCE CO PEMCO CA0813295 35 IN EFFECT &POLICY# �1'OP VEwcLE CHARGE ❑ 36 LEGALLY YFS❑NO❑ CITATION# BOTTOM 15❑ STANDING MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE UNIT 02 VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES 1/ NO D:2063723172 16 a LAST NAME GARCIA CORTES FIRST NAME JUAN-CARLOS MIDDLE INITIAL 17 STREET NEW ADOREss❑' 907 JERICHO PL NE CITY' RENTON ST WA ZIP 98059 37 18� CDL IGNITION REQUIRED IGNITION PRESENT MEDICALTRANSPORTED 38 INTERLOCK YEs❑NO INTERLOCK vEs❑NOF YEs❑NOF,/ 19 DRIVER'S STATE WA SEX M D.O.B. 05 _ 02 _ 1979 39 LICENSE# MMDDYY 20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 H U EET 2 NJAURSY 1 NATURE OF INJURIES 40 ❑21❑ PLATE# B2909 41 0U TArE WA VIN# 1FTSS34L75H846087 1 42 22❑ PLATE# STATE PLATE# STATE TRLR 23❑ VIN#. N#. 43 RLR % 'I TOWED By Gov HI 44 VEH YEAR 2005 MAKE FORD MODEL ECONOLI STYLE VN —TEHICLE TOWED✓ NOO BLIN BANKERS TOWING YES No�/ 24❑ REGISTERED OWNER INFO OWNED SY DRIVER VEHICLE N0.2 SHADEDAMAGEDAREA 3 4 LIABILITY INSURANCE I PORGY#ECO PABON INSURANCE AGENCY CB002390202 STOP 5 IN EFFECT VE""LE ❑ Nu,J CITATION# CHARGE LEGAL to BOTTOM LY YES 25 ' a OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# JAGENCY 26 E.EDMUNDS 12576 WA0171300 PART A PAGE 01 OF C7 3000-345-159 OR 11/181 STATE OF POLICETRAFFICN CORRECTION REPORT NO. EF09964 COLLISION REPORT III III III III III 111 1591972 CASE# 24-8895 ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY) NAME MIDDLE INITIAL) REYES NICOLE (LAST FIRST, ADDRESS&PHONE# 2064884588 SEX' F MMDDYYYY -❑ --------------------------- PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT ' HELMET INJURY NATURE OF INJURIES ❑ ❑✓ POS. USE CLASS NAME (LAST,FIRST,MIDDLE INITIAL) DINH MITZI ADDRESS&PHONE# D O E4 4257851207 SEX IF MMDDvvYv PASSENGER UNIT# SEAT AIRBAG RESTR. EJECT HELMET INJURY NATURE OF INJURIES []WITNESS POS. USE CLASS NAME (LAST FIR57 MIDDLE INITIAL) AppRESS&PHONE# SEX D.O.B.MMDD -❑ YYYY. PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET NJURY NATURE OF INJURIES ❑ ❑ POS. USE CLASS ----� NARRATIVE' Unit 1 was stopped on SW 41st ST at a stop sign, waiting to make a left turn onto Oakesdale Ave SW. Unit#2 was traveling northbound on Oakesdale Ave SW. Unit 1 attempted to make the left turn, entering Oakesdale Ave SW and misjudging the speed of oncoming traffic. Unit#2 struck Unit#1 as it was crossing the lane of travel causing damage to both vehicles. The improper left turn of Unit#1 was the proximate cause of the collision. Both driver's provided WA DL and current insurance. Banker's towing responded to the scene and removed both vehicle. I provided an exchange of information to both drivers for documentation. 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 E. Edmunds/#12576 at 1906 hours on 08/23/2024, in the City of Renton, WA. I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT. E.EDMUNDS 08-23-24 08:30 PM INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED APPROVED BY DATE J.TRADER 4553 1 8/30/2024 12:29:46 AM BADGE OR ID# 12576 OR]# WA0171300 TIME POLICE DISPATCHED 4:13 PM TIME POLICE ARRIVED',4:13 PM PART I PAGE IT]OF 3� REPORT NO. EF09964 CASE# ' 24-8895 DATE AND TIME 08/23/24 16:13 OF COLLISION _ u= z' t 1 u �o �s N, y R i � a PAGE 3 OF 3