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HomeMy WebLinkAbout24-8905 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 5 27c COLLISION REP FIT 1591971 CASE 24-8905 z INTERSTATE ❑ CITY STREET FIRE ❑ RESULTED 1 STATE ROUTE OTHER STOLEN ❑ ❑ HFH1C;l F ❑ LOCAL AOENC 3 HIT&RUN CODING COUNTY RD PRIVATE WAY INVOLVED 2 TOTAL#OF OBJECT 1 28 TRIBAL UNITS 01 STRUCK' BUILDING RESERVATION z 3❑ DATE OF M M D D Y Y Y Y TIME(2400) COUNTY# MILES N E IN CITY# ❑ C{YLLISION O8 - 1-— 2024 2101 17 ❑.= S 8 W IN e 1070 3 4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑ SE CARR RD BLOCK NO. e✓ 10712 4a❑ MILEPOST DISTANCE OF(REFERENCE OR CROSS STREET) 5❑ ❑ FEET e S ❑ W e 108THAVES 0 4 29 MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE UNIT 01 VEHICLE ❑ CYCLE El ,/No D:2532284549 30 6� LAST NAME LINARES FIRSTNAME ADRIAN MIDDLE 1 F 2 31 INITIAL STREET ❑, 4220 57TH ST CT NW I CITY GIG HARBOR ST WA ZIp' 98335 z NEW ADDRESS 7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3 INTERLOCK YES[:]NO 1/ INTERLOCKYEs NO�/ YES R No�/ 8❑ LRIIVER # ON DUTY❑ STATUS AIRBAG 6 RESTR 4 EJECT 1 HELMET 2 CLASS 1 NATURE OF INJURIES z❑ 3 10❑ P1 aT�S� AXG8659 sTArr WAVIN# 5FRYD4H99G8031632 IT STATE TRAILER STATE 11 0 0 PLATE# PLATE# Rom ro TRLR. TRLR $ 7 33 12❑ VIN#' UIN#' 2016 ACUR MDX UT I HI FROM 34 ❑ VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO u BLIN TOWED BY GOVT.VEHICLE 13 $ DAMAGE YES NO �/ YES[:] HI REGISTERED OWNER INFO ,HARBOR CONSTRUCTION COMPA 422057TH ST CT NW GIG HARBOR WA 98335 D:2532284549 VEHICLE NO. 1 ❑ SHADE IN DAMAGED AREA 35 14❑ LIABILITY INSURANCE z INSURANCE CO FARMERS 607180871 <�3 4 LI EFFECT &SUR N#VEHICLE CHARGE 36 LEGALLv res❑NO❑ CITATION# TTOM 15❑ STAIN,DIING 6 UNIT U2 VEHICCMOTOLE ❑ CYCLE ❑ PEDESTRIAN ❑ OWNER YES [:]I DYES NO OLD MET PHONE 16❑ LAST NAME FIRST NAME MIDDLE INITIAL STREET CITY' ST ZIP 4❑ 37 17❑ NEW ADDRESS❑' 18❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED ❑ 38 INTERLOCK YES❑NOR INTERLOCK YEs❑NOF YEs❑NO❑ 19 LLIRIVERSTICENS # STATE SEX MMDDYY —�_ 39 HELMET INJURY NATURE OF INJURIES 40 20❑ ON DUTY STATUS' AIRBAG RESTR EJECT USE CLASS ❑ ❑21❑ LICENSE TArE IN# 41 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 24❑ DAMAGE YES NO YES NO REGISTERED OWNER INFO VEHICLE NO.2 SHADE IN DAMAGED AREA 2 3 4 LIABILITY INSURANCE❑ INSURANCE #E CO IN EFFECT &PO IGQVE""LE ❑ ,J� CITATION# CHARGE LEGALLY YES N`L J 25 OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# 777T�NCY 26 E.EDMUNDS 12576 0171300 PART A PAGE 01 OF C7 3000-345-159 OR 11/181 STATE OF POLICETRAFFICN CORRECTION REPORT NO. EF09960 COLLISION REPORT III III III III III 111 1591972 CASE# 24-8905 ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY) NAME (/AST 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' Unit 1, driven by Adrian Linares (02/06/1993), was making a left turn from 108th Ave SE onto SE Carr RD. As he completed the turn, Linares stated he saw a flash and tensed his grip on the steering wheel. As he did so, the vehicle left the roadway, riding alonside the sidewalk then striking the bustop in front of the CVS store (10712 SE Carr Rd) before coming to a stop. Linares did not complain of injury, but Firefighters responded to the location for an evaluation due to an airbag deployment. No immediate medical attention was deemed necessary. Linares provided a WA DL, current registration, and proof of insurance. An NCIC/WACIC returned clear. A King County Metro supervisor responded to the scene and was provided with and exchange of information for the damage to the bustop. 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 2218 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 10:19 PM INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED APPROVED BY DATE J.TRADER 4553 1 8/30/2024 12:28:46 AM BADGE OR ID# 12576 OR]# WA0171300 TIME POLICE DISPATCHED'; 9:09 Pry] TIME POLICE ARRIVED',9:01 PM PART I PAGE IT]OF 3� REPORT NO. EF09960 CASE# 24-8905 DATE AND TIME 08/23/24 21:01 OF COLLISION a r" ..t T 5 } i c y 1 t � u 4 c 12ti 4 13 2 i c t 1 tk t l tx� enertn , t r t � � PAGE 3 OF 3