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HomeMy WebLinkAbout24-10280 iiTFiNII IIIII III IIIII II IIII IIIII I . 27c REPORT NO EF22188oc� RA
COLLISION REPORT 1591971
CASE# 24-10280 2
INTERSTATE CITY STREET FIRE I
RESULTEDSTOLENSTATE ROUTE OTHER VEHICLE LDCAI-AGENCY 4200 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 TOTAL#OF OBJECT 1 s 28
TRIBAL UNITS 02 STRUCK
RESERVATION : 1 1
2
3� M M D D Y Y Y Y TIME(2400) COUNTY# MILES CITY#
eaCL s o v' 10 - 01 - 2024 1637 17 =.[� S 8 W e OF e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓
SUNSET BL N BLOCK NO. e 353 .�
4a❑ MILE POST
❑ DISTANCE OF(REFERENCE OR CROSS STREET)
5 6001.1 00 FEET e✓ S 8 W e NE 3RD ST
0 4 29
MOTOR ✓ PEDAL- DAM AG THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE ❑ YEs Vl No D:4255450651 0 1 30
5 LAST NAME KAR FIRST NAME BARAN MIDDLE N 1 1 2 31
INITIAL
STREET ❑ 3728 NE 5TH PL CITY; RENTON ST I WA ZIP 980563974 2
NEW ADDRESS
7� +CDL IGN(TIUN REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
INTERLOCKYEs NO INTERLOCKY No YES F NO
8❑ DCIENSE# STATE WA SEXI M MMDDYY' 09 - 05 - 1997 1 2 32
9 ON DUTY STATUS' AIRBAG 6 RESTR 4 EJECT 1 N UET SE LA SY 1 [NATURE of INJURIES 2
LICENSE, CKT8235 STATE WA VIN# 2HMZE2H52C001873 3
10 Fq I as ATP rt
TRAILER STATE TRAILER STATE
11 3 0 PLATE# PLATE# ROM To
TRLR TRLR 5 1 7 33
12 3 0 VIN#' vIN#
FROM TO
VEH.YEAR 2012 MAKE TOYT MODEL pRIUS STYLE VEHICLE TOWED TO fjBFI T�ff BY GOVT VEHICLE 1 5 34
13� DAMAGE YES ✓ NO II_II V t YESII_I) NO
REGISTERED OWNER INFO 7SA KAR 3728 NE 5TH PL RENTON WA 98056 VEHICLE NO. 1
SHADE IN DAMAGED AREA 35
14 LIABILITY INSURANCE� INSURANCE CO SAME.
IN EFFECT &POLICY# 9TOP _
srgNOLNG ❑ ❑ 4A0652686 CHARGE FA►L YIELD LEFT TURN MOTOR s taooTro�m z 36
Ves NO CITATION#
15
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM OLD MET PHONE
UNIT 02 VEHICLE CYCLE nWNFR YES�/ THR NO D:4258910056
16�
LAST NAME UR►OSTEGUI BUSTAMANTE FIRST NAME LUIS MIDDLE N
INITIAL
17 STREET ❑ 1100 SUNSET BLVD NE APT 6111 CITY' RENTON ST, WA ZIP 37
980562971
NEW ADDRESS I I I I I 1
❑
18❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED' ❑ 38
INTERLOCKYEs No INTERLOCI£YES NOFYEs NO
19 DRIVER'S
MMDDYYj I —
HELMET INJURY: NATURE OF INJURIES 40
20❑ ON DUTY� STATUS AIRBAG 2 RESTR 4 EJECT 1 USE CLASS 1 ❑
21 LICEN#LATE ID74370D rare WA vIN# 1 N6ED1 CM9NN666098 41
22❑ PLATE# STATE PLATE# STATE 42
23 TRLR r RLR 43
UIN#. 'IN#
TOWED BY GOV HI 44
VEH.YEAR 2022 MAKE pJJ$$ MODEL FRONT/E STYLE VEHICLE
TOWED✓ No BLIN BANKERS
24
REGISTERED OWNER INFO LUfS URtOSTEGUI BUSTAMANTE 1100 SUNSET BLVD NE APT 8111 RENTON WA 950562971 D:4258910056 VEHICLE NO.2
SHADEDAMAGEDAREA
3 4
LIABILITY INSURANCE INSURANCE CO TBA 4106975351795
IN EFFECT &POLICY# 9TOP
VEHICLE
❑ ,J—I CITATION# CHARGE 7060TTOM
LEGnLLv YES N`[
25 e
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
J
26
M.LEVERTON 2517 WA0171300
PAGE 01 OF
PART A 3000-345-189(R 11/18)
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EF22188
COLLISION REPORT III III III III III 111
1591972 CASE# 24-10280
ADDITIONAL PERSONS INVOLVED(PASSENGERS AND/OR WITNESSES ONLY)
'.NAME
(LAST,FIRST,MIDDLE INITIAL)
ADDRESS&PHONE
SEXi D.O.B. —
MMDDYYYY
PASSENGERQ WITNESS� UNIT SEAT AIRBAG RESTR. EJECT ; HELMET INJURY NATURE OF INJURIES
POS. ' USE CLASS 1 ----�
:NAME
(LAST FIRST MIDDLE INITIAL)
ADDRESS&PHONE#
SEX D.O.B. —
MMDDYYYY
PASSENGER❑WITNESS UNIT# : SEAT AIRBAG RESTR. EJECT HELMET INJURY: NATURECFINJURIES
POS. USE CLASS ----�
:NAME
(LOST,FIRST,MIDDLE INITIAL)
ADDRESS&PHONE#
SEX MMDDYY D.O.B.
YY
PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET NJURY NATURE OF INJURIES
POS. I 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.
M.LEVERTON 10-02-24 07:24 AM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST.DET DATED PLACE SIGNED
APPROVED BY DATE
C.JACOBS 1953 10/7/2024 12:34:32 PM
BADGE OR ID# ; 2517 ORI# WA0171300 TIME POLICE DISPATCHED 4:40 Pry] TIME POLICE ARRIVED i 4:40 PM
PAST B 3 Do-3mx—attar(t 1Mff) PAGE 2�OF 4
REPORT NO. EF22188 CASE# 24-10280 DATE OF COLLI r�510NN + 10/01/24 16:37
L1
NARRATIVE
grn trk lane 1 sb slv/2 left turn to enterprise
CC
Within the city limits of Renton/King/WA I responded to a 2 vehicle blocking crash at the 353 block of
Sunset Blvd N.
When I arrived I located a green truck/unit 2 facing southbound lane 1 with front end damage. A
small sedan with pulled into a nearby parking lot.
I contacted the driver of unit 2 who told me he was south in lane 1 Sunset Blvd N when unit 1 made a
left turn across his lane without enough space to avoid contact. He did not complain of injury and
damages did require a tow truck.
I contacted the driver of unit 1 ID'd by non picture temp WADL. He told me he was making a left
towards the parking lot when he vehicle remained with heavy damage to the passenger side. He
mentioned he believed because the heavy traffic in lane 3 and 2 were stopped he was clear to go.
He made his turn without clearing lane 1 as well causing the collision with unit 2. He did not complain
of injury and damages required a tow truck. Unit 1 provided his own private tow.
I cited unit 1 ref RCW 46.61.185 FTYROW Left turn two car crash via complaint.
I certify (declare) under penalty of perjury under the laws of the State of Washington that the
foregoing is true and correct.
M.Leverton/2517 City of Renton/King/Wa 10/02/2024
PAGE 3 OF 4
REPORT NO. EF22188 CASE# 24-10280 DATE AND TIME 10/01/2416:37
OF COLLISION
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PAGE 4 OF 4