HomeMy WebLinkAbout25-1001 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 6 27c
COLLISION REP FIT 1591971
INTERSTATE ❑ CITY STREET FIRE ❑
CASE 2s-1oo1 2
RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHICCI F ❑ LOCAL AOENC 4900 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 2 TOTAL#OF OBJECT 1 1 8 28
TRIBAL UNITS OZ STRUCK
RESERVATION
z
3❑ DATE OF M M D D Y Y Y Y TIME(2400) COUNTY# MILES N E IN CITY#
cowsloN 01 - 1-- 2025 1056 17 ❑-= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
BLOCK NO. e✓ --- ----� ❑
NE 4TH ST MILEPOST
4a❑
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ 1.❑ FEET e S ❑ W e 156THAVESE
0 1 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
�/No D:4254992787 0 4 30
6� LAST NAME IRVIN FIRSTNAME AMYA MIDDLE R 1 1 2 31
INITIAL
STREET ❑ 14535 171 ST AVE SE CITY RENTON ST WA 2jP, 980597934 z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
INTERLOCK YES[:]NO INTERLOCKYEs NO YES NO
8❑ LIDS
#
ON DUTY❑ STATUS' AIRBAG 2 RESTR 12 . EJECT 1 H U EET CLASS 7 NECK CHEST RIES z❑
3
10 1❑ P1ATE14 AHH8621 STATE WA VIN# 1G6DS1E30C0136513
TRAILER STATE TRAILER STATE
11 3 5 PLATE# I PLATE# I I FROM TO
TRLR. TRLR 3 7 33
12 3 5 VIN#' VIN#
>; FROM TO
❑ VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN T VgyENp/(g GOVT.VEHICLE 3 $ 34
13 2 ZO12 CADI CIS DAMAGE YES NO """- RS YES : NO✓
REGISTERED OWNER INFO BRIAN IRVIN 14535171STAVE SE RENTON WA 98059 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
14 LIABILITY INSURANCE INSURANCE CO ST FARM 5554798 C01 47 3 4
IN EFFECT &POLICY# 9TOP
vEHICLe 5 36
-ALLY re6 No CITATION# CHARGE FAIL TO OBEY TRAFFIC CONTROL o aorrom
15❑ STAIN."' 6
UNIT 02 VEHICLE CYCLE ❑ PEDESTRIAN ❑ OWN ARTY ❑ DYES✓ NO OLD MET PHONE
16 a
LAST NAME LEAVITT FIRST NAME COOPER MIDDLE I j
INITIAL
17❑ STREET ❑', 16427 SE 116TH PL CITY' RENTON ST WA ZIP 980598322 37
NEW ADDRESS ❑
18� CDL IGNITION REQUIRED IGNITION PtR-E-S1ENT MEDICAL TRANSPORTED ❑ 38
INTERLOCKYES�NOR INTERLOCK YEs I I NOF YEs t l No❑
19 DRIVER'S STATE WA SEX M D.C... 04 27 2007 El 39
LICENSE# MMDDYY
WELMET INJURY1 NATURE OF INJURIES 40
20❑ ON DUTY STATUS AIRBAG 6 RESTR 4 EJECT 1 USE CLASS ❑
21❑ LICENSE 658ZL1 TATe WA vIN1 1HGCG225X2A034586
❑ 41
PLATE#
42
22❑ PLATE# STATE PLATE# STATE
23❑ VIN#. 43
TRLR RLR
'IN#.
VEH YEAR 2002 MAKE HOND MODEL ACCORD STYLE VEHICLE TOWED TO BLIN TOWED eY GOV HI 44
24❑ DAMAGE YES✓ NO BANKERS YES NO✓
REGISTERED OWNER INFO JENNIFER LEAVITT 16427 SE 116TH PL RENTON WA 98059 VEHICLE NO.2
SHADEDAMAGEDAREA
3 4
LIABILITY
INSURANCE INSU8PORGY#ECO ALLSTATE 064 457 840IN STOP 5
VEwGLE ❑ ,J CITATION# CHARGE
25 io BOTTOM
LEGALLY YES Nu
' e
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
J
26
M.LEVERTON 2517 WA0171300
PART A PAGE 01 OF C7
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EF67726
COLLISION REPORT III III III III III 111
1591972 CASE# 25-1001
ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY)
NAME MIDDLE INITIAL) OLSBY JULIA G
(LAST FIRST,
ADDRESS&PHONE# D O.B. '
20409 SE 136TH ST ISSAQUAH WA 980278436 4258919708 SEXi F MMDOYyry 06 - 22 - 2007
SEAT HELMET INJURY NATURE OF INJURIES
PASSENGER I�IWITNESS❑ UMT# 1 POS, 3 AIRBAG 2 RESTR. q EJECT 1 USE CLASS 7 cHesraECK
NAME L�1
(LAST,FIRST,MIDDLE INITIAL) POUDEL
ADDRESS&PHONE# D O E4
SEX u MMDDYYYY 05 - 10 - 1984
PASSENGER ❑ POS. USE CLASS WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET NJURY NATURE OF INJURIES
NAME
(LAST FIRST,MIDDLE INITIAL) HAYES RON
AooREss&PHONE# 2066390239 _
SEX U. I. -❑
MDDYYYY
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.
M.LEVERTON 01-31-25 03:37 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
C.JACOBS 1953 1 2/21/2025 1:49:47 PM
BADGE OR ID# 2517 OR]#' WA0171300 TIME POLICE DISPATCHED 10:56 AM TIME POLICE ARRIVED]11:02 AM
PART I PAGE IT]OF 4�
TIME
REPORT NO. EF67726 CASE# 25-1001 OF COLLISION01/31/25 10:56
NARRATIVE
red/1 lane 2 eb ran red slv It wb to sb
CC
Within the city limits of Renton/King/WA I responded to a 2 vehicle blocking crash at the intersection
of NE 4th St at 156th Ave SE.
I contacted the driver of unit 2 who told me he was making a left turn on his green left turn light when
unit 1 crashed into his car. He said when he was done spinning around he was able to still see his
light was green. He was checked on scene by Renton Fire and released on scene with no complaint.
His vehicle was tow for damages.
I contacted the driver of unit 1 ID'd by her picture WADL. She told me she didnt understand why unit
2 turned in front of her when her light was green. She said she could not avoid unit 2. She and her
passenger complained of injury. They were both checked and released on scene by Renton Fire.
Damages required a tow truck.
I contacted one of the witnesses on scene who told me he was stopping for the red light and was
going the same direction as unit 1. He told me the light was solid red, yet unit 1 continued through
the light and crashed into the front/side of unit 2 spinning him out. I tried contacted the other witness
Ron H via phone calls and text with negative results. Unit 2 did tell me that Ron contacted him and
said he observed that unit 2 light was green for the left turn and unit 1 must have run a red light and
crashed into him.
The camera at this intersection was facing southbound and did not capture the crash on video.
Based on the statements made by Unit 2 and the witness I cited unit 1 ref RCW 46.61.055 FTCWTCD
-Red Light 2 car injury 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 1/31/2025
PAGE 3 OF 4
REPORT NO. EF67726 CASE# ' 25-1001 DATE AND TIME 01/31/25 10:56
OF COLLISION
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PAGE 4 OF 4