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HomeMy WebLinkAbout24-9081 POLICETRAFF'c" III !�� I IIIllI111IN II II I REPORT NO. EF10939 170 27 COLLISION REP FIT 1591971 INTERSTATE ❑ CITY STREET FIRE ❑ CASE 24-so81 z RESULTED 1 STOLEN STATE ROUTE ❑ OTHER ❑ VFHICI F ❑ LOCAL AOENC 4900 3 HIT&RUN CODING COUNTY RD PRIVATE WAY INVOLVED 2 1 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# COLLISION'. O8 - 1-- 2024 1045 17 ❑-= S 8 IN e 1070 3 4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑ 108TH AVE SE BLOCK NO. e ❑ 4a❑ MILEPOST DISTANCE OF(REFERENCE OR CROSS STREET) 5❑ �.❑ FEET e S ❑ VV e SE 186TH ST 0 4 29 MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE UNIT 01 VEHICLE ❑ CYCLE El NO D:2064124477 0 11 30 6� LAST NAME JENSEN FIRSTNAME RANDY MIDDLE L 1 1 2 31 INITIAL STREET ❑, 10919 SDE 186TH ST CITY RENTON ST WA ZIP 98055 z NEW ADDRESS 7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3 iNTERLOCKYEs NO INTERLOCKYEs NO YES R NO 8❑ DRIVERS E# ON DUTY❑ STATUS' AIRBAG 6 RESTR 4 EJECT 1 H U EETI I INJURY [NATURE CLASS 6 CHEST OF INJURIES 2❑ 3 10 9❑ p7 ATE 14 BSS9421 STATE WA VIN# 1FM5K8HF3JGC06818 TRAILER STATE TRAILER STATE 11 2 5 PLATE# PLATE# FROM TO TRLR. TRLR. 3 5 33 12 4 0 VIN#' VIN# >; FROM TO ❑ VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TR Y GOVT.VEHICLE 5 1 34 13 2 2018 FORD EXPLOR DAMAGE YES NO �MEYER YES : NO✓ REGISTERED OWNER INFO RANDY JENSEN 10919 SDE 186TH ST RENTON WA 98055 VEHICLE NO. 1 ❑ SHADE IN DAMAGED AREA 35 3 4 14 LIABILI INSURANCE INSURANCE CO TBA IN EFFECT &POLICY# 9TOP ❑ LEGALLYE LE CHARGE 5 36 15 2 YEs No clTAnoN# 4A0652631 FAIL YIELD LEFT TURN MOTOR o aorrob MOTOR PEDAL- PROPERTY DAM THR OLD MET PHONE UNIT(12 ❑ PEDESTRIAN ❑ ❑ YES,/ No D:2532598240 VEHICLE CYCLE OWNER 16 a LAST NAME STROMBERG FIRST NAME CAILEY MIDDLE F INITIAL 17❑ STREET ❑', 20309 144TH PL SE CITY' KENT ST WA ZIP 98042 37 NEW ADDRESS ❑ 18� CDL IGNITION REQUIRED IGNITION PtR-E-S1ENT MEDICAL t-T�RANSPORTED ❑ 38 INTERLOCKYES�NOR INTERLOCK YEs I I No� YES t l No❑ 19 LICENSE# STATE WA SEX U M D.C.B. 08 _ 24 2005 39 WELMET INJURY NATURE OF INJURIES 40 20❑ ON DUTY STATUS AIRBAG,6 RESTR 4 EJECT 1 USE CLASS 7 WRISTS KNEES 21❑ LICENSE A VP8469 TATe I WI VIN 1t 5YFS4RCE9LP015972 ❑ 41 PLATE# 42 22❑ PLATE# STATE PLATE# STATE 23❑ UIN#. 43 TRLR RLR 'IN#. VEH YEAR 2020 MAKE TOYT MODEL COROLL STYLE VEHICLE TOWED TO BLIN TOWEDBY GOV HI 44 24❑ DAMAGE YES NO GENE MEYER YES NO REGISTERED OWNER INFO WILLIAM LEDGER 56 STREETER CT FOND DU LAC WI 54935 VEHICLE NO.2 SHADEDAMAGEDAREA 3 4 INAEFFITY ECTNSURANCE INSU&POLICY#E CO TBA 9TOP 5 'E""LE ❑ ,J� CITATION# CHARGE io BOTTOM LEGALLY YES Nu 25 ' e OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# 26 M.LEVERTON 2517 [V7�ENCY A0171300 PART A PAGE 01 OF 3000-345-159 OR 11/181 STATE OF POLICETRAFFICN CORRECTION REPORT NO. EF10939 COLLISION REPORT III III III III III 111 1591972 CASE# 24-9081 ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY) NAME MIDDLE INITIAL) JENSEN KATHYA (LAST FIRST, ADDRESS&PHONE k D O.B. ' 10919 SE 186TH ST RENTON WA 98055 2063346544 SEXi F MMDovyry 04 - 19 - 1960 SEAT HELMET INJURY NATURE OF INJURIES PASSENGER WITNESS❑',UNIT# 1 POS. 9 AIRBAG j y RESTR. q EJECT 1 USE CLASS 6 CHESTNECK NAME (LAST,FIRST,MIDDLE INITIAL) SLOBODEN ROBERT✓ ADDRESS&PHONE# DOB 18410 SE 207TH ST RENTON WA 98055 2069497287 SEX' M MMDDvvvv - SEAT HELMET I INJURY NATURE of INJURIES PASSENGER P]WITNESS UNIT# 1 POS 3 AIRBAG 6 RESTR. 4 EJECT 1 USE CLASS 1 NAME (LAST FIRST,MIDDLE INITIAL) MBADUGHA MISTY AooREss PHONE a 4253065325 SEX U 11 _ 1978 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. M.LEVERTON 08-29-24 12:47 PM INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED APPROVED BY E DAT C.JACOBS 1953 9/2/2024 12:22:26 PM BADGE OR ID# 2517 OR]#' WA0171300 TIME POLICE DISPATCHED; 10:50 AM TIME POLICE ARRIVED]10:50 AM PART I PAGE IT]OF 5� STATE OF POLICETRAFFICN CORRECTION REPORT NO. EF10939 COLLISION REPORT III III III III III 111 1591972 CASE# 24-9081 ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY) NAME MIDDLE INITIAL) HRRIMAN GABIELLE C (LAST FIRST, ADDRESS&PHONE# 2068820340 SEX i U MMDDYYYY 04 - 07 - 1993 --------------------------- PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT ' HELMET INJURY NATURE OF INJURIES ❑✓ ; PM USE CLASS NAME '(LAST,FIRST,MIDDLE INITIAL) ADDRESS&PHONE# D O 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' 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 08-29-24 12:47 PM INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED APPROVED BY DATE C.JACOBS 1953 1 9/2/2024 12:22:26 PM BADGE OR ID# 2517 OR]#' WA0171300 TIME POLICE DISPATCHED; 10:50 AM TIME POLICE ARRIVED]10:50 AM PART I PAGE 3�OF 5� REPORT NO. EF10939 CASE# 24-9081 OF COLLISION 08/29/24 10:45 OF CbLLI510N NARRATIVE CC Within the city limits of Renton/King/WA I responded to a 2 car blocking injury crash at 108th Ave SE and SE 186th St. I arrived and found a blue sedan and red SUV partially blocking northbound lane 2 and the 2 way center turn lane along with a portion of southbound lane 2. 1 contacted a witness on scene who was holding the driver door open on unit 1. She said the driver was injured and did not want to get out of the car. She also told me there was another passenger in the back seat injured and not getting out. Renton Fire assisted both occupants who were later transported to VMC-ED for additional checks/treatment. I contacted the driver of unit 2 who told me she was northbound lane 1 at about 35-40 mph when unit 1 turned across her lane. She said she tried to swerve away from his car but could not avoid contact. She said her wrists and knees were sore with obvious abrasions. She was checked and released on scene by Renton Fire. Her vehicle was impounded for heavy damages by Gene Meyer. I contacted unit 1 ID'd by his picture WADL. He told me the car was going very fast while he was making his left turn. I asked him if unit 2 was speeding why did he pull out. He said he was only repeating what a witness told him. He told me he didnt in fact see the vehicle/unit 2 while making a left turn from his neighborhood. Unit 1 was cited via complaint ref RCW 46.61.185 FTYROW-left turn. 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 8/29/2024 PAGE 4 OF 5 REPORT NO.! EF10939 CASE# ' 24-9081 DATE AND TIME 08/29/24 10:45 OF COLLISION � C1 k ' i I r t 24 � t��t�, � e�.�<:��.,.;v o„..� �.:............:... ..�. .�. ".�a� 1�'��„�.'�`-°.£�'?+,. .3 as. ems` ,��*t�, car,,..,.#£, t•. PAGE 5 OF 5