No preview available
HomeMy WebLinkAbout24-9396 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 1 27c COLLISION REP FIT 1591971 CASE 24-9396 z INTERSTATE ❑ CITY STREET FIRE ❑ RESULTED 1 STATE ROUTE OTHER STOLEN ❑ ❑ HFHIC;I F ❑ LOCAL AOENC 3 HIT&RUN CODING COUNTY RD PRIVATE WAY INVOLVED 2� 1 1 8 28 TOTAL#OF OBJECT TRIBAL UNITS 02 STRUCK' TRAFFIC SIGNAL POLE RESERVATION z 3❑ DATE OF M M D D Y Y Y Y TIME(2400) COUNTY# MILES N E IN CITY# ❑ C{YLLISION O9 - 1-— 2024 1254 17 ❑.= S 8 W IN e 1070 3 4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑ NE 4TH ST BLOCK NO. e 4a❑ MILEPOST DISTANCE OF(REFERENCE OR CROSS STREET) 5❑ �.❑ FEET e S ❑ W e DUVAL!AVE NE 0 1 29 UNIT MOTOR Z PEDAL- CYCLE ❑ YESA,GEE NHORESHOLD MET PHONE 0 4 30 6� LAST NAME L/ FIRSTNAME BIAO MIDDLE 1 2 31 INITIAL STREET ❑, 6301LWACO AVE NE CITY RENTON ST WA 2jp, 98059 z NEW ADDRESS 7❑ CDL IGNITION REQUIRED IGNITION : PRESENT MEDICAL TRANSPORTED 3 iNTERLOCKYEs NO 1/ I INTERLOCK YES NO�/ YES R NO ❑ DRIVER'S' STATE WA SEX'M MM ovY 11 1- 10 - 1967 2 32 8 LICENSE# 9 ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 H USEET IINLJAURY 1 NATURE OF INJURIES z❑ 3 10❑ Pi aTES� ACF9130 sTArr~ WAurN# 2HGES16193H623639 0 TRAILER STATE TRAILER STATE 11 0 0 PLATE# PLATE# FROM TO TRLR. TRLR 7 3 33 12 0 0 VIN#' VIN# >; FROM TO ❑ VEH.YEAR 2003 MAKE MODEL STYLE VEHICLE TOWED TO BLIN 1 3 TOWED BY GOVT.VEHICLE 34 13 4 HOND CIVIC SD DAMAGE YES NO YES❑ No✓ REGISTERED OWNER INFO BIAO 11.0 ILWACOAVE NE RENTON WA 98059 VEHICLE NO. 1 ❑ SHADE IN DAMAGED AREA 35 14� IN EF ITY INSURANCE z INSURANCE CO LEMONADE INSURANCE LCP 296-5620.091 4 LI EFFECT I POLICY# TOPVEHICLE CHARGE 36 LEGALLv res❑NO❑ CITATION# <1�3 OTTOM 15❑ STANDING 7 6 MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE UNIT U2 VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES 1/ NO D:2533507034 16 2 LAST NAME STRATTON FIRST NAME GUY MIDDLE ID INITIAL 17❑ NEW STREETRE87 37611 SE FURY ST UNIT 100 CITY SNOQUALMIE ST' WA ZIP 98065 37 18� CDL IGNITION REQUIRED IGNITION PRESENT MEDICALTRANSPORTED 38 INTERLOCK YES❑ND� INTERLOCK YEs❑NOF YES ❑NOF,/ 19[—] LICENSE# STATE WA SEX M M D.O.B. 02 _ 22 _ 1962 39 20 ON DUTY STATUS AIRBAG,6 RESTR 4 EJECT 1 HELMET INJURY 6 NATURE OF INJURIES 40 USE CLASS HEAD PAIN ❑21❑ PLATE# C55595N TArE 41 WA VIN# 1C6RR7HT7FS667530 1 42 22❑ PLATE# STATE PLATE# STATE 23❑ UIN#. 43 TRLR RLR 'IN#. VEH YEAR 2015 MAKE RAM MODEL 1500 STYLE TR VEHICLETOWED TO BLIN TOWEDBY GOV HI 44 L4❑ DAMAGE YES NO YES NO REGISTERED OWNER INFO GUY STRATTON 37611 SE FURY ST UNIT 100 SNOQUALMIE WA 98065 D:2533507034 VEHICLE NO.2 SHADE DAGED AREA 4 LIABILITY INSURANCE INSU&PORGY#E CO GRANGE INSURANCE 5104440118928 IGQI IN EFFECT"'LLE ❑ ,J� CITATION# CHARGE LEGALLY YES N`L J 25 s � e =SLINKMAN AME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY26 11618 WA0171300 PART A PAGE 01 OF C7 3000-345-159 OR 11/181 STATE OF POLICETRAFFICN CORRECTION REPORT NO. EF12969 COLLISION REPORT III III III III III 111 1591972 CASE# 24-9396 ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY) NAME MIDDLE INITIAL) SHIVE SONJA L (IAST FIRST, ADDRESS&PHONE# D O.B. ' 14041 154TH AVE SE RENTON WA 98059 4254176685 SEXi F MMDDYyry 01 - 13 - 1967 PASSENGER L, WITNESS❑'UNIT# 2 PEATOS. 9 AIRBAG 6 RESTR. 4 EJECT ? 1 USE HELMET CLASS LASS NATURE OF INJURIES ' 11 NAME AST FIRST,MIDDLE INITIAL) STRATTON KRISTINE M ADDRESS&PHONE# D O E4 965 FIELD AVE NE RENTON WA 98059 2535699276 SEX IF .M.D Y, 03 - 19 - 1964 SEAT HELMET INJURY NATURE OF INJURIES PASSENGER WITNESS UNIT# 2 PGS 7 AIRBAG 6 RESTR. 4 EJECT 1 USE CLASS 1 NAME (LAST FIRST,MIDDLE INITIAL) IRWIN CORY J ADDREss PHONE# 15932 SE JONES RD RENTON WA 98058 2069092514 SEX M D•o•B• 05 M _ 19 _ 1989 MDDYYYY PASSENGER WITNESS UNIT# ! 2 SEAT 3 AIRBAG 6 RESTR. 4 EJECT 1 HELMET NJURY 6 NATURE OF INJURIES POS. USE CLASS HEAD AND BODY PAIN,D_1NESS NARRATIVE' Unit 1 was traveling eastbound on NE 4th St in Lane 1 approaching Duvall Ave NE. Unit 2 was facing southbound on Duvall Ave NE at NE 4th St in lane 2 (Inner turn lane). Unit 2 proceeded through the intersection to make a left hand turn to go eastbound on NE 4th St. Unit 1 proceeded through the intersection and collided with unit 2. Unit 1 then drifted and hit a street light pole. Drivers of both unit 1 and unit 2 believed that they had the green light. A witness was on Duvall Ave NE facing northbound in lane one and was stopped at the red light. He believed that unit 2 had the green light and unit 1 had ran a red light. I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT. ROBERT SL/NKMAN 09-07-24 03:06 PM INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED APPROVED BY DATE DESIRES SCOTT 10272 1 9/8/2024 10:23:17 AM BADGE OR ID# 11618 ORI#' WA0171300 TIME POLICE DISPATCHED; 12:55 PM TIME POLICE ARRIVED 12:58 PM PART I PAGE IT]OF 4] STATE OF POLICETRAFFICN CORRECTION REPORT NO. EF12969 COLLISION REPORT III III III III III 111 1591972 CASE# 24-9396 ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY) NAME MIDDLE INITIAL) MC DOLE GREGORYB (LAST FIRST, ADDRESS&PHONE# 12632 155TH AVE SE RENTON WA 98059 2067131629 SEX M MMDDYyry 02 - 08 - 1961 PASSENGER WITNESS SEAT AIRBAG RESTR. EJECT ' HELMET INJURY NATURE OF INJURIES ❑ ❑✓ UNIT# POS. USE CLASS NAME (LAST,FIRST,MIDDLE INITIAL) ADDRESS&PHONE# DOB SEX' MMDDYVYV PASSENGER ❑WITNESS❑ UNIT# SEAT AIRBAG RESTR. EJECT HELMET NJURY NATURE OF INJURIES 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 traveling eastbound on NE 4th St in Lane 1 approaching Duvall Ave NE. Unit 2 was facing southbound on Duvall Ave NE at NE 4th St in lane 2 (Inner turn lane). Unit 2 proceeded through the intersection to make a left hand turn to go eastbound on NE 4th St. Unit 1 proceeded through the intersection and collided with unit 2. Unit 1 then drifted and hit a street light pole. Drivers of both unit 1 and unit 2 believed that they had the green light. A witness was on Duvall Ave NE facing northbound in lane one and was stopped at the red light. He believed that unit 2 had the green light and unit 1 had ran a red light. I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT. ROBERT SL/NKMAN 09-07-24 03:06 PM INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED APPROVED BY DATE DESIRES SCOTT 10272 1 9/8/2024 10:23:17 AM BADGE OR ID# 11618 ORI#' WA0171300 TIME POLICE DISPATCHED; 12:55 PM TIME POLICE ARRIVED 12:58 PM PART I PAGE IT]OF 4� REPORT NO.! EF12969 CASE# ' 24-9396 DATE AND TIME 09/07/24 12:54 OF COLLISION n , r s a� n �.t s t ro cy, 1ti u. k 3 r� PAGE 4 OF 4