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HomeMy WebLinkAbout24-9444 iiTFiNII IIIII III IIIII II IIII IIIII I . 27c REPORT NO EF13096oc� RA COLLISION REPORT 1591971 CASE# 24-9444 2 INTERSTATE CITY STREET El STATE ROUTE OTHER LOCAI-AGENCY 4150 3 C©DING COUNTY RD PRIVATE WAY 2 TOTAL#OF OBJECT 28 TRIBAL UNITS 01 STRUCK RESERVATION : 2 3� M M D D Y Y Y Y TIME(2400) COUNTY# MILES CITY# eaCL s o v' 09 - 08 - 2024 2039 17 =.= S 8 W e IN OF e 1070 s 4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑ BLOCK NO. SUNSET BlVD NE 4a❑ MILE POST ❑ DISTANCE OF(REFERENCE OR CROSS STREET) 5 MILES 1.1 FEET e S 8 W e NB I-405 0 1 29 MOTOR PEDAL- DAM G THRESHOLD MET PHONE UNIT 01 VEHICLE ❑ CYCLE ❑ YES'Vl No D:4253813193 30 5❑ LAST NAME URRUELA MEDIA FIRST NAME STEPHEN MIDDLE t 1 2 31 INITIAL STREET ❑ 2204 NE 9TH ST CITY; RENTON I ST WA I ZIP 1 98056 2 NEW ADDRESS 7 +CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3 INTERLOCK YES NO✓ INTERLOCKYEs Na✓ YES F NO✓ 8 DCIENSE# STATE WA SEXI M MMDDYY' 03 - 29 - 2007 32 9 ON DUTY STATUS' AIRBAG 6 RESTR 3 EJECT 1 HELMET 2 INJURY 6 NATURE of INJURIES 2 USE ,CLASS PAIN IN LEFT ARM,HEAD PAIN 10 LI ENSE', BSE8530 STATE WA VIN# 2HGFC2F54GH512304 3 TRAILER STATE TRAILER STATE ROM 11 3 5 PLATE# PLATE# T. 7 TRLR TRLR 3 7 33 12 VIN#' VIN# : FROM TO 13 3 VER YEAR 2016 MAKE HOND MODEL CIVIC STYLE SO VEHICLE TOWED TO fjl4 N TgAWIJ�R S TOWING VEHICLE✓ m 34 DAMAGE IIII._IIII REGISTERED OWNER INFO MARISOL URRUELAMEJIA 2204 NE 9TH ST RENTON WA 98056 D:4254963485 VEHICLE NO. 1 SHADE IN DAMAGED AREA 35 3 4 14❑ LIABILITY INSURANCE NSURANCE CO STATEFARM 514 1104-D12-47 IN EFFECT &POLICY# 4TOP CHARGE t VEHICLE 5 Lemur yes❑NO❑ CITATION# 36 7 0 80TTOM 15❑ sTANowc MOTOR PEDAL-:. PROPERTY DAM THR OLD MET PHONE UNIT 0' PEDESTRIAN VEHICLE CYCLE' OWNER YES NO 16❑ LAST NAME FIRST NAME MIDDLE' INITIAL 17❑ STREET ❑ CITY ST ZIP 4❑ 37 NEW ADDRESS 1$❑ CDL IGNITION REQUIRED IGNITION PRESENT MED[CALTRANSPORTED 38 INTERLOCKYEs NO INTERLOCK YES R No vEs NQ 19� DRIVERS # STATE SEX MMDDYY —� 39 HELMET INJURY NATURE OF INJURIES 4Q 20❑ ON DUTY STATUS AIRBAG RESTR EJECT USE CLASS ❑ 21 1 PLATE# rare vIN# 41 22❑ [TILER TAILER PLATE# STATE PLATE# STATE 42 23 TRLR RLR 43 UIN#. '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 CO IN EFFECT &POLICY# 9TOP vewcLe ❑ CITATION CHARGE AE to BOTTOM EEGEy YES N`0 25 a s OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY 26 NATHANIEL BROWN 12765 WA0171300 PAGE 01 OF PART A 3000-348-189(R 11/18) STATE OF POLICETRAFFICN CORRECTION REPORT NO. EF13096 COLLISION REPORT III III III III III 111 1591972 CASE# 24-9444 E NA ADDITIONAL PERSONS INVOLVED(PASSENGERS AND/OR WITNESSES ONLY) M (LAST,FIRST,MIDDLE INITIAL) URRUELA MEDIA MARISOL ADDRESS&PHONE# 2204 NE 9TH ST RENTON WA 98506 SEXi F MMDDD B. 10 — 17 — 1993 PASSENGER WITNESS UNIT SEAT AIRBAG RESTR. EJECT HELMET INJURY NATURE OF INJURIES z � 1 POS. 3 9 9 9 USE 9 CLASS 0 ----� :NAME (LAST FIFS7 MIDDLE INITIAL) ADDRESS R 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 Unit 2 was traveling southwest down Sunset Blvd NE and was crossing the intersection with the northbound 1-405 on-ramp when unit 1, a grey Toyota sedan (unknown make, model, driver) failed to yield at the left turn onto the on-ramp, causing the front end of unit 1 to strike the left side of unit. This caused unit 2 to spin 180 degrees and face the opposite direction in addition to extensive damaged to the driver side of unit 2. Unit 1 had severe front end damage. The driver of unit 2 reported left arm pain and head pain from the collision but no major injuries. Unit 2 was not driveable and was towed from the scene. Unit 1 did not stop and continued onto northboud 1-405. Unit 1 made no attempt to exchange information. The driver of unit 2 did not see the driver of unit 1 and did not know what model the vehicle was. There was a front license plate on the ground nearby, WA CKW4491, that returned to a grey Toyota Prius. It is unclear if this was the involved suspect vehicle (unit 1). Unit 1 failing to yield to oncoming traffic was the proximate cause of this collision. There is probable cause for hit and run if the driver can be identified. I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT. NATHANIEL BROWN 09-09-24 12:48 AM INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST.DET DATED PLACE SIGNED APPROVED BY DATE P.SUMMERS 8887 9/9/2024 12:59:34 AM BADGE OR ID# 12765 ORI# WA0171300 TIME POLICE DISPATCHED 1 8:53 PM TIME POLICE ARRIVED i 8:57 PM PAST B 3 Da-3m5—attar(t 1Mff) PAGE 2�OF F3 REPORT NO. EF13096 CASE# 24-9444 DATE AND TIME 09/08/24 20:39 OF COLLISION v PAGE 3 OF 3