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HomeMy WebLinkAbout24-9382 iiTFiNII IIIII III IIIII II IIII IIIII I . 27c REPORT NO EF13089oc� RA COLLISION REPORT 1591971 CASE# 24-9382 2 INTERSTATE CITY STREET FIRE I RESULTEDSTOLENSTATE ROUTE OTHER VEHICLE LOCALANG 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# eaCLson' 09 - 06 - 2024 1931 17 =.= S 8 W e IN e 1070 s 4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓ S 2ND ST BLOCK NO. e 200 .� 4a❑ MILE POST ❑ DISTANCE OF(REFERENCE OR CROSS STREET) 5 100 00 FEET e✓ S 8 Nl a LAKE AVE S 2 0 29 MOTOR ✓ PEDAL- DAM AG THRESHOLD MET PHONE UNIT 01 VEHICLE ❑ CYCLE ❑ YEs Vl No D:3235071774 0 1 30 5 LAST NAME ZAVALA FIRST NAME VICTORIA MIDDLE B 1 1 2 31 INITIAL STREET ❑ 417 WILLIAMS AVE S CITY; RENTON ST I WA ZIp; 98055 2 NEW ADDRESS 7 CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3 INTERLOCKYES NO✓ INTERLOCK VEs NO✓ YEs NO✓ 8 DRIVER # STATE WA SEXI F MMDDYY' 04 - 25 - 2003 1 2 32 9 ON DUTY❑ STATUS' AIRBAG 2 RESTR 4 EJECT 1 N USEET 6 CLASSY',1 NATURE of INJURIES 2= LICENSE, GFC8326 STATE WA V JNKCV51EX3M304079 3 10� as ATP tt IN# TRAILER STATE TRAILER STATE 11 3 5 ,LATE# PLATE# FROM To TRLR TRLR 7 5 33 12 3 5 VIN# vIN# FROM TO VEH.YEAR 2003 MAKE INFI MODEL G35 STYLE SD VEHICLE TOWED[n TO ZBLIN TOWEDBY GOVT VEHICLE 3 7 34 13� DAMAGE YES II_II NO YESII_I) NO✓ REGISTERED OWNER INFO VICTORIA ZAVALA 417 WILLIAMS AVE S RENTON WA 98055 D:3235071774 VEHICLE NO. 1 SHADE IN DAMAGED AREA 35 14❑ LIABILITY INSURANCE❑ NSURANCE CO 3 4 IN EFFECT &POLICY# 4TOP VEn" CHARGE 5 36 LEc Lv YES❑NO❑ CITATION# 70 BOTTOM 15❑ STANDING e MOTOR ✓ PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE UNIT VEHICLE ❑ CYCLE ❑ ❑ nWNRR YEs✓ No D:3604025955 16� LAST NAME CICALA FIRST NAME NATALIE MIDDLE' M INITIAL 17 F1 STREET ❑ ❑ 6111 S 124TH ST CITY SEATTLE ST, WA ZIP 98178 q 37 NEW ADDRESS 18❑ CDL IGNITION REGtUJRED IGNITION PRESENT MEDICALTRANSPC7RTED 38 INTERLOCKYES ND INTERLOCK YES R NO YES NO 19 DRIVER'S STATE AZ SEX F D.O.B. 12 16 1996 39 LICENSE# MMDDYY — 20❑ ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 H U ET 2 INJ 6Y 1 NATURE OF INJURIES 40 21 P CLA ATE#LICENSE 2PA6LS TATE AZ VIN# 41 22❑ [TILER TAILER PLATE# STATE PLATE# STATE 42 23 TRLR RLR 43 UIN#. 'IN# VEH.YEAR 2016 MAKE VOLJ( MODEL TIGUAN S STYLE $IIV VEHICLE TOWED TO BLIN TOWED BY GOV HI 44 24 DAMAGE YES NO VES NO✓ REGISTERED OWNER INFO NATALIE CICALA 6111 S 124TH ST SEATTLE WA 98178 D:3604025955 VEHICLE NO.2 SHADE DAGED AREA 4 LIABILITY INSURANCE INSURANCE CO GEIC04560012306 IN EFFECT &POLICY# 9TOP w1— CHARGE LvEeALY YES❑ NL] 7060TTOM 25 a e OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY 26 J.TRADER 4553 WA0171300 PAGE 01 OF PART A 3000-348-189(R 11/18) STATE OF POLICETRAFFICN CORRECTION REPORT NO. EF13089 COLLISION REPORT III III III III III 111 1591972 CASE# 24-9382 E NA ADDITIONAL PERSONS INVOLVED(PASSENGERS AND/OR WITNESSES ONLY) M (LAST,FIRST,MIDDLE INITIAL) CARPENTER PAULA C ADDRESS&PHONE# D O 417 WILLIAMS AVE S RENTON WA 98057 2064761774 SEXi F MM DDYVYv 03 — 16 — 1971 PASSENGER Z WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET INJURY NATURE OF INJURIES Q 1 POS. 3 2 4 1 USE 2 CLASS 1 ----� :NAME (LAST FIRST MIDDLE INITIAL) ADDRESS R PHONE# SEX D.O.B. — MMDDYYYY PASSENGER❑WITNESS UNIT# : SEAT AIRBAG RESTR. EJECT HELMET INJURY: NATURECFINJURIES POS. USE CIASS ----� :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 On 09/06/2024 at approximately 1931 hours, i was driving W Bin the 200 bock of S 2nd ST, in the City of Renton, County of King. I saw a two vehicle non injury collision in the roadway and stopped to investigate. I spoke with the driver of Unit 1 Zavala and she told me she was driving WB in the number two lane and made a left turn attempting to go into the parking lot. In doing so Unit 1 collided with unit 2 causing reportable damage. The driver of Unit 2 Cicala confirmed the account of the collision. The driver of Unit 1 Zavala made and unsafe left turn which was the proximate cause of the collision. I did not issue any citations. I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT. J.TRADER 09-08-24 11:22 PM INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST.DET DATED PLACE SIGNED APPROVED BY E J.TRADER 4553 DAT 9/8/2024 11:23:24 PM BADGE OR ID# 4553 ORI# WA0171300 TIME POLICE DISPATCHED 1 7:31 Pry] TIME POLICE ARRIVED i 7:31 PM PAST B 3 Da-3mx—attar(t 1Mff) PAGE 2�OF F3 REPORTNO. EF13089 CASE# 24-9382 DATE AND TIME 09/06/2419:31 OF COLLISION � d r, 4f >.� xmratx%, PAGE 3 OF 3