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HomeMy WebLinkAbout24-9726 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 1 27c
COLLISION REP FIT 1591971
SASE 24-sns z
INTERSTATE ❑ CITY STREET FIRE ❑RESULTED
1 STATE ROUTE OTHER STOLEN
❑ ❑ HFH1C;l F ❑ LOCAL AOENC 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: O9 — 1—— 2024 1638 17 ❑. S 8 W Li OF e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
PARK AVE N BLOCK NO. e✓ 1200
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ ❑ FEET e S ❑ W e N 1ST ST
0 3 29
MOTOR PEDAL- DAM THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El YEs No ,/ D:4252284743 0 3 30
6❑ LAST NAME SOTO FIRSTNAME JULIAN MIDDLE R 1 1 2 31
INITIAL
STREET ❑ 14003 146TH AVE SE CITY RENTON ST WA 21p 98059 z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
INTERLOCK YES[:]NO INTERLOCKYEs NO YEs NO
8❑ LDRIVER # STATE WA SEX'M MID
-O B 01 1— 20 — 1936 2 32
9 ON DUTY❑ STATUS AIRBAG 2 RESTR 2 EJECT 1 H USEET ICNLJAURY 1 NATURE OF INJURIES z❑
3
10❑ PI QTpS� ACX9479 sTArr WAVIN# 2T18U4EEXAC443255
TRAILER STATE TRAILER STATE
11 0 0 PLATE# PLATE# FROM TO
TRLR. TRLR 1 7 33
12 0 0 vIN#' VIN#
FROM TO
VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE 1 7 34
13 A 2010 TOYT COROL SD DAMAGE YES L]NO YES❑ NO
REGISTEREDOWNERINFO OWNEDBYDRIVER VEHICLE NO. 1
SHADE IN DAMAGED AREA ❑ 35
14[Al
LIABILITY INSURANCE� INSURANCE CO PEMCO CA 0163909 4
IN EFFECT &POLICY# TOPVE—LE CHARGE 36
LECALLv res❑NO CITATION# <1�3
OTTOM
15❑ STANDING 6
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT 02 VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES NO ,/ D:2063028875
16 2
LAST NAME TEELER FIRST NAME ABIGA/L MIDDLE R
INITIAL
17❑ STREET ❑', 17825 123RD PL SE CITY' RENTON ST WA ZIP 98058 37
NEW ADDRESS ❑
18� CDL IGNITION REQUIRED IGNITION PRESENT MEDICALTRANSPORTED 38
INTERLOCK YEs❑NOR INTERLOCK YEs❑NOF YEs❑NO❑
19 LICENSE# STATE WA SEX F M .C... 09 _ 05 _ 1996 El 39
WELMET INJURY1 NATURE OF INJURIES 40
20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 USE CLASS ❑
21❑ LICENSE I BMU8535 TAre WA VIN# 1N4AL3AP4CaC256620
❑ 41
PLATE#
42
22❑ PLATE# STATE PLATE# STATE
23❑ VIN#. 43
TRLR RLR
'IN#.
TOWED BY Gov HI 44
VEH YEAR 2016 MAKE jy/$$ MODEL SQL)-/Nj�Q STYLE $D DAMAGE TOWED NOO✓ BLIN YES NO,�
24❑ REGISTERED OWNER INFO OWNED SY DRIVER VEHICLE N0.2
SHADE IN DAMAGED AREA
2 3 4
LIABILITY
INSURANCE INSU&PORGY#E CO STATE FARM 371-1353-C18-47FIN 1URVE"LE
❑ ,J� CITATION# CHARGELEGALYYES N
25 OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
J
26
SlTIVEN/TAMA/VENA 12812 WA0171300
PART A PAGE 01 OF
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EF16919
COLLISION REPORT III III III III III 111
1591972 CASE# 24-9726
ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY)
NAME
(LAST FIRST,MIDDLE INITIAL)_
ADDRESS&PHONE#
SEX D.O.B. - -
MMDDYYYY.
PASSENGER❑WITNESS UNIT# SEAT AIRBAG RESTR. EJECT ' HELMET INJURY NATURE OF INJURIES
PM USE CLASS
NAME
'(LAST,FIRST MIDDLE INITIAL)
ADDRESS&PHONE# D D 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.
S/TIVENI TAMAIVENA 09-17-24 12:17AM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
DESIRES SCOTT 10272 9/21/2024 5:44:19 AM
BADGE OR ID# 12812 ORI# WA0171300 TIME POLICE DISPATCHED; 4:38 PM TIME POLICE ARRIVED:4:38 PM
PART Ei PAGE IT]OF 4�
REPORT NO. EF16919 CASE# 24-9726 OF COLLISION
09/16/24 16:38
OF CbLLI510N
NARRATIVE
On 09/16/2024, at approximately 1638 hours, while employed as a uniformed Patrol Officer for the
City of Renton, I was dispatched to an accident at Park Ave N and N 1 st St, within the City of Renton,
County of King, State of Washington.
The Driver of Unit 2 is Teeler, Abigail R (DOB 09-05-1996). Teeler is the registered owner of a 2016
Nissan Altima with license plate WA/BMU8535.
The Driver of Unit 1 is Soto, Julian R (DOB 01-20-1936). Soto is the registered owner of a 2010
Toyota Corolla with license plate WA/ACX9479.
Unit 2 stated that she was driving in lane 2, going southbound on Park Ave N. Her light turned green,
and when she started driving to make the right turn into Bronson Way N, she was struck by Unit 1.
Unit 1 stated that he was traveling in lane 1, going southbound on Bronson Ave N. He said he got a
green light turning and took a right, trying to get into Pelly Ave N, going northbound. Unfortunately,
there is no Pelly Ave N, which makes me believe he meant Park Ave N. Unit 1 said that Unit 2 came
out of nowhere and struck his vehicle. He believes she came out of a driveway but did not see Unit 2
in the driveway.
Observing the accident, Unit 1 stated that he was trying to turn into Pelly Ave N (which is actually
Park Ave N). When Unit 1 struck Unit 2 it seemed Unit 1 was trying to go on to N 1 st St.
There were no injuries.
There was minimal damage to Unit 2 and Unit 1's vehicle.
My Axon camera was on for this call.
I certify (declare) under penalty of perjury under the laws of the State of Washington that the
foregoing is true and correct. This report was electronically signed by Officer Si. Tamaivena #12812,
September 17, 2024, at 0004 Renton, WA.
PAGE 3 OF 4
REPORT NO.! EF16919 CASE# ' 24-9726 DATE AND TIME 09/16/24 16:38
OF COLLISION
Svv,
PAGE 4 OF 4