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HomeMy WebLinkAbout24-9791 POLICETRAFF'c" III !�� I IIIllI111IN II II I REPORT NO. EF16462 170 27 COLLISION REP FIT 1591971 CASE 24-9791 z INTERSTATE ❑ CITY STREET FIRE ❑RESULTED 1 STOLEN STATE ROUTE ❑ OTHER ❑ VFHIl.I F ❑ LOCAL AOENC 4Y00 3 HIT&RUN CODING COUNTY RD PRIVATE WAY INVOLVED 2 2 TOTAL#OF OBJECT 1 1 8 28 TRIBAL UNITS OZ RESERVATION STRUCK z 3❑ DATE of; M M D D Y Y Y Y TIME(2400) COUNTY# MILES CITY# COLLISION.. O9 - 18 - 2024 0751 17 . N E IN� S 8 W H OF e 1070 3 4❑ oN (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑ MAPLE VALLEY HWY BLOCK NO. e✓ --- ----� ❑ 4a❑ MILEPOST DISTANCE OF(REFERENCE OR CROSS STREET) 5❑ ❑ FEET e S ❑ W e 150TH LN SE 2 0 29 UNIT MOTOR VEHICL PI CYCLE ElOYESA✓THRESHOLD PHONE O 11 30 6� LAST NAME GUTIERREZ FIRSTNAME CELENE MIDDLE 1 1 1 2 31 INITIAL STREET ❑ 17138 SE 128TH ST CITY RENTON ST WA Zlp' 980598623 z NEW ADDRESS 7❑ CDL IGNITION REQUIRED IGNITION : PRESENT MEDICAL TRANSPORTED 3 iNTERLOCKYEs NO INTERLOCKYEs NO YES NO 8❑ LRIIVER # ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 H USEET ICNLJAURY 1 NATURE OF INJURIES 2❑ 3 10 9❑ Pi aT�S� CJD5165 sTArI WAurN# 5J6RM4H72FL103104 TRAILER STATE TRAILER STATE 11 4 0 PLATE# PLATE# FR.. ro TRLR. TRLR 7 3 33 12 4 0 VIN#' VIN#' >; FROM TO VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE 7 3 34 13 2 2015 HOND CR-V DAMAGE YES NO YES❑ NO✓ REGISTERED OWNER INFO TINA GUTIERREZ 17138 SE 128TH ST RENTON WA 98059 VEHICLE NO. 1 ❑ SHADE IN DAMAGED AREA 35 14 LIABILITY INSURANCE INSURANCE CO SAME. 3 4 IN EFFECT &POLICY# 9TOP VewcLF CHARGE 5 36 LECALLv YES❑NO❑ CITATION# 10 BOTTOM 15❑ STANDING 8 7 MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE UNIT 02 VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES 1/ No D:2532577401 16 a LAST NAME VICK FIRST NAME LORIE MIDDLE I L INITIAL 17❑ STREET ❑', 27323 327TH AVE SE CITY RAVENSDALE ST WA ZIP 980510000 37 NEW ADDRESS ❑ 18� CDL IGNITION REQUIRED IGNITION PR—E-1SENT MEDICAL TRANSPORTED ❑ 38 INTERLOCKYES�NOR INTERLOCK YEs It I NOF YES t t— l NO❑ 19 LICENSE# STATE WA SEX F MMDDW 08 _ 04 1969 39 WELMET INJURY1 NATURE OF INJURIES 40 20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 USE CLASS ❑ 21❑ LICENSE I CJW1281 TAre WA VIN# 1G1AL18F187330123 ❑ 41 PLATE# 42 22❑ PLATE# STATE PLATE# STATE TRLR 23❑ UIN#. N#. 43 RLR 'I VEH YEAR 2008 MAKE CHEV MODEL COBALT STYLE VEHICLE TOWED TO BLIN TOWEDBY GOV HI �44 24❑ DAMAGE YES NO BANKERS YES NO REGISTERED OWNER INFO ROBERT COHN 21723 SE 291ST ST BLACK DIAMOND WA 98010 VEHICLE NO.2 SHADEDAMAGEDAREA 3 4 LIABILITY INSURANCE❑ INSURANCE CO IN EFFECT &POLICY# 1 9TOP 5 vLeFcALLYLJ DICLE YES❑ Nc CITATION# 4A0652661,4A0652661 CHARGE NO VALID OPER LICENSE WITH VALID 10 BOTTOM 25 s � a OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# 777PNCY 26 M.LEVERTON 2517 0171300 PAGE 01 OF PART A 3000-345-159 OR 11/181 STATE OF POLICETRAFFICN CORRECTION REPORT NO. EF16462 COLLISION REPORT III III III III III 111 1591972 CASE# 24-9791 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 POS. 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. M.LEVERTON 09-18-24 02:50 PM INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED APPROVED BY E DAT C.JACOBS 1953 9/19/2024 1:51:55 PM BADGE OR ID# 2517 OR]#' WA0171300 TIME POLICE DISPATCHED! 7:51 AM TIME POLICE ARRIVED',7:54 AM PART I PAGE IT]OF 4� REPORT NO. EF16462 CASE# 24-9791 OF COLLISION 09/18/24 07:51 OF CbLLI510N NARRATIVE red/2 Itl wht merged left CC Within the city limits of Renton/King/WA I responded to a 2 vehicle blocking crash at the intersection of 150th Lane SE at Maple Valley Hwy. I arrived and found one car with wheel damage not allowing it to me moved under its own power and another vehicle on the southbound shoulder. I contacted the driver of unit 1 who told me she had signaled her intent to change lanes from lane 1 into lane 2 She told me he was completely clear of hazard/vehicle as she began to change lanes when she described being hit from behind by unit 2. She did not complain of injury and damages did not require a tow truck. I contacted the driver of unit 2 ID'd by picture WA-ID and could not provide valid proof of insurance for her vehicle. A WACIC/DOL check via Dispatch revealed unit 2 did not have a valid drivers license. I asked her for her recollection of the crash and she told me she was in the left turn lane when unit 1 swerved into the side of her car. I pointed to the lanes in the road and she was clear she was in the left turn lane and unit 1 drove into the side of her. Another driver returned to the scene and provided a dash camera video of what took place. Unit 1 was southbound in lane one, with her signal on she began to merge into lane 2 while it was clear. Unit 2 was in lane 1 behind unit 1 and began making the same merge from lane 1 into lane 2. Unit 1 and 2 were both, but for a brief moment occupying both lanes during the POI. Unit 2 hit unit 1 from the rear, and unit 2 became slightly airborne on the passenger side of the car. I cited unit 2 ref RCW 46.20.015 NVOL 2nd and ref RCW 46.30.020 2 car crash no insurance via complaint. Information/Insurance only, minus the license-insurance issues with unit 2 driver. 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 9/18/2024 PAGE 3 OF 4 REPORT NO.! EF16462 CASE# 24-9791 DATE AND TIME 09/18/24 07:51 OF COLLISION w. it U �4 "'•'tom yS� aa.�„� � t '., `n .i y�� 4: � v� r PAGE 4 OF 4