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HomeMy WebLinkAbout24-9703 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 6 27c COLLISION REP FIT 1591971 CASE 24-9703 z INTERSTATE ❑ CITY STREET FIRE ❑RESULTED 1 STOLEN STATE ROUTE ❑ OTHER ❑ VFHIC;I F ❑ LOCAL AOENC 4200 3 HIT 8 RUN CODING COUNTY RD PRIVATE WAY INVOLVED 2 1 TOTAL#OF OBJECT 1 1 8 28 TRIBAL UNITS 02 STRUCK RESERVATION z 3❑ DATE OF M M D D Y Y Y Y TIME(2400) COUNTY# MILES N E IN CITY# COLLISION'. 09 - 1-— 2024 1801 17 ❑-= S 8 IN e 1070 3 4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑ SW 7TH ST BLOCK NO. e✓ 100 ❑ 4a❑ MILEPOST DISTANCE OF(REFERENCE OR CROSS STREET) 5❑ ❑ FEET e S ❑ VV a HARDIEAVE SW 0 1 29 MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE UNIT 01 VEHICLE ❑ CYCLE El ,/No D:7863700436 0 11 30 6� LAST NAME TAM FIRSTNAME FRANCIS MIDDLE J 1 1 2 31 INITIAL STREET ❑ 865 COVINGTON CT CITY ROCKLEDGE ST FL Zjp, 32955 z NEW ADDRESS 7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3 INTERLOCK YES[:]NO 1/ INTERLOCKYEs NO�/ YES R No�/ 8❑ LRIIVER # ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 H U SE CLA Sy 1 NATURE OF INJURIES z❑ 3 10 1❑ LICENS P1 ATE 14 9KJX500 sTATe CA vN# 2ACPDFCWOR3A28952 0 TRAILER STATE TRAILER STATE 11 3 0 PLATE# PLATE# FROM TO TRLR. TRLR 7 3 33 12 2 5 VIN#' VIN# >; FROM TO VEH.YEAR 2024 MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE 1 5 34 13 4 DODG HORNS DAMAGE YES NO YES[:] No ✓ REGISTERED OWNER INFO PVHOLDING CORP 5721 W96TH ST LOS ANGELES CA 90045 D:2064335231 VEHICLE NO. 1 ❑ ❑ SHADE IN DAMAGED AREA 35 4 3 4 14 INSURANCE INSURANCE CO CONTINENTAL CASUALTY COMPANYBUA 7001700830 IN EFFECT IN EFFEE CT &POLICY# 9TOP ve'CLE CHARGE 5 36 LEGALLv Yes❑NO❑ CITATION# 10 BOTTOM 15❑ STANDING 6 MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE UNIT 02 VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES 1/ NO D:2063723275 16 a LAST NAME KEENAN FIRST NAME JEFFREY MIDDLE I G INITIAL 17 STREET I3RD PL NE CITY' SEATTLE ST WA ZIP 981254211 4❑ 37 NEW ADDREs�' 13031 2 18� CDL IGNITION REQUIRED IGNITION PtR—E—S1ENT MEDICAL TRANSPORTED 38 INTERLOCKYES�NO� INTERLOCK YEs I I NOF YEs t l NOF,/ 19 LDI IVER # STATE WA SEX M M D.C.B. 04 14 1961 39 20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 H U EET NJAURSY 1 NATURE OF INJURIES ❑ 40 ❑21❑ PLATE# AKN2330 TATE WA VIN# 41 JTDK8200063142731 1 42 22❑ PLATE# STATE PLATE# STATE TRLR 23❑ UIN#. IN#. 43 RLR ' VEH YEAR 2006 MAKE TOYT MODEL PRIUS STYLE VEHICLETOWED TO BLIN TOWEDBY GOV HI 44 L4❑ DAMAGE YES NO YES NO REGISTERED OWNER INFO JEFF KEENAN 1303123RD PL NE SEATTLE WA 98125 D:2063723275 VEHICLE NO.2 SHADE IN DAMAGED AREA 2 3 4 LIABILITY INSURANCE 8 POLICY#E CO PEMCO CA0448441IN VEHICLE ❑ ,.I—I CITATION# CHARGEC�Ql LEGALLY YES N`E] 25 —TA s � e 7p-, S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY 26 TAGNE 12575 WA0171300 PART A PAGE 01 OF C7 3000-345-159 OR 11/181 STATE OF POLICETRAFFICN CORRECTION REPORT NO. EF16917 COLLISION REPORT III III III III III 111 1591972 CASE# 24-9703 ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY) NAME (/AST 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.E.MMDD -F YYYY. 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. P.LANTAGNE 09-19-24 08:36 AM INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED APPROVED BY DATE DESIRES SCOTT 10272 9/21/2024 5:44:16 AM BADGE OR ID# 12575 ORI#' WA0171300 TIME POLICE DISPATCHED 6:02 PM TIME POLICE ARRIVED 6:07 PM PART Ei PAGE IT]OF 4� REPORT NO. EF16917 CASE# 24-9703 OF COLLISION 09/15/24 18:01 OF CbLLI510N NARRATIVE 24-9703 On 09/15/2024 at approximately 1801 hours, I, Officer Lantagne, responded to a non-blocking, non- injury collision which occurred at the intersection of SW 7th St and Hardie AVE SW, which is located in the City of Renton, County of King, and the State of Washington. I responded in my fully marked police vehicle, wearing my patrol uniform. I arrived on scene and observed Unit#1, a 2024 Dodge Hornet with license plates 9KJX500 issued out of California, and Unit#2, a 2006 Toyota Prius with license plates AKN2330 issued out of Washington State, parked in a lot to the southeast of the intersection. 1 was advised there were no injuries. I contacted the driver of Unit#1, Francis J. Tam (DOB 08/18/1992), who told me the following: Tam was driving eastbound on SW 7th ST. As Tam's vehicle crossed through the intersection at Hardie AVE SW, the left side of the vehicle was struck by Unit#2. Tam could not recall what the signal light was showing. I contacted the driver of Unit#2, Jeffrey G. Keenan (DOB 04/14/1961), who told me the following: Keenan was driving southbound on Hardie AVE SW. As Keenan's vehicle crossed the intersection at SW 7th ST, Unit#1 ran a red light and Keenan was not able to stop his vehicle in time. The front of Keenan's vehicle struck the driver's side of Unit#1. Keenan stated his signal showed a solid green light. I observed the damage to the vehicles and other physical evidence was consistent with the statements made by both drivers. Unit#1 had significant crumple damage to the driver's side front and rear doors. Unit#2 had significant damage to the front bumper and crumple damage to the hood. The collision diagram is an accurate illustration of the events leading up to the collision. I provided an exchange of information to Tam and Keenan. I, Officer P. Lantagne #12575, certify (or declare) under penalty of perjury, under the laws of the State of Washington, the foregoing is true and correct. Electronically signed by Officer P. Lantagne #12575 at 0817 hours on 09/19/2024 at Renton, WA. PAGE 3 OF 4 REPORT NO.! EF16917 CASE# ' 24-9703 DATE AND TIME 09/15/24 18:01 OF COLLISION #24-970,3 N'o t to Sao 4, rl' 7 �v t 33 l PAGE 4 OF 4