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HomeMy WebLinkAbout24-9965 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 5 27c COLLISION REP FIT 1591971 CASE 24-9965 z INTERSTATE ❑ CITY STREET FIRE ❑RESULTED 1 STOLEN STATE ROUTE ❑ OTHER ❑ VFHIr.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 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 0803 17 ❑.= S 8 IN e 1070 3 4❑ oN (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑ BRONSON WAY N BLOCK NO. e✓ 1400 ❑ 4a❑ MILEPOST DISTANCE OF(REFERENCE OR CROSS STREET) 5❑ e S ❑❑ FEET VV e FACTORY AVE N 0 1 29 MOTOR PEDAL- DAMAGE THRESHOLDHONE UNIT 01 VEHICLE ❑ CYCLE El MET P YES �/No D:4254289124 0 11 30 6� LAST NAME AAHZ FIRSTNAME ZAIRA MIDDLE N 1 2 31 INITIAL STREET ❑ 535 WELLS AVE S APT B CITY RENTON ST WA 21p 980572782 z NEW ADDRESS 7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3 INTERLOCK YES[:]NO INTERLOCKYEs NO YES R NO 8❑ LRIIVER # ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 HELMET USE 2 1 CLASS NATURE OF INJURIES 2❑ 3 10[1 PI P1 ATE 14 BZS0310 sTAT WA u N#' JN8AS5MVXDW151596 0 TRAILER STATE TRAILER STATE 11 3—LATE# PLATE# FROM ro TRLR. TRLR 5 1 33 12 3 0 VIN#' VIN# >; FROM TO ❑ VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TR Y GOVT.VEHICLE 3 7 34 13 4 2013 NISS ROGUE UT DAMAGE YES NO �MEYER YES❑ NO✓ REGISTERED OWNER INFO ZAIRA AAHZ 535 WELLS AVE S APT B RENTON WA 98057 D:4254289124 VEHICLE NO. 1 ❑ SHADE IN DAMAGED AREA 35 14 LIABILI INSURANCE INSURANCE CO PROGRESSIVE 951368093 IN EFFECT &POLICY# 9TOP LVEHICLe 1 5 LEGALLY re6�No D CITATION# 4A0196796 CHARGE 36 INATTENTIVE DRIVING I o aorrom 15❑ NDING 8 6 MOTOR PEDAL- 'PEDESTRIAN PROPERTY DAM E THR OLD MET PHON UNIT VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES 1/ No D:4253061258 16 a LAST NAME SEIFERT FIRST NAME PATRICIA MIDDLE I F INITIAL 17 STREET NEW ADDREs7 24919 235TH WAY SE CITY MAPLE VALLEY ST WA ZIP 980385906 4❑ 37 18� CDL IGNITION REQUIRED IGNITION PRESENT MEDICALTRANSPORTED 38 INTERLOCKYES�NOR INTERLOCK YEs❑NOF YEs❑No❑ 19 DRIVER'S STATE WA ]SEX IF D.C.B. 07 30 _ 1980 39 LICENSE# MMDDYY 20❑ ON DUTY STATUS AIRBAG 6 RESTR 4 EJECT 1 H U EET 2 NJAURSY 1 NATURE OF INJURIES ❑ 40 ❑21❑ PLATE# CDT9763 TATE WA VIN# 41 KNDNESH30P6197584 1 42 22❑ PLATE# STATE PLATE# STATE 23❑ VIN#. 43 TRLR RLR 'IN#. VEH YEAR 2023 MAKE KJA MODEL CARNIVA STYLE SD I VEHICLE TOWED TO BLIN TOWED eY GOV HI 44 24❑ DAMAGE YES NO GENE MEYERS YES NO REGISTERED OWNER INFO PATRICIA SEIFERT 24919235TH WAY SE MAPLE VALLEY WA 98038 VEHICLE NO.2 SHADEDAMAGEDAREA 3 4 LIABILITY INSURANCE INSU&PORGY#E CO FISRT NATIONAL X5587011(7-24) IN 9TOP VEwGLE ❑ ,J� CITATION# CHARGE to BOTTOM LEGALLY YES N J 25 ' e OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY J 26 C.JACOBS 1953 WA0171300 PART A PAGE 01 OF 3000-345-159 fR 11/181 STATE OF POLICETRAFFICN CORRECTION REPORT NO. EF22194 COLLISION REPORT III III III III III 111 1591972 CASE# 24-9965 ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY) NAME MIDDLE INITIAL) AAHZ BRANDEE L (LAST FIRST, ADDRESS&PHONE# D.0 .B. 535 WELLS AVE S APT B RENTON WA 980572782 SEX F MMDOYyry 12 - 17 - 1994 PASSENGER Z WITNESS UNIT# j 1 POST USE 2 CLASS 3 AIRBAG 5 RESTR. 4 EJECT ? 1 HELMET NATURE OF INJURIES '1 NAME (LAST,FIRST,MIDDLE INITIAL) ADDRESS&PHONE# D O B SEX MMDDYYYY PASSENGER ❑WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET NJURY NATURE OF INJURIES POS. USE CLASS NAME (LAST FIR57 MIDDLE INITIAL) AppRESS&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. C.JACOBS 09-23-24 10:17 AM INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED APPROVED BY DATE C.JACOBS 1953 1 101712024 12:36:39 PM BADGE OR ID# 1953 ORI# WA0171300 TIME POLICE DISPATCHED 8:06 AM TIME POLICE ARRIVED',8:10 AM PART I PAGE IT]OF 4� REPORT NO. EF22194 CASE# 24-9965 OF COLLISION 09/23/24 08:03 OF CbLLI510N NARRATIVE On 9-23-24 at about 0810 1 arrived at the intersection of Bronson Way N and factory Ave N for a 2- vehicle collision. Both vehicles were out of the roadway and up on the sidewalk. There was heavy mechanism and there was a variety of airbags deployed. I contacted all parties involved in or near their vehicles. All parties were identified via WADL. Driver 1, Zaira Aahz told me; She was northbound in the wrong lane of houser way north. She needed to be in the lane that went straight through the intersection onto Factory Ave N, but she was in the turning lane to take her onto Bronson Way N. A driver in the northbound lane flagged her over so she proceeded to change lanes and just kept going through the intersection that was being held by a solid red light. As she proceeded through the intersection, unit 2 came around the corner and collided with the passengers side of her vehicle. She nor her passenger were injured. Driver 2 was being checked by Renton Fire authority. When I was able to speak to her she told me; She was driving in lane 2 of the roadway that had just turned from Sunset Blvd North to Bronson way N when unit 1 suddenly pulled in front of her and they collided. She was shaken up. She would self-transport to the hospital. There were no obvious signs of injuries but driver 2 was extremely upset and crying about the collision. Both vehicles were towed at the owners request due to disabling damages. I cited Zaira Aahz for driver inattention via complaint. This incident occurred in the city of Renton, County of King. I declare under penalty of perjury under Washington state law that the foregoing is true and correct. C. Jacobs/1953 PAGE 3 OF 4 REPORT NO. EF22194 CASE# 24-9965 DATE AND TIME 09/23/24 08:03 OF COLLISION t h l k S C { t ; �bg;a i 4 ° PAGE 4 OF 4