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HomeMy WebLinkAbout24-10387 (2) ITFF' "POLCERA II I !�� I III I III I IIII III II I . 0 27c COLLISION REP FIT 1591971 CASE 24-10387 z INTERSTATE ❑ CITY STREET FIRE ❑RESULTED 1 STOLEN STATE ROUTE ❑ OTHER ❑ VFHIr.I F ❑ LOCAL AOENC 4900 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.. 10 - 1-- 2024 1249 17 ❑.= S 8 IN e 1070 3 4❑ oN (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓ HOUSERWAYBYPASS BLOCK NO. e✓ 500 4a❑ MILEPOST DISTANCE OF(REFERENCE OR CROSS STREET) 5❑ 750 00 FEET e S MILES N B W e NE 3RD ST 0 1 29 MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE UNIT 01 VEHICLE ❑ CYCLE El ,/No D:2064345817 0 11 30 6� INITIAL LAST NAME FOXX FIRSTNAME TARREL MIDDLE M 1 1 2 31 STREET ❑, 2101 SW SUNSET BLVD APT C305 CITY RENTON ST WA Zjp, 980576113 z NEW ADDRESS 7❑ CDL IGNITION REQUIRED IGNITION : PRESENT MEDICAL TRANSPORTED 3 INTERLOCK YES[:]NO INTERLOCKYEs NO YES R NO 8❑ LDRIVER # STATE WA SEX'M MID -O B 10 1— 09 — 2006 2 32 9 ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 HELMETU E ICNLJAUSSY 1 NATURE OF INJURIES z❑ 3 10 9❑ P1 aT�S� CFX4693 sTArI WAurN# KMHDN46D86U367214 TRAILER STATE TRAILER STATE 11 3 0 PLATE# PLATE# FROM TO TRLR. A'RLR. 1 5 33 12 3 0 VIN#' VIN# FROM TO ❑ VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN T Y GOVT.VEHICLE 5 1 34 13 2 2006 HYUN ELANTR DAMAGE vEs 0NO agW�MEYER ves❑ No REGISTERED OWNER INFO LELA FO.13001 20TH STAPTH1030 RENTON WA 98056 VEHICLE NO. 1 ❑ ❑ 14 LIABILITY INSURANCE SAME SHADE IN DAMAGED AREA 35❑ INSURANCE CO . IN EFFECT &POLICY# 9TOP VEHCLE CHARGE to BOTTOM 5 36 LEGALLY YES❑NO❑ CITATION# 4A0765708 SPEED TOO FAST FOR CONDITIONS 15❑ STANDING 7 6 MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE UNIT 02 VEHICLE ❑ CYCLE ❑ ❑ PROPSOWNE ❑ YES 1/ No D:2063845752 16 a LAST NAME CLEMENT FIRST NAME MICHAEL MIDDLE I J INITIAL 17❑ STREET ❑', 6505 SE 4TH PL CITY RENTON ST WA ZIP 980597084 37 NEW ADDRESS ❑ 18� CDL IGNITION REQUIRED IGNITION PRESENT MEDICALTRANSPORTED 38 INTERLOCKYES�NOR INTERLOCK YEs❑NOF YES ❑NO❑ 19 LDIIVER # STATE WA SEX M M .C.B. 05 _ 13 _ 1961 39 WELMET INJURY1 NATURE OF INJURIES 40 20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 USE CLASS ❑ 21❑ LICENSE BWA0925 TAre WA VIN# 2(BNAXSEV1J6234034 ❑ 41 PLATE# 42 22❑ PLATE# STATE PLATE# STATE 23❑ UIN#. 43 TRLR RLR 'IN#. VEH YEAR 201E MAKE CHEV MODEL EQUINOX STYLE I VEHICLE TOWED TO BLIN TOWED ev GOV HI 44 24 DAMAGE YES NO (,ENE MEYER YES NO REGISTERED OWNER INFO MICHAEL CLEMENT 6505 SE 4TH PL RENTON WA 980597084 D:2063845752 VEHICLE NO.2 SHADE IN DAMAGED AREA 2 3 4 LIABILITY INSURANCE 8 POINSURGY#E CO ALLSTATE 817586016IN 9TOP 5 VETILE ❑ ,J� CITATION# CHARGE i o BOTTOM LEGALLY YES FINE] 25 ' OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY J 26 M.LEVERTON 2517 WA0171300 PART A PAGE 01 OF 3000-345-159 OR 11/181 STATE OF POLICETRAFFICN CORRECTION REPORT NO. EF37918 COLLISION REPORT III III III III III 111 1591972 CASE# 24-10387 ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY) NAME MIDDLE INITIAL) CLEMENT CAROL A (LAST FIRST, ADDRESS&PHONE# 6505 SE 4TH PL RENTON WA 980597084 2063845752 SEX M MMDDYyry 09 - 11 - 1959 PASSENGER WITNESS❑'!UNIT# 2 POS. USE CLASS T 9 AIRBAG 2 RESTR. 4 EJECT ? 1 HELMET INJURY NATURE OF INJURIES 1 NAME (LAST,FIRST,MIDDLE INITIAL) CLEMENT JAMES M ADDRESS&PHONE# D O B 6505 SE 4TH PL RENTON WA 980597084 2063845752 SEX( M MMDDYvvv 03 _ 01 _ 1988 SEAT HELMET INJURY NATURE OF INJURIES PASSENGER WITNESS UNIT# 2 POS 3 AIRBAG 2 RESTR. 4 EJECT 1 USE CLASS 6 L LEG 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' Within the city of Renton/King/WA I responded to a 2 vehicle crash in the Houser Way Bypass tunnel. I contacted the driver of unit 2 that told me he was northbound just entering the tunnel when unit 1 crossed over the center line and hit his car. As a result of this his son suffered a leg injury and was transported to VMC-ED for further treatment (Renton Fire). Unit 2 driver and his wife were checked and released by Renton Fire on scene. Damaged to his vehicle required a tow truck. I contacted the driver of unit 1 ID'd by picture WADL. He told me he was going about 40 mph in a 30 zone when he went around the curve and crossed over the center line and hit unit 2. He did not complain of injury and damages required a tow truck. I cited unit 1 ref RCW 46.61.400 driving too fast for conditions 2 vehicle injured collision via complaint. 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 10/04/2024 I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT. M.LEVERTON 10-04-24 01:41 PM INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED APPROVED BY E DAT C.JACOBS 1953 1112112024 7:32:58 AM BADGE OR ID# 2517 OR]# WA0171300 TIME POLICE DISPATCHED 12:50 PM TIME POLICE ARRIVED 12:50 PM PART I PAGE IT]OF 3� REPORT NO. EF37918 CASE# ' 24-10387 DATE AND TIME 10/04/24 12:49 OF COLLISION i ti Orr .Y g mre'"' t t lia ti el 4. 4 i LN r I 1l i. 3} J�3 a a PAGE 3 OF 3