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HomeMy WebLinkAbout24-10860 iiTFiNII IIIII III IIIII II IIII IIIII I . 27c REPORT NO EF26187oc� RA COLLISION REPORT 1591971 CASE# 24-10860 2 INTERSTATE CITY STREET FIRE I RESULTEDSTATE ROUTE OTHER STOLEN vEwCLE LOCALANG 3 HIT&RUN C©DIN6 COUNTY RD PRIVATE WAY INVOLVED 2 3 TOTAL#OF OBJECT 1 28 TRIBAL UNITS 09 STRUCK MAILBOX RESERVATION 1 1 2 3� M M D D Y Y Y Y TIME(2400) COUNTY# MILES CITY# eaCL s on' 10 - 18 - 2024 1234 17 =.= S 8 W e OF e 1070 s 4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓ NE 4TH STREET BLOCK NO. e 4500 .� 4a❑ MILE POST ❑ DISTANCE OF(REFERENCE OR CROSS STREET) 5 5631.1 00 FEET e✓ S 8 Nl e✓ DUVALL 0 1 29 MOTOR ✓ PEDAL- DAM AG THRESHOLD MET PHONE UNIT 01 VEHICLE ❑ CYCLE ❑ YEs Vl No D:4254907579 30 5 LAST NAME WEST FIRST NAME LILY MIDDLE C 1 1 2 31 INITIAL STREET ❑ 13340 SE79TH PL CITY; NEWCASTLE ST WA ZIP; 98059 2 NEW ADDRESS 7� +CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3 INTERLOCKYEs NOW INTERLOCKYEs Na�/ YES NOW 1 8❑ DRIVER # STATE WA SEXI F MMDDYY' 04 - 28 - 1951 32 9 ON DUTY STATUS' AIRBAG 2 RE 9 EJECT 1 N USE CLASSY 1 [NATURE of INJURES 2 10 aI ENSrtEI APH1965 STATE WA VIN# JT3HN87RXY0277150 3 TRAILER STATE TRAILER STATE 11 0 0 PLATE# PLATE# FROM To TRLR TRLR 5 1 7 33 12 VIN#' VIN# FROM TO 13 2 VEH.YEAR2000 MAKE 7-Dy- MODEL 4 STYLE 4C VEHICLE TOYED NO�iS46LIN T�VyED.6LR$ �ESEENp m 34 DAMAGE IIII._IIII HHttVVii((tt I_I REGISTERED OWNER INFO LILY WEST 13340 SE79TH PL NEWCASTLEWA 98059 D:4254907579 VEHICLE NO. 1 SHADE IN DAMAGED AREA 35 14❑ LIABILITY INSURANCE / INSURANCE CO FARMERS 688290648-0 3QIN 4 EFFECT &POLICY#VEn" CHARGE 36 LEcLY YES❑NO❑ CITATION# 70 9 15❑ sTnNowc e MOTOR PEDAL-:. PROPERTY DAM THR OLD MET PHONE UNIT 0' PEDESTRIAN 1:1VEHICLE CYCLE' DOWNER YES NO 16❑ LAST NAME FIRST NAME MIDDLE' INITIAL 17❑ STREET CITY ST ZIP 4❑ 37 NEW ADDRESS 18❑ CDL IGNITION REQUIRED IGNITION PRESENT MED[CALTRANSPORTED: 38 INTERLOCKYEs NO INTERLOCK YES R No vEs NQ 19 LICENS# STATE SEX MMDUYY = 39 HELMET INJURY NATURE OF INJURIES 4Q 20❑ ON DUTY STATUS AIRBAG RESTR EJECT USE CLASS ❑ 21 PLATE# TATE VIN# 41 22❑ [TILER TAILER PLATE# STATE PLATE# STATE 42 23 TRLR RLR 43 UIN#. 'IN# VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOV HI 44 24 DAMAGE YES NO YES NO REGISTERED OWNER INFO VEHICLE NO.2 SHADE IN DAMAGED AREA 2 3 4 LIABILITY INSURANCE❑ INSURANCE CO IN EFFECT &POLICY# 9TOP 25 LEGnLLY vewa YES E ❑ N.I,—I CITATION CHARGE to BOTTOM a s OFFICER'S NAME(PRINT) 26 OFFICER PHONE BADGE OR ID# AGENCY SHANNON O'ROURKE 13007 WA0171300 PART A PAGE 01 OF 3000-345-189(R 11/181 STATE OF POLICETRAFFICN CORRECTION REPORT NO. EF26187 COLLISION REPORT III III III III III 111 1591972 CASE# 24-10860 ADDITIONAL PERSONS INVOLVED(PASSENGERS AND/OR WITNESSES ONLY) '.NAME (LAST,FIRST,MIDDLE INITIAL) ADDRESS&PHONE SEXi D.O.B. — MMDDYYYY PASSENGERQ WITNESS� UNIT SEAT AIRBAG RESTR. EJECT ; HELMET INJURY NATURE OF INJURIES POS. ' USE CLASS 1 ----� :NAME (LAST FIRST MIDDLE INITIAL) ADDRESS&PHONE# SEX D.O.B. — MMDDYYYY PASSENGER❑WITNESS UNIT# : SEAT AIRBAG RESTR. EJECT HELMET INJURY: NATURECFINJURIES POS. USE CLASS ----� :NAME (LOST,FIRST,MIDDLE INITIAL) ADDRESS&PHONE# SEX MMDDYY D.O.B. YY PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET NJURY NATURE OF INJURIES POS. I 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. SHANNON 0WOURKE 10-18-24 05:59 PM INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST.DET DATED PLAGE SIGNED APPROVED BY DATE 10/19/2024 3:00:02 PM P.KORDEL 9676 BADGE OR ID# j 13007 ORI# WA0171300 TIME POLICE DISPATCHED 12:37 PM TIME POLICE ARRIVED i 12:43 PM PAST B 3 Do-3mx—attar(t 1Mff) PAGE 2�OF 4 REPORT NO. EF26187 CASE# 24-10860 OF DATE AND r�N + 10/18/24 12:34 O�COLLISION NARRATIVE Case Number: 24-10860 Unless otherwise noted, all events took place in the City of Renton, in the County of King, in the State of Washington. This incident was captured on my body worn video camera and in-car cameras. This report is a summary of events that occurred and is not an exact sequencing of events. On 10/18/2024, at approximately 1237 hours I was dispatched to an accident with unknown details at NE 4th St. and Bremerton Ave I arrived on scene at approximately at 1243 hours and observed a tan Toyota 4 Runner (WA LIC APH1965; VIN JT3HN87RXY0277150) that had driven over the sidewalk, bushes, fire hydrant, and collided with several mailboxes and a telephone pole directly in front of McClincy's (located at 4604 NE 4th St.). I contacted the driver, who I identified by her WAID as Lily C. West (DOB 04/28/1951). She did not require aid. Lily provided me her driver's license, insurance, and the vehicle registration. Lily explained to me that while driving southbound on Duval, she turned westbound onto NE 4th St. She stated the road was very slippery from the rain, and she attempted to shift the car into 4 wheel drive. In doing so, she stated she lost control of the vehicle and collided with the telephone pole. Lily stated airbags were not deployed. I contacted the store owner, Tim McClincy (DOB 09/26/1955) who stated the mailboxes belonged to him. He estimated the total cost of damage to the property would be approximately $10,000. I provided an exchange of information to Tim with Lily's insurance information on it. Lilly stated she was not injured. Lily's 4 Runner was towed. This ends my report. I certify (declare) under penalty of perjury under the laws of the State of Washington that the foregoing is true and correct. Electronically signed by Officer S. O'Rourke on 10/18/2024 at 1426 Hours Renton, King County, Washington. PAGE 3 OF 4 REPORT NO. EF26187 CASE# 24-10860 DATE AND TIME 10/18/24 12:34 OF COLLISION �w a x Y � I'. t. t i\ �x3 } x �s �i a \ PAGE 4 OF 4