HomeMy WebLinkAbout25-2023 25-2030 POLICETRAFFicN I� I �I) , II� I I I (III I�I �) REPORT NO. EF71833 5 1 27
COLLISION REPORT 1591971
CASE 25-2023 25-2030 2
INTERSTATE CITY STREET El
STATE ROUTE OTHER LOCAL ANG 4200 3
CODINGCOUNTY RD PRIVATE WAY
2❑ TOTAL#OF OBJECT 1 8 28
TRIBAL UN1T3 02 STRUCK'. ❑
RESERVATION 2
3 M M D D Y Y Y Y TIME(2400) COUNTY# MILES CITY#
CDt�usox 03 - 04 - 2025 1441 17 ❑.❑ S 8 E IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
BLOCK NO.
OAKESDALE AVE SW
e --- ----� ❑
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ ❑ FEET ❑ S ❑ W❑ SW GRADYWAY
0 1 29
UNIT MOTOR ❑ PEDAL- El DAMAGE THRESHOLD MET PHONE
VEHICLE CYCLE'. YES
`/No D:2532048675 0 7 30
6� LAST NAME CHANDLER-FROST FIRSTNAME KY MIDDLE A 1 2 31
INITIAL
STREET ❑, 1819 9TH AVE SE CITY PUYALLUP ST WA 2jp', 983724022 2
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
INTERLOCKYES NO INTERLOCK YES NO YES NO
8❑ LRIENSE# STATE I WA SEXM I D-MMDDYY' 05 - O6 - 1997 1 2 32
9 ON DUTY❑ STATUS'. AIRBAG 2 RESTR 4 EJECT 1 HELMET
CLASS 1 NATURE OF INJURIES 2❑
❑10 1❑ LICENSE C94597W sTAr' WA VrN# 3TMC25AN3HM120930 3
PLATE#
5 TRAILER STATE TRAILER STATE
11 3 5 PLATE# PLATE# ROM To
TRLR' TPILR 5 1 33
12 0 0 VIN# VIN#
FROM TO
VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE g 9 34
ZO17 TOYT TACOM DAMAGE YES NO YES❑ NO
13❑ REGISTERED OWNER INFO KY CHAND1ER-1ROST18199TH AVE SE PUYALLUP WA983724022 D:2532048675 VEHICLE NO. 1
SHADE IN DAMAGED AREA ❑ 35
❑ LIABILITY INSURANCE❑ INSURANCE CO 2 3 4
14 PEMCO CA 1591059
IN EFFECT 8 POLICY# 9TOP
VEHICLE CHARGE 5 36
LEGALLY YES NO CITATION# 5A0151311 INATTENTIVE DRIVING I o BorroM
15❑ STANDING 8 7 6
El
MOTOR PEDAL- PROPERTY DAM THR OLD MET PHONE
(SNIT 02 ❑✓ ❑ PEDESTRIAN ❑ ❑ D:2064763432
VEHICLE CYCLE OWNER YES�/ NO
16 2
LAST NAME VILlARROEL CENTENO FIRST NAME INGREIDIS MIDDLE I,I
INITIAL
17❑ STREET ❑', 300 VUEMONT PL NE APT N104 CITY RENTON ST WA ZIP 980564541 37
NEW ADDRESS ❑
18� CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED ❑ 38
INTERLOCK YEs❑NoR INTERLOCK YEs❑NOF YES
❑NO❑
19 DRIVER'S STATE WA SEX'M D.O.B.O6 _ 23 _ 1975 0 39
LICENSE# MMDDYY
WELMET INJURY1 NATURE OF INJURIES 40
20❑ ON DUTY STATUS' AIRBAG 2 RESTR 4 EJECT '1 USE CLASS ❑
21❑ LICENSE I BCA6816 TAr�WA vIN1t ZFBERFBT9G6604277
❑ 41
PLATE#
42
22❑ PLATE# STATE PLATE#ILER STATE
23❑ UIN#. 43
TRLR RLR
'IN#.
VIER,YEAR 2016 MAKE RAM MODEL PROMAS STYLE VEHICLETOWED TO BLIN TOWEDBY GOV HI 44
24❑ DAMAGE YES NO YES NO
REGISTERED OWNER INFO CAR PROS AUTOMOTIVE GROUP 7230 SOUTH TACOMA WAY TACOMA WA 98409 VEHICLE NO.2
SHADE IN DAMAGEbAREA
2 3 4d
LIABILITY INSURANCE INSU8 POLRICY#E CO SAME. I 9TOP
IN EFFECT Ri
VEwCLE CITATION# CHARGE
YES
25 N I o BOTTOM
LEGALLY u
❑ s
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
26
M.LEVERTON 2517 WA0171300
PAGE 01 OF
PART A 3000-345-159(R 11/18)
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EF71833
COLLISION REPORT III III III III III 111
1591972 CASE# 25-2023
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 FIRST 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 03-05-25 07:33 AM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY E
DAT
M.LEVERTON 2517 31712025 2:31:04 PM
BADGE OR ID# 2517 ORI# WA0171300 TIME POLICE DISPATCHED 2:41 PM TIME POLICE ARRIVED',2:47 PM
PART I PAGE IT]OF 4�
REPORT NO. EF71833 CASE# 25-2023 OF COLLISION
03/04/25 14:41
OF CbLLI510N
NARRATIVE
gray/2 stopped tan/1 rear unknown distraction
CC
Within the city limits of Renton/King/Wa I responded to 2 vehicle blocking crash at the intersection of
Oakesdale Ave SW at SW Grady Way.
While enroute Dispatch updated that both vehicles had moved to the nearby Shell station.
I contacted the driver of unit 2 who told me he was stopped in lane 1 northbound Oakesdale when he
was hit from behind. He did not complain of injury and damages did not require a tow truck.
I contacted the driver of unit 1 Id'd by his picture WADL. He told me he had looked away from traffic
for a brief moment and suddenly rear ended unit 2. He denied being on the cell phone and told me
he just wasnt paying attention when he hit unit 2. He did not complain of injury and damages were
unremarkable.
I cited unit 1 ref RMC 10-12-25 Inattentive Driving 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 3/5/2025
PAGE 3 OF 4
REPORT NO. EF71833 CASE# ' 25-2023 DATE AND TIME 03/04/25 14:41
OF COLLISION
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PAGE 4 OF 4