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HomeMy WebLinkAbout24-11355 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 1 27c COLLISION REP FIT 1591971 CASE 24-11355 z INTERSTATE ❑ CITY STREET FIRE ❑ RESULTED 1 STOLEN STATE ROUTE ❑ OTHER ❑ VFHICI F ❑ LOCAL AGENCI 4150 3 HIT&RUN ✓ CODING COUNTY RD PRIVATE WAY INVOLVED 2 TOTAL#OF OBJECT 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.. 11 — 01 — 2024 1342 17 �. S 8 W H OF e 1070 3 4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑ BURNETT AVE S BLOCK NO. e✓ --- ----� ❑ 4a❑ MILEPOST DISTANCE OF(REFERENCE OR CROSS STREET) 5❑ �.❑ FEET e S ❑ W e S 3RD ST 0 4 29 MOTU '�01 VEHtOCLEPI PEAL-CYMLE. El �ESAGE NHORE✓LD MET PHONE 30 6� LAST NAME UNKNOWN FIRSTNAME MIDDLE 1 1 2 31 INITIAL STREET ❑ CITY ST ZIP z NEW ADDRESS 7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3 iNTERLOCKYEs NO INTERLOCK YES NO YES No 8❑ LIRCIENSRE# STATE SEX u MMDOOYY '❑- 32 9 ON DUTY❑ STATUS I AIRBAG 9 RESTR 9 EJECT 1 H USEEr 9 CLAY 0 NATURE OF INJURIES z❑ 3 10[1 PI ATNE 14 CMC5486 sTAT WAv N# 1 N46t4DV4NN367321 5 TRAILER STATE TRAILER STATE 11 2 5 PLATE# PLATE# ROM ro TRLR. TRLR 7 1 33 12❑ VIN#j UIN# FROM r0 VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE 7 $ 34 13 1 2022 NISS ALTIMA DAMAGE YES NO ✓ YES❑ NO✓ REGISTERED OWNER INFO TIA.MCLARTY 4600 DAVIS AVE S G104 RENTON WA 98055 VEHICLE NO. 1 ❑ SHADE IN DAMAGED AREA 35 14 LIABILI INSURANCE❑ INSURANCE CO 3 4 IN EFFECT &POLICY# 9TOP VEwcLe 1 5 36 LEGALLv res❑NO❑ CITATION# CHARGE 10 BOTTOM 15❑ STANDING 6 UNIT 02 VE IOOR ❑ CYCLE ❑ PEDESTRIAN ❑✓ OWNER ❑ DYES✓ H OLD MET PHONE 16 a LAST NAME DUCAY FIRST NAME CZARINA MIDDLE I j INITIAL 17 STREET❑ NEW ADOREss❑' 4724 31 STAVE S UNIT 3 CITY SEATTLE ST WA ZIP 981082139 37 18❑ CDL IGNITION REQUIRED IGNITION PtR-E-S1ENT MEDICAL t-T�RANSPORTED ❑ 38 INTERLOCKYES�NOR INTERLOCK YEs I I No� YES t l NO❑ 19 DRIVE # STATE I SEX F MMDDYY 08 _ 22 _ 1992 39 20 ON DUTY STATUS 3 AIRBAG RESTR EJECT I HELMET INJURY 7 NATURE of INJURIES ❑ 40 USE CLASS LEG/BACK/HEAD ❑21❑ LICENSE TATE 41 YIN# `1 PLATE# 42 22 [TRAILER TILER ❑ PLATE# STATE pLATE# STATE 23❑ 43 TRLR RLR VIN#. IN#. VEH YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY Gov HI 44 24 0 1 DAMAGE YES NO YES NO REGISTERED OWNER INFO VEHICLE NO.2 SHADE IN DAMAGED AREA 2 3 4 LIABILITY INSURANCE❑ INSURANCE #E CO IN EFFECT &PO IGQVE""LE ❑ ,J� CITATION# CHARGE LEGALLY YES N`L J 25 OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# 777T�NCY 26 M.LEVERTON 2517 0171300 PART A PAGE 01 OF C7 3000-345-159 OR 11/181 STATE OF POLICETRAFFICN CORRECTION REPORT NO. EF37565 COLLISION REPORT III III III III III 111 1591972 CASE# 24-11355 ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY) NAME(LAST FIRST,MIDDLE INITIAL) UNK ADDRESS&PHONE# D O.B. SEX' F MMDDYYYY -❑ PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT ' HELMET INJURY NATURE OF INJURIES ❑ �' POS. USE CLASS NAME '(LAST,FIRST MIDDLE INITIAL) ADDRESS&PHONE# D O 8 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.B.MMDD -❑ 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. M.LEVERTON 11-07-24 06:41 AM INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED APPROVED BY DATE C.JACOBS 1953 1112012024 10:38:35 AM BADGE OR ID# 2517 OR]#' WA0171300 TIME POLICE DISPATCHED 1:42 Pry TIME POLICE ARRIVED 1:42 PM PART I PAGE IT]OF 4� TIME REPORT NO. EF37565 CASE# 24-11355 OF COLLISION11/01/24 13:42 NARRATIVE c/p RTF Within the city limits of Renton/King/Wa I responded to a car v ped hit and run that occurred at the intersection of S 3rd St at Burnett Ave S. While enroute one of the first officers who arrived on scene advised it was a non injury collision, but to have Renton Fire continue as a precaution. A silver sedan with WA license number CMC5486 bumped listed pedestrian and fled the scene. A Wit took photos and described the collision as unit 1 was eastbound on S 3rd St making a left onto northbound Burnett Ave S and struck the ped in the crosswalk. Unit 1 backed up after contact and fled the area. No one was able to provide any type of ID ref the driver. The Wit that provided this information refused to ID herself but did show me the pics of the car from her cell phone. The Ped/victim ID'd by matching picture WA-ID told me she was crossing on the walk signal/green light in the marked crosswalk and thought she had been pushed over, maybe by a person. She realized she had been hit by a car when she saw the car next to her pull away and leave the area. It only had a rear plate, no front plate. Ped complained of leg, back and head soreness. She was treated on scene by Renton Fire and released on scene. Ped had a friend close by who said she was going to take Ped to Urgent Care for additional checks. Other Renton Officers went to the license plate/RO address at 4600 Davis Ave S G104. The vehicle was not located on scene and a check at the door was negative. No other witnesses came forward with any additional information for this contact. No other picture of videos were recovered in reference to this incident. 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 11/1/2024 PAGE 3 OF 4 REPORT NO. EF37565 CASE# 24-11355 DATE AND TIME 11/01/2413:42 OF COLLISION irw Aw �i i s e i kL gi t, s trli�e v: a i } PAGE 4 OF 4