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HomeMy WebLinkAbout24-11425 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 1 27c
COLLISION REP FIT 1591971
CASE 24-11425 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#
GawsloN 11 - 1-- 2024 2051 17 ❑-= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
BURNETT AVE S BLOCK NO. e✓ 300 ❑
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ ❑ FEET e S ❑ W e S 4TH ST
0 3 29
MOTU '�01 VEHtOCLEZ 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
LICENSE sTATI urN#'
10❑ PI ATE 14
TRAILER STATE TRAILER STATE
11 2 5 PLATE# PLATE# ROM ro
rRLR. TRLR 1 7 33
12❑ VIN# VIN#
FROM TO
❑ VEH.YEAR MAKE MODEL STYLE UT VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE 7 $ 34
13 4 DAMAGE YES NO YES❑ NO✓
REGISTERED OWNER INFO UNKNOWN VEHICLE NO. 1
SHADE IN DAMAGED AREA ❑ 35
14 ABILI INSURANCE❑ NSURANCE CO 3 4
IN EFFECT &POLICY# 9TOP
VEwcLe CHARGE 1 5 36
LECALLv YES❑NO❑ CITATION# 10 BOTTOM
15❑ STANDING 8 6
MOTOR PEDAL- PEDESTRIAN ✓ PROPERTY DAM THR OLD MET PHONE
UNIT VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES 1/ NO D:2136040621
16 a
LAST NAME AMAYA FIRST NAME JOSE MIDDLE R
INITIAL
17 STREET❑ NEW ADOREss❑' 339 BURNETT AVE S,APT 203 CITY' RENTON ST WA ZIP 98057 37
18❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL—T�RANSPORTED ❑ 38
INTERLOCK YES�NOR INTERLOCK YEs It I NO YES t l NO❑
19 DCENS# SEX M M D.C.B.
02 1_ 22 _ 1980 39
20 ON DUTY STATUS 3 AIRBAG RESTR EJECT H U MEET CLASINJURS ABRASION
7 NATURE OF INJURIES ABRASION TO LEFT KNEE,PAIN IN FOOT ❑ 40
❑21❑ LICENSE TATE 41
VIN# `1
PLATE#
42
22 [TRAILER T
❑ PLATE# STATE PLATE#ILER STATE
23❑ 43
TRLR RLR
VIN#. IN#.
VEH YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN
TOWED BY GOV HI 44
24 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 I 9TOP 5
VEHICLE ❑ ,.I—I CITATION# CHARGE i o BOTTOM
LEGALLY YES N`LJ
25 s e
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
26
M.THOMPSON 10499 WA0171300
PAGE 01 OF
PART A
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EF38793
COLLISION REPORT III III III III III 111
1591972 CASE# 24-11425
ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY)
NAME MIDDLE INITIAL) ALMONTE HAYLIE S
(LAST FIRST,
ADDRESS&PHONE#
RENTON 2532408297 SEXi F MMDOYyry 07 - 01 - 2000
PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT ' HELMET INJURY NATURE OF INJURIES
❑ ❑✓ POS. USE CLASS
NAME
(LAST,FIRST,MIDDLE INITIAL) CHANEY EMILY A
ADDRESS&PHONE# DOB
408 SHATTUCK AVE S RENTON WA 98057 2534315706 SEX F MMDDYVYv 02 - 20 - 1994
PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET INJURY NATURE OF INJURIES
❑ POS. USE CLASS
NAME
(LAST FIR57 MIDDLE INITIAL)
AppRESS&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.THOMPSON 11-03-24 10:01 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
DESIRES SCOTT 10272 1 1112312024 9:53:20 AM
BADGE OR ID# 10499 ORI# WA0171300 TIME POLICE DISPATCHED 8:82 Pry] TIME POLICE ARRIVED',8:54 PM
PART Ei PAGE IT]OF 4]
REPORT NO. EF38793 CASE# 24-11425 OF COLLISION
11/03/24 20:51
OF CbLLI510N
NARRATIVE
Case 24-11425
On November 3, 2024, at about 2052 hours I was dispatched to the intersection of Burnett AVE S and
S 4th ST in Renton City, King County, Washington State for a hit and run collision involving one
vehicle and a pedestrian.
Upon arrival I located the pedestrian lying on the NE corner of the intersection on the sidewalk. The
pedestrian was know to be deaf and blind. His wife and other witnesess were with him. The wife did
not see what happened just heard her husband scream and when she looked back he was lying on
the ground with his guide dog.
The two witnessess relayed what they observed. The pedestrian was stopped facing east on the NE
corner of the intersection. They were stopped facing west on S 4th ST at Burnett AVE S. They were
to continue westbound. Their light turned green and as they were entering the intersection a small
silver SUV came through the intersection from the north and turned west onto S 4th ST. The vehicle
almost hit them and they began honking at it. A person yelled from the Unit 1. They also heard
someone scream from where they were almost hit. They turned around and saw the pedestrian on
the ground.
The pedestrian had a large abrasion to their left knee and relayed their foot hurt.
The pedestrian's wife said the pedestrian never exits the crosswalk until he feels the vibration. This
conicides with the witnessess stating their light was green.
An area check was conducted but Unit 1 was not located. I checked for surveillance cameras but I did
not see any that were pointed to the intersection.
There is no suspect information at this time. The pedestrian was transported by his wife to the
hospital for follow-up.
I certify (declare) under penalty of perjury under the laws of the State of Washington that the
foregoing is true and correct.
Officer Thompson, M #10499
PAGE 3 OF 4
REPORT NO. EF38793 CASE# ' 24-11425 DATE AND TIME 11/03/24 20:51
OF COLLISION
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PAGE 4 OF 4