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HomeMy WebLinkAbout24-11484 a ITFFi "POLCERA II IfI) 1 IlfII ('II (Illf If( fI I . 5 27c COLLISION REP FIT 1591971 CASE 24-11484 z INTERSTATE ❑ CITY STREET FIRE ❑RESULTED 1 STOLEN STATE ROUTE ❑ OTHER ❑ VFHIr.I F ❑ LOCAL AOENC 4200 3 HIT&RUN CODING COUNTY RD PRIVATE WAY INVOLVED 2 1 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# cowsloN 11 - 1-- 2024 1910 17 ❑-= S 8 IN e 1070 3 4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑ HOQUTAM AV NE BLOCK NO. e✓ 14200 ❑ 4a❑ MILEPOST DISTANCE OF(REFERENCE OR CROSS STREET) 5❑ �.❑ FEET e S ❑ VV a SUNSET BLVD NE 0 1 29 MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE UNIT 01 VEHICLE ❑ CYCLE El �/No D:4252605549 0 4 30 6� LAST NAME FRITZ FIRSTNAME DELIGHT MIDDLE 9 2 31 INITIAL STREET ❑ 11505 155TH AVE SE CITY RENTON ST WA 21p 980596022 z 'NEW ADDRESS 7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3 INTERLOCK YES[:]NO 1/ INTERLOCKYEs NO Z/ YES R No�/ 8❑ LRIIVER # ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 H USEET ICNLJAURY 1 NATURE OF INJURIES z❑ 3 10 1❑ P1 ATNES14 AQT8867 STATE WA u N# JTNBE46K473096665 11[-j- TRAILER STATE TRAILER STATE 11 3 5 PLATE# PLATE# IR.. ro TRLR. TRLR 7 3 33 12 3 5 VIN#j VIN# :: FROM TO VEH.YEAR 2007 MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE 5 7 34 13 4 TOYT CAMRY SD DAMAGE YES NO YES[:] NO✓ REGISTERED OWNER INFO DELIGHTFRITZ 11505155THAVE SE RENTON WA 98059 VEHICLE NO. 1 ❑ ❑ SHADE IN DAMAGED AREA 35 14 LIABILI INSURANCE INSURANCE CO STATE FARM 1804354B2847U 3 4 IN EFFECT &POLICY# 9TOP VEHICL' CHARGE 1 5 36 LEGALLv YES❑NO❑ CITATION# 1 o BOTTOM 15❑ STANDING 8 6 MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE UNIT a2 VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES 1/ NO D:4254668012 16 a LAST NAME DEAN FIRST NAME KELSEY MIDDLE S INITIAL 17❑ STREET � 16110 SE 146TH PL CITY RENTON ST WA ZIP 980597606 37 NEW ADDRESS ❑ 18� CDL IGNITION REQUIRED IGNITION PtR—E—S1ENT MEDICAL TRANSPORTED ❑ 38 INTERLOCK YEs❑No� INTERLOCK YEs I I NOF YEs t l NOF,/ 19 LICENSE# STATE WA SEX F M .C... 08 _ 24 1984 El 39 WELMET INJURY1 NATURE OF INJURIES 40 20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 USE CLASS ❑ 21❑ LICENSE ADH0693 TATe WA VIN# 1FMHK8F836CoA01643 ❑ 41 PLATE# 42 22❑ PLATE# STATE PLATE# STATE TRLR 23❑ UIN#. IN#. 43 RLR ' VEH YEAR 2011 MAKE FORD MODEL EXPLORE STYLE SI/ VEHICLE TOWED TO BLIN TOWEDBY GOV HI 44 L4❑ DAMAGE YES NO,/ YES NO REGISTERED OWNER INFO ZACHARY DEAN 16110 SE 146TH PL RENTONWA98059 VEHICLE NO.2 SHADEDAMAGEDAREA 3 4 LIABILITY INSURANCE &POLICY#E CO SAFECO H2391519IN CQ"'LE ❑ ,J� CITATION# CHARGE to LEGALLY YES N`L J 25 OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY J 26 HANSEN HSU 12651 WA0171300 PART A PAGE 01 OF 3000-345-159 OR 11/181 STATE OF POLICETRAFFICN CORRECTION REPORT NO. EF33168 COLLISION REPORT III III III III III 111 1591972 CASE# 24-11484 ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY) NAME MIDDLE INITIAL) DEAN ACE T (IAST FIRST, ADDRESS&PHONE# 16110 SE 146TH PL RENTON WA 980597606 4254668012 SEX M MMDDYyry 06 - 12 - 2015 PASSENGER WITNESS[] UNIT# 2 SOS 3 AIRBAG 2 RESTR. q EJECT ? 1 HELMET INJURY NATURE OF INJURIES USE CLASS i1 NAME (LAST,FIRST,MIDDLE INITIAL) ADDRESS&PHONE# DOB SEX MMDDYVYV PASSENGER ❑WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET NJURY NATURE OF INJURIES POS. USE CLASS NAME (LAST FIR57 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' Unit 1 traveling east along Sunset Blvd NE where it turns into Renton Issaquah Rd SE at the intersection of Hoquiam Av NE. Unit 2 traveling north attempting to make a left turn on Hoquaim Av NE onto Sunset Blvd NE. Unit 1 driver reportedly unsure if she ran red light and reported adjusting eyeglasses/new prescription while driving. Unit 2 driver reported that she had the green light at intersection upon collision. Both units sustained non disabling reportable front passenger side damage. No injuries reported. Based on the evidence presented, it appears that the proximate cause of the collision was Unit 1 driver. I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT. HANSEN HSU 11-05-24 10:25 PM INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED APPROVED BY DATE P.SUMMERS 8887 11/7/2024 6:50:52 PM BADGE OR ID# ! 12651 ORI#' WA0171300 TIME POLICE DISPATCHED; 7:14 PM TIME POLICE ARRIVED',7:17 PM PART I PAGE IT]OF 3� REPORT NO. EF33168 CASE# ' 24-11484 DATE AND TIME 11/055/24 19:10 OF COLLISION b*, to ILL x1 I t x� s w } a a ;' y Pl PAGE 3 OF 3