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HomeMy WebLinkAbout24-11549 a ITFFi "POLCERA II IfI) 1 IlfII ('II (Illf If( fI I . 1 27c
COLLISION REP FIT 1591971
CASE 24-11549 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#
cawsloN 11 - 07 - 2024 0805 17 ❑-= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
SW GRADY WAY BLOCK NO. e✓ ❑
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ �.❑ FEET e S ❑ W e OAKESDALE AVE SW
0 3 29
UNIT MOTOR
Z PEDAL ❑ YESAGE NHORE✓LD MET PHONE 30
6� LAST NAME UNKNOWN FIRSTNAME MIDDLE 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
DRIVERS
STATE SEX D '❑- 328 LICENSE MMDYY❑
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 3 5 PLATE# PLATE# ROM ro
rRLR. TRLR 1 7 33
12❑ VIN# VIN#
FROM TO
VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE 7 $ 34
13❑ DAMAGE YES NO YES❑ NO✓
REGISTERED OWNER INFO [NEW] VEHICLE NO. 1
SHADE IN DAMAGED AREA ❑ 35
14 LIABILITY INSURANCE❑ INSURANCE CO 3 4
IN EFFECT &POLICY# 9TOP
VEwcLE 5 36
LECALLv YES❑NO❑ CITATION# CHARGE 10 BOTTOM
15❑ STANDING 8 6
MOTOR PEDAL- PEDESTRIAN ✓ :. PROPERTY DAM THR OLD MET PHONE
UNIT VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES 1/ NO D:2065306078
16 a
LAST NAME SHAW FIRST NAME CODY MIDDLE JA
INITIAL
17 STREET❑ NEW ADOREss❑' 702 SPRING ST#1112 CITY' SEATTLE ST' WA ZIP 98104 37
18❑ CDL IGNITION REQUIRED IGNITION PRESENT tSENT MEDICAL—T�RANSPORTED ❑ 38
INTERLOCK YEs❑NoR INTERLOCK YES It1 I NOF YES l NO❑
19 DRIVE # STATE SEX M M D.C.B.
07 09 _ 1990 El 39
ON DUTY STATUS 3 AIRBAG RESTR EJECT HELMET 2 INJURY 7 NATURE of INJURIES ❑ 40
USE CLASS KNEE INJURY
❑21❑ LICENSE TATE 41
VIN# `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
7CA
NAME(PRINT) OFFICER PHONE BADGE OR ID# 777T�NCY
26LAN 12007 0171300
PART A PAGE 01 OF
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EF35241
COLLISION REPORT III III III III III 111
1591972 CASE# 24-11549
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 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'
On November 7, 2024, at approximately 0822 hours, I was dispatched to a hit and run collision
involving a pedestrian at the intersection of SW Grady Way and Oakesdale Ave SW, within the City
Limits of Renton, County of King, State of Washington.
Dispatch advised that a green SUV had fled after the collision. Dispatch also stated that the
pedestrian was actively being treated by RRFA. The pedestrian wanted police contact by phone.
Later, I contacted the pedestrian and he explained he sustained a minor injury to his knee. He
mentioned that he was medically evaluated by RRFA.
The pedestrian said he was traveling eastbound on SW Grady Way on sidewalk. As he received the
crosswalk sign to proceed forward across the south and northbound lanes of Oakesdale Ave SW, he
observed unit 1 in the southbound right turn lane. He proceeded forward but was then struck by unit
1, causing pain to his left knee. The pedestrian fell and subsequently noticed that the driver of unit 1
was making an unrecognizable hand gesture through the windshield.
The pedestrian moved out the way and noticed that the driver of unit 1 made no attempts to exchange
information. Unit 1 completed his right turn and was last seen going westbound on SW Grady Way.
The pedestrian did not notice the make or model of the vehicle but believed it could have been a
newer Ford. He also did not write down the license plate of the vehicle.
The pedestrian said he would be unable to identify the driver if seen again, so this is an information
report only.
He only wanted police to be aware of the situation.
I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT.
C.CATALAN 11-07-2411:17AM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
C.JACOBS 1953 1 1111312024 3:29:19 PM
BADGE OR ID# 1Y007 OR]#' ' WA0171300 TIME POLICE DISPATCHED 8:24 AM TIME POLICE ARRIVED 8:45 AM
PART I PAGE IT]OF 3�
REPORT NO. EF35241 CASE# ' 24-11549 DATE AND TIME 11/07/24 08:05
OF COLLISION
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