HomeMy WebLinkAbout24-8757 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 0 27c
COLLISION REP FIT 1591971
CASE 24-8757 z
INTERSTATE ❑ CITY STREET FIRE ❑RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHICI F ❑ LOCAL AOENC 4Y00 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 3 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#
COLLISION.. 08 - 1-— 2024 0843 17 ❑-= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
LOGAN AVE N
BLOCK NO. e✓ --- ----� ❑
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ ❑ FEET e S ❑ W e N 6TH ST
0 1 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
✓NO D:2062883552 2 01
30
6� LAST NAME ABDOROHMAN FIRSTNAME KHOLISOH MIDDLE N 1 F 2 31
INITIAL
STREET ❑ 12929 MARTIN LUTHER KING JR W TRLR 44 CITY SEATTLE ST WA 2jp, 981784651 z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
iNTERLOCKYEs NO I INTERLOCK YESO NO M YES R NO
8❑ LRIIVER #
ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 HELMET
2 CLASS 1 NATURE OF INJURIES z❑
3
10❑ P1 aT�S� BCX6844 sTArI WAvIN# 2T3DFREV9HW543931
TRAILER STATE TRAILER STATE
11 3 0 PLATE# PLATE# FROM TO
TRLR. YRLR. 5 1 33
12 3 5 VIN#' VIN#
>; FROM TO
VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE 5 1 34
13 2 2017 TOYT RAV4 DAMAGE YES NO YES[:] No✓
REGISTERED OWNER INFO TY TOEUNG 12929 MARTIN LUTHER KING JR W SEATTLE WA 98178 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
14 LIABILI INSURANCE INSURANCE CO SAFECO H2442123 3 4
IN EFFECT &POLICY# 9TOP
VEHICLe CHARGE 5 36
LEGALLY, YES❑NO❑ CITATION# 1 o BOTTOM
15❑ STANDIN 8 7 6
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
16 a UNIT VEHICLE ❑ CYCLE ❑ ❑ : OWNER ❑ YES NO 1/ D:4254295412
LAST NAME ETTER FIRST NAME LOGAN MIDDLE I G
INITIAL
17❑ STREET ❑', 22943 SE 287TH ST CITY' MAPLE VALLEY ST WA ZIP 980383319 37
NEW ADDRESS ❑
18� CDL IGNITION REQUIRED IGNITION PR—E-1SENT MEDICAL TRANSPORTED ❑ 38
INTERLOCKYES�NOR INTERLOCK YEs It I NOF YES t t— l NO❑
19[-] D IVEW # STATE WA SEX M Mr D.O.B. 05 _ 08 _ 2000 39
HELMET {NJURY 1 NATURE OF INJURIES 40
20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 USE 2 CLASS ❑
21❑ LICENSE I C54281F TAre WA vIN1t 1FDUF5ITY5GE642506
❑ 41
PLATE# ❑
42
22❑ TRAILER 97393AG STATE WA TRAILER STATE
PLATE# PLATE#
43
23❑ TRLR WA98254056 RLR
VIN# N#
VEH YEAR 2016 MAKE FORD MODEL F550 STYLE TR VEHICLETOWED TO BLIN TOWEDBY GOV HI 44
L4❑ DAMAGE YES NO YES NO
REGISTERED OWNER INFO INFRASOURCE SERVICES LLC 14103 STEWART RD SUMNER WA 98390 VEHICLE NO.2
SHADE IN DAMAGED AREA
2 3 4
LIABILITY INSURANCE &PORGY#E CO OLD REPUBLIC INSURANCE MWTB313092 24 1GQIN EFFECT
VE""LE ❑ ,J� CITATION# CHARGE
LEGALLY YES N`L J
25
7CA
NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
J
26LAN 12007 WA0171300
PART A PAGE 01 OF
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EF10929
COLLISION REPORT III III III III III 111
1591972 CASE# 24-8757
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 August 20, 2024, at 0835 hours, dispatch requested that I respond to a collision that occurred at
Logan Ave N and N 6th St, in the city of Renton.
Upon my arrival I spoke with the driver of unit 2 and he explained he was going northbound on Logan
Ave N when the collision occurred. He was in the right turn lane when he noticed he needed to go
through the light instead of making a right turn. He signaled left and proceeded through the gap that
unit 1 had made. As he approached the intersection a vehicle in front of him stopped abruptly. He
slowed his vehicle but was struck by unit 1 from behind. Unit 2 was towing a utility trailer so unit 1
struck the trailers left turn light. The trailer sustained minor damage, but unit 1 was substantially
damaged.
I then spoke with the driver of unit 1 and they related a similar story. The driver explained they were
approaching N 6th St on Logan Ave N when the collision occurred. Unit 2 needed to merge left, so
unit 1 created a gap for them to enter. As they entered the through lane, unit 2 stopped abruptly. Unit
1 was moving forward but failed to notice unit 2 slowing down. They moved forward but struck unit 2's
trailer from behind.
I provided an exchange of information to the two drivers and provided them with my contact
information.
I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT.
C.CATALAN 08-27-24 08:29 AM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
C.JACOBS 1953 1 9/2/2024 12:16:14 PM
BADGE OR ID# 1Y007 ORI# WA0171300 TIME POLICE DISPATCHED; 8:47 AM TIME POLICE ARRIVED';8:57 AM
PART I PAGE IT]OF 3�
REPORT NO.! EF10929 CASE# ' 24-8757 DATE AND TIME 08/20/24 08:43
OF COLLISION
v,
a
Si
1{
h,
PAGE 3 OF 3
