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HomeMy WebLinkAbout24-8631 POLICETRAFF'c" III !�� I IIIllI111IN II II I REPORT NO. EF10932 170
27
COLLISION REP FIT 1591971
CASE 24-8631 z
INTERSTATE ❑ CITY STREET FIRE ❑RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHIr.I F ❑ LOCAL AOENC 4Y00 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#
COLLISION'. OS - 1-— 2024 1319 17 ❑-= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
RAINIER AVE S
BLOCK NO. e✓ --- ----� ❑
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ ❑ FEET e S ❑ VV e S 7TH ST
2 0 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
No ,/ I D:2062508554 0 11
30
6� LAST NAME SIRIYA FIRSTNAME KEOW MIDDLE N 1 2 31
INITIAL
STREET ❑ 4032 31ST AVE S CITY SEATTLE ST WA 2jp, 981081605 z=
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
INTERLOCK YES[:]NO INTERLOCKYEs NO YES R NO
8❑ LRIIVERS STATE WA SEX'M MM DAY' 12 1— 05 — 1943 2 32
CENSE 9 ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 H USE 2 1 CLASS NATURE OF INJURIES z❑
3
10 1❑ P1 ATE 14 ARZ3774 BTAT WA u N#' 2HGEJ8642YH598886
11[-j- TRAILER STATE TRAILER STATE
11 3 5 PLATE# PLATE# IRM ro
TRLR. A'RLR. 1 5 33
12 3 5 VIN#j VIN#'
:: FROM TO
VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE 1 $ 34
13 2 2000 HOND ClV4D SD DAMAGE YES NO YES[:] No
✓
REGISTERED OWNER INFO KEOWSIRIYA 403231 AVE S SEATTLE WA 98108 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
14 LIABILI INSURANCE INSURANCE CO GEICO 4280-93.11.65 3 4
IN EFFECT &POLICY# 9TOP
Ela.e CHARGE 5 36
LvECALHLv res❑NO❑ CITATION# 1 o BOTTOM
MOTO PEDAL
15❑ STAIN.D'ING 8 7 6
UNIT 02 VE ICCLE CYCLE ❑ PEDESTRIAN ❑ OWNERRTY ❑ DYES NO SOLD MET PHONE
16 a
LAST NAME CLEGG FIRST NAME SHAWNTAY MIDDLE 0
INITIAL
17❑ STREET ❑', 27637 43RD PL S CITY'AUBURN ST WA ZIP 980011117 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 #
{NJURY 1 NATURE OF INJURIES 40
20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 USE 2 CLASS ❑
21❑ LICENSE I CEB2743 TATe WA vIN# 5FNYF6H72N6050087
❑ 41
PLATE#
42
22❑ PLATE# STATE PLATE# STATE
23❑ UIN#. 43
TRLR RLR
'IN#.
VEH YEAR 2022 MAKE HOND MODEL PILOT EX STYLE UT VEHICLE TOWED TO BLIN TOWED eY GOV HI 44
L4❑ DAMAGE YES NO,� YES NO
REGISTERED OWNER INFO MATTHEW CLEGG 2763743RD PL S AUBURN WA 98001 VEHICLE NO.2
SHADE IN DAMAGED AREA
2 3 4
LIABILITY
INSURANCE &POINSURGY#E CO GEICO 6141-43-05-76IN I STOP 5
vE""LE ❑ Nu,J CITATION# CHARGE
LEG i o BOTTOM
ALLY YES
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. EF10932
COLLISION REPORT III III III III III 111
1591972 CASE# 24-8631
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 16, 2024, at 1319 hours dispatch requested that I respond to a collision that occurred at
SW 7th St and Rainier Ave S, in the city of Renton.
Upon my arrival I spoke with the driver of unit 2 and they explained that both vehicles were going
southbound on Rainier Ave S. Unit 2 was in the right turn lane and unit 1 was in the number 1 through
lane. As they approached SW 7th St, unit 1 merged right and side swiped unit 2's drivers side doors.
The driver of unit 2 believes that the driver of unit 1 failed to see them as they approached the traffic
light.
I then spoke with the driver of unit 1 and they explained a similar story. They stated they were going
southbound on Rainer Ave S. As they approached SW 7th St, they merged right but struck unit 2 who
was in the right turn lane.
Both vehicles sustained moderate damage, but neither of the two needed to be towed away.
An exchange of information was given to both drivers, and I believe that the main contributing factor
to the collision is that the driver of unit 1 made an improper lane change.
I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT.
C.CATALAN 08-20-24 03:52 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
C.JACOBS 1953 1 9/2/2024 11:56:35 AM
BADGE OR ID# 1Y007 ORI# i WA0171300 TIME POLICE DISPATCHED; 1:21 Pry TIME POLICE ARRIVED]1:44 PM
PART I PAGE IT]OF 3�
REPORT NO.! EF10932 CASE# ' 24-8631 DATE AND TIME 08/16/24 13:19
OF COLLISION
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t
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