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HomeMy WebLinkAbout24-8965 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 1 27c COLLISION REP FIT 1591971 CASE 24-8965 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' 08 - 1-- 2024 0721 17 ❑.❑ S 8 W e IN e 1070 3 4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓ TALBOT RD S BLOCK NO. e✓ 900 4a❑ MILEPOST DISTANCE OF(REFERENCE OR CROSS STREET) 5❑ 400 00 FEET MILES e S B W e S GRADyWAy 1 2 29 R PEDAL- DAMAGE MOTO THRESHOLD MET PHONE UNIT 01 VEHICLE ❑ CYCLE ❑ YES NO F/ I D:2068542370 0 81 30 LAST NAME ALMANZA DE ANDA FIRST NAME FIL/BERTO MIDDLE 6 INITIAL 1 2 31 STREET ❑, 4830 168TH SR SW#6 CITY LYNNWOOD ST WA 2jp, 98037 z 'NEW ADDRESS 7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3 iNTERLOCKYEs NO 1/ INTERLOCKYEs NO YES R No�/ 8❑ LRIIVER # STATE WA SEX'M MD. I D Y' 05 - 28 - 1977 1 2 32 9 ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 HELMET U E 2 CLASS 1 NATURE OF INJURIES z❑ 3 10❑ P1 aT�S� C65791E sTAr� WAVrN# 1GCHG35R2W1094313 TRAILER STATE TRAILED STATE 11 3 5 PLATE# PLATE# FROM TO TRLR. TRLR. 3 1 33 12 3 5 VIN#j VIN# FROM TO VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE R 34 13 3 1998 CHEV EXPRES VN DAMAGE YES NO YES FROM ✓ REGISTERED OWNER INFO OWNEDBYDRIVER VEHICLE NO. 1 SHADE IN DAMAGED AREA ❑ 35 14 LIABILI INSURANCE[Z INSURANCE CO FARMERS 514218716 IN EFFECT &POLICY# 9TOP El .e YES CHARGE 5 36 LvECALHaLv ❑NO❑ CITATION# 10 BOTTOM 15❑ STANDING 8 6 MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE UNIT 02 VEHICLE ❑ CYCLE ❑ ❑ OWNER [:]EA. YES 1/ NO D:6025619887 16 a LAST NAME HUYCK FIRST NAME JESSICA MIDDLE M INITIAL 17 STREET❑ NEW ADDREss❑' 16617 132ND PL SE CITY RENTON ST WA ZIP 98058 4❑ 37 18❑ CDL IGNITION REQUIRED IGNITION PR-E-1SENT MEDICAL—T�RANSPORTED � 38 INTERLOCK YEs❑No� INTERLOCK YEs It I NOF YES t l NOF,/ 19 F] LDI IVERS STATE WA SEX F M .C... 11 23 _ 1982 39 20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 H U EET 2 NJAURSY 1 NATURE OF INJURIES 40 ❑LICENSE I 21❑ PLA E# CGN2884 TArE 41 WA VIN 1t KM8KNDAFOPU144392 1 42 22❑ PILER LATE# STATE PLATE# STATE 23❑ VIN#. 43 TRLR RLR 'IN#. TOWED BY GOV HI 44 VEH YEAR 2023 MAKE yyU/)/ MODEL /ON/(,� STYLE (/T DAMAGE TOWED NOO✓ BLIN YES NO 1/ 24❑ REGISTERED OWNER INFO OWNED SY DRIVER VEHICLE N0.2 SHADE IN DAMAGEbAREA 2 3 Cd LIABILITY INSURANCE INSU&PORGY#E CO PROGRESSIVE 960481292IN 1 LEGAL25 GQ LY YES N� ❑ s e OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY J 26 C.JACOBS 1953 WA0171300 PART A PAGE 01 OF C7 3000-345-159 OR 11/181 STATE OF POLICETRAFFICN CORRECTION REPORT NO. EF14070 COLLISION REPORT III III III III III 111 1591972 CASE# 24-8965 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 8-26-24 at about 0730 1 arrived at the Chevron at the intersection of Talbot Rd S and S. Grady Way for a 2 vehicle non injury collision. I contacted both parties in the parking lot near their vehicles. Both drivers identified themselves via WADL. Driver 2 told me; She was stopped in traffic waiting for the traffic light to change when unint 1 exited the Home depot parking lot and struck the drivers side rear corner of her vehicle. She was not injured. Driver 1, Filiberto Almanza told me; He exited Home depot then driver 1 flagged him down and said he hit her vehicle. He was not injured. I checked both vehicles and found damage consistent with driver 2's recollection of events. I cited driver 1 for inattention via complaint. I declare under penalty of perjury under the laws of Washington state that the foregoing is true and correct. C. Jacobs/1953 I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT. C.JACOBS 09-02-24 10:41 AM INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED APPROVED BY DATE C.JACOBS 1953 1 9/2/2024 12:26:15 PM BADGE OR ID# 1953 ORI# WA0171300 TIME POLICE DISPATCHED; 7:28 AM TIME POLICE ARRIVED 7:30 AM PART I PAGE IT]OF 3� REPORT NO.! EF14070 CASE# 24-8965 DATE AND TIME 08/26/24 07:21 OF COLLISION cn t ;p i y ; r y. 1 t PAGE 3 OF 3