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HomeMy WebLinkAbout24-8832 a POLICETRAFFic" II I f I) 11I1ll(111(111l If( f 11 REPORT NO. EF14458 170
27
COLLISION REP FIT 1591971
CASE 24-8832 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 3 TOTAL#OF OBJECT 1 1 8 28
TRIBAL UNITS 02 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 0744 17 ❑.❑ S 8 W e IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓
AIRPORT WAY
BLOCK NO. e✓ --- ----�
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ 100 00 FEET MILES e S ❑ W e LAKEAVES
2 0 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
✓NO D:2067084576 0 11
30
6� LAST NAME PENA-SANCHEZ FIRSTNAME NORMA MIDDLE E 1 1 2 31
INITIAL
STREET ❑, 22416 88TH AVE S,APT B105 CITY KENT ST WA ZIP 98031 z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
iNTERLOCKYEs NO INTERLOCKYEs NO YES R NO
8❑ LRIIVER #
ON DUTY❑ STATUS AIRBAG 6 RESTR 4 EJECT 1 H USE 2 1 CLASS NATURE OF INJURIES 2❑
3
10 1❑ PICENSE1I ATE 14 BLP2213 STATE WA u N# 2HGFC2E5XJH558390
TRAILER STATE TRAILER STATE
11 3 5 PLATE# PLATE# FROM To
TRLR. TRLR 7 3 33
12 3 5 VIN#j VIN#
:: FROM TO
VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN T /[g GOVT.VEHICLE 7 3 34
13 2018 HOND CIVIC DAMAGE YES NO � '` RS TOWING YES[:] No✓
REGISTERED OWNER INFO JOSUE PEREZABREGO 2241688TH AVE S APTBI05 KENT WA 98031 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
3 4
14 LIABILITY INSURANCE INSURANCE CO STATE FARM 514110947
IN EFFECT &POLICY# 9TOP
❑ LEGALLY LE CHARGE 1 5 36
15 2 YEs No clTAnoN# 4A0619903 IMPROPER LANE USAGE o aorrom
MOTOR PEDAL-: PROPERTY DAM THR OLD MET PHONE
UNIT 02 ❑✓ ❑ PEDESTRIAN ❑ ❑ YES,/ No DD 4257721371
VEHICLE CYCLE OWNER
16 a
LAST NAME JACOBS FIRST NAME CASSIE MIDDLE M
INITIAL
17❑ STREET ❑', 11232 1 STAVE IN CITY EVERETT ST WA ZIP 982046468 37
NEW ADDRESS ❑
18� CDL IGNITION REQUIRED IGNITION PRESENT MEDICALTRANSPORTED 38
INTERLOCKYES�NOR INTERLOCK YEs❑NOF YES❑NO❑ 11
19[—] DRIVER'S STATE WA SEX F D.C.B. 09 _ 16 _ 1970 0 39
LICENSE# MMDDYY
HELMET {NJURY 1 NATURE OF INJURIES 40
20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 USE 2 CLASS ❑
21❑ LICENSE AKN4361 TATe WA vIN# JM3KE4DE9D0154596
❑ 41
PLATE#
42
22❑ PLATE# STATE PLATE# STATE
TRLR
23❑ UIN#. IN#.
43
RLR
'
TOWED BY Gov HI 44
VEH YEAR 2013 MAKE {IggZp MODEL CX-5 SE STYLE (/T _rEHICLE
TOWED✓ NOO BLIN BANKERS TOWING YES NO�/
24❑ REGISTERED OWNER INFO OWNED SY DRIVER VEHICLE N0.2
SHADEDAMAGEDAREA
3 4
LIABILITY
INSURANCE INSU&PORGY#E CO FARMERS INSURANCE 518789482IN STOP 5
'E""LE ❑ Nu,J CITATION# CHARGE
LEGAL io BOTTOM
LY YES
25 ' a
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. EF14458
COLLISION REPORT III III III III III 111
1591972 CASE# 24-8832
ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY)
NAME MIDDLE INITIAL) MANG MALISSA
(LAST FIRST,
ADDRESS&PHONE# D O.B.
RENTON WA 98055 2067905323 SEX F MMDDYyry - -
PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT ' HELMET INJURY NATURE OF INJURIES
❑ ❑✓ POS. USE CLASS
NAME
(LAST,FIRST,MIDDLE INITIAL)
ADDRESS&PHONE# DOB
SEX MMDDYYYY
PASSENGER ❑WITNESS❑ UNIT# SEAT AIRBAG RESTR. EJECT HELMET INJURY NATURE OF INJURIES
POS. USE CLASS
NAME
(LAST FIR57 MIDDLE INITIAL)
AppRESS&PHONE#
SEX D.O.B.MMDD -❑
YYYY.
PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET NJURY NATURE OF INJURIES
❑ ❑ POS. USE CLASS ----�
NARRATIVE'
On August 22, 2024, at 0744 hours dispatch requested that I respond to a collision that occurred at
Airport Way and Lake Ave S, in the city of Renton.
Upon my arrival I spoke a witness who pulled me aside. The witness explained that she was following
unit 1 eastbound on Airport Way when the collision occurred. As they approached Lake Ave S, unit 1
turned their hazard lights on and proceeded to make a left turn. Unit 1 made a left turn from the
number 1 lane to the number 3 lane, and it almost appeared as if they were making a U-turn.
I then spoke with the driver of unit 2 and she explained a similar story. They stated they were in the
number 3 lane as unit 1 followed beside her in the number 1 lane. As they approached Lake Ave S,
unit 1 made an abrupt lane change. Unit 1 merged left and crossed in front unit 1's front bumper. The
driver of unit 2 mentioned she had no time to stop her vehicle.
I then spoke with the driver of unit 1 and she explained she was going eastbound on Airport Way.
She planned to merge left, looked for vehicles in her blind spot, and then decided to merge. As she
moved left, she struck unit 2. The driver states she never saw the vehicle and has no idea how the
collision occurred.
Both vehicles sustained moderate damage costing over$1000. Both vehicles were also towed away
by Bankers Towing.
An exchange of information was given to the two drivers, and I believe that the contributing factor to
this collision is unit 1's 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 08-27-24 08:29 AM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
C.JACOBS 1953 1 9/12/2024 3:54:49 PM
BADGE OR ID# 1Y007 OR]#' ' WA0171300 TIME POLICE DISPATCHED 7:47 AM TIME POLICE ARRIVED 7:51 AM
PART I PAGE IT]OF 3�
REPORT NO.! EF14458 CASE# 24-8832 DATE AND TIME 08/22/24 07:44
OF COLLISION
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