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HomeMy WebLinkAbout24-11881 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 1 27c
COLLISION REP FIT 1591971
SASE 24-11881 2
INTERSTATE ❑ CITY STREET FIRE ❑
RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHICI F ❑ LOCAL AGENCI 4200 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# ❑
COLLISION'. 11 - 1-- 2024 0457 17 ❑.= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓
EDMONDS AVE NE BLOCK NO. e✓ 1140
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ 60 00 FEET MILES e S B W e NE 12TH ST
0 1 29
UNIT 01 VEHICLE
MOTZ PEDAL-ORCYCLE ElDESA✓NHORESHOLDMET PHONE 1 4 30
6� LAST NAME UNKNOWN FIRSTNAME MIDDLE 1 1 2 31
INITIAL
STREET ❑ CITY RENTON ST ZIP 2
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 U EEr 9 CLAY 0 NATURE OF INJURIES z❑
3
LICENSE sTATI urN#'
10❑ PI ATE 14
C7
TRAILER STATE TRAILER STATE
11 3 5 PLATE# PLATE# Rom ro
rRLR. TRLR. 1 5 33
12 0 0 VIN#' VIN#
CHEV UNKNO pK OIIF ❑ RO�34
❑ VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED If TO BLIN TOWED BY GOVT.VEHICLE
13 2 DAMAGE YES NO ✓ YES NO✓
REGISTERED OWNER INFO UNKNOWN RENTON VEHICLE NO. 1
SHADE IN DAMAGED AREA ❑ 35
14❑ ABILI INSURANCE❑ INSURANCE CO 3 4
IN EFFECT &POLICV# 9TOP
VEHICLE CHARGE 5 36
LEGALLY YES❑NO❑ CITATION# 1 o BOTTOM
15❑ STAIN.D'ING 7 6
UNIT VE IMOTOOR CYCLE ❑ PEDESTRIAN ❑ OWNER PEDAL ES❑ DYES✓ NO AM THR OLD MET PHONE
16❑
LAST NAME NONE FIRST NAME MIDDLE
INITIAL
STREET CITY RENTON ST ZIP $
17❑ NEW ADDRESS❑ ❑ 37
18❑ CDL IGNITION REQUIRED IGNITION PtR—E—S1ENT MEDICAL t—T�RANSPORTED � 38
INTERLOCK YEs❑NO� INTERLOCK YEs I I No� YES t l NO❑
19 LLIICENS RIVEWS# STATE SEX U MMDDYY —=_ 39
WELMET INJURY NATURE OF INJURIES 40
20❑ ON DUTY STATUS' AIRBAG 9 RESTR 9 EJECT '1 USE 9 CLASS 0 ❑
❑21❑ PLA E# CL(a7219 TATE 41
WA VIN# 1HGCP2F48AA185085 4
42
22 [TRAILER TILER
❑ PLATE# STATE PLATE# STATE
23❑ 43
TRLR RLR
UIN#. 'IN#.
VEH YEAR 2010 MAKE HOND MODEL ACCORD STYLE 4D VEHICLE TOWED TO BLIN TOWEDBy GOV HI 44
24❑ DAMAGE YES NO✓ YES NO✓
REGISTERED OWNER INFO JOSE JANCITO 1140 EDMONDS AVE NE,APT 101 RENTONWA98056 D:4253065038 VEHICLE NO.2
SHADE IN DAMAGEbAREA
2 3 Cd
INAEFFITY ECTNSURANCE❑ &POINSULICY#E CO I 9TOP
IETILe YES❑ N,J� CITATION# CHARGE i o BOTTOM
LEGALLY J
25 $
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# JAGENCY
26
C.STEED 8770 WA0171300
PAGE 01 OF
PART A
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EF36175
COLLISION REPORT III III III III III 111
1591972 CASE# 24-11881
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 11/16/24 at about 0517 hrs I arrived in front of 1140 Edmonds Ave NE for a Hit and Run Collision
report, in the City of Renton, County of King, and State of Washington. Jose Jacinto advised at about
0457 hrs a white Chevrolet pickup truck rear ended the back of his parked and unoccupied 2010
Honda Accord. Jose advised the witness did not see the driver or get a license plate of the vehicle.
The witness, who was no longer in the area, said the hit and run vehicle went NB after the collision.
Jose's vehicle was legally parked on the west side of Edmonds Ave NE about 60 ft south of NE 12th
St. It appears the hit and run vehicle was traveling SB on Edmonds Ave NE and failed to stop at the
stop sign. The vehicle rear ended the parked vehicle causing significant damage to the back of Jose's
vehicle. There is no further suspect information.
This incident was captured on my body worn video camera. This report is a summary of events that
occurred and is not an exact sequencing of events. Statements have been paraphrased and
summarized. The video was uploaded to evidence.com.
I certify (declare) under penalty of perjury under the laws of the State of Washington that the
foregoing is true and correct.
Electronically Signed by Officer Steed on 11/16/24 0613 hrs, Renton Washington
Cassidy Steed/8770
I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT.
C.STEED 11-16-24 06:18 AM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
QUINT TIBEAU 07691 11/16/2024 11:40:15 AM
BADGE OR ID# 8770 OR]# WA0171300 TIME POLICE DISPATCHED! 5:09 AM TIME POLICE ARRIVED 5:17 AM
FART I PAGE IT]OF 3�
REPORT NO. EF36175 CASE# ' 24-11881 DATE AND TIME 11/16/24 04:57
OF COLLISION
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