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HomeMy WebLinkAbout24-6513 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 0 27c
COLLISION REP FIT 1591971
CASE 24-6513 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 1 TOTAL#OF OBJECT 1 1 8 28
TRIBAL UNITS OZ RESERVATION STRUCK
z
3❑ DATE OF M M D D Y Y Y Y TIME(2400) COUNTY# MILES N E IN CITY#
cawsloN 06 - 1-- 2024 2009 17 ❑.❑ S 8 W e IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
SUNSET BLVD NE BLOCK NO. e ❑
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ ❑ FEET e S ❑ W e NE1405
0 4 29
UNIT MOTOR
VEHICL Z CYCLE ElOYESA✓NOTHRESHOLDMET PHONE O 1 30
6❑ LAST NAME WEYERS FIRSTNAME JASON MIDDLE D 1 2 31
INITIAL
STREET ❑, 16108 WESTWICK RD CITY SNOHOMISH ST WA 2jp, 98290 z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
iNTERLOCKYEs NO 1/ INTERLOCKYEs NO�/ YES R No�/
8❑ LDRIVER # STATE WA SEX'M MID
-O B 04 1— 07 — 1990 2 32
9 ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 HELMET U E 2 1 CLASS NATURE OF INJURIES z❑
3
10 9❑ PI ATE 14 BF66614 STATE WA VIN#' 1 NXBR32E77Z805372
TRAILER STATE TRAILER STATE
11 0 0 PLATE# PLATE# FROM ro
TRLR. TRLR. 5 7 33
12 0 0 VIN#' VIN#'
FROM TO
❑ VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TR Y GOVT.VEHICLE 1 $ 34
13 3 2007 TOYT COROL SD DAMAGE YES NO MEYERS YES[:] NO✓
REGISTERED OWNER INFO JASON WEYERS 16108 WESTWICK RD SNOHOMISH WA 98290 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
14 LIABILITY INSURANCE❑ INSURANCE CO NIA 4
IN EFFECT &POLICY# 9TOP
VEHICLE CHARGE 5 36
LEGALLY YES❑NO❑ CITATION# 1 o BOTTOM
15❑ STAINDIING 6
UNIT U2 TFIR
VEHIMOTOCLE CYCLE ❑ PEDESTRIAN ❑ OWNER PEDAL
[:]EA.
DYES NO ✓OLD MET PHONE
16 2
LAST NAME UNKNOWN FIRST NAME UNKNOWN MIDDLE
INITIAL
STREET CITY FEDERAL WAY ST ZIP 4
17❑ NEW ADDRESS❑ ❑ 37
18❑ CDL IGNITION REQUIRED IGNITION PtR—E—S1ENT MEDICAL—T�RANSPORTED � 38
INTERLOCKYES�NO INTERLOCK YEs I I NOF YES t l NOF,/
19 LLIICENS # STATE SEX U MMDDYY —❑_ 39
WELMET INJURY NATURE OF INJURIES 4O
20❑ ON DUTY STATUS' AIRBAG 9 RESTR 9 EJECT '1 USE 2 CLASS 1 ❑
LICENSE I ❑21❑ PLA E# CJY5766 TATe 41
WA VIN# 5N1ED28Y71C507425 1
42
22❑ PLATE# STATE PLATE# STATE
23❑ 43
TRLR RLR
UIN#. 'IN#.
VEH YEAR 2001 MAKE NISS MODEL XTERRA STYLE 4D VEHICLETOWED TO BLIN TOWEDBY GOV HI 44
L4❑ DAMAGE YES NO YES NO
REGISTERED OWNER INFO FRANCISCO ESTRADA 2102 SW 334TH PL FEDERAL WAY WA VEHICLE NO.2
SHADEDAMAGEDAREA
3 4
LIABILITY INSURANCE❑ INSURANCE CO N/A
IN EFFECT &POLICY# 9TOP 5
VE. LE YES N� CITATION# NA CHARGE to BOTTOM
LecALLY `L-
0(
25 ' e
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
26
JASON TURNER 12650 WA0171300
PAGE 01 OF
PART A
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EF36290
COLLISION REPORT III III III III III 111
1591972 CASE# 24-6513
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'
Unit 1 was traveling north bound on Sunset BLVD NE and then made a left turn at the entrance to
1405. Unit 1 disregarded the yield sign and crossed into the south bound lanes of Sunset Blvd NE
directly into the path of Unit 2, causing the vehicles to collide.
Unit 1 had no injuries, unit 1's vehicle had extensive front end damage and was unable to drive under
it's own power. Unit 1 was towed by Gene Meyers Towing.
Unit 2 was no longer on scene but Unit 1 stated that the two had exchanged information. Unit 1
provided me the licence plate of Unit 2. Unit 1 could not provide me with the name or phone number
of the driver but did provide the license plate of the vehicle. Unit 2 never contacted the police to make
a report about the incident.
There is no further information at this time.
I declare under penalty of perjury under the laws of the State of Washington that the foregoing is true
and correct. Electronically signed by J. Turner 12650 on 11/16/2024 at 0333 hours.
I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT.
JASON TURNER 11-16-24 03:34 AM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
J.CHRISTIANSEN 10437 1 1111712024 12:21:02 AM
BADGE OR ID# 12650 ORI#' WA0171300 TIME POLICE DISPATCHED} 8:09 Pry TIME POLICE ARRIVED 8:15 PM
PART I PAGE IT]OF
REPORT NO. EF36290 CASE# 24-6513 DATE AND TIME 06/20/24 20:09
OF COLLISION
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