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HomeMy WebLinkAbout24-11968 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 2 27c
COLLISION REP FIT 1591971
SAS 24-11968 2
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 3 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 CITY#
COLLISION.. 11 — 1$ — 2024 2211 17 =.= N E IN S 8 W H OF e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
e✓ --- ----� ❑
S 2ND ST MILEPOST
4a❑
DISTANCE OF(REFERENCE OR CROSS STREET) BLOCK NO.
5❑ ❑ FEET e S ❑ W e SHATTUCKAVES
0 4 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
NO F,/ I D:8484587671 30
6❑ LAST NAME NGUYEN FIRSTNAME THOMAS MIDDLE 1 1 2 31
INITIAL
STREET ❑ 2523 NE 205TH ST CITY SHORELINE ST WA 21p 98155 z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
iNTERLOCKYEs NOWINTERLOCKYEs NO�/ YES R No�/
8❑ LDRIVER # STATE WA SEX'M MID
LOB 11 - 04 - 1948 32
9 ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 HELMET
2 CLASS 1 NATURE OF INJURIES z❑
3
10❑ P1 aT�S� BPN0232 sTATI WAvIN# 2T1KR32E45C422150
TRAILER STATE TRAILER STATE11 2 5 PLATE# PLATE# FROM TO
TRLR. YRLR. 3 5 33
12❑ VIN#j VIN#
FROM TO
❑ VEH.YEAR MAKE MODEL STYLE VEHICLE
T MATRIX 4DEHICLETOWED TO BLIN TOWED BY GOVT.VEHICLE 3 ] 34
13 2 2007 TOYT MATRIX 4D DAMAGE YES NO YES[:] NO✓
REGISTERED OWNER INFO SAM NGUYEN 2523 NE 205TH ST SHORELINE WA 98155 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
14 LIABILITY INSURANCE❑ INSURANCE CO 3 4
IN EFFECT &POLICY# 9TOP
vwcLE YES CHARGE 5 36
❑NO❑ CITATION# 10 BOTTOM
15❑ LEeGALLY STANDING 8 7 6
MOTOR PEDAL- PEDESTRIAN ✓ PROPERTY DAM THR OLD MET PHONE
UNIT 02 VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES 1/ NO D:2066277403
16 a
LAST NAME BARSTOW FIRST NAME JAMES MIDDLE L
INITIAL
17 STREET❑ NEW ADOREss❑' 419 S 2ND ST APT 369 CITY RENTON ST WA ZIP 98057 4❑ 37
18❑ CDL IGNITION REQUIRED IGNITION PR-E-1SENT MEDICAL-T�RANSPORTED � 38
INTERLOCKYES�NOR INTERLOCK YEs It I NOF YES t l NO❑
19 DRIVER'S STATE WA SEX M D.O.B. 04 03 _ 1975 39
LICENSE# MMDDYY
20❑4 HELMET INJURY NATURE OF INJURIES 3 40
ON DUTY STATUS 3 AIRBAG RESTR EJECT USE 2 CLASS 1 ❑
❑21❑ LICENSE TATE 'l 41
1
PLATE#
42
22❑ PLATE# STATE PLATE# STATE
TRLR
23❑ UIN#. N#.
43
RLR
'I
VEH YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN
TOWED BY Gov HI 44
24 0 1 DAMAGE YES NO YES NO
REGISTERED OWNER INFO VEHICLE NO.2
SHADE IN DAMAGED AREA
2 3 4
LIABILITY
INSURANCE❑ INSURANCE
#E CO
IN EFFECT &PO I 9TOP 5
vE""LE ❑ ,J� CITATION# CHARGE i o BOTTOM
LEGALLY YES N J
25
FR'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
26
HUNTER DEIGHAN 13030 WA0171300
PART A PAGE 01 OF
3000-345-159 fR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EF36996
COLLISION REPORT III III III III III 111
1591972 CASE# 24-11968
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'
Please see subsequent narrative pages
I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT.
HUNTER DEIGHAN 11-19-24 01:09 AM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
J.THIELMAN 11462 1111912024 2:39:01 AM
BADGE OR ID# 13030 ORI# WA0171300 TIME POLICE DISPATCHED; 10:13 PM TIME POLICE ARRIVED',10:14 PM
PART I PAGE IT]OF 4]
REPORT NO. EF36996 CASE# 24-11968 OF COLLISION
11/18/24 22:11
OF CbLLI510N
NARRATIVE
24-11968
On 11/18/2024 at approximately 2213 hours, I was dispatched to a vehicle collision at the intersection
of S 2nd St and Shattuck Ave S, within the City Limits of Renton, County of King, State of
Washington. A vehicle had struck a pedestrian and there were reports of injury.
Upon my arrival, I observed a man, later identified as James L. Barstow (04/03/1975) by his WA DOL,
standing on the sidewalk on the west side of Shattuck Ave S speaking to another Officer. As I
approached him members of the Renton Fire Department contacted him to ask him if he was ok and
if he needed treatment for any injuries. James said he was fine and that a car had struck him while he
was walking across Shattuck Ave S. He said the car was stopped on S 2nd St and hit him as it was
turning onto Shattuck Ave S and was not moving very fast when it hit him. Renton Fire assessed that
James was not injured and was ok to go home. The firefighters then left.
James reiterated to me that he was walking from east to west across Shattuck Ave S in the
crosswalk. He had the walk sign and the light controlling westbound traffic on S 2nd St turned green.
He was about halfway across when he said that Unit#1 struck him. He pointed out Unit#1 which was
parked on the west side of Shattuck Ave S facing south. He said the Unit#1 was not moving very fast
when it struck him, but it knocked him over. He once again said he was fine and was going to walk
home. He said after he fell down the driver of Unit# 1 pulled over, got out, and helped him up. James
then called 911. He said he did not want to press charges against the driver of Unit#1 as he was not
injured. James said he lived at the Compass Center on S 2nd St and was heading to the Safeway on
S 2nd St before he was hit.
Officer Mello told me that the driver of Unit#1 told him that he was traveling westbound on S 2nd St
and stopped at the red light when he reached Shattuck Ave S in lane 2. The light turned green and he
began turning south onto Shattuck Ave S. He said James was south of the cross walk and was just
walking west across the street. He did not see him until too late and applied his brakes but still hit
James, knocking him down. The driver of Unit#1 then pulled over to the right and got out to help
James up. The driver of Unit#1 remained on scene until Fire and Police arrived. There was no
damage to Unit#1.
Based on the above statements I believe Unit#1 was the proximate cause for this collision. Since
James was walking from his apartment on S 2nd St to the Safeway on S 2nd St it would make sense
he was in the crosswalk and crossed when he had the walk sign and would not have been south of
the crosswalk in the street. Both James and the driver of Unit#1 agreed the light was green when
James crossed the street.
Unit#1 was able to drive away from the scene. James walked back to his apartment. There is no
probable cause that a crime was committed. No further action is necessary.
I certify (or declare) under penalty of perjury under the laws of the State of Washington that the
foregoing is true and correct.
Electronically signed by Officer H. Deighan #13030 12:08 AM 11/18/2024 Renton, King County,
WA.
PAGE 3 OF 4
REPORT NO. EF36996 CASE# ' 24-11968 DATE AND TIME 11/18/24 22:11
OF COLLISION
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