HomeMy WebLinkAbout24-12106 a ITFFi "POLCERA II IfI) 1 IlfII ('II (Illf If( fI I . 1 27c
COLLISION REP FIT 1591971
SASE 24-12106 2
INTERSTATE ❑ CITY STREET FIRE ❑RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHIC;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.. 11 - 1-— 2024 1141 17 ❑-= S 8 IN e 1070 3
4❑ oN (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
SUNSET BLVD N BLOCK NO. e✓ ❑
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ �.❑ FEET e S ❑ VV e N 3RD ST
0 1 29
MOTU '�01 VEHtOR Z CLE CYDCLE. El �ESAGE NHORE✓LD MET PHONE 0 a 30
6� LAST NAME YESILYURT FIRSTNAME MAH MIDDLE 1 2 31
INITIAL
STREET ❑ 16807 53RD AVE S CITY TUKWILA ST WA ZIP 98188 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 2 RESTR 4 EJECT 1 HELM
USEET INJUR
5Y NA
1 TURE OF INJURIES z❑
3
10 1❑ P1 ATE 14 CLF8315 STATE WA VIN# JTDKN3DU1A1001212
TRAILER STATE TRAILER STATE
11 3 0 PLATE# PLATE# FROM TO
rRLR TRLR 3 7 33
12 3 0 VIN#' VIN#
>; FROM TO
VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE 3 $ 34
13 2 2010 TOYT PRIUS DAMAGE YES NO YES[:] No✓
REGISTERED OWNER INFO Cl.YESILYURT 1680753RD AVE S TUKWILA WA 98188 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
14 LIABILITY INSURANCE❑ INSURANCE CO eq�T3 4
IN EFFECT &POLICY# 9TOP
VEwcLE CHARGE 5 36
LEGALLv YEs❑NO❑ CITATION# 1 o BOTTOM
15❑ STANDING 8 7 6
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT U2 VEHICLE ❑ CYCLE ❑ ❑ PROPERTY
❑ YES NO 1/ D:4257571148
16 a
LAST NAME CABRERA FIRST NAME ADRIELL MIDDLE I T
INITIAL
17❑ STREET ❑', 508 ROSARIO AVE NE CITY' RENTON ST WA ZIP 980594553 37
NEW ADDRESS ❑
18� CDL IGNITION REQUIRED IGNITION PtR—E—S1ENT MEDICAL TRANSPORTED ❑ 38
INTERLOCKYES�NOR INTERLOCK YEs I I NOF YEs t l NO❑
19[—] DRIVER'S STATE WA SEX M D.C.B. 03 _ 27 2000 0 39
LICENSE# MMDDYY
WELMET INJURY1 NATURE OF INJURIES 40
20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 USE CLASS ❑
21❑ LICENSE AUA6033 TATe WA VIN# 2HGF62F50CH606712
❑ 41
pLATE#
42
22❑ PLATE# STATE PLATE# STATE
23❑ 43
TRLR RLR
VIN#. IN#.
VEH YEAR 2012 MAKE HOND MODEL CIVIC STYLE VEHICLETOWED TO BLIN TOWEDBY GOV HI 44
L4❑ DAMAGE YES NO YES NO
REGISTERED OWNER INFO RONALDO CABRERA 508 ROSARIO AVE NE RENTON WA 98059 VEHICLE NO.2
SHADE IN DAMAGED AREA
2 3 4
LIABILITY
INSURANCE I PORGY#ECO ALLSTATE 820 900 120IN 1 9TOP 5
VE""LE ❑ ,J� CITATION# CHARGE i o BOTTOM
LEGALLY YES N`L J
25 $ '
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
J
26
M.LEVERTON 2517 WA0171300
PAGE 01 OF
PART A
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EF39416
COLLISION REPORT III III III III III 111
1591972 CASE# 24-12106
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'
gry/2 outside Itl slv/1 center Itl went straight
RTF
Within the city limits of Renton/King/Wa I responded to a 2 car crash at the intersection of Sunset
Blvd N at N 3rd St.
I contacted the driver of unit 2 who told me he was in lane 2 making a left turn from N 3rd St onto
southbound Sunset Blvd N when unit 1 from lane 3 went straight and crashed into the side of his
vehicle. Minor damage. He did not complain of injury and damages did not require a tow truck.
I contacted the driver of unit 1 ID'd by his Turkish international drivers license, as he is visiting the
USA and learning English. He told me he was not familiar with the area and he caused the crash by
going straight vs making the required left turn, making contact with unit 2. He did not complain of
injury and damages did not require a tow truck.
Information/Insurance only
I certify (declare) under penalty of perjury under the laws of the State of Washington that the
foregoing is true and correct.
M.Leverton/2517 City of Renton/King/Wa 11/22/2024
I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT.
M.LEVERTON 11-22-24 12:38 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY E
DAT
C.JACOBS 1953 1112512024 12:08:44 PM
BADGE OR ID# 2517 OR]#' WA0171300 TIME POLICE DISPATCHED 11:41 AM TIME POLICE ARRIVED 12:00 PM
PART I PAGE IT]OF 3�
REPORT NO. EF39416 CASE# ' 24-12106 DATE AND TIME 11/22/24 11:41
OF COLLISION
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