HomeMy WebLinkAbout24-12051 IT �i " II IIIII III IIIII II IIII IIIII I . Q 27c REPORT NO EF39414OLCERA
COLLISION REPORT 1591971
CASE# 24-12051 2
INTERSTATE CITY STREET FIRE I
RESULTEDSTOLENSTATE ROUTE OTHER VEHICLE LQCCODIGENC'Y 4200 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 TOTAL#OF OBJECT 1 s 28
TRIBAL UNITS 02 STRUCK
RESERVATION : 1 1
2
3� M M D D Y Y Y Y TIME(2400) COUNTY# MILES CITY#
DATE OF N E IN eDLLISION' 11 - 21 - 2024 0747 17 =.= S 8 W E OF M 1070 a
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
BLOCK NO.
NE SUNSET BLVD
4a❑ MILE POST
❑ DISTANCE OF(REFERENCE OR CROSS STREET)
5 1.1 FEET e S 8 W e ANACORTES AVE NE
0 1 29
MOTOR PEDAL- DAM AG THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE ❑ YEs Vl No D:2067391144 0 8 30
5 LAST NAME GARCIA FIRST NAME PAMELA MIDDLE I 1 1 2 31
INITIAL
STREET ] 4065 EAST MCKINLEYAVE CITY; TACOMA ST I WA ZIp; 98404 2
NEW ADDRESS
7 CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED. 3
INTERLOCK YEs No INTERLOCKYEs NCJ YES NO
8❑ DRIVER # STATE WA SEXI F MMDDYY' 10 - 01 - 1996 1 2 32
9 ON DUTY STATUS' AIRBAG 2 RESTR 4 EJECT 1 N USE ET CLASSY 1 [NATURE of INJURIES 2
LICENSE, C24872A STATE WA VIN#; 3C63R3JL4EG108774 3
10 Fl I PI ATP tI
5 TRAILER STATE TRAILER STATE
11 3 5 PLATE# PLATE# ROM To
TRLR TRLR 3 1 7 33
12 0 0 VIN#' VIN#
FROM TO
LE
13 2 VEH.YEAR 2014 MAKE RAM MODEL 3500 STYLE VEHICLE TO YED NOIyS46LIN diW9YMEYER GESr`-IVT ENp 9 9 34
DAMAGE IIII._IIII I_I
REGISTERED OWNER INFO MICHAEL RUST 34704 SE DAVID POWELL RD FALL CITY WA 98024 VEHICLE NO. 1
SHADE IN DAMAGED AREA 35
3 4
14 2 LIABILITY INSURANCE❑ NSURANCE CO 11
IN EFFECT &POLICY# 9TOP
VEn" CHARGE 10 BOTTOM 5 36
11
15
Lrn Lyc yes❑NO❑ CITATION# 4A0765735,4A0765735, OP MOT VEH W/OUT INSURANCE, 7 e
MOTCYR PEDAL- PEDESTRIAN1:1 PROPERTY DAM THR OLD MET PHONE
UNIT O2 VEHICLE CYCLE nWNFR YES f/ NO D:4257366492
16�
LAST NAME MATTSON FIRST NAME MARIA MIDDLE I,/
INITIAL
17
STREET ❑ 37
NEW ADORE SS❑ 6567125TH AVE SE CITY BELLEVUE ST, WA ZIP 980063936
18❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED: ❑ 38
INTERLOCKYEs NO INTERLOCK YES Na YES NO
19 DRIVER'S STATE WA SEX,F D.O#. 04 11 1968 39
LICENSE# MMDDYY —
HELMET INJURY: NATURE OF INJURIES 4Q
20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 USE CLASS 1 ❑
21 ILICENSE PATE# AYA4946 rare WA vIN# 1 HGCR2F82GA056796 41
22❑ PLATE# STATE PLATE# STATE 42
23 TRLR RLR 43
UIN#. 'IN#
VEH.YEAR 2Q16 MAKE HOND MODEL ACCORD STYLE VEHICLE TOWED TO BLIN TOWED BY GOV HI 44
24 DAMAGE YES �/ No GENE MEYER vEs ND�/
REGISTERED OWNER INFO MARIA MATTSON 6567125TH AVE SE BELLEVUE WA 980063936 D:4257366492 VEHICLE NO.2
SHADE IN DAMAGEAREA
2 3
LIABILITY INSURANCE INSURANCECO ALLSTATE 007936035
IN EFFECT &POLICY# I STOP
YemaE ,.I—I CITATION# CHARGE to BOTTOM
LE—LY YES N`.L J
25 � '
7'OFFLIl'tER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
26
VERTON 2517 WA0171300
PAGE 01 OF
PART A 3000-345-189(R 11/18)
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EF39414
COLLISION REPORT III III III III III 111
1591972 CASE# 24-12051
ADDITIONAL PERSONS INVOLVED(PASSENGERS AND/OR WITNESSES ONLY)
'.NAME
(LAST,FIRST,MIDDLE INITIAL)
ADDRESS&PHONE
SEXi D.O.B. —
MMDDYYYY
PASSENGERQ WITNESS� UNIT SEAT AIRBAG RESTR. EJECT ; HELMET INJURY NATURE OF INJURIES
POS. ' USE GLASS 1 ----�
:NAME
(LAST FIRST MIDDLE INITIAL)
ADDRESS&PHONE#
SEX D.O.B. —
MMDDYYYY
PASSENGER❑WITNESS UNIT# : SEAT AIRBAG RESTR. EJECT HELMET INJURY: NATURECFINJURIES
POS. USE CLASS ----�
:NAME
(LOST,FIRST,MIDDLE INITIAL)
ADDRESS&PHONE#
SEX MMDDYY D.O.B.
YY
PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET NJURY NATURE OF INJURIES
POS. I 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.
M.LEVERTON 11-21-24 03:19 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST.DET DATED PLAGE SIGNED
APPROVED BY DATE
C.JACOBS 1953 1 1112512024 12:10:58 PM
BADGE OR ID# ; 2517 ORI# WA0171300 TIME POLICE DISPATCHED 7:47 AM TIME POLICE ARRIVED i 8:04 AM
PAST B 3 Do-3mx—attar(t 1Mff) PAGE 2�OF 4
REPORT NO. EF39414 CASE# 24-12051 DATE OF COLLI r�510NN + 11/21/24 07:47
L1
NARRATIVE
slv/trk/1 lane 2 wht sedan stopped for light/out
CC
Within the city limits of Renton/King/WA I responded to a 2 vehicle crash at the intersection of NE
Sunset Blvd
Both vehicles were able to move from the intersection and off the roadway.
I contacted the driver of unit 2 who told me she was in lane 2 / Sunset-WB stopped at the intersection
as required while the power was out at the time of the crash. Ref RCW 46.61.183. She told me she
was hit from behind by unit 1 who did not yield or stop for unit 2 or the requirements of (183). She did
not complain of injury and damages did require a tow truck.
contacted the driver of unit 1 ID'd by picture WADL. She did not provide a reason for hitting unit 2.
She was not paying attention to the fact the power/traffic lights were out and drove into the back of a
stopped vehicle. Unit 2 was lawfully standing at the time of the crash. Unit 1 told me she did not
have insurance as it was cancelled but chose to drive without it. She did not complain of injury and
damages required a tow truck.
I cited unit 1 ref RMC 10-12-25 Driver Inattention, ref RCW 46.61.183 Requirement during
nonfunctioning signal lights and ref RCW 46.30.020 No valid proof of insurance via complaint.
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 11/21/2024
PAGE 3 OF 4
REPORT NO. EF39414 CASE# 24-12051 DATE AND TIME 11/21/2407:47
OF COLLISION
it �...
nv.
h'
F� n
N{�
t , \
Cl �
t
}
Y
�v
�n5
\tt1
�r
i
gym'
r �
PAGE 4 OF 4
