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HomeMy WebLinkAbout24-12048 IT �i " II IIIII III IIIII II IIII IIIII I . 27c REPORT NO EF39574OLCERA
COLLISION REPORT 1591971
CASE# 24-12048 2
INTERSTATE CITY STREET FIRE I
RESULTEDSTATE ROUTE OTHER STOLEN vEwCLE LOCALANG 3
HIT&RUN C©DIN6
COUNTY RD PRIVATE WAY INVOLVED
2 TOTAL#OF OBJECT 1 1 s 28
TRIBAL UNITS 02 STRUCK
RESERVATION : 2
3� M M D D Y Y Y Y TIME(2400) COUNTY# MILES CITY#
DATE OF N E
eDUISION' 11 - 21 - 2024 0430 17 =.�� S W OF 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
RAINIER AVE S BLOCK NO. e 0 .�
4a❑ MILE POST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ 1.1 FMILES EET e S 8 W e RAINIER AVE EXT
0 1 29
MOTOR PEDAL- DAM G THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE ❑ YES'Vl No D:2539271784 0 1 30
5 LAST NAME JOYNER FIRST NAME MARY MIDDLE K 1 1 2 31
INITIAL
STREET ] 4301 NORPOINT WAY NE APT 4A CITY; TACOMA ST I WA ZIP; 984221595 2
NEW ADDRESS
7 CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
INTERLOCKYEs NO W/ INTERLOCK YEs NO�/ YES N,D,/
8❑ DRIVER # STATE WA SEXI F MMDDYY' 04 — 05 — 1939 1 1 2 32
9 ON DUTY STATUS' AIRBAG 2 RESTR 9 EJECT 1 N USEET INJUR
CLASSY 14 1
NATURE of INJURES 2
10 LI ENSE' ANW8742 STATE WA VIN# 5NPDH4AEODH412553 3
TRAILER STATE TRAILER STATE
11 3 5 PLATE# PLATE# FROM To
TRLR zRLR 5 1 33
12 3 5 VIN# vIN#
FROM TO
13 2 VEH.YEAR2013 MAKE HYUN MODEL ELANTR STYLE 4D VEHICLE TOYED NO�iS46LIN Tl� {J RSTOW►NG Ges❑ENICLE o� 7 3 34
DAMAGE IIII._IIII
REGISTERED OWNER INFO MARYJOYNER4301 NORPOINTWAYNE TACOMA WA 98422 VEHICLE NO. 1
SHADE IN DAMAGED AREA 35
2 LIABILITY INSURANCE INSURANCE CO 2 3 4
14 PROGRESSIVE INSURANCE 65171716
IN EFFECT &POLICY# 4TOP
VEHICLE CHARGE S 36
LEGALLY yes❑NO❑ CITATION# 7 0 80TTOM
15❑ sTANowc 7 e
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT 02 VEHICLE CYCLE PROPSnWNr YES�/ NO D:2066123061
16�
LAST NAME TRAN FIRST NAME ALEXANDER MIDDLE N
INITIAL
17 F1 STREET ❑❑ 37 701 S 38TH CT CITY RENTON ST, WA ZIP 980555893 4
NEW ADDRESS
18❑ IGNITION REQUIRED IGNITION PRESENT MEDICALTRANSPORTED 38
CDL INTERLOCKYES No INTERLOCI£YES NO YEs No
19 DRIVERS STATE WA SEXI M I D.O.B. 09 30 1989 � 39
LICENSE# MMDDYY
HELMET INJURY: NATURE OF INJURIES 4Q
20❑ ON DUTY STATUS AIRBAG 3 RESTR 9 EJECT 1 USE CLASS 6 HEADACHE AND SORE LEFT SHOULDER ❑
21 LICENSLATE E CMS4445 TATE WA VIN# SHHEP33582U310538 41
22❑ PLATE# STATE[TILER I PLATE# STATE 42
23 TRLR r RLR 43
UIN#. 'IN#
VEH.YEAR 2002 MAKE HOND MODEL CIVIC STYLE HB VEHICLE TOWED TO BLIN TOWED BY GOV HI �44
24 DAMAGE YES �/ No BANKERS TOWING
REGISTERED OWNER INFO ALEXANDER TRAN 701 S38TH CT RENTON WA 98055 VEHICLE NO.2
SHADEY DAMAGEDAREA
$� 3 4
LIABILITY INSURANCE❑ INSURANCE CO
IN EFFECT &POLICY# 9TOP
1-ICLE CITATION# 4A0598504 CHARGE OP MOT VEH W/OUT INSURANCE io aorroM
EEGAEEY YES❑ NC❑
25 s 6
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
26
JESSE VANDERHOEK 11631 WA0171300
PAGE 01 OF
PART A 3000-345-189(R 11/18)
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EF39574
COLLISION REPORT III III III III III 111
1591972 CASE# 24-12048
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
It should be noted it was dark outside, the power was out due to a recent storm, all street lights were
off, and the traffic signals at the intersection were off. Vehicle #1 was traveling northbound on Rainier
Ave S, approaching Renton Ave Extension. Vehicle #2 was traveling eastbound on Renton Ave
Extension approaching Rainier Ave S. The driver of vehicle #1 indicated to me she did not see the
traffic signals that had no power, and did not stop before proceeding northbound through the
intersection. The driver of vehicle #2 advised he stopped at the stop line before proceeding
eastbound through the intersection. The front left corner of vehicle #1 collided with the front right
corner of vehicle #2. Due to the totality of the circumstances, it appreared the driver of vehicle #1
caused this collision.
RTF
I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT.
JESSE VANDERHOEK 11-25-24 08:26 AM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST.DET DATED PLACE SIGNED
APPROVED BY DATE
D.SKELTON 9139 11/26/2024 4:02:37 AM
BADGE OR ID# j 11631 ORI# WA0171300 TIME POLICE DISPATCHED 4:32 AM TIME POLICE ARRIVED i 4:35 AM
PAST B 3 Da-3mx—attar(txIMR) PAGE 2�OF F3
REPORT NO. E F39574 CASE# 24-12048 DATE AND TIME 11/21/24 04:30
OF COLLISION
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