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HomeMy WebLinkAbout24-12275 a POLICETRAFFic" II I f I) 11I1ll(111(111l If( f 11 REPORT NO. EF43959 170
27
COLLISION REP FIT 1591971
CASE 24-12275 z
INTERSTATE ❑ CITY STREET FIRE ❑RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHICI F ❑ LOCAL AOENC 4900 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 3 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 0723 17 ❑-= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
e✓ --- ----� ❑
S 7TH ST MILEPOST
4a❑
DISTANCE OF(REFERENCE OR CROSS STREET) BLOCK NO.
5❑ ❑ FEET e S ❑ V\a MOSES LN S
0 4 29
UNIT MOTOR
VEHICL Z CYDDAL ElDDAMA✓NOESHOLDMET PHONE 0 11
30
LAST NAME CRUZALVARADO FIRSTNAME MARITZA MIDDLE E
6 INITIAL 1 2 31
STREET ❑ 616 SHATTUCK AVE S APT D CITY RENTON ST WA ZIP 980572450 z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
:NTERLOCKYEs NO INTERLOCK YES NO YES No
8❑ D
RI
VER # STATE WA SEX'F MMDDYY' 11 - 03 - 1994 1 2 32
9 ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 HELMETU E C ASSS 1 NATURE OF INJURIES z❑
3
LICENSE CNZ2737 sTArI WAurN# 1HGCM66503A026394
10[ PI ATE#
5 TRAILER STATE TRAILER STATE
11 2 5 PLATE# PLATE# FROM TO
TRLR. A'RLR. 1 3 33
12 2 5 VIN#' VIN#
>; FROM TO
VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE
DAMAGE YES NO 3 ] 34
13 2 2003 HOND ACCOR YES[:] NO✓
REGISTERED OWNER INFO MARITZA CRUZALVARADO 616 SHATTUCKAVE SAPTD RENTON WA 980572450 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
2 3 4
14 2 LIABILITY INSURANCE❑ INSURANCE CO
IN EFFECT &POLICY# 9TOP 5
VEHlcl.e CHARGE 10 BOTTOM 36
LEGALLY YES❑NO❑ CITATION# 4A0765737,4A0765737, FAIL YIELD LEFT TURN MOTOR
15❑ STANDING 7 6
MOTOR PEDAL-: PROPERTY DAM THR OLD MET PHONE
�NiT VEHICLE CYCLE' ❑ PEDESTRIAN ❑ OWNER ❑ YES V NO D:2062507791
16 a
LAST NAME WILLIAMS FIRST NAME KAYLA MIDDLE D
INITIAL
17❑ STREET ❑' 4253 S BATEMAN ST CITY SEATTLE ST WA ZIP 98118 37
NEW ADDRESS ❑
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 #
❑ ON DUTY STATUS AIRBAG,3 RESTR 4 EJECT 1 HELMET INJURY 7 NATURE OF INJURIES ❑ 40
USE CLASS L KNEE
21❑ LICENSE I CGM2024 TArE WA VIN1i 5J6YH28797L008609
❑ 41
PLATE#
42
22❑ PLATE# STATE PLATE# STATE
TRLR
23❑ UIN#. IN#.
43
RLR
'
VEH YEAR 2007 MAKE HOND MODEL ELEMENT STYLE VEHICLE TOWED TO BLIN TOWEDBY GOV HI 44
24❑ DAMAGE YES NO BANKERS YES NO
REGISTERED OWNER INFO KAYLA WILLIAMS 4253 S BATEMAN ST SEATTLE WA 98118 D:2062507791 VEHICLE NO.2
SHADEDAMAGEDAREA
3 4
INAEFFITY ECTNSURANCE INSU&POLICY#E CO SAME. 9TOP 5
'E""LE ❑ Nu,J CITATION# CHARGE
LEGAL to BOTTOM
LY YES
25 ' e
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
J
26
M.LEVERTON 2517 WA0171300
PART A PAGE 01 OF C7
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EF43959
COLLISION REPORT III III III III III 111
1591972 CASE# 24-12275
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.
M.LEVERTON 11-27-24 08:07 AM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
C.JACOBS 1953 12/9/2024 12:46:54 PM
BADGE OR ID# 2517 OR]#' WA0171300 TIME POLICE DISPATCHED; 7:25 AM TIME POLICE ARRIVED',7:Y9 AM
PART I PAGE IT]OF 4�
REPORT NO. EF43959 CASE# 24-12275 OF COLLISION
11/27/24 07:23
OF CbLLI510N
NARRATIVE
slv/2 wb blue/1 It from moses
CC
Within the city limits of Renton/King/WA I responded to a 2 vehicle blocking crash at the intersection
of S 7th St at Moses Ln S.
I contacted the driver of unit 2 who told me she was going about 25 mph west on S 7th St when unit 1
pulled out in front of her without time to avoid contact. She was checked and released on scene by
Renton Fire for leg pain. Her vehicle was tow for damages.
I contacted unit 1/ language barrier-Spanish, told me with the help of another person that she was
making a left turn from south on Moses to east S 7th St. She did not provide additional information
ref the crash. She did not have valid proof of insurance. She provided a picture WA-ID. A
WACIC/DOL check via MDC revealed she was ID only with no valid license.
I cited unit 1 ref RCW 46.61.185 FTYROW-Left turn injury crash, ref RCW 46.30.020 no insurance
and red RCW 46.20.015 NVOL 2nd with ID 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 11/27/2024
PAGE 3 OF 4
REPORT NO. EF43959 CASE# ' 24-12275 DATE AND TIME 11/27/24 07:23
OF COLLISION
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PAGE 4 OF 4