Press Alt + R to read the document text or Alt + P to download or print.
This document contains no pages.
HomeMy WebLinkAbout24-11578 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 1 27c
COLLISION REP FIT 1591971
CASE 24-11578 z
INTERSTATE ❑ CITY STREET FIRE ❑
RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHIr.I F ❑ LOCAL AGENCI 4950 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 TOTAL#OF OBJECT 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#
cowsloN 11 - 1-- 2024 1852 17 ❑-= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
AIRPORT WAY BLOCK NO. e✓ 54 ❑
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ ❑ FEET e S ❑ W e RAINIER AVE S
0 1 29
UNIT MOTOR
Z PEDAL-
CYCLE ❑ YESAGE NHORE✓LD MET PHONE 0 8 30
6� LAST NAME UNKNOWN FIRSTNAME MIDDLE 1 2 31
INITIAL
STREET ❑ CITY ST ZIP z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
iNTERLOCKYEs NO 1/ INTERLOCKYEs NO�/ YEs No�/
8❑ LIRCIENSRE#
STATE I
SEX u MMDDYY '❑- 1 1 2 32
9 ON DUTY❑ STATUS I
AIRBAG 9 RESTR 9 EJECT 1 H U EEr 9 CLAY 0 NATURE OF INJURIES z❑
3
10[1 PI ATE 14 BLK1273 sTAT WAu N#' 2G1WH52KX59113880
5 TRAILER STATE TRAILER STATE
11 3 5 PLATE# PLATE# FR.. To
TRLR. TRLR 3 7 33
12 3 5 VIN#' VIN#'
>; FROM TO
VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED By GOVT.VEHICLE g 9 34
13 4 2005 CHEV IMPALA SD DAMAGE YES NO YES
❑ NO✓
REGISTERED OWNER INFO .IOYANDREWS 151 TORYLYNN DR WINLOCKWA 98596 VEHICLE NO. 1
❑ ❑
SHADE IN DAMAGED AREA 35
14 LIABILITY INSURANCE❑ INSURANCE CO 3 4
IN EFFECT &POLICY# 9TOP
vEHICLe CHARGE 1 5 36
LEcnLLv res❑NO❑ CITATION# 10 BOTTOM
15❑ STANDING 8 6
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT 02 VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES NO ,/ D:2064767733
16 a
LAST NAME TUBERA FIRST NAME MYKEE MIDDLE S
INITIAL
17 STREET I❑ 2101 SW SUNSET BLVD,APT G206 CITY' RENTON ST WA ZIP 98057 37
NEW ADOREss❑'
18❑ CDL IGNITION REQUIRED IGNITION PtR-E-S1ENT MEDICAL TRANSPORTED � 38
INTERLOCK YEs❑NO INTERLOCK YEs I I NOF YES t l NOF,/
19 DRIVERS
# STATE WA SEX F M.C.B. 10 _ 20 _ 2003 39
20❑ ON DUTY STATUS AIRBAG,2 RESTR 4 EJECT 1 HELMET 2 INJURY 6 NATURE of INJURIES ❑ 40
USE CLASS MINOR BACK PAIN
❑ 41
21❑ LICENSE I PLA E# CKE7121 TATE WA vIN# 1G6DWSRK8P0148542 4
42
22❑ PLATE# STATE PLATE# STATE
23❑ UIN#. 43
TRLR RLR
'IN#.
Gov HI
VEH YEAR 2023 MAKE CADI MODEL CTS STYLE $D DAMAGE TOWED NOO✓ BLIN TOWED BY 44
YES
NO
24❑ ES
REGISTERED OWNER INFO OWNED SY DRIVER VEHICLE N0.2
SHADE IN DAMAGEbAREA
2 3 Cd
LIABILITY
INSURANCE INSU&PORGY#E CO GENERAL WA9864999IN IGD
vE""LE CITATION# CHARGE
LEGALLY YES Nu
25❑ s a
=RSE
PRINT) OFFICER PHONE BADGE OR ID# AGENCY26 12994 WA0171300
PART A PAGE 01 OF C7
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EF63210
COLLISION REPORT III III III III III 111
1591972 CASE# 24-11578
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.
JAMAAL KEARSE 11-07-24 08:50 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
QUINT TIBEAU 07691 1 2/6/2025 10:51:34 PM
BADGE OR ID# ( 12994 OR]#' WA0171300 TIME POLICE DISPATCHED; 6:54 PM TIME POLICE ARRIVED]7:02 pry
FART I PAGE IT]OF 4�
REPORT NO. EF63210 CASE# 24-11578 OF COLLISION
11/07/24 18:52
OF CbLLI510N
NARRATIVE
Unless otherwise noted, all events took place in the City of Renton, in the County of King, in the State
of Washington.
This incident was captured on my body worn video camera and in-car cameras. This report is a
summary of events that occurred and is not an exact sequencing of events.
On 11/7/2024, at approximately 1857 hours I was dispatched to a report of a hit and run at Banner
Bank located at 54 Rainier Ave S. Dispatch advised that the reporting party stated no damage to the
suspect vehicle but her vehicle does have damage. Dispatch then advised the reporting party was
waiting in the parking lot of Walgreens off Rainier Ave S.
At approximately 1902 hours I arrived on scene at Walgreens and located Unit 2. 1 did not see any
noticeable damage to the vehicle. I contacted the driver of Unit 2. 1 asked if she had any injuries and
she stated she had some minor back pain. Renton Fire responded to do a medical evaluation due to
the complaints of back pain and her pregnancy. Renton Fire cleared her but recommended she get
checked out by her doctor for her pregnancy. She provided me with her driver's license, registration
and proof of insurance. The driver of Unit 2 was identified as Mykee S. Tubera DOB 10/20/2003 via
WADL.
The driver of Unit 2 relayed the following information. She was eastbound on Airport Way in lane 4 of
4 (the inside turn lane). She was stopped at the red light of Rainier Ave S waiting to turn southbound
on Rainier Ave S. Unit 1 was directly behind her. She felt Unit 1 bump into the rear bumper of her
vehicle with the front bumper of Vehicle 1. She got out of the car and she stated there was damage to
the rear bumber of her car. She approached the driver of Unit 1 and informed him that he hit her car.
The driver of Unit 1 denied hitting her vehicle and then drove off heading southbound on Rainier Ave
S. She took a picture of the driver of Unit 1 and his license plate. I ran the license plate of Unit 1 and
pulled up a photo of the registered owner. However, it was a female identified as Joy A. Andrews
DOB 02/08/1942. This was not the driver that she spoke with.
I provided the driver of Unit 2 with a case number. I also provided her with an axon link so she can
upload the photo she took of the driver of Unit 1.
If the suspect can be identified there is probable cause for Hit and Run Attended with Injury.
I certify (declare) under penalty of perjury under the laws of the State of Washington that the
foregoing is true and correct.
Electronically signed by Officer J. Kearse #12994 11/07/2024 Hours Renton, King County,
Washington
PAGE 3 OF 4
REPORT NO.! EF63210 CASE# ' 24-11578 DATE AND TIME 11/07/24 18:52
OF COLLISION
�F.
t.
u' 9
� I
r� �h dve
� 1:1rL r4 s�
1t
z'
Y;.
YY
Y �h.
PAGE 4 OF 4