HomeMy WebLinkAbout25-1164 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 1 27c
COLLISION REP FIT 1591971
CASE 25-1164 z
INTERSTATE ❑ CITY STREET FIRE ❑
RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHICI F ❑ LOCAL AGENCI 4250 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2❑ TOTAL#OF OBJECT ❑2$
TRIBAL UNITS 02 STRUCK' FENCE
RESERVATION
z
3❑ DATE OF M M D D Y Y Y Y TIME(2400) COUNTY# MILES N E IN CITY#
CowsloN 02 - 05 - 2025 0355 17 ❑-= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
BLOCK NO. e✓ --- ----� ❑
MAIN AVE S MILEPOST
4a❑
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ ❑ FEET e S ❑ W e S 2ND ST
0 3 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
,/No D:2538804597 30
6� LAST NAME SCRIPTURE FIRSTNAME STEVEN MIDDLE C 1 1 2 31
INITIAL
STREET ❑ 4125 NE 7TH ST CITY RENTON ST WA 21p 98059 z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
INTERLOCK YES[:]NO INTERLOCKYEs NO YEs NO
8❑ LRIIVER #
ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 HELMET USE 9 CLASS 1 NATURE OF INJURIES 2❑
3
10❑ P1 aT�S� BZY6630 sTArI WAvrN# 1 N4At 2AP4CN574925
TRAILER STATE TRAILER STATE
11 2 5 PLATE# PLATE# FROM TO
TRLR. RLR 1 7 33
12❑ VIN#j VIN#
2012 NISS ALTIMA OIIF nIG FROM 34
VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED ILJ TO TOWED BY GOVT.VEHICLE
13 DAMAGE YES NO YES[:] NO✓
REGISTERED OWNER INFO STEVEN SCRIPTURE 4125 NE 7TH ST RENTON WA 98059 D:2538804597 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
14❑ LIABILI INSURANCE INSURANCE CO FARMERS 0653236840 3 4
IN EFFECT &POLICY# 9TOP
VE—LE CHARGE 5 36
LEGALLY
res❑NO❑ CITATION# 10 BOTTOM
15❑ TANDING 6
MOTOR PROPERTY ✓ DAM THR OLD MET PHONE
UNIT PEDAL- PEDESTRIAN VEHICLE ❑ CYCLE ❑ ❑ OWNER YES NO ,/ D:4254307400
16❑
LAST NAME RENTON FIRST NAME CITY OF MIDDLE
INITIAL
17❑ NEW STREETRESS 1:1 3555 NE 2ND ST CITY RENTON ST WA ZIP 98058 37
18❑ CDL IGNITION REQUIRED IGNITION PR—E-1SENT MEDICAL—T�RANSPORTED ❑ 38
INTERLOCKYES�NOR INTERLOCK YEs It I NOF YES t l NO❑
19 LLIICENS # STATE SEX U MMDDYY —❑_ 39
HELMET INJURY NATURE OF INJURIES 40
20❑ ON DUTY STATUS' AIRBAG RESTR EJECT USE CLASS ❑
❑21❑ LICENSE TArE vIN# 41
4
PLATE#
42
22❑ PR TRAILER LATE# STATE PLATE# STATE
23❑ 43
TRLR RLR
VIN#. IN#.
VEH YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN
TOWED BY Gov HI 44
24❑ DAMAGE YES NO YES NO
REGISTERED OWNER INFO VEHICLE NO.2
SHADE IN DAMAGED AREA
2 3 4
LIABILITY
INSURANCE❑ INSURANCE
#E CO
IN EFFECT &PO I 9TOP 5
vE""LE ❑ ,J� CITATION# CHARGE i o BOTTOM
LEGALLY YES N J
25 s e
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
26
M.LEVERTON 2517 WA0171300
PAGE 01 OF
PART A
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EF64628
COLLISION REPORT III III III III III 111
1591972 CASE# 25-1164
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 02-05-25 02:24 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY E
DAT
C.JACOBS 1953 2/11/2025 10:53:04 AM
BADGE OR ID# 2517 OR]#' WA0171300 TIME POLICE DISPATCHED', 4:00 AM TIME POLICE ARRIVED',1:30 PM
PART I PAGE IT]OF 4�
REPORT NO. EF64628 CASE# 25-1164 OF COLLISION
02/05/25 03:55
OF CbLLI510N
NARRATIVE
RTF
Within the city limits of Renton/King/Wa I was dispatched to a phone follow up reference a hit and run
crash from today at about 0355 hours RP250006422.
At about 0400 hours officers responded to a tire marks in the snow into a small shrubbery/fence with
vehicle debris and no car. Noted it was minor/unremarkable damage and cleared with an ocean.
The R/O of that car called 911 today to report he was the driver and provided the following
information. He regrets leaving for work so early in the morning in snowy and icy conditions but does
not have a choice as he is the sole provider for his family working two jobs. He told me even though
he was only going about 15-20 mph turning right from Main ave S to S 2nd St his vehicle started to
slide. He told me he panicked and rather than steering he locked up his brakes and slid off the
roadway. Unit 1 said that his work is very strict about call outs or being sick or any other excuse and
he was worried about being late to work so he left. He told me when he finished his work hours is
when he called 911 to make his report, while on his way to his second job.
He told me he was very sorry and left because he was worried about being discipline or terminated
from his morning job. He told me at 0355 hours there was no one person in the area he thought he
could contact about the damage on scene. Why he called 911 later.
He did not complain of injury and damages to his vehicle 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 2/5/2024
PAGE 3 OF 4
REPORT NO. EF64628 CASE# 25-1164 DATE AND TIME 02/05/25 03:55
OF COLLISION
4
t\S
4
i
i
v b
t�
t r
S 3 s
t
s 3tt f s
4
i
zV
i`
F
PAGE 4 OF 4