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HomeMy WebLinkAbout25-1220 iiTFi " II IIIII III IIIII II IIII IIIII I . 27c REPORT NO EF66456oc� RA COLLISION REPORT 1591971 INTERSTATE CITY STREET FIRE I CASE# 25-1220 2 RESULTEDSTOLENSTATE ROUTE OTHER VEHICLE LOCALANG 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# eDCLson' 02 - 07 - 2025 0855 17 =.= S 8 W e IN e 1070 s 4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓ NE 4TH ST BLOCK NO. e 3000 .� 4a❑ MILE POST ❑ DISTANCE OF(REFERENCE OR CROSS STREET) 5 175 00 FEET e✓ S 8 W e MONROE AVE NE OF 4 29 MOTOR ✓ PEDAL- DAM AG THRESHOLD MET PHONE UNIT 01 VEHICLE ❑ CYCLE ❑ YEs Vl No D:2066832396 0 1 30 6 LAST NAME RICKS FIRST NAME ELLIS MIDDLE A 1 1 2 31 INITIAL STREET ❑ 2708 CEDAR AVE S CITY; RENTON ST I WA Zlp; 980555078 2 NEW ADDRESS 7 CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3 INTERLOCKYES ND INTERLOCKVEs N© YES NO 8 DCIENSE# STATE WA SEXI M MMDDYY' 07 - 28 - 1973 1 2 32 9 ON DUTY STATUS' AIRBAG 2 RESTR 4 EJECT 1 N USE ET CLASSY 1 [NATURE of INJURIES 2 10 LI ENSE'' BGU7356 STATE WA VIN# JM3TB3BVE0430363 3 TRAILER STATE TRAILER STATE 11 3 5 PLATE# PLATE# ROM To TRLR TRLR 5 1 7 33 12 3 5 VIN# vIN# FROM TO VEH.YEAR 2014 MAKE MAID MODEL CX9 STYLE VEHICLE TOWED TO BLIN TOWED By GOVT VEHICLE 7 $ 34 13� DAMAGE YES II_II NO `/ YESII_] NO REGISTERED OWNER INFO FRANKLIN RICKS 1152611TH PL SW FEDERAL WAY WA 98023 VEHICLE NO. 1 SHADE IN DAMAGED AREA 35 3 14 LIABILITY INSURANCE� INSURANCE CO GE/CO 4203-78-11-35 4 IN EFFECT &POLICY# 4TOP _ srgNOLNG ❑ ❑ 5AO151273 CHARGE FA►L YIELD PRIVATE RD MOTOR a ooTro�m z 36 ves NO CITATION# 15 MOTOR PEDAL- PEDESTRIAN1:1 PROPERTY DAM THR OLD MET PHONE UNIT 02 VEHICLE CYCLE nWNFR YES�/ NO D:4253207505 16� LAST NAME HAXBY FIRST NAME ALESABET MIDDLE' M INITIAL 17 F1 STREET ❑❑ 3613 MILL AVE S CITY RENTON ST, WA ZIP 9 37 80555888 NEW ADDRESS 18❑ IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED: ❑ 38 CDL INTERLOCKYES Na INTERLOCK YES No YEs ND 19 DRIVER'S STATE WA SEX F D.O.g. 07 09 1988 39 LICENSE# MMbt7YY — HELMET INJURY: NATURE OF INJURIES 4Q 20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 USE CLASS 1 ❑ 21 LICENSE CJL2600 rarE WA vIN# 2C4RC1N72LR267662 41 22❑ PLATE# STATE[TILER I PLATE# STATE 42 23 TRLR RLR 43 UIN#. 'IN# VEH.YEAR 2020 MAKE CHRY MODEL pACiF/CA STYLE VEHICLE TOWED TO BLIN TOWED BY GOV HI 44 24� DAMAGE YES NO� VES NO REGISTERED OWNER INFO TRENTONHAXBY3613 MILL AVE S RENTON WA 98055 VEHICLE NO.2 SHADE IN DA GWREA 2 AAA LIABILITY INSURANCE INSURANCE CO ST FARM 402 5256-D16.47A IN EFFECT &POLICY# 9TOP LVEHICLE '—LY YES❑ N.I—I, CITATION# CHARGE to BOTTOM LEGALL 25 a e OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY J 26 M.LEVERTON 2517 WA0171300 PAGE 01 OF PART A 3000-345-189(R 11/18) STATE OF POLICETRAFFICN CORRECTION REPORT NO. EF66456 COLLISION REPORT III III III III III 111 1591972 CASE# 25-1220 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 02-07-25 09:50 AM INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST.DET DATED PLAGE SIGNED APPROVED BY DATE C.JACOBS 1953 2/17/2025 10:35:02 AM BADGE OR ID# ; 2517 ORI# WA0171300 TIME POLICE DISPATCHED 9:10 AM TIME POLICE ARRIVED i 9:10 AM PAST B 3 Do-3mx—attar(t 1Mff) PAGE 2�OF 4 REPORT NO. EF66456 CASE# 25-1220 OF DATE AND r�N + 02/07/25 08:55 O�COLLISION NARRATIVE wht/1 It uhaul across wht/2 2wcltl CC Within the city limits of Renton/King/WA I responded to a 2 vehicle crash at about the 3100 block of NE 4th St. I contacted the driver of unit 2 who told me she was just pulling into the left turn lane eastbound NE 4th St to go north on Monroe Ave NE when unit 1 made a left turn out of Uhaul parking lot into the side of her car. She did not complain of injury and damages did not require a tow truck. I contacted the driver of unit 1 ID'd by picture WADL. He told me he was making a left from Uhaul 3131 NE 4th St. He told me traffic in the eastbound lanes of NE 4th St stopped and left a space for him to pull out but he did not see unit 2 as he pulled across traffic. He told me she was going way too fast. I asked him why did he pull out in front of a car he has identified as going way too fast and he said because he didnt see her. Unit 1 driver did not complain of injury and he did not request a tow truck I cited unit 1 ref RCW 46.61.205 FTYROW from private drive onto the roadway two vehicle collision 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 2/7/2025 PAGE 3 OF 4 REPORT NO. EF66456 CASE# 25-1220 DATE AND TIME 02/07/2508:55 OF COLLISION s sl; r 3 ' r s s �l r PAGE 4 OF 4