HomeMy WebLinkAbout25-2084 iiTFiNII IIIII III IIIII II IIII IIIII I . 27c REPORT NO EF71837oc� RA
COLLISION REPORT 1591971
CASE# 25-2084 2
INTERSTATE ❑ CITY STREET FIRE I
RESULTEDSTOLENSTATE ROUTE OTHER VEHICLE LOCAI-AGENCY 4100 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#
eaCL s on' 03 - 06 - 2025 1344 17 =.= S 8 W❑ OF e 1070 s
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
SUNSET BLVD NE BLOCK POST
e
4a MILE POST 600 .�
❑
❑ DISTANCE OF(REFERENCE OR CROSS STREET)
5 F--1 MILES. FEET e S 8 W e ON RAMP NB I-405
OF 4 29
MOTOR ✓ PEDAL- DAM AG THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE ❑ YEs Vl No D:2066790249 0 1 30
6 LAST NAME ROGERS FIRST NAME MARK MIDDLE A 1 1 2 31
INITIAL
STREET ] 13405 RIVIERA BLVD
'NEW ADDRESS CITY I $NONOMISH ST'. WA ZIP: 982909766 2
7 CDL IGNITION REQUIRED IGNITION PRESENT MEDIQAL TRANSPORTED 3
INTERLOCKYEs NO INTERLOCKYEs NC YES NO
8❑ DRIVER # STATE WA SEXI M MMDDYY' O6 - 15 - 1974 1 2 32
9� ONDUTY� STATUS' AIRBAG 1 RESTR 9 EJECT 1 HELMET INJURY'7 NAruREOFINJURIES 2❑
USE CLASS UNK
LICENSE, 20349CV srATe WA yIN#, 1122323814 3
10� PI ATP tt
11 3 0 TRAILER STATE TRAILER STATE
PLATE# PLATE# FROM To
TRLR rRLR 7 1 1 33
12 3 0 VIN#' vIN#
FROM TO
HICLE
13 2 VEH.YEAR 1972 MAKE VOLK MODEL BEETLE STYLE VEHICLE TO YED NO fiS46LIN diW9YMEYER YESE IGOVT ENp 3 7 34
DAMAGE IIII._IIII I_I
REGISTERED OWNER INFO MARK ROGERS 13405 RIVIERA BLVD SNOHOMISH WA 982909766 VEHICLE NO. 1
SHADE IN DAMAGED AREA 35
14 LIABILITY INSURANCE❑ &PO NPC y,E CO TRAVELERS 6102903093 203 1
IN EFFECT LIC 9TOP _
Yes
sE"ALLY ❑NO❑ CITATION# 5A0151314 CHARGE FAIL YIELD LEFT TURN MOTOR s t a oorrob s 36
15❑
UNIT 02 MOTOR PEDAL- ❑ PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
VEHICLE CYCLE CIWNER
16�
LAST NAME ✓ONES FIRST NAME DAVID MIDDLE' W
INITIAL
17 F1 STREET ❑❑ 37 949 ABERDEEN AVE NE APT D112 CITY RENTON ST, WA ZIP 980562878
NEW ADDRESS
1$❑ IGNITION REQUIRED IGNITION PRESENT MEDICALTRANSPORTED' 38
CDL INTERLOCKYES No INTERLOCK YES No Nai
19 DRIVER'S STATE WA SEX M D.DOY 05 - 01 1959 39
LICENSE# MMDDYY —
20❑ ON DUTY STATUS AIRBAG 6 RESTR 4 EJECT 1 HELMET INJURY', 7 NATURE OF INJURIES ❑ 40
USE CLASS UNK
21 LICENSE D54223D rare WA vIN# 4S4BT61C137102829 41
22❑ PLATE# STATE PLAAILER
TE# STATE 42
23 TRLR RLR 43
UIN#. 'IN#
VEH.YEAR 2003 MAKE SUBA MODEL BAIA STYLE VEHICLE TOWED TO BLIN TOWED BY GOV HI 44
24 DAMAGE YES �/ No GENE MEYER
REGISTERED OWNER INFO DAVID JONES 949 ABERDEEN AVE NE APT D112 RENTON WA 98056 19:2066978866 VEHICLE NO.2
SHADFjy DAMAGED AREA
3 4
LIABILITY INSURANCE INSURANCE CO SAME.
IN EFFECT &POLICY# 9TOP
VEHICLE ❑ ,J—I CITATION# CHARGE t080TTOM
L'—LY YES N J
25 e
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
26
M.LEVERTON 2517 WA0171300
❑
PAGE 01 OF
PART A 3000-348-189(R 11/18)
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EF71837
COLLISION REPORT III III III III III 111
1591972 CASE# 25-2084
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 CLASS 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
PC& 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 03-06-25 05:08 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST.DET DATED PLACE SIGNED
APPROVED BY DATE
M.LEVERTON 2517 1 31712025 2:27:24 PM
BADGE OR ID# ; 2517 ORI# WA0171300 TIME POLICE DISPATCHED 1 1:44 pry] TIME POLICE ARRIVED i 1:50 PM
PAST B 3 Do-3mx—attar(t 1Mff) PAGE 2�OF 4
REPORT NO. EF71837 CASE# 25-2084 OF DATE AND r�N + 03/06/25 13:44
O�COLLISION
NARRATIVE
yellow/1 It nb 405 slv straight down hill
CC
Within the city limits of Renton/King/Wa I responded to a 2 vehicle blocking crash at the intersection
of Sunset Blvd NE at the on ramp to NB 1-405.
1 contacted the driver of unit 2 who told me he was headed down the hill, meaning east to west when
unit 1 turned left in front of him with no room to avoid contact. He did complain of injury and was
checked on scene by Renton Fire. He did not disclose his complaint of injury. Damages to his
vehicle required a tow truck.
I contacted the driver of unit 1 ID'd by his picture WADL. He told me he was making a left turn and
believed it was clear. He did complain of injury but did not disclose what they were. He was checked
and released on scene by Renton Fire. Later during the investigation he requested Fire return to the
scene to transport him VMC. His vehicle had significant damage and required a tow truck.
I cited unit 1 Ref RCW 46.61.185 FTYROW Left Turn two vehicle injury crash 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 3/6/2025
PAGE 3 OF 4
REPORT NO. EF71837 CASE# 25-2084 DATE AND TIME 03/06/2513:44
OF COLLISION
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PAGE 4 OF 4