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HomeMy WebLinkAbout25-2312 IT si " II IIIII III IIIII II IIII IIIII I . 27c REPORT NO EF75389OLCERA COLLISION REPORT 1591971 CASE# 25-2312 2 INTERSTATE CITY STREET El STATE ROUTE OTHER LOCAI-A`NG 4250 3 C©DINGCOUNTY RD PRIVATE WAY 2 TOTAL#OF OBJECT 1 1 8 28 TRIBAL UNITS 02 STRUCK RESERVATION : 2 3� M M D D Y Y Y Y TIME(2400) COUNTY# MILES CITY# DATE OF N E IN eDLLISION' 03 - 14 - 2025 1015 17 =.= S 8 W E OF M 1070 a 4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION �✓ WILLIAMS AVE S BLOCK NO. e 227 .� 4a❑ MILE POST ❑ DISTANCE OF(REFERENCE OR CROSS STREET) 5 MILES 1.1 FEET B S B W e 0 1 29 MOTOR ✓ PEDAL- F DAM AG THRESHOLD MET PHONE UNIT 01 VEHICLE CYCLE YES NO 1 4 30 6 LAST NAME UNKNOWN FIRST NAME MIDDLE t 1 2 31 INITIAL STREET F� CITY', ST ZIP 2 NEW ADDRESS 7 CDL IGN(TIUN REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3 INTERLOCKYEs No INTERLOCKY NO YES NO 8❑ LCEENSE# SRVERSTTATE SEX U MMDDYY' -�- 32 9 ON DUTY STATUS' AIRBAG 9 RESTR 9 EJECT 1 HELM USEET 9 CLASSY 0 NATURE OF INJURIES 2 LICENSE, C280116 STATE WA VIN# 1FT8W 3 10 F1 PI ATP tt 11[-i--] TRAILER STATE TRAILER STATE 11 2 5 PLATE# PLATE# 11ROM To TRLR TRLR 1 1 5 33 12 0 0 VIN#' VIN# FROM TO VEH.YEAR 2014 MAKE FORD MODEL F350 STYLE VEHICLE TOWED[n TO ZBUN TOWED By GOVT VEHICLE m 34 13 DAMAGE YES II_II NO YESII_I) NO REGISTERED OWNER INFO JACK CLEVENGER 16136 SE 156TH ST RENTON WA 98058 VEHICLE NO. 1 SHADE IN DAMAGED AREA 35 3 4 14 ABILITY INSURANCE❑ INSURANCE CO IN EFFECT &POLICY# 11 9TOP VEn" CHARGE 10 BOTTOM 36 Lec , YES[:]NO[:] CITATION# 5 15❑ STM ING B 7 e UNIT 02 MOTOR PEDAL- ❑ PEDESTRIAN PROPERTY DAM THR OLD MET PHONE VEHICLE CYCLE nWNRR YES NO �/ 16❑ LAST NAME UNKNOWN FIRST NAME MIDDLE' INITIAL 17❑ STREET F-1 CITY, RENTON ST ZIP 37 NEW ADDRESS 18❑ IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED'. 38 CDL INTERLOCKYES NO INTERLOCK YES NO YES NO 19[ DRIVER'S # STATE SEX U M.00B. —� � 39 HELMET INJURY: NATURE OF INJURIES 4Q 20❑ ON DUTY❑� STATUS AIRBAG g RESTR g EJECT 1 USE 9 CLASS 0 ❑ 21 LICENSEC9591C TATE GOV VIN# 1FDUF4HT9KEF73275 41 22❑ [TILER TAILER PLATE# STATE PLATE# STATE 42 23 TRLR RLR 43 UIN#. 'IN# VEH.YEAR 2019 JAKE FORD MODEL F450 STYLE VEHICLE TOWED TO BLIN TOWED BY GOV HI 44 24 DAMAGE YES NO VES NO REGISTERED OWNER INFO RENTON REGIONAL FIRE AUTHORIT 18002108TH AVE SE RENTONWA98055 D:4252769500 VEHICLE NO.2 SHADE IN DAMAGED AREA 2 3 4 LIABILITY INSURANCE INSURANCE CO SELF TBA IN EFFECT &POLICY# t STOP 1-1— ❑ ,.I—I CITATION# CHARGE to BOTTOM EEGnEEY YES N 25e 7'0FFLIC"ER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY 26 VERTON 2517 WA0171300 PAGE 01 OF PART A 3000-345-189(R 11/18) STATE OF POLICETRAFFICN CORRECTION REPORT NO. EF75389 COLLISION REPORT III III III III III 111 1591972 CASE# 25-2312 ADDITIONAL PERSONS INVOLVED(PASSENGERS AND/OR WITNESSES ONLY) NAME MILLER CHRIS (LAST,FIRST,MIDDLE INITIAL) ADDRESS&PHONE# 2067580035 SEXi M MpDDYBVYY PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET INJURY NATURE OF INJURIES POS. : USE CLASS 1 ----� :NAME (LAST FIRST MIDDLE INITIAL) ADDRESS&PHONE# SEX MMDDYYYY D.D.B. — PASSENGER❑WITNESS UNIT# : SEAT AIRBAG RESTR. EJECT HELMET INJURY: NATURE CFINJURIES POS. USE CLASS ----� :NAME (LOST,FIRST,MIDDLE INITIAL) ADDRESS&PHONE# SEX MMDDYY D.D.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 03-19-25 07:56 AM INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST.DET DATED PLACE SIGNED APPROVED BY DATE M.LEVERTON 2517 312012025 7:00:26 AM BADGE OR ID# ; 2517 ORI# WA0171300 TIME POLICE DISPATCHED 10:32 AM TIME POLICE ARRIVED i 11:02 AM PAST B 3 Do-3mx—attar(t 1Mff) PAGE 2�OF 4 REPORT NO. EF75389 CASE# 25-2312 OF DATE AND r�N + 03/14/25 10:15 O�COLLISION NARRATIVE parker dry mirror strike unit 1 fled wit plate and observe Within the city limits of Renton/King/Wa I responded to a 2 vehicle hit and run. I contacted the Renton Fire Authority staff at Fire Station 11. I was told that Aid 11 was parking on Williams Ave S facing south, just north of S 3rd St. The ambulance was parked lawfully and unattended when it was stuck by a truck. The damage caused was the driver side rear view mirror glass was broken out. It didnt appear to be any additional damage. The driver of unit 1 fled the scene without stopping A witness provided a license plate and described the truck, but could not ID the driver. A records check of the plate provided by teh witness did come back to a similar truck. I called the RO several times with no answer. I tried calling this number a good portion of the day and eventually the number was just a busy signal. I'm guessing they left the phone off the hook and didnt want to talk to me. Without being able to ID the driver and minor damages this will be for insurance/information 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 3/19/2025 PAGE 3 OF 4 REPORT NO. EF75389 CASE# 25-2312 DATE AND TIME 03/14/2510:15 OF COLLISION> ' 40 NA t u d e � z .g011ll, ix,ft a W, +tt J XI IM a PAGE 4 OF 4