HomeMy WebLinkAbout23-1578 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 2 27c
COLLISION REP FIT 1591971
CASE 23-1578 z
INTERSTATE ❑ CITY STREET FIRE ❑RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHICI F ❑ LOCAL AOENC 4200 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 2 TOTAL#OF OBJECT 1 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# ❑
COLLISION.. 02 - 1-- 2023 1411 17 ❑.= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓
BLOCK
EASTVALLEYRD ST e✓
MILEPOST 4200
4a❑
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ 400 00 FEET MILES e S B W e SW 43RD ST
0 5 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
,/No D:2534992536 0 11
30
6� LAST NAME GLADDEN FIRSTNAME LACEY MIDDLE L 1 1 2 31
INITIAL
STREET ❑ 308 SUMMIT AVE N APT 4 CITY KENT ST WA Zjp, 980304777 z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
INTERLOCK YES[:]NO INTERLOCKYEs NO YES R NO
8❑ LRIIVER #
ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 H U SE
ICNLJAUSSY 1 NATURE OF INJURIES z❑
3
10 9❑ P1 aT�S� BZL4099 sTArI WAurN# 1N4AA6AP2GC444799
TRAILER STATE TRAILER STATE
11 3 5 PLATE# PLATE# FROM TO
TRLR. TRLR. 5 5 33
12 3 5 VIN#' VIN#
>; FROM TO
VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE 5 1 34
13 2 ZO16 NISS MAXIMA DAMAGE YES NO ✓ YES[:] No
✓
REGISTERED OWNER INFO LACEY GLADDEN 308 SUMMIT AVE N APT 4 KENTWA980304777 D:2534992536 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
14 ❑ INSURANCE CO 3 4
LIABILITY INSURANCE
IN EFFECT &POLICY# 9TOP 5
❑ LEGALLY CHARGE 10BOTTOM 36
15 2 srA1No'NG re5 No clTAnoN# 3A0081029,3A0081029, FL RENEW EXPIRED REG>2 MTHS, e
UNIT a2 VE ICCLE CYCLEMOTO PEDAL- ❑ PEDESTRIAN ❑ OWNERRTY ❑ DYES✓ NO OLD MET PHONE
16 a
LAST NAME HARMON FIRST NAME STEVEN MIDDLE L
INITIAL
17❑ STREET ❑', 605 S G ST CITY' TACOMA ST WA ZIP 984050000 37
NEW ADDRESS ❑
18� CDL IGNITION REQUIRED IGNITION PR-E-1SENT MEDICAL TRANSPORTED 38
INTERLOCKYES�NOR INTERLOCK YEs It I NOF YES
t t- l No❑
19 LDIIVER # STATE WA SEX M M .C.B. 05 _ 12 _ 1960 39
HELMET I INJURY1 NATURE OF INJURIES 40
20❑ ON DUTY STATUS AIRBAG 2 RESTR 12 EJECT 1 USE CLASS ❑
21❑ LICENSE BON5837 TAre WA IN# 4T1BD1FK2FU166660
❑ 41
PLATE#
42
22❑ PILER LATE# STATE PLATE# STATE
23❑ VIN#. 43
TRLR RLR
'IN#.
VEH YEAR 2015 MAKE TOYT MODEL CAMRY STYLE VEHICLE TOWED TO BLIN TOWED eY GOV HI 44
24❑ DAMAGE YES✓ NO BANKERS YES NO✓
REGISTERED OWNER INFO STEVEN HARMON 470878TH ST E TACOMA WA 98443 D:2067695606 VEHICLE NO.2
SHADEDAMAGEDAREA
3 4
INAEFFITY ECTNSURANCE INSU&POLICY#E CO SAME. I VEwGLE ❑ ,J� CITATION# CHARGE25 GQ
LEGALLY YES N`L J
s � a
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
J
26
M.LEVERTON 2517 WA0171300
PART A PAGE 01 OF C7
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. ED32152
COLLISION REPORT III III III III III 111
1591972 CASE# 23-1578
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
PM 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 02-07-23 03:38 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
S.MORR/S 2613 2/8/2023 9:21:31 AM
BADGE OR ID# 2517 ORI# WA0171300 TIME POLICE DISPATCHED' 2:32 Pry TIME POLICE ARRIVED',2:52 PM
PART I PAGE IT]OF 4�
REPORT NO. ED32152 CASE# 23-1578 OF COLLISION
02/07/23 14:11
OF CbLLI510N
NARRATIVE
slv sedan/unit 2 nb lane 2 unit 1 wht sedan u turn
CC
Within the city limits of Renton/King/WA I responded to a 2 car crash near the 4200 block of East
Valley Rd.
I contacted the driver of unit 2 who told me he was north on EVR in lane 2 when unit 1 looked like she
was making a U-turn in front of him with out room to avoid contact. He did not complain of injury and
damages did require a tow truck.
I contacted the driver of unit 1 ID'd by her picture WADL. She told me she made a right turn from her
place of work and then was going to make a U-turn to get around some of the heavy traffic. She said
unit 2 must have been in the head on lane because she made her U-turn from the 2WCLTL. She did
not complain of injury and damages did require a tow truck, but unit 1 left it parked in a private
parking lot to make her own tow arraignments later. Unit 1 vehicle license displayed 8-2022. A
WACIC/DOL check revealed they were expired 08-13-2022. Unit 1 was unable to provide valid proof
of insurance.
I cited unit 1 Ref RCW 46.16A.030 Expired Tabs, Ref RCW 46.30.020 No valid proof of insurance
and Ref RCW 46.61.140 improper lane use 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 2/7/2022
PAGE 3 OF 4
REPORT NO. ED32152 CASE# ' 23-1578 DATE AND TIME 02/07/23 14:11
OF COLLISION
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