HomeMy WebLinkAbout23-1667 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 6 27c
COLLISION REP FIT 1591971
CASE 23-1667 z
INTERSTATE ❑ CITY STREET FIRE ❑RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHICI F ❑ LOCAL AOENC 4900 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 CITY#
cowsloN 02 - 09 - 2023 1033 17 . N E IN� S 8 W H OF e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
SW SUNSET BL BLOCK NO. e✓ ❑
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ ❑ FEET e S ❑ W e STEVENS AVE SW
0 1 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
✓NO D:2064992265 0 11
30
6� LAST NAME YOUNG FIRSTNAME JOHN MIDDLE G 1 1 2 31
INITIAL
STREET ❑ 18020 125TH AVE SIN CITY VASHON ST WA ZIP 980704706 z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
iNTERLOCKYEs 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
LICENSE C29062Y sTArI WAvIN# 2GCEK133181139856
10❑ PI ATE 14
TRAILER STATE TRAILER STATE
11 2 5 PLATE# PLATE# FROM TO
TRLR. TRLR 5 1 33
12 3 5 VIN# VIN#
FROM TO
❑ VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN T GOVT.VEHICLE 3 ] 34
13 2 2008 CHEV SILVER DAMAGE vE5 0NO f �LAWkkRS vEs❑ No✓
REGISTERED OWNER INFO J.YOUNG PO BOX 1.9 VASHON WA 98070 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
14 LIABILITY INSURANCE NPOLIC # CO SAME.
IN EFFECT &POLICV# � 9TOP
vEwcLE CHARGE 36
EGALLY res No CITATION# 3AO081033 FAIL TO OBEY TRAFFIC CONTROL o sorrom
15❑ STAIN.D'ING 8 7 6
UNIT a2 VEHICMOTOLE CYCLE ❑ PEDESTRIAN ❑ OWNER YES
❑ DYES✓ NO OLD MET PHONE
16 a
LAST NAME JUAREZ DOROTEO FIRST NAME ULISES MIDDLE I N
INITIAL
17❑ STREET ❑', 6919 S 120TH PL CITY' SEATTLE ST WA ZIP 981784138 37
NEW ADDRESS ❑
18� CDL IGNITION REQUIRED IGNITION PtR-E-S1ENT MEDICAL TRANSPORTED ❑ 38
INTERLOCKYES�NOR INTERLOCK YEs I I NOF YEs t l NO❑
19 LICENSE# STATE WA SEX M MMDDW 11 05 _ 1988 39
20❑ ON DUTY STATUS AIRBAG,6 RESTR 4 EJECT 1 HELMET INJURY 7 NATURE of INJURIES ❑ 40
USE CLASS CHEST
21❑ LICENSE I C73143V TArE WA vIN1t 5TFAY5F19MX978505
❑ 41
PLATE#
42
22❑ PILER LATE# STATE pLATE# STATE
23❑ VIN#. 43
TRLR RLR
'IN#.
VEH YEAR 2021 MAKE TOYT MODEL TUNDRA STYLE VEHICLE TOWED TO BLIN TOWEDBY GOV HI 44
24❑ DAMAGE YES✓ NO BANKERS YES NO✓
REGISTERED OWNER INFO ULISES JUAREZ DOROTEO 10731 SE 304TH WAY AUBURN WA 98092 D:2062342824 VEHICLE NO.2
SHADE DAGED AREA
4
INAEFFIECTTY NSURANCE❑ &POINSULICY#E CO 9TOP 5
'E""LE ❑ ,J� CITATION# CHARGE io BOTTOM
LEGALLY YES N`L J
25 ' e
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID#
26
M.LEVERTON 2517 [V7�ENCY
A0171300
PAGE 01 OF
PART A
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT No. ED34979
COLLISION REPORT III III III III III 111
1591972 CASE# 23-1667
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'
grn unit 1 nb ran red blk unit 2 lane 1 wb
CC
Within the city limits of Renton/King/WA I responded to a 2 vehicle blocking crash at the intersection
of SW Sunset Blvd and Steven Ave SW.
I contacted the driver of unit 2 who told me he was west on SW Sunset Blvd on his green light when
unit 1 ran the red and crashed into him. He was treated and released on scene by Renton Fire.
Damages required a tow truck.
I contacted the driver of unit 1 ID'd by his picture WADL. He told me he was north on Steven and ran
the red light causing the crash. He did not complain of injury. However, the impact was enough that
it broke both rear wheels off the axles and required a tow truck.
I cited unit 1 Ref RCW 46.61.055 FTCWTCD-Red light 2 car 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 2/14/2023
I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT.
M.LEVERTON 02-14-23 11:03 AM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
CO.JOHNSON 0505 2/17/2023 4:33:01 PM
BADGE OR ID# 2517 ORI# WA0171300 TIME POLICE DISPATCHED; 10:33 AM TIME POLICE ARRIVED 10:38 AM
PART I PAGE IT]OF
REPORT NO. ED34979 CASE# ' 23-1667 DATE AND TIME 02/09/23 10:33
OF COLLISION
nt :
s
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