HomeMy WebLinkAbout23-2001 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 5 27c
COLLISION REP FIT 1591971
CASE 23-2001 z
INTERSTATE ❑ CITY STREET FIRE ❑RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHIr.I F ❑ LOCAL AOENC 4Y00 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 3 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#
COLLISION.. 02 - 19 - 2023 1941 17 . N E IN� S 8 W H OF e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
DUVALL AVE NE BLOCK NO. e✓ 2400 ❑
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5 .❑ FEET e S ❑ W e NE 24TH ST
❑ �
0 4 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
,/No D:3252390244 0 11
30
6� LAST NAME FISHCHUK FIRSTNAME ANATOLIY MIDDLE 1 1 1 2 31
INITIAL
STREET ❑ 15423 168TH AVE SE CITY RENTON ST WA ZIP 98272 z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
INTERLOCK YES[:]NO 1/ INTERLOCKYEs NO�/ YES R No�/
8❑ LDRIVER # STATE WA SEX'M MM D Y' 05 1- 25 - 1962 2 32
9 ON DUTY❑ STATUS AIRBAG 4 RESTR 4 EJECT 1 H U EET 2 INJURY CLASS 1 NATURE OF INJURIES z❑
3
,OF
P1 ATNES# ALC6415 sTAr WAV N# JTMBD31V865012109
TRAILER STATE TRAILER STATE
11 0 0 PLATE# PLATE# ROM ro
TRLR. TRLR 7 1 33
12 0 0 VIN# VIN#
ROM TO
VEH.YEAR 2006 MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED By GOVT.VEHICLE 1 5 34
13 4 TOYT RAV4 UT DAMAGE YES NO YES[:] NO✓
REGISTERED OWNER INFO OWNEDBYDRIVER VEHICLE NO. 1
❑
SHADE IN DAMAGED AREA ❑ 35
14 LIABILITY INSURANCE INSURANCE CO ALL STATE 964 963 690 3 4
IN EFFECT &POLICY# 9TOP
VEHae CHARGE 1 5 36
LEGALLY YES❑NO❑ CITATION# 10 BOTTOM
15❑ STANDING
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT VEHICLE ❑ CYCLE ❑ ❑ : OWNER ❑ YES 1/ NO D:4255163107
16 2
LAST NAME CRNICH FIRST NAME MICHAEL MIDDLE J
INITIAL
17❑ STREET NEW ADDREs7 4503 NE 23RD ST CITY RENTON ST WA ZIP 98059 4❑ 37
18� CDL IGNITION REQUIRED IGNITION PR-E-1SENT MEDICAL TRANSPORTED 38
INTERLOCK YEs❑NO INTERLOCK yEs It I NOF YES
t l NOF,/
19 D IVE
❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 H U EET 2 NJAURSY 1 NATURE OF INJURIES ❑ 40
❑ILICENSE 21❑ PLA E# BTD2828 TArE WA VIN# 41
JTHBN30F810006998 1
42
22❑ PLATE# STATE PLATE# STATE
23❑ VIN#. 43
TRLR RLR
'IN#.
GI
VEH YEAR 2001 MAKE LEX$ MODEL LS 400 STYLE $D DAMAGE TOWED NOO✓ BLIN TOWED BY ov HyES NO 1/ 44
24❑ ES
REGISTERED OWNER INFO OWNED BY DRIVER VEHICLE N0.2
SHADEDAMAGED AREA
3 4
LIABILITY
INSURANCE INSU&PORGY#E CO ALLSTATE 987194004IN 9TOP 5
VE""LE ❑ ,J CITATION# CHARGE io BOTTOM
LEGALLY YES Nu
25 ' e
7CA
NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
J
26LAN 12007 WA0171300
PART A PAGE 01 OF
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT No. ED35396
COLLISION REPORT III III III III III 111
1591972 CASE# 23-2001
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'
On February 19, 2023, at 1941 hours dispatch requested that I respond to a collision that occurred at
Duvall Ave NE and NE 24th St. One of the involved parties, reported a blocking collision on Duvall
Ave NE.
Upon my arrival I spoke with the driver of unit 1, a 2006 Toyota Rav4 bearing Washington plates
ALC6415. The driver, identified by his WADL as Anatoly J. Fishchuk, explained he was facing
eastbound on NE 24th St. He was stopped at a stop sign, he looked both ways, did not see anyone
driving on either direction, so he proceeded forward. As he crossed through the number 1
southbound lane to Duvall Ave NE, he was struck by unit 2 who was going southbound. Anatoly
mentioned he was sure no one was driving on Duvall Ave NE but assumed unit 2 was driving at a
high rate of speed.
I then spoke with the owner of unit 2, a 2001 Lexus LS bearing Washington plates BTD2828. The
driver, Michael J. Crnich, said he was driving southbound on Duvall Ave NE. As he approached NE
24th St, unit 1 randomly pulled in the roadway, causing the collision.
Both drivers refused any medical attention and both vehicles were inoperable, so they were removed
from the scene by Gene Myers Towing.
I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT.
C.CATALAN 02-19-23 08:58 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
P.SUMMERS 888 1 2/19/2023 10:23:10 PM
BADGE OR ID# ! 12007 OR]# WA0171300 TIME POLICE DISPATCHED` 7:43 PM TIME POLICE ARRIVED;7:48 PM
PART I PAGE IT]OF 3�
REPORT NO. ED35396 CASE# ' 23-2001 DATE AND TIME 02/19/23 19:41
OF COLLISION
Duvall Ave NE
N``
NE 24th St
i
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