HomeMy WebLinkAbout23-1828 ITFF' "POLCERA II I !�� I III I III I IIII III II I . B 27c
COLLISION REP FIT 1591971
INTERSTATE ❑ CITY STREET FIRE ❑
CASE 23-1828 2
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 N E IN CITY#
cawsloN 02 - 1-- 2023 0922 17 ❑-= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
BLOCK NO.
NE SUNSET BLVD e✓ --- ----� ❑
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ ❑ FEET e S ❑ VV a UNION AVE NE
0 1 29
MOTUNIT U1 VEHIOR Z PEDAL-CLE CYCLE ElYESA,G/E NHORESHOLD MET PHONE 0 4 30
6� LAST NAME LOCKE FIRSTNAME EDWARD MIDDLE D 1 1 2 31
INITIAL
STREET ❑ 3517 S DEDHAM ST CITY SEATTLE ST WA 2jp, 981185236 z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
:NTERLOCKYEs NO INTERLOCK YES NO YES No
8❑ DRIVERS
LICENSE# STATE WA SEX'M I ELMIDIAY' 09 - 25 - 1994 1 2 32
9 ON DUTY❑ STATUS' AIRBAG 3 RESTR 4 EJECT 1 H U EETI [NATURE OF
CLASS 7 L THUMB INJURIES z❑
3
10❑ P1 aT�S� 8LZM841 sTATI CA vrN# SALCK2FX7LH835146
TRAILER STATE TRAILER STATE
11 3 5 PLATE# PLATE# FROM TO
TRLR. TRLR 3 7 33
12 3 0 VIN#' VIN#
>; FROM TO
❑ VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN T Y GOVT.VEHICLE 1 3 34
13 2 2020 LNDR DISCOV DAMAGE vEs 0NO agW�MEYER ves❑ No
REGISTERED OWNER INFO EAN HOLDING 140W 321ST ST#1500 TULSA OK 74134 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
14 ❑ INSURANCE CO 4
LIABILITY INSURANCEIN EFFECT &POLICY# TOPVE—LE CHARGE <1�3
OTTOM 5 36
LEGALLY YES NO CITATION# 3A0081031,3A0081031, FAIL TO OBEY TRAFFIC CONTROL
15❑ STANDING 7 6
MOTOR PROPERTY DAM�/ THR OLD MET PHONE
PEDAL- PEDESTRIAN
UNIT a2 VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES NO D:2064825360
16 a
LAST NAME LE FIRST NAME AYDIN MIDDLE M
INITIAL
17❑ STREET ❑', 3706 NE 19TH ST CITY' RENTON ST WA ZIP 980563363 37
NEW ADDRESS ❑
18� CDL IGNITION REQUIRED IGNITION PtR-E-S1ENT MEDICAL-T�RANSPORTED ❑ 38
INTERLOCKYES�NOR INTERLOCK YEs I I NOF YEs t l NO❑
19 DRIVER'S STATE WA SEX M D.Q.B. 03 �_ 03 _ 2006 39
LICENSE# MMDDYY
HELMET INJURY1 NATURE OF INJURIES 40
20❑ ON DUTY STATUS AIRBAG 6 RESTR 4 EJECT 1 USE CLASS ❑
21❑ LICENSE ANA2805 rare.WA VIN# 2HNYD18986H534796
❑ 41
PLATE#
42
22❑ PIR- I TRAILER LATE# STATE PLATE# STATE
23❑ UIN#. 43
TRLR RLR
'IN#.
VEH YEAR 2006 MAKE ACUR MODEL MDX STYLE VEHICLE TOWED TO BLIN TOWEDBv GOV HI 44
24❑ DAMAGE YES NO GENE MEYER YES NO
REGISTERED OWNER INFO 11.1 LE 3706 NE 1911 ST REN1O1WA.1716 VEHICLE NO.2
SHADEDAMAGED AREA
3 4
INAEFFITY ECTNSURANCE INSU&POLICY#E CO SAME. 9TOP 5
VE"'LE ❑ N`L J,J� CITATION# CHARGE io BOTTOM
LEGALLY YES
25 e
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. ED35811
COLLISION REPORT III III III III III 111
1591972 CASE# 23-1828
ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY)
NAME(LAST FIRST,MIDDLE INITIAL) YEE GREG
ADDRESS&PHONE# D O.B.
9164793544 SEX' U MMDDYYYY -❑
PASSENGER [:]WITNESS❑✓ POS. USE ICLASS
J UNIT# SEAT AIRBAG RESTR. EJECT ' HELMETCLAINJURY RYSS NATURE OF INJURIES
NAME
(LAST,FIRST,MIDDLE INITIAL)
ADDRESS&PHONE# DOB
SEX' MMDDYYYY
PASSENGER ❑WITNESS❑ UNIT# SEAT I AIRBAG RESTR. EJECT HELMET INJURY NATURE OF INJURIES
POS. USE CLASS
NAME
(LAST FIR57 MIDDLE INITIAL)
AppRESS&PHONE#
SEX D.O.B.MMDD -❑
YYYY.
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 02-14-23 11:03 AM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
CO.JOHNSON 0505 212112023 8:39:20 AM
BADGE OR ID# 2517 ORI# WA0171300 TIME POLICE DISPATCHED; 9:22 AM TIME POLICE ARRIVED]9:31 AM
PART I PAGE IT]OF 4�
REPORT NO. ED35811 CASE# 23-1828 OF COLLISION
02/14/23 09:22
OF CbLLI510N
NARRATIVE
blk suv rn red lane 1 slv suv making left
CC
Within the city limits of Renton/King/WA I responded to a 2 car blocking crash at the intersection of
NE Sunset Blvd at Union Ave NE.
I contacted the driver of unit 2 who told me he was southbound on Union Ave NE and was going to
make a left turn on his green arrow when he was hit by unit 1. He did not complain of injury and
damages required a tow truck. He was checked and released on scene by Renton Fire.
I contacted the driver of unt 1 ID'd by his picture WA-ID. He told me he dropped a water bottle on the
floor and while reaching for it ran a red light causing the crash. A WACIC/DOL check via MDC
revealed he was not licensed, but eligible. He did complain of injury/left thumb. He was checked and
released on scene by Renton Fire. Damages required a tow truck. Unit 1 did not provide a
registration or proof of insurance for his rental car.
I cited Unit 1/1-ocke ref RCW 46.20.015 NVOL 2nd with ID, Ref RCW 46.30.020 No Insurance and
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
PAGE 3 OF 4
REPORT NO. ED35811 CASE# 23-1828 DATE AND TIME 02/14/23 09:22
OF COLLISION
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