HomeMy WebLinkAbout23-2281 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 0 27c
COLLISION REP FIT 1591971
CASE 23-2281 z
INTERSTATE ❑ CITY STREET FIRE ❑RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHICI F ❑ LOCAL AOENC 4Y00 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 1 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#
cowsloN 02 - 1-- 2023 1137 17 ❑-= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
NE 3RD STREET BLOCK NO. e✓ 300 ❑
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ ❑ FEET e S ❑ VV a SUNSET BLVD N
0 3 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
�/No D:4259613201 0 3 30
6� LAST NAME MANNING FIRSTNAME AVA MIDDLE J 1 1 2 31
INITIAL
STREET ❑ 20210 SE 127 ST CITY ISSAQUAH ST WA ZIP 98027 z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
INTERLOCK YES[:]NO 1/ INTERLOCKYEs NO�/ YES R No�/
8❑ LRIIVER #
ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 H USE 2 1 CLASS NATURE OF INJURIES z❑
3
10[3 PI ATE 14 CDt 8177 STATE WA u N#' 2T1 FF28PX2C597253
11[-j- TRAILER STATE TRAILER STATE
11 3 5 PLATE# PLATE# IR.. ro
TRLR. TRLR. 3 1 33
12 3 5 VIN#j VIN#
FROM TO
VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE 3 1 34
13 3 2002 TOYT CAMRY P2 DAMAGE YES NO YES[:] No✓
REGISTERED OWNER INFO OWNEDBYDRIVER VEHICLE NO. 1
SHADE IN DAMAGED AREA ❑ 35
14 LIABILITY INSURANCE INSURANCE CO ALLSTATE 820-227.910 7/3/2023 4
LI EFFECT I SUR N# TOPVEHICLE CHARGE 36
LEGALLY YES❑NO❑ CITATION# <1�3
OTTOM
15❑ STANDING 7 6
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES 1/ NO D:2064505528
16 a
LAST NAME KING FIRST NAME BROOKS MIDDLE JE
INITIAL
17 STREET❑ NEW ADDREss❑' 2617 NE 4TH ST#113 CITY RENTON ST WA ZIP 98056 37
18❑ CDL IGNITION REQUIRED IGNITION PR-E-1SENT MEDICAL-T�RANSPORTED � 38
INTERLOCK YEs❑NO� INTERLOCK YEs It I NOF YES
t l NOF,/
19 DRIVER #
❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 H U EET 2 NJAURSY 1 NATURE OF INJURIES ❑ 40
❑21❑ PLATE# CFJ6391 TATE 41
WA VIN# KM8JUCACXDU576675 1
42
22❑ PLATE# STATE PLATE# STATE
TRLR
23❑ VIN#. IN#. 43
RLR
'
GoI
VEH D
YEAR 2013 MAKE yy�N MODEL TUCSON STYLE 4B AMAGE TOWED NOO✓ BLIN TOWED BY v HYES NO 1/ 44
24❑ fj
REGISTERED OWNER INFO OWNED SY DRIVER VEHICLE N0.2
SHADE IN DAMAGEbAREA
2 3 Cd
LIABILITY INSURANCE I PORGY#E CO pROGRESSIVE 962464203 4/13/2023 1 9TOP
IN EFFECT
"'LE ❑ N`LJ
,.I— CITATION# CHARGE
25 i o BOTTOM
LEGALLY YES $ '
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# JAGENCY
26
DES/REE SCOTT 10272 WA0171300
PART A PAGE 01 OF C7
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. ED37227
COLLISION REPORT III III III III III 111
1591972 CASE# 23-2281
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 2/25/23 at approximately 1136 hours I was dispatched to the intersection of N 3rd ST and 300
block of Sunset BLVD N (City of Renton, County of King, and State of Washington) due to a report of
a vehicle collision.
Upon arrival I contacted Driver#1 who stated she was coming down the hill traveling East on N 3rd
ST, following Vehicle #2 and saw that they both were going to take a right hand turn onto N Sunset
BLVD to head North bound.
Driver#1 was looking at traffic on N Sunset Blvd and did not notice that Driver#1 had Yielded at the
sign to also make sure traffic was clear on N. Sunset BLVD. Driver#1 struck Vehicle #2 with Vehicle
#1. Vehicle #1 sustained damage to its front passenger light, bumper and hood.
I spoke to Driver#2 who was yielding at the intersection of N. 3rd ST and Sunset BLVD N waiting for
traffic to clear when Vehicle #2 was struck him from behind. Vehicle #2 sustained damage to its rear
bumper and hatchback.
No injuries were reported. Pictures taken and attached to the case file.
I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT.
DESIRES SCOTT 02-25-23 12:37 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY E
DAT
DESIRES SCOTT 10272 2/25/2023 12:39:44 PM
BADGE OR ID# 10272 ORI# WA0171300 TIME POLICE DISPATCHED', 11:44 AM TIME POLICE ARRIVED 11:49 AM
PART I PAGE IT]OF
REPORT NO. ED37227 CASE# ' 23-2281 DATE AND TIME 02/25/23 11:37
OF COLLISION
f
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