HomeMy WebLinkAbout23-1974 a ITFFi "POLCERA II IfI) 1 IlfII ('II (Illf If( fI I . 1 27c
COLLISION REP FIT 1591971
CASE 23-1974 z
INTERSTATE ❑ CITY STREET FIRE ❑RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHIC;I F ❑ LOCAL AOENC 4Y00 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 2 TOTAL#OF OBJECT 1 1 8 28
TRIBAL UNITS OZ RESERVATION STRUCK
z
3❑ DATE of M M D D Y Y Y Y TIME(2400) COUNTY# MILES CITY#
cowsloN 02 - 18 - 2023 1808 17 . N E IN� S 8 W H OF e 1070 3
4❑ oN (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
OAKSDALE AVE SW BLOCK NO. e✓ 4300 ❑
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ e S ❑ W❑ FEET e SW 43RD ST
0 4 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
,/No D:2068515318 0 11
30
6❑ LAST NAME OLSEN FIRSTNAME MICHAEL MIDDLE J 1 2 31
INITIAL
STREET ❑ 28126 46TH AVE S CITY AUBURN ST WA 2jp, 98001 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 MID
-O B 05 1- 09 - 2003 2 32
9 ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 HELMETU E 2 CLASS 1 NATURE OF INJURIES z❑
3
LICENSE CDM0908 sTArI WAurN# 1J4GZ78Y9RC343189
10❑ PI ATE 14
TRAILER STATE TRAILER STATE
11 0 0 PLATE# PLATE# FROM TO
TRLR. TRLR 7 1 33
12 0 0 VIN#' VIN#
>; FROM TO
VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE 3 ] 34
13 4 1994 JEEP GRAND PK DAMAGE YES NO YES[:] NO✓
❑
REGISTERED OWNER INFO OWNEDBYDRIVER VEHICLE NO. 1
SHADE IN DAMAGED AREA ❑ 35
14 LIABILI INSURANCE INSURANCE CO GEICO 6063521600 3
IN EFFECT &POLICY# 9TOP
VIC CHARGE 1 5 36
LECAIIEHLEv YES❑NO❑ CITATION# 10 BOTTOM
15❑ STANDING 8 7 6
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT 02 VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES 1/ No D:6464742265
16 a
LAST NAME DEMBA FIRST NAME FATY MIDDLE
INITIAL
17 NEW STREETREs7' 2018 179TH STREET CT E CITY SPANAWAY ST WA ZIP 98387 4❑ 37
18� CDL IGNITION REQUIRED IGNITION PR-E-1SENT MEDICAL TRANSPORTED 38
INTERLOCKYES�NO� INTERLOCK yEs It I NOF YES
t l NOF,/
19 DRIVER'S STATE WA SEX M D.Q.B. 09 _ 12 _ 1985 39
LICENSE# MMDDYY
20❑ ON DUTY STATUS AIRBAG 6 RESTR 4 EJECT 1 HE 2 INJURY 6 NATURE OF INJURIES ❑ 40
USE CLASS CUT ON RIGHT THUMB
LICENSE I ❑21❑ PLA E# CEV7043 TArE WA VIN# 41
SXXGM4A76DG256461 1
42
22❑ PLATE# STATE PLATE# STATE
TRLR
23❑ VIN#. N#. 43
RLR
'I
TOWED BY Gov HI 44
VEH YEAR 2013 MAKE /(//� MODEL QP'I'/fllJ/� STYLE $D DAMAGE TOWED TOO✓ BLIN YES
NO 1/
24❑ REGISTERED OWNER INFO OWNED SY DRIVER VEHICLE N0.2
SHADEDAMAGED AREA
3 4
LIABILITY
INSURANCE INSU&POLICY#E CO GEICO 6033328003IN STOP 5
VEHICLE ❑ ,.I—I CITATION# CHARGE
25 to BOTTOM
LEGALLY YES N
' a
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
26
MICAH BATTLE 12049 WA0171300
PART A PAGE 01 OF C7
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT No. ED41393
COLLISION REPORT III III III III III 111
1591972 CASE# 23-1974
ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY)
NAME
(/AST 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'
23-1974
On 2/19/23 at 1810 hours, I was dispatched to an collision near Seven Eleven, 4300 Oaksdale Ave
SW, within the City of Renton, County of King, Washington.
Unit 1 was identified as Michael J. Olsen (5/9/03, verified by WADL) who was driving WA-CDM0908.
Unit 2 was identified as Faty Demba (9/12/85, verified by WADL)
Unit 1 stated that he was traveling eastbound on S 43rd St approaching the Oaksdale Ave SW
intersection, he stated he thought he was in the turn lane to make a left turn, but he might not have
been in the right lane. However, he was sure he had a green light to turn left, and he did not have a
flashing yellow light. He made the left turn onto northbound Oaksdale Ave SW when Unit 2 struck his
rear passenger side quarter panel.
Unit 2 stated he was traveling westbound on S 43rd St passing though the Oaksdale Ave SW
intersection on a green light when Unit 1 pulled in front of him. He struck Unit 1 with his front bumper.
I observed moderate damage to the rear passenger quarter panel of Unit 1 and the front bumper of
Unit 2. Both vehicles were drivable, however Unit 2's airbags had deployed.
Unit 2 had a minor laceration on his right thumb, he was medically evaluated on scene by the Renton
Fire Authority.
I certify (declare) under penalty of perjury under the laws of the State of Washington that the
foregoing is true and correct.
Electronically Signed, M. Battle 12049, 2/19/23, 2014
I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT.
MICAH BATTLE 02-19-23 08:41 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
J.CHRISTIANSEN 10437 1 311112023 12:30:07 AM
BADGE OR ID# 12049 OR]#' WA0171300 TIME POLICE DISPATCHED! 6:10 PM TIME POLICE ARRIVED',6:17 PM
PART I PAGE IT]OF
REPORT NO. ED41393 CASE# ' 23-1974 DATE AND TIME 02/18/23 18:08
OF COLLISION
S-43rd St
Not drawn too scab
Oaksdale Ave SW
N �
PAGE 3 OF 3