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Home My WebLink About23-3002 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 6 27c COLLISION REP FIT 1591971 CASE 23-3002 z INTERSTATE ❑ CITY STREET FIRE ❑ RESULTED 1 STOLEN STATE ROUTE ❑ OTHER ❑ VFHIC;I F ❑ LOCAL AGENCI 4150 3 HIT 8 RUN CODING COUNTY RD PRIVATE WAY INVOLVED 2 TOTAL#OF OBJECT 1 8 28 TRIBAL UNITS 03 STRUCK NONE RESERVATION z 3❑ DATE of M M D D Y Y Y Y TIME(2400) COUNTY# MILES N E IN CITY# cowsloN 03 - 14 - 2023 0550 17 ❑-= S 8 IN e 1070 3 4❑ oN (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑ RAINIER AVE S BLOCK NO. e✓ --- ----� ❑ 4a❑ MILEPOST DISTANCE OF(REFERENCE OR CROSS STREET) 5❑ �.❑ FEET e S ❑ W e SW SUNSET BLVD 0 1 29 UNIT MOTOOR Z CYDDAL ❑ OYESA✓NOESHOLDMET PHONE O 1 30 6� LAST NAME UNKNOWN FIRSTNAME UNKNOWN MIDDLE 1 2 31 INITIAL STREET ADO ❑ UNKNOWN CITY FEDERAL WAY 'NEW ADDRESS ST ZIp'. 2 7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3 1/ I iNTERLOCKYEs NO NTERLOCKYEs NO�/ YES R No�/ 8❑ LIRCIENSRE# STATE SEX u MMDOOYY '❑- 1 1 2 32 9 ON DUTY❑ STATUS I AIRBAG 6 RESTR 9 EJECT 9 H USEEr 9 CLAY 0 NATURE OF INJURIES z❑ 3 10❑ P1 ATE 14 BTR4450 STATE WA VIN# JTDBL40E799031256 TRAILER STATE TRAILER STATE 11 0 0 PLATE# PLATE# FROM TO TRLR. TRLR. 7 3 33 12 0 0 VIN#' VIN#' >; FROM TO ❑ VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TR Y GOVT.VEHICLE 1 5 34 13 4 2009 TOYT COROL 4D DAMAGE YES NO �MEYER YES❑ No✓ REGISTERED OWNER INFO ADRIAN G01206 SW349TH ST FEDERAL WAY WA 98023 D:8182054058 VEHICLE NO. 1 ❑ SHADE IN DAMAGED AREA 35 14 LIABILITY INSURANCE❑ INSURANCE CO �3g 4 IN EFFECTI POLICY#VEHICLE CHARGE 5 36 LEGALLvYes❑NO CITATION# 15❑ STANDING 6 MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE �IJNITU2 VEHICLE ❑ CYCLE ❑ ❑ PROPOWNER ❑ YES1/ No D:2064844914 16 a LAST NAME BUI FIRST NAME PETER MIDDLE H INITIAL 17❑ STREET ❑', 11130 LAKE RIDGE DR S CITY SEATTLE ST' WA ZIP 98178 37 NEW ADDRESS ❑ 18� CDL IGNITION REQUIRED IGNITION PtR-E-S1ENT MEDICAL TRANSPORTED 38 INTERLOCK YEs❑No� INTERLOCK YEs I I NOF YEs I� NO❑ 19 DRIVE ❑ ON DUTY STATUS AIRBAG 6 RESTR 4 EJECT 1 HELMET INJURY 7 NATURE OF INJURIES ❑ 40 USE I CLASS RIB PAIN 21❑ LICENSE I CA61974 TATE I WA VIN# 2HGFG1B608H516985 ❑ 41 PLATE# 42 22❑ PLATE# STATE PLATE# STATE 23❑ UIN#. 43 TRLR RLR 'IN#. VEH YEAR 2011 MAKE HOND MODEL CIVIC STYLE 2D VEHICLE TOWED TO BLIN TOWEDBY GOV HI 44 24❑ DAMAGE YES NO GENE MEYER YES NO REGISTERED OWNER INFO PETER BUI 11130 LAKE RIDGE DR S SEATTLE WA 98178 D:2064844914 VEHICLE NO.2 SHADE DAGELLAREA LIABILITY INSURANCE 8 POINSURGY#E CO STATE FARM 500-7251-C22-47IN 9TOP 5 'E""Le ❑ ,J� CITATION# CHARGE to BOTTOM LEGALLY YES N`L J 25 ' e OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY 26 ALEKSANDR IGNATOV 12619 WA0171300 PAGE 01 OF PART A 3000-345-159 OR 11/181 STATE OF POLICETRAFFICN CORRECTION REPORT NO. ED42502 COLLISION REPORT III III III III III 111 1591972 CASE# 23-3002 ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY) NAME MIDDLE INITIAL) MATHESON BRADLEYJ (I.P.ST FIRST, ADDRESS&PHONE# 1458 S COUGAR DR MOSES LAKE WA 98837 5094312477 SEX M MMDDYyry 01 - 15 - 2001 PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT ' HELMET INJURY NATURE of INJURIES ❑ ❑✓ SEA USE CLASS NAME (LAST,FIRST,MIDDLE INITIAL) ADDRESS&PHONE# DOB SEX MMDDYYYY PASSENGER ❑WITNESS❑ UNIT# SEAT AIRBAG RESTR. EJECT HELMET NJURY 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' Unit one was traveling eastbound on SW Sunset Blvd approaching Rainier Ave S possibly in lane 2 of 4. Unit two was traveling southbound on Rainier Ave S at the intersection of SW Sunset Blvd possibly in lane 3 of 4. Unit three was traveling northbound on Rainier Ave S, approaching SW Sunset Blvd, possibly in lane 4 of 5. Unit two and three had a green light. Unit one had a red light. Unit one ran the red light, struck unit two casing him to spin and strike unit three. Unit one driver then took off on foot eastbound on S 3rd ST. Witnesses described the driver as an unknown race male wearing dark shorts, gray, beanie and a gray/red t-shirt. Area check at the R/O's address by Federal Way PD was with a negative result. Area check near the collision was with a negative result. The R/O of unit one had his wallet laying on the front passenger floor board. I was not able to find anyone who observed the driver of the causing vehicle (unit one). Photos of the scene were uploaded into Axon Evidence. I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT. ALEKSANDR IGNATOV 03-14-23 04:14 PM INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED APPROVED BY DATE D.SKELTON 9139 1 311512023 4:01:06 AM BADGE OR ID# 12619 ORI# WA0171300 TIME POLICE DISPATCHED 5:55 AM TIME POLICE ARRIVED f 5:58 AM PART I PAGE IT]OF 4] SUPPLEMENTAL REPORT NO. ED425502 r`) POLICE TRAFFIC 1 1 8 27 COLLISION REPORT CASE# 23-3002 1 COMMERCIAL MOTOR CARRIER INTERSTATE INTRASTATE G UNIT'# USDOT ICC# VEHICLE TYPE CARGO BODY ;TYPE 2 ❑ 1 28 CARRIER NAME 3 CARRIER L ADDRESS ` CITY ST ZIP—1 I ' 4 ❑ NAME # PLACARD: :❑ GI PLACARD IF NO NUMBER SOURCE AXLES + 4a ❑ ADDITIONAL UNITS MOTOR PEDAL- PROPERTY DAMAGE THRESHOLD MET PHONE 5 ❑ UNIT# 3 VEHICLE tSJ CYCLE I_) PEDESTRIAN OWNER YEs NO D:2065950546 0 1 Zg LAST NAME BARRERA FIRST NAME HECTOR MIDDLE F INITIAL STREET 30 NEW AnDRFSP' 12234 SE 199TH ST CITY KENT ST WA ZIP 98031 6 ❑ 1 1 2 31 CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TANSPORTED INTERLOCK YES No NTERLOCK YES❑N0� YEs N DRIVER'S LICENSE STATE I WA SEX M MMDDYYv 12 - 26 - 1967 7 ON DUTY� STATUS AIRBAG' g RESTR. Q EJECT 1 HELMET I INJURY 1 1 NATURE OF INJURIES USE CLASS 8 ❑ 1 32 LICENSE C361582 TAr WA VIN# 5TFDY5F18CX211398 PLATE# 9 TRAILER TRAILER PLATE# STATE PLATE# STATE 10 ❑ TRLR TRLR VIN.#. VIN.#. 11 0 0 VEH.YEAR2012 MAKE TOYT MODEL TUNDRA STYLE PK I VEHICLE TOWS E T SABLI T ';tALB�'ER Gf1VT VFHIG P FROM TO DAMAGE YES NO YES NO REGISTERED OWNER INFOELVIA GARCIA 12234 SE 199TH ST KENT WA 98031 D:2065950546 rj 1 33 SHADE IN DAMAGED AREA 7 j 4 12 FROM TO LIABILITY INSURANCE INSURANCE CO PROGRESSIVE 909786863 q"i"Olx IN EFFECT &POLICY# VEHICLE 34 13 ❑ LEGALLY YES[:] NO❑ CITATION# CHARGE gg�@ 10 BOTTUM STANDING } MOTOR l:9 7 6 14 ❑ UNIT Tr Vd IRE O CYCLE OWNERRTY YES AGE NOHRESHOLD MET PHONE ❑ 35 PEDESTRIAN 15 LAST NAME FIRST NAME INITIAL 36 MIDDLE ❑ STRE 16 NEW ETETnnR"� CITY ST ZIP CDL IGNITION REdUiRED IGNITtGN PRESENT MEDICALTANSPORTED NTERLOCK YES No INTERLOCK YEs NO YES NO ❑ 17 4 37 LICENSE# STATE SEX MMDDDYBYY -� II 18 ❑ ON DUTY� STATUS AIRBAG RESTR. ; EJECT HELMET INJURY NATURE of 1NJURIEs 38 USE CLASS 19 ❑ LICENSE TAr VIN# 39 PLATE# 20 ❑ TRAILER' STATE TRAILER STATE ❑ 40 PLATE#< PLATE# 21 ❑ ❑ 41 TRLR TRLR VIN# YIN#i 42 22 VEH.YEAR MAKE I MODEL STYLE I VEHICLE TO DUET SABLIN TOWED BY GOVT.VEHICLE DAMAGE YES NO YES NO 23 REGISTERED OWNER INFO_ SHADE IN DAMAGED AREA 43 3 4 71 LIABILITY INSURANCE INSURANCE CO ' VINE EFFECT &POLICY# i 970P - 4 E:l 44 24 VEHICLE YES❑ NO❑ CITATION# CHARGE iq 60TiOM LECALLv STANDING 8 7 6 1 CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT. ALEKSANDR IGNATOV 03-14-23 04:14 PM 25 INVESTIGATING OFFICER'S SIGNATURE OFFICER'S PHONE UNIT OR DIST DET DATED: PLACE SIGNED APPROVED BY EAT E 26 ORID# 12619 O#II,WA0171300 SKELTON 3/15/2023 PAGE F OF 4 3000-345-013(R 11118) REPORT NO. ED42502 CASE# 23-3002 DATE AND TIME 03/14/23 05:50 OF COLLISION S 3rd ST w SW SUNSET BLVD d Iz w r.N ol PAGE 4 OF 4