HomeMy WebLinkAbout23-3599 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 0 27c
COLLISION REP FIT 1591971
CASE 23-3599 z
INTERSTATE ❑ CITY STREET FIRE ❑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 03 - 1-- 2023 0747 17 ❑.= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓
AIRPORT WAY BLOCK NO. e✓ 060
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ 135 00 FEET MILES e S ❑ W e L AVE S
0 4 29
UNIT MOTOR
VEHICL Z CYCLE ElDDAMYESA✓THRESHOLD MET PHONE 0 1 30
6� LAST NAME IXCOYXANTE FIRSTNAME OSCAR MIDDLE L 1 2 31
INITIAL
STREET ❑, 2655 S HANFORD ST CITY SEATTLE ST WA ZIP', 981446537 z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
iNTERLOCKYEs NO INTERLOCKYEs NO YES R NO
8❑ LRIIVER #
ON DUTY❑ STATUS' AIRBAG 2 RESTR 2 EJECT 1 H USEET 7 CLASS UNKNE OF INJURIES 2❑
3
10 9❑ P1 ATNES14 BWN5691 STATE WA uN# 2T1BU4EE3DC080107
TRAILER STATE TRAILER STATE
11 3 5 PLATE# PLATE# FROM To
TRLR. TRLR $ 7 33
12 3 5 VIN#' VIN#
ROM TO
❑ VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TR Y GOVT.VEHICLE 7 3 34
13 2 2013 TOYT COROL DAMAGE YES NO MEYER YES[:] NO✓
REGISTERED OWNER INFO FRANSICO D:COYXANTE 2655 S HANFORD ST SEATTLE WA 981446537 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
14 ❑ INSURANCE CO 3 4
LIABILITY INSURANCE
IN EFFECT &POLICY# 9TOP
VEHlcl.e CHARGE 10BOTTOM 5 36
LEGALLY YES❑NO❑ CITATION# 3A0081115,3A0081115, NO VALID OPER LICENSE WITH
15❑ �STfANDING 'j 7 6
UNIT a2 VEHIMOTCLE CYCLE ❑ PEDESTRIAN ❑ PROPERTY ❑ DYES✓ NO OLD MET PHONE
16 a
LAST NAME BARRIENTES FIRST NAME LEILANNA MIDDLE M
INITIAL
17❑ STREET ❑', 34625 56TH AVE S CITY' AUBURN ST WA ZIP 980019768 37
NEW ADDRESS ❑
18� CDL IGNITION REQUIRED IGNITION PR-E-1SENT MEDICAL TRANSPORTED 38
INTERLOCKYES�NOR INTERLOCK YEs It I NOF YES
t t- l NO❑ 11
19 LICENSE# STATE WA SEX F M D.C.B. 10 _ 11 1985 0 39
20 ON DUTY STATUS AIRBAG,2 RESTR 4 EJECT 1 HELMET INJURY 7 NATURE OF INJURIES 40
USE CLASS UNKN
21❑ LICENSE I BPJ0200 TATE WA VIN# 1(BIZF5SX5CoF233398
❑ 41
PLATE#
42
22❑ PLATE# STATE PLATE# STATE
TRLR
23❑ VIN#. IN#. 43
RLR
'
VEH YEAR 2016 MAKE CHEV MODEL MALIBU STYLE VEHICLE TOWED TO BLIN TOWEDBY GOV HI 44
24 DAMAGE YES NO (,ENE MEYER YES NO
REGISTERED OWNER INFO LEILANNA BARRIENTES 3462556TH AVE S AUBURN WA 98001 VEHICLE NO.2
SHADEDAMAGEDAREA
3 4
INAEFFIECTTY NSURANCE INSU&POLICY#E CO SAME. CQ'E""LE
❑ ,J� CITATION# CHARGE to
LEGALLY YES N`L J
25
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. ED46973
COLLISION REPORT III III III III III 111
1591972 CASE# 23-3599
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'
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 03-30-23 08:51 AM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
CO.JOHNSON 0505 313012023 3:39:28 PM
BADGE OR ID# 2517 ORI# WA0171300 TIME POLICE DISPATCHED 8:08 AM TIME POLICE ARRIVED',8:10 AM
PART I PAGE IT]OF 4�
REPORT NO. ED46973 CASE# 23-3599 OF COLLISION
03/30/23 07:47
OF CbLLI510N
NARRATIVE
maroon lane 3 eb gry right or left from 065
CC
Within the city limits of Renton/King/WA I responded to a 2 car blocking injury crash at about the 060
block of Airport way.
I contacted the driver of unit 2 who told me she was east on Airport Way in lane 3 when from out of
nowhere unit 1 crashed into the side of her car. She did complain of injury. She was treated and
released on scene by Renton Fire. Her car was impounded for damages.
I contacted the driver of unit 1 ID'd by matching WA-ID. Unit 1 did not provide any additional
information reference the crash. He did complain of injury. He was treated and released on scene by
Renton Fire. His vehicle was impounded for damages.
Based on the debris field and damages it appears unit 1 pulled from the Banner Bank parking lot.
However, I could not clarify whether he was going west of east on Airport, most likely west based on
the depth of he lane travel before impact. Unit 1 was unable to provide insurance for the vehicle he
was driving. A WACIC/DOL check revealed he was ID only.
I cited unit 1 Ref RCW 46.61.205 FTYROW from private drive 2 car injury crash, RCW 46.20.015
NVOL 2nd with ID and RCW 46.30.020 No Valid Proof of Insurance 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 3/30/2023
PAGE 3 OF 4
REPORT NO. ED46973 CASE# 23-3599 DATE AND TIME 03/30/23 07:47
OF COLLISION
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