HomeMy WebLinkAbout23-3214 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 1 27c
COLLISION REP FIT 1591971
CASE 23-3214 z
INTERSTATE ❑ CITY STREET FIRE ❑
RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHICI F ❑ LOCAL AGENCI 4250 3
HIT&RUN ✓ CODING
COUNTY RD PRIVATE WAY INVOLVED
2 TOTAL#OF OBJECT 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 - 20 - 2023 0045 17 ❑.= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓
SW SUNSET BLVD BLOCK NO. e✓ 2101
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ MILES N❑ FEET e S B OF NACHES AVE SW
0 1 29
UNIT MOTOR
Z PEDAL ElD DYESAMAGE NHORESHOLD MET PHONE 01 1 4 30
6� LAST NAME UNKNOWN FIRSTNAME MIDDLE [1 —ll 31
INITIAL
STREET ❑ CITY ST zlp 2
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
iNTERLOCKYE3 No✓ INTERLOCKYEs NO✓ YEs No✓
DRIVERS
STATE SEX D - 328 LICENSE MMDYY❑
9 ON DUTY❑ STATUS I
AIRBAG 3 RESTR 9 EJECT 9 H USEEr 9 CLAY 0 NATURE OF INJURIES z❑
3
10 P1 ATE 14 BUR8046 sTAT WAV N# 4T18F1FK1GU211583
TRAILER STATE TRAILED STATE
11 0 0 PLATE# PLATE# FROM TO
TRLR. TRLR 3 7 33
12 0 0 VIN#' UIN#
FROM
34
13❑ VEH.YEAR2OIG MAKE TOYT MODEL CAMRY STYLE 4D VEHICLE TOWED NOOpLSABLIN TSIYYEp9vMEYER vo3❑ENo✓
DAMAGE IILLJJII (S�IV6
REGISTERED OWNER INFO KEDIJA ISMAEL 13445 MLKJR WAYS,UNITE102 SEATTLE WA 98178 VEHICLE NO. 1 ❑
❑ SHADE IN DAMAGED AREA 35
14 LIABILITY INSURANCE❑ INSURANCE CO N/A
IN EFFECT &POLICY#
VEwcLE CHARGE ❑ 36
LECALLv res❑NO❑ CITATION# BOTTOM
15❑ 1NDIING
UNIT 02 VEHICCLE CYCLE ❑ PEDESTRIAN ❑ OWNFRRTY ❑ DYES✓ NO OLD MET PHONE
16❑
LAST NAME UNKNOWN FIRST NAME MIDDLE
INITIAL
STREET
CITY' Sr ZIP 37
17❑ NEW ADDRESS❑'
18❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL t-T�RANSPORTED � 38
INTERLOCK YES❑No� INTERLOCK YES It1 I NoF t l YES NO
19 LLIICENS RIVEWS# STATE SEX U MMDDYY -�_ 39
WELMET INJURY NATURE OF INJURIES 40
20❑ ON DUTY STATUS AIRBAG 2 RESTR 9 EJECT 1 USE 9 CLASS 0 ❑
❑21❑ PLATE# ANJ9193 TATe 41
WA VIN# JHMCG5641XC003559 4
42
22 [TRAILER TILER
❑ PLATE# STATE pLATE# STATE
23❑ 43
TRLR RLR
UIN#. 'IN#.
VEH YEAR 1999 MAKE HOND MODEL ACCORD STYLE 4D VEHICLE TOWED TO BLIN TOWEDeY GOV HI �44
L4❑ DAMAGE YES NO✓ YES NO✓
REGISTERED OWNER INFO YULIYAOLIY605HOQUTAMAVENE RENTONWA98059 VEHICLE NO.2
SHADE IN DAMAGEbAREA
2 3 Cd
INAEFFIECTTY NSURANCE❑ &POINSULICY#E CO NSA I 9TOP
VETILE ES❑ N,J� CITATION# CHARGE i o BOTTOM
LEGALLY Y J
25 $
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# JAGENCY
26
J RAYGOZA 12503 WA0171300
PAGE 01 OF
PART A
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT No. ED52143
COLLISION REPORT III III III III III 111
1591972 CASE# 23-3214
ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY)
NAME MIDDLE INITIAL) LEWIS AIYSHA M
(LAST FIRST,
ADDRESS&PHONE#
2223 BENSON RD S APT N101 RENTON WA 98055 2064458877 SEXi F MMDDYyry 02 - 25 - 1982
PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT ' HELMET INJURY NATURE OF INJURIES
�✓ POS. USE CLASS
NAME
(LAST,FIRST,MIDDLE INITIAL)
ADDRESS&PHONE# DOB
SEX' MMDDYVYV
PASSENGER ❑WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET NJURY 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'
RPD CASE#: 23-3214
On 03/20/2023 at approximately 0051 hours, I responded to 2101 SW Sunset Blvd, in the City of
Renton, King County, Washington, for a report of a two-motor vehicle traffic accident.
Upon arrival I identified Unit 1 as a black 2016 Toyota Camry, bearing WA license BUR8046
VIN#4T1 BF1 FK1 GU211583. Unit 1 sustained major damage all around the vehicle and was 3 yards
in a ditch just south of SW Sunset Blvd. Unit 1 was unoccupied on arrival. Other officers and I
attempted to locate the driver of unit 1 in the woods, but we were unable to locate anyone.
I identified Unit 2 as a white 1999 Honda Accord, bearing WA license ANJ9193
VIN#JHMCG5641XC003559 that was legally parked on the street facing west on SW Sunset Blvd.
Unit 2 sustained heavy damage to the rear of the vehicle and was also unoccupied during the
incident. I was unable to contact the registered owner of unit 2 and left my business card with the
case number on the windshield of the vehicle.
Unit 1 was towed from the location by Gene Meyer Towing. I was unable to charge anyone with a
crime due to not having any of the involved parties at the location.
Once all three parties left the area, I cleared the scene.
I certify (declare) under penalty of perjury under the laws of the State of Washington that the
foregoing is true and correct.
Electronically signed by J. Raygoza on 03/20/2023 at 0230 hours in the City of Renton.
I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT.
J RAYGOZA 03-20-23 02:28 AM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
DESIREE SCOTT 10272 1 411712023 5:44:24 PM
BADGE OR ID# 12503 ORI#' i WA0171300 TIME POLICE DISPATCHED; 12:51 AM TIME POLICE ARRIVED]12:53 AM
PART I PAGE 2�OF
REPORT NO. ED52143 CASE# 23-3214 DATE AND TIME 03/20/23 00:45
OF COLLISION
Unit 2
Unit 1
�r
PAGE 3 OF 3