HomeMy WebLinkAbout23-4660 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 1 27c
COLLISION REP FIT 1591971
CASE 23-4660 z
INTERSTATE ❑ CITY STREET FIRE ❑
RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHICI F ❑ LOCAL AGENCI 4Y50 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 TOTAL#OF OBJECT 2$
TRIBAL UNITS 02 STRUCK STREET LIGHT POLE
RESERVATION
z
3❑ DATE OF M M D D Y Y Y Y TIME(2400) COUNTY# MILES N E IN CITY# ❑
GawsloN 04 - 1-- 2023 0324 17 ❑.= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓
HARDIE AVE SW BLOCK NO. e✓ 400
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ 1.❑ FEET e S ❑ W e 0 1 29
UNIT 01 VEHICLE
MOTPI PEDAL-ORCYCLE ElDESA✓NHORESHOLD MET PHONE 30
6� LAST NAME UNKNOWN FIRSTNAME MIDDLE 1 1 2 31
INITIAL
STREET ❑
NEW ADDRESS CITY KENNEWICK ST ZIP z
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
iNTERLOCKYEs NO INTERLOCK YES NO YES No
DRIVERS
STATE SEX D - 328 LICENSE MDYY❑ M
9 ON DUTY❑ STATUS I
AIRBAG 9 RESTR 9 EJECT 1 H USEEr 9 CLAY 0 NATURE OF INJURIES z❑
3
10❑ P1 ATNES# CAH3110 sTAT WA u N# JHt RE48587C107342
TRAILER STATE TRAILER STATE
11 0 0 PLATE# PLATE# Rom ro
TRLR. TRLR 1
2❑ 5 33
1 VIN#' VIN#
Rom 34
13 4 VEH.YEAR2007 MAKE HOND MODEL CRV STYLE SD VEHICLE TOWED NOOpLSABLIN TSIYYEp9vMEYERS vOVT.V
❑ DAMAGE IILLJJII (�ciV6
REGISTERED OWNER INFO JAIDYN GARZA-ROSS 1119 N IRVING PL KENNEWICK WA 99336 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
14❑ LIABILITY INSURANCE❑ INSURANCE CO 3 4
IN EFFECT &POLICY# 9TOP
vEHICLE CHARGE 5 36
LEGALLv Yes❑NO❑ CITATION# 10 BOTTOM
15❑ STANDING 7 6
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT VEHICLE ❑ CYCLE ❑ ❑ : OWNER ❑ YES 1/ NO D:4254307500
16❑
LAST NAME CITY OF RENTON FIRST NAME MIDDLE
INITIAL
17 NEW STREETREs7' 1055 S GRADY WAY CITY RENTON ST WA ZIP 98059 37
18� CDL IGNITION REQUIRED IGNITION PtR—E—S1ENT MEDICAL—T�RANSPORTED 38
INTERLOCK YEs❑NOR INTERLOCK YEs I I NOF YEs t l NO❑
19 LLIICENS # STATE SEX U MMDDYY 39
HELMET INJURY NATURE OF INJURIES 40
20❑ ON DUTY STATUS' AIRBAG RESTR EJECT USE CLASS ❑
❑21❑ LICENSE TATE VIN# 41
`1
PLATE#
42
22❑ PLATE# STATE PLATE# STATE
23❑ 43
TRLR RLR
VIN It IN#.
VEH YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN
TOWED BY Gov HI 44
24❑ DAMAGE YES NO YES NO
REGISTERED OWNER INFO VEHICLE NO.2
SHADE IN DAMAGED AREA
2 3 4
INAEFFIECTTY NSURANCE❑ &POINSULICY#E CO 1 9TOP 5
VEHICLE ❑ C[:] CITATION# CHARGE
25 i o BOTTOM
LEGALLY YES N
s e
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
MICAH BATTLE
26 12049 WA0171300
PAGE 01 OF
PART A
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. ED56517
COLLISION REPORT III III III III III 111
1591972 CASE# 23-4660
ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY)
NAME MIDDLE INITIAL) MCKAY MARCEL M
(LAST FIRST,
ADDRESS&PHONE#
495 RENTON CENTER WAY SW APT 521 RENTON WA 98059 4256527380 SEX i U MMDDYyry 10 - 31 - 1965
PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT ' HELMET INJURY NATURE OF INJURIES
POS. USE CLASS
NAME
(LAST,FIRST,MIDDLE INITIAL)
ADDRESS&PHONE# DOB
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'
Unit 1 was unoccupied, plate WA-CAH3110.
A witness, Marcel M. Mckay (10/31/65) stated the following both verbally and by written statement:
She heard tires screeching; she looked out her window and saw that U1 had hit a light pole. She
witnessed a woman exit the driver's seat and run northbound on Hardie Ave SW. She described the
women as white female, 5-5, dark hair, wearing a navy-blue sweatshirt, black stretch pants and white
shoes. She later stated she would recognize the women again if she saw her.
I observed U1 was traveling southbound on Hardie Ave SW when it crossed the center lane, lost
control on the eastern sidewalk and spun clockwise just over 90 degrees while hitting a light pole,
knocking it to the ground.
U1 was impounded by Gene Meyers Towing.
I completed a city damages form.
I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT.
MICAH BATTLE 04-29-23 03:33 AM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
DESIRES SCOTT 10272 1 5/2/2023 2:55:21 PM
BADGE OR ID# 12049 OR]# WA0171300 TIME POLICE DISPATCHED 3:25 AM TIME POLICE ARRIVED 3:29 AM
PART Ei PAGE IT]OF
REPORT NO. ED56517 CASE# 23-4660 DATE AND TIME 04/26/23 03:24
OF COLLISION
Street Light
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