HomeMy WebLinkAbout24-1226 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 1 27c
COLLISION REP FIT 1591971
SASE 24-1226 2
INTERSTATE ❑ CITY STREET FIRE ❑
RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHICI F ❑ LOCAL AGENC 4100 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 1 TOTAL#OF OBJECT 1 5 6 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# ❑
COLLISION'. 02 - 1-— 2024 1651 17 ❑.= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓
NILE AVE NE BLOCK NO. e✓ 959
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ 100 00 FEET MILES e S B W e NE 10TH ST
0 1 29
MOTUNIT U1 VEHICR Z PEDAL-CLE CYCLE ElYESA,G/E NHORESHOLD MET PHONE =30
6� LAST NAME NIIKKONEN FIRSTNAME DONNA MIDDLE L 1 1 2 31
INITIAL
STREET ❑, 6625 134TH PL SE UNIT 202 CITY NEWCASTLE ST WA ZIP 980593323 z
'NEW ADDRESS
]❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
iNTERLOCKYEs NO INTERLOCKYEs NO YES R NO
8❑ LRIIVER #
ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 H U SE
ICNLJAUSSY 1 NATURE OF INJURIES z❑
3
10 9❑ PI ATE AOE8797 sTArI WAvrN#' JF2SJAJCOEH471189
TRAILER STATE TRAILER STATE
11 3 5 PLATE# PLATE# FROM TO
TRLR. TRLR. 5 1 33
12❑ VIN#j UIN#
FROM TO
VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE 3 ] 34
13 3 2014 SUBA FOREST DAMAGE YES NO ✓ YES[:] No✓
REGISTERED OWNER INFO DONNA NIIKKONEN 6625134TH PL SE UNIT 202 NEWCASTLE WA 98059 D:4252839621 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
14 LIABILI INSURANCE INSURANCE CO SAME. 3 4
IN EFFECT &POLICY# 9TOP
vE—LE CHARGE 5 36
LECALLv ❑NO❑ CITATION# 1 o BOTTOM
15❑ YES STANDING 8 7 6
UNIT a2 VE ICCLE ❑ CYCLE ❑ PEDESTRIAN ❑MOTO ✓ OWNFRRTY ❑ DYES✓ NO OLD MET PHONE
16 a
LAST NAME REYES FIRST NAME SOPHIA MIDDLE R
INITIAL
17❑ STREET ❑', 14524 SE 114TH PL CITY RENTON ST WA ZIP 98059 37
NEW ADDRESS ❑
18� CDL IGNITION REQUIRED IGNITION PtR—E—S1ENT MEDICAL TRANSPORTED 38
INTERLOCKYES�NOR INTERLOCK YEs I I NOF YEs t l NO❑
19 LICENSE# STATE SEX IF M D.C.B.
09 _ 11 _ 2010 39
20 ON DUTY STATUS 3 AIRBAG RESTR EJECT , HELMET I INJURY 5 NATURE OF INJURIES 40
USE CLASS HEAD
El 41
21❑ LICENSE I TArE YIN#
PLATE#
42
22❑ PLATE# STATE PLATE# STATE
TRLR
23❑ UIN#. IN#.
43
RLR
'
VEH YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN
TOWED BY Gov HI 44
L4 1 ] DAMAGE YES NO YES NO
REGISTERED OWNER INFO VEHICLE NO.2
SHADE IN DAMAGED AREA
2 3 4
LIABILITY
INSURANCE❑ INSURANCE
#E CO
IN EFFECT &PO I 9TOP 5
vE""LE ❑ ,J� CITATION# CHARGE i o BOTTOM
LEGALLY YES N`L J
25 s � e
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
26
M.LEVERTON 2517 WA0171300
PAGE 01 OF
PART A
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EE50252
COLLISION REPORT III III III III III 111
1591972 CASE# 24-1226
ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY)
NAME MIDDLE INITIAL) REYES MYA R
(LAST FIRST,
ADDRESS&PHONE# D O.B.
14524 SE 114TH PL RENTON WA 98059 SEX F MMDDYyYv 08 - 29 - 2012
PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT ' HELMET INJURY NATURE OF INJURIES
�✓ POS. USE CLASS
NAME
'(LAST,FIRST MIDDLE INITIAL)
ADDRESS&PHONE# D O B
SEX MMDDYYYY
PASSENGER ❑WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET NJURY
POS. NATURE OF INJURIES
USE CLASS
NAME
(LAST FIR57 MIDDLE INITIAL)
AppRESS&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 02-06-24 10:01 AM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY E
DAT
C.JACOBS 1953 2/14/2024 10:46:45 AM
BADGE OR ID# 2517 OR]#' WA0171300 TIME POLICE DISPATCHED; 4:53 PM TIME POLICE ARRIVED',4:55 PM
PART I PAGE IT]OF 4�
REPORT NO. EE50252 CASE# 24-1226 OF COLLISION
02/02/24 16:51
OF CbLLI510N
NARRATIVE
unit 1 nb ped playing tripped fell forward hit head on front hl/fender
RTF
Within the city limits of Renton/King/Wa I responded to a car v ped injury crash at 959 Nile ave NE.
When I arrived on scene Renton Fire was already treating the Ped/Reyes a minor child.
I contacted the driver of unit 1. She told me she was northbound about the posted speed limit. She
noticed a group of kids playing in a field to the east. Some of the kids were headed west towards the
roadway. She said it looked like one of the kids/Reyes had lost her balance falling forward and
tripped out into traffic making contact with her vehicle. She was able to stop immediately and call
911. Unit 1 showed me on her car where the contact was made.
Renton Fire was updated on contact and location ref Peds injuries. Medics were requested, arrived
and decided to take Reyes to Harborview for additional checks/treatment.
I was not able to talk to Reyes/Ped, but her sister/Wit said Reyes was running near the roadway and
appeared to have tripped and fell into the path of unit 1.
Joe Reyes was also onscene, Reyes/ped father. He was updated and prepared to follow Medics to
Harborview.
There was no recklessness or negligence on unit 1's driving or actions. This was an unfortunate
circumstance. Information/Insurance only.
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 2/2/2024
PAGE 3 OF 4
REPORT NO. EE50252 CASE# ' 24-1226 DATE AND TIME 02/02/24 16:51
OF COLLISION
f
PAGE 4 OF 4