HomeMy WebLinkAbout24-1158 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 1 27c
COLLISION REP FIT 1591971
SASE 24-1158 z
INTERSTATE ❑ CITY STREET FIRE ❑
RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHIC;I F ❑ LOCAL AOENC 4Y00 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 3 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# ❑
COLLISION.. 01 - 1-- 2024 1730 17 ❑.= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓
RAINIER AVE N BLOCK NO. e✓ 400
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ 1 0 ❑ FEET ❑ S ❑ W e AIRPORT WAY
0 1 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
✓NO D:2065662210 0 11
30
6� LAST NAME MEYER FIRSTNAME JOHN MIDDLE T 1 0 1 31
INITIAL
STREET ❑✓ 19235 108 AVE SE#203 CITY KENT ST WA 2jp, 98042 z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
iNTERLOCKYEs NO 1/ INTERLOCKYEs NO�/ YES R No�/
8❑ LRIIVER #
ON DUTY❑ STATUS AIRBAG 6 RESTR 4 EJECT 1 H USE 2 1 CLASS NATURE OF INJURIES z❑
3❑10 9❑ PI ATE 14 ADK3034 STATE WA V N# 1 HGCM56857AO07480
11[-j- TRAILER STATE TRAILER STATE
11 3 5 PLATE# PLATE# IR.. ro
TRLR. A'RLR. 1 5 33
12 3 5 VIN#j VIN#
:: FROM TO
❑ VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TR Y GOVT.VEHICLE 1 5 34
13 4 2007 HOND ACCOR SD DAMAGE YES NO �MEYERS YES❑ No✓
REGISTERED OWNER INFO OWNEDBYDRIVER VEHICLE NO. 1
SHADE IN DAMAGED AREA ❑ 35
❑ ❑ INSURANCE CO <�3
4
14 LIABILITY INSURANCE NONE
IN EFFECT &POLICV#❑ LEGALE CHARGE TTOM 5 36
15 2 LEGALLY YES
res No CITAnoN# gg0148250,4A0148251 DWLS 3RD DEGREE,OP MOT VEH e
MOTOR PEDAL-: :PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT a2 VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES 1/ No Do 2536528147
16 a
LAST NAME YUSUF FIRST NAME AHMED MIDDLE ID
INITIAL
17 STREET I❑ s❑' 5700 S 129TH ST,APT E301 CITY' SEATTLE ST WA ZIP 98178 4❑ 37
NEW ADDREs
18❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED � 38
INTERLOCK YEs❑No� INTERLOCK YEs❑NOF YEs❑NoF,/
19 DRIVER'S STATE WA SEX M D.C.B. 01 01 1997 39
LICENSE# MMDDYY
20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 H U EET 2 NJAURSY 1 NATURE OF INJURIES 40
❑ILICENSE 21❑ PLA E# BPY4739 TATE 41
WA VIN# JTDKN3DU1F0480289 1
42
22❑ PLATE# STATE PLATE# STATE
TRLR
23❑ VIN#. IN#. 43
RLR
'
GI
VEH YEAR 2015 MAKE 7'Oy7' MODEL pRIUS STYLE $D DAMAGE TO TOWED II OV H 44
Yr
✓WED NOO BLIN GENE MEYERS YES No
24❑ REGISTERED OWNER INFO OWNED SY DRIVER VEHICLE N0.2
SHADE DA GEbAREA
LIABILITY
INSURANCE INSU PORGY#E CO PROGRESSIVE 930340279IN 1 9TOP
VEHICLE ❑ C[:] CITATION# CHARGE io BOTTOM
LEGALLY YES N
25 $ '
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
26
J.CARSTENSEN 11648 WA0171300
PART A PAGE 01 OF
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EE47401
COLLISION REPORT III III III III III 111
1591972 CASE# 24-1158
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
PM 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.
J.CARSTENSEN 01-31-24 07:09 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
DESIRES SCOTT 10272 21512024 6:53:10 AM
BADGE OR ID# 11648 OR]# WA0171300 TIME POLICE DISPATCHED 5:34 PM TIME POLICE ARRIVED',5:39 PM
PART Ei PAGE IT]OF 4�
TIME
REPORT NO. EE47401 CASE# 24-1158 OF COLLISION01131/2417:30
NARRATIVE
On 1/31/24 at about 1734 hours I was working uniformed patrol in my unmarked patrol vehicle when I
was dispatched to a collision at 400 Rainier Ave N in the City of Renton, King County, WA.
I arrived and contacted the driver of Unit 1, who was identified by his WA DOL photo. Unit 1 relayed
the following: Unit 1 was driving southbound in the above location and in the right lane. Unit 1 went to
pass another vehicle and the accelerator pedal got stuck. Unit 1 tried to evade other vehicles but
collided with Unit 2. Unit 2 said he did not have insurance. Unit 2 also advised he has a suspended
license.
A WA DOL records check of Unit 2, John T. Meyer (DOB: 10/25/01), showed his driving status as
Suspended/Revoked 3rd Degree.
I contacted Unit 2, who relayed the following: Unit 2 was driving southbound in the above location and
in the left lane. All of a sudden, Unit 2 was hit from behind by Unit 1.
Both vehicles were not drivable.
Gene Meyers Towing arrived and towed both vehicles away.
I gave both Units a business card with the case number.
By operating a motor vehicle in WA state with a suspended license, John T. Meyer (DOB: 10/25/01)
committed the crime of DWLS.
Citation #4A0148250 was forwarded to the Prosecutor's Office for DWLS.
Meyer was issued Infraction #4A0148251 via Court Mail for No Insurance.
PAGE 3 OF 4
REPORT NO. EE47401 CASE# 24-1158 DATE AND TIME 01/31/2417:30
OF COLLISION
AN
i t 1
400
I
�i � gpI
Rainier
I
PAGE 4 OF 4