HomeMy WebLinkAbout24-2560 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 1 27c
COLLISION REP FIT 1591971
SASE 24-2560 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 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 CITY# ❑
cowsloN 03 - 08 - 2024 1006 17 ❑.❑ N E IN S 8 W H OF e 1070 3
4❑ oN (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓
SW 34TH ST BLOCK NO. e✓ 200
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ ❑ FEET e S ❑ W e 0 3 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
No ,/ I D:3053439152 0 11
30
6 LAST NAME LOPEZ LEZCANO FIRST NAME YOANKIS MIDDLE N 1 1 2 31
INITIAL
STREET ❑, 14511 NW 88 PL CITY MIAMI LAKES ST I FL ZIP' 330180000 z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
INTERLOCK YES[:]NO INTERLOCKYEs NO YES R NO
8❑ LRIIVER #
ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 HELMET
2 'NJUR 5Y 1 NATURE OF INJURIES z❑
3
10 9❑ P1 aT�S� RP11156 sTArI WAurN# 3AKJHHDR5RSVE4812
TRAILER 82134AH STATE WA TRAILER STATE
11 3 0 PLATE# PLATE# FROM ro
TRLR TRLR 3 1 33
12 3 0 vIN#' 1 UYVS2530S2212811 YIN If
FROM TO
VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED By GOVT.VEHICLE 3 ] 34
13 2 2024 FRHT PT126S TR DAMAGE YES NO YES❑ NO✓
REGISTERED OWNER INFO P T TRANSPORT LLC 3012 S FIFE ST TACOMA WA 984097613 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
2 INSURANCE CO 3 4
14 LIABILITY INSURANCE SELF MSURED-ACCORD INSURANCE 999.785.4677
IN EFFECT &POLICY# 9TOP
ve EFFECT
CHARGE 5 36
LEH'C Yes❑NO❑ CITATION# 10 BOTTOM
15❑ STANDING 8 7 6
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT 02 VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES, No D:2064452878
16 a
LAST NAME MACKEY FIRST NAME IESHA MIDDLE S
INITIAL
17 STREET ❑', 6014 S 237TH ST APT A302 CITY KENT ST WA ZIP 980323687 37
NEW ADDRESS ❑
181 CDL IGNITION REQUIRED IGNITION PRESENT MEDICALt—T�RANSPORTED 38
INTERLOCK YES❑NoR INTERLOCK ves NoF YEs t l No❑
11
19[ D IVEW #
{NJURY NATURE OF INJURIES 40
20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 USE 2 CLASS 1 ❑
21❑ LICENSE BZD4750 TAre WA vIN1t 1(B11J5SX9EF112057
❑ 41
PLATE#
42
22❑ PLATE# STATE PLATE# STATE
23❑ 43
TRLR RLR
UIN#. 'IN#.
TOWED BY Gov HI 44
VEH YEAR 2014 MAKE CHEV MODEL MALIBU STYLE $D DAMAGE TOWED NOO✓ BLIN YES
NO,�
24❑ REGISTERED OWNER INFO OWNED SY DRIVER VEHICLE N0.2
SHADE IN DAMAGED AREA
2 3 4
LIABILITY
INSURANCE I PORGY#E CO BRISTOL WEST G013936116 00IN 1URV'""LE
❑ ,J� CITATION# CHARGELEGALLYYES N
25 7CA
NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
J
26LAN 12007 WA0171300
PART A PAGE 01 OF
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EE60149
COLLISION REPORT III III III III III 111
1591972 CASE# 24-2560
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.
C.CATALAN 03-12-24 12:11 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
C.JACOBS 1953 311812024 12:02:10 PM
BADGE OR ID# 1Y007 ORI# WA0171300 TIME POLICE DISPATCHED; 10:09 AM TIME POLICE ARRIVED',10:18 AM
PART I PAGE IT]OF 5�
REPORT NO. EE60149 CASE# 24-2560 OF COLLISION
03/08/24 10:06
OF CbLLI510N
NARRATIVE
On March 8, 2024, at 1006 hours dispatch requested that I respond to a collision at 400 SW 34th St.
in the city of Renton.
Upon my arrival I spoke with the driver of unit 1 and he stated that he had just made a left turn from
East Valley Rd. to SW 34th St. when the collision occurred. The driver of unit one was attempting to
enter a property near 200 SW 34th St. Because he was driving a semi-truck she needed to use both
lanes to make the right turn into the property. He was in lane 2 when he made his right turn. The
driver of unit 1 failed to see unit 2 in their blind spot striking unit twos driver side Fender and door.
I then spoke with the driver of unit 2 and she explained she was in the number one lane going
westbound when the collision occurred. As they approached 200 SW 34th St. Unit 1 made a right turn
from lane 2 which then struck her vehicle. The driver of unit 2 stated that the semi truck never use
their turn signal.
I clarified that statement with the driver of unit 1 and he stated that he did have his blinker on and
suggested that the driver of unit 2 possibly failed to see it.
Based on the information above I was unable to determine who committed the traffic violation.
While I was at the location, I observed the damages on both vehicles and neither appeared to have
severe damage that would disable the vehicle.
I provided the two drivers with an exchange of information.
As I completed my investigation the driver of unit 2 stated they would go to the hospital because
they're back hurt.
It is important to note that the driver of unit 1 did have his dash camera recording. After I reviewed the
footage, I was unable to determine whether he had his blinker on or not.
PAGE 3 OF 5
SUPPLEMENTAL REPORT NO. EE60149
r` POLICE TRAFFIC 1 27
COLLISION REPORT CASE# 24-2560
1 COMMERCIAL MOTOR CARRIER INTERSTATE INTRASTATE ✓ G
UNIT# 1 USDOT ICC# VEHICLE TYPE 4 CARGO BODY 9
TYPE
2 ❑ CARRIER 1 28
NAME
3 CARRIER
ADDRESS `
CITY ST' ZIP'
4 ❑ NAME # PLACARD: :❑ AME N IF NO NUMBER
SOURCE 3 AXLES 05 GI 10000 +
4a ❑ ADDITIONAL UNITS
MOTOR PEDAL- PROPERTY DAMAGE THRESHOLD MET PHONE
5 ❑ UNIT# VEHICLE I_J CYCLE _) PEDESTRIAN � OWNER � YES NO
i MIDDLE'... 29
LAST NAME FIRST NAME INITIAL
STREET 30
NFW AnDRFrtP. CITY ST ZIP
6 �
CDL GNITIttN REQUIRED GNITION PRESENT MEDICAL TANSPORTED 1 31
INTERLOCK YES No zERLOCK YES❑N0� vES N
LLIICIENSE STATE I SEX M��DYEYY' 2
7 F-I
ON DUTYl STATUS AIRBAG' RESTR. EJECT HELMET INJURY NATURE OF INJURIES
USE CLASS
8 ❑ ' 1 32
LICENSE+ rar VIN.#
PLATE#
9 TRAILER TRAILER
PLATE# STATE PLATE# STATE
10 ❑ TRLR TRLR
VIN.#. VIN.#.
11 VEH.YEAR MAKE I MODEL STYLE I VEHICLE TOWS E T SABLIN TOWED BY anvi vEHII' P FROM TO
DAMAGE YES NO YES NO
REGISTERED OWNER INFO. m 33
12 � SHADE IN DAMAGED AREA
7 j 4 FROM TO
LIABILITY INSURANCE❑ INSURANCE CO
IN EFFECT &POLICY# t 9 101?
VEHICLE 1 o BarroM 34
13 ❑ LEGALLY YES[:] NO❑ CITATION# CHARGE
STANDING �} MOTOR
8 7 6
14 ❑ UNIT Tr Vd 1 RE O CYDDAL OWNERRTY YES D-AMAGE NOHRESHOLD MET PHONE ❑ 35
PEDESTRIAN
❑15 LAST NAME FIRST NAME NIDDL 36
STREET
16 NFln+Aon "F—] CITY ST I ZIP
CDL IGNITION REdUiRED IGNITION PRESENT MEDICALTANSPORTED
INTERLOCK YES No INTERLOCK YEs NO YEs NO El
17 37
LICENSE# STATE SEX MMDDDYBYY
18 ❑ ON DUTY� STATUS AIRBAG RESTR. ; EJECT HELMET INJURY NATURE of INJURIES 38
USE (CLASS
19 ❑ vIN 39
LICENSE #
PLATE# rnr
20 ❑ TRAILER' TRAILER ❑ 40
PLATE# STATE PLATE# STATE
21 ❑ TRLR TRLR 41
VIN# YIN#i
42
22 VEH.YEAR MAKE I MODEL STYLE I VEHICLE TOWED DUE T SABLIN TOWED BY GOVT.VEHICLE
DAMAGE YES NO YES NO El
23 REGISTERED OWNER INFO_ SHADE IN DAMAGED AREA 43
3 4 71
LIABILITY INSURANCE INSURANCE CO '
IN EFFECT � &POLICY# i 970P - 4 E:l
A44
24 ....... YES❑ NO❑ CITATION# CHARGE iq 60TiOM
.Glly
STANDING 8 7 6
1 CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT.
C.CATALAN 03-12-24 12:11 PM
25 INVESTIGATING OFFICER'S SIGNATURE OFFICER'S PHONE UNIT OR DIST DET DATED: PLACE SIGNED
APPROVED BY DATE
26 OR ID# 12007 O#IL WA0171300 JACOBS 3/18/2024 PAGE�OF
3000-345-013(R 11118)
REPORT NO. EE60149 CASE# ' 24-2560 DATE AND TIME 03/08/24 10:06
OF COLLISION
NTS
SW 34th St
PAGE 5 OF 5