HomeMy WebLinkAbout23-823 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 1 27c
COLLISION REP FIT 1591971
❑ ❑ FIRE RESULTED ❑ CASE 23-823 z
INTERSTATE CITY STREET FIRE
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHIr.I F ❑ LOCAL AGENCI 4250 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 TOTAL#OF OBJECT 1 8 2$
TRIBAL UNITS OZ STRUCK
RESERVATION
z
3❑ DATE OF M M D D Y Y Y Y TIME(2400) COUNTY# MILES CITY# ❑
cawsloN 01 - 19 - 2023 1013 17 ❑.❑ N E IN S 8 W H OF e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
BLOCK NO.
NE SUNSET BLVD e✓ --- ----�
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ �.❑ FEET e S ❑ W e DUVAL!AVE NE
1 9 29
UNIT 01 VEHICLE
MOTZ PEDAL-ORCYCLE ElDESA✓NHORESHOLD MET PHONE 0 4 30
6� LAST NAME UNKNOWN FIRSTNAME MIDDLE 1 1 2 31
INITIAL
STREET ❑ CITY ST zIP 2
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
iNTERLOCKYEs NO INTERLOCK YES NO YES No
8❑ LIRCIENSRE#
STATE I
SEX u MMDDYY - 1 1 2 32
9 ON DUTY❑ STATUS I
AIRBAG 9 RESTR 9 EJECT 1 H U EEr 9 CLAY 0 NATURE OF INJURIES z❑
3
10 1❑ P1 ATNES# CCt 6079 sTAT WAu N# KNDJN2A23F7781274
5 TRAILER STATE TRAILER STATE
11 3 5 PLATE# PLATE# Rom To
TRLR. TRLR 3 7 33
12 3 5 VIN#' VIN#'
>; FROM TO
VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE 3 $ 34
13 2 2015 KIA SOUL DAMAGE YES NO YES❑ NO✓
REGISTERED OWNER INFO KAYLA LOCK 3543168TH AVE NE BELLEVUE WA 98008 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
14 LIABILITY INSURANCE❑ INSURANCE CO
IN EFFECT &POLICY# 9TOP
VENICLE CHARGE 5 36
LECALLv YES❑NO❑ CITATION# 1 o BOTTOM
15❑ STANDING
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES 1/ NO D:4253010430
16 a
LAST NAME VAKHTEROV FIRST NAME ANNA MIDDLE N
INITIAL
17 STREET❑ NEW ADDRESS❑' 4205 NE 7TH ST CITY RENTON ST WA ZIP 980594746 37
18❑ CDL IGNITION REQUIRED IGNITION PtR—E—S1ENT MEDICAL—T�RANSPORTED ❑ 38
INTERLOCKYES�NOR INTERLOCK YEs I I NOF YEs t l NO❑
19 LICENSE# STATE WA SEX F M D.C.B. 01 01 1982 El 39
WELMET INJURY1 NATURE OF INJURIES 40
20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 USE CLASS ❑
LICENSE ❑21❑ PLA E# BRW1301 TATe 41
WA VIN# SFNYF8H06K6024571 4
42
22❑ PLATE# STATE PLATE# STATE
TRLR
23❑ UIN#. IN#.
43
RLR
'
VEH YEAR 2019 MAKE HOND MODEL PASSPOR STYLE VEHICLETOWED TO BLIN TOWEDBY GOV HI 44
L4❑ DAMAGE YES NO YES NO
REGISTERED OWNER INFO ANNA VAKHTEROV4205NE7THST RENTON WA 980594746 D:4253010430 VEHICLE NO.2
SHADE IN DAMAGED AREA
2 3 4
LIABILITY
INSURANCE INSU&PORGY#ECO ALLSTATE 917 950 783IN 1UQ'E""LE
❑ ,J� CITATION# CHARGELEGALLYYES N`L J25
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
J
26
M.lEVERTON 2517 WA0171300
PAGE 01 OF
PART A
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. ED26475
COLLISION REPORT III III III III III 111
1591972 CASE# 23-823
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.
M.LEVERTON 01-19-23 12:02 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
CO.JOHNSON 0505 1 111912023 1:09:24 PM
BADGE OR ID# 2517 ORI# WA0171300 TIME POLICE DISPATCHED'; 10:13 AM TIME POLICE ARRIVED]10:56 AM
PART I PAGE IT]OF 4�
REPORT NO. ED26475 CASE# 23-823 OF COLLISION
01/19/23 10:13
OF CbLLI510N
NARRATIVE
suspect vehicle fled hit white suv/unit 2 loc her It
Within the city limits of Renton/King/WA I responded to the intersection of NE Sunset Blvd and Duvall
Ave Ne for a hit and run.
I contacted unit 2 near the Starbucks parking lot. She told me she was just about to proceed on her
green light to make a left turn from Sunset to SB Duvall when a smaller black SUV going very fast
passed her on her left and clipped her front fender. She did not complain of injury and damages did
not require a tow truck. Unit 2 described the suspect car/unit 1. 1 showed her a very short video clip
of the car and she was positive it was the same car that hit her.
Unit 1 was involved in a variety of other crimes, including hit and run to several other vehicles while
fleeing police. The driver was never contacted but the car was eventually impounded ref those other
crimes. It was later discovered the car was an unreported stolen at the time of the crash-hit and run.
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 1/19/2023
**** AUTO-POPULATED SECTION ****
THE FOLLOWING ARE DESCRIPTIONS ENTERED FOR ITEMS SELECTED AS "OTHER":
Motor Vehicle Unit 1
Action Code: LEFT OF CENTER FLEEING CRIME SCENE
**** END OF AUTO-POPULATED SECTION ****
PAGE 3 OF 4
REPORT NO. ED26475 CASE# ' 23-823 DATE AND TIME 01/19/23 10:13
OF COLLISION
tAV
AV
PAGE 4 OF 4