HomeMy WebLinkAbout23-6837 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 5 27c
COLLISION REP FIT 1591971
CASE 23-6837 z
INTERSTATE ❑ CITY STREET FIRE ❑RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHIr.I F ❑ LOCAL AOENC 4Y00 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 1 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# ❑
cawsloN 06 - 1-- 2023 1550 17 ❑.= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓
SW43RD BLOCK e✓ 200
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ ❑ FEET e S ❑ W e 0 1 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
✓NO D:2065141902 0 11
30
6� LAST NAME WASHINGTON FIRSTNAME WALTER MIDDLE A 1 1 2 31
INITIAL
STREET ❑ 315 33RD AVE CITY SEATTLE ST WA ZIP, 981226337 z
NEW ADDRESS
7❑ 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
LICENSE CDV7787 sTArI WAVIN# WDDDJ72X67A088368
10 F91 PI ATE#
-- TRAILER STATE TRAILER STATE
11 3 5 PLATE# PLATE# FROM To
TRLR. TPILF1 1 5 33
12 3 5 VIN#j VIN#
FROM TO
VEH.YEAR 2007 MAKE MERZ MODEL CLS STYLE VEHICLE TOWED fn TO VBLINJ TOWED BY I GOVT.VEHICLE 7 3 34
DAMAGE YES NO YES[:] NO✓
13❑ REGISTERED OWNER INFO MACHELLEWASH/NGTON31533RDAVESEATTLEWA98122 VEHICLE NO. 1
SHADE IN DAMAGED AREA ❑ 35
14❑ LIABILI INSURANCE INSURANCE CO THE GENERAL WA 6196288 4
IN EFFECT &POLICY# 9TOP
ELE 1 5 36
LEGALGALLY YES❑NO❑ CITATION# 3A0387734 CHARGE FAIL TO YIELD MOTOR VEHICLE
L o eorroM
15❑ NDING 8 6
MOTOR PEDAL-:. PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
16
UNIT 02 VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES 1/ NO D:2067418888
a
LAST NAME AU FIRST NAME ANNA MIDDLE N
INITIAL
17❑ STREET ❑', 3625 EVERETT AVE APT 209 CITY EVERETT ST WA ZIP 982013879 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 DRIVER'S STATE I WA ]SEX IF I D.C.B. 03 _ 09 _ 1990 39
LICENSE# MMDDYY
WELMET INJURY1 NATURE OF INJURIES 40
20❑ ON DUTY STATUS AIRBAG 3 RESTR 4 EJECT 1 USE CLASS ❑
21❑ LICENSE I BZD2529 TAre WA VIN# JTDK820UX77088767
❑ 41
PLATE#
42
22❑ PLATE# STATE PLATE# STATE
TRLR
23❑ VIN#. IN#. 43
RLR
'
VEH YEAR 2007 MAKE TOYT MODEL PRIUS STYLE VEHICLETOWED TO BLIN TOWEDBY GOV HI 44
L4❑ DAMAGE YES NO YES NO
REGISTERED OWNER INFO ANNA AU 111018THAVEE#12 SEATTLEWA98112 VEHICLE NO.2
SHADEDAMAGEDAREA
3 4
LIABILITY
INSURANCE &POINSURGY#E CO PROGRESSIVE 214 53 2952IN STOP 5
'E""LE ❑ ,J� CITATION# CHARGE io BOTTOM
LEGALLY YES N`L J
25 ' a
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# JAGENCY
26
J.M/TCHELL 10377 WA0171300
PART A PAGE 01 OF C7
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. ED74242
COLLISION REPORT III III III III III 111
1591972 CASE# 23-6837
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
POS. 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'
On 061523 1 responded to a 2-vehicle non-injury/non-blocking collision at the 200 block of SW 43rd.
I contacted the driver of unit 2 who told me they were traveling eastbound in the right-turn only lane of
SW 43rd they were involved in a collision with unit 1 after unit 1 cut in front of them. The two vehicles
collided in the in the right-turn only lane. The driver says they were traveling at speeds around
30mph. The driver of unit 2 was not injured. Unit 2 sustained heavy front-end damage.
I contacted the driver of unit 1, identified as Walter A Washington (dob 09-24-87) via his WA DL.
Washington says he was crossing SW 43rd from a private way on the north side of SW 43rd.
Washington says both lane 1 and 2 of eastbound SW 43rd were stopped when he proceeded into the
right-turn only lane. Washington says he believes the driver of unit 2 was speeding and believes that
is why the vehicles were involved in a collision.
Both vehicles were able to make into a private driveway.
But not for the action of UNIT 1 DRIVER the result would not have happened.
I cited Washington via SECTOR under RCW 46.61.180.1 -Failure to Yield
I declare under penalty of perjury under the laws of the State of Washington that the foregoing is true
and correct.
I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT.
J.MITCHELL 06-20-23 03:20 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
C.JACOBS 1953 1 612712023 12:15:12 PM
BADGE OR ID# 10377 ORI# WA0171300 TIME POLICE DISPATCHED! 3:50 PM TIME POLICE ARRIVED',4:00 PM
PART I PAGE IT]OF 3�
REPORT NO. ED74242 CASE# 23-6837 DATE AND TIME 06/15/2315:50
OF COLLISION
N ml
SIN 43RD ST
4
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