HomeMy WebLinkAbout23-8491 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 1 27c
COLLISION REP FIT 1591971
CASE 23-8491 z
INTERSTATE ❑ CITY STREET FIRE ❑RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHICCI F ❑ LOCAL AOENC 4900 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 3 TOTAL#OF OBJECT 1 1 8 28
TRIBAL UNITS OZ RESERVATION STRUCK
z
3❑ DATE OF M M D D Y Y Y Y TIME(2400) COUNTY# MILES N E IN CITY# ❑
CowsloN 07 - 1-- 2023 1850 17 ❑.= S 8 E IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓
S CARR RD BLOCK NO. e ---
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ 100 00 FEET MILES e S ❑ W e 111THAVESE
0 1 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
,/No D:4255186623 0 11
30
6� LAST NAME AYDELOTTE FIRSTNAME KYLE MIDDLE A 1 1 2 31
INITIAL
STREET ❑, 18631 E SPRING LAKE DR SE CITY RENTON ST I WA 2jp, 98058 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 H USE 2 1 CLASS NATURE OF INJURIES 2❑
3
10 9❑ Pi ATE 14 BZS4592 STATE WA u N# 1J4GW48S73C610047
11[-j- TRAILER STATE TRAILER STATE
11 3 5 PLATE# PLATE# 1R.. ro
TRLR. TRLR 7 3 33
12 3 5 VIN#j VIN#
:: FROM TO
VEH.YEAR 2003 MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE 7 3 34
13 4 JEEP GRAND UT DAMAGE YES NO YES[:] No
✓
REGISTERED OWNER INFO KYLE AYDELOTTE 18631 E SPRING LAKE DR SE RENTON WA 98058 D:4255186623 VEHICLE NO. 1
❑ ❑
SHADE IN DAMAGED AREA 35
14 LIABILITY INSURANCE INSURANCE CO LIBERTY MUTUAL AOS261965327023
IN EFFECT &POLICY# 9TOP
VEHICLe CHARGE 5 36
LECALLv YES❑NO❑ CITATION# 1 o BOTTOM
15❑ STANDING 8 6
MOTOR PEDAL- PEDESTRIAN
16 a PROPERTY DAM THR OLD MET PHONE
UNIT VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES 1/ NO D:2065169689
LAST NAME BARRERRA AMARO FIRST NAME ANA MIDDLE Y
INITIAL
17 STREET❑ NEW ADOREss❑' 7901 199TH ST SW CITY EDMONDS ST WA ZIP 98026 37
18❑ CDL IGNITION REQUIRED IGNITION PR-E-1SENT MEDICAL-T�RANSPORTED � 38
INTERLOCKYES�NOR INTERLOCK YEs It I NOF YES
t l NO❑
19 D IVEW #
ON DUTY STATUS AIRBAG,2 RESTR 4 EJECT 1 HE 2 INJURY 7 NATURE of INJURIES 40
USE CLASS SORESACK
LICENSE I ❑21❑ PLA E# CFX1698 TATE 41
WA VIN# 7SAYGAEESPF629132 1
42
22❑ PLATE# STATE PLATE# STATE
TRLR
23❑ UIN#. N#.
43
RLR
'I
VEH YEAR 2023 MAKE TESL MODEL MODELS STYLE SD VEHICLE TOWED TO BLIN TOWEDBY GOV HI 44
L4❑ DAMAGE YES NO YES NO
REGISTERED OWNER INFO ANA BARRERRA AMARO 7901199TH ST SW EDMONDS WA 98026 D:2065169689 VEHICLE NO.2
SHADE IN DAMAGED AREA
2 3 4
LIABILITY
INSURANCE INSU&PORGY#E CO PROGRESSIVE 04328871IN 1Cal
vE""LE ❑ ,J� CITATION# CHARGE
LEGALLY YES N`L J
25 7TRADER
NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
J
26 4553 WA0171300
PART A PAGE 01 OF
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. ED82680
COLLISION REPORT III III III III III 111
1591972 CASE# 23-8491
ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY)
NAME MIDDLE INITIAL) VANGELIS /NESESKAI K
(LAST FIRST,
ADDRESS&PHONE#
7901 199TH ST SW EDMONDS WA 98026 SEXi F MMDDYyry 11 - 29 - 2021
PASSENGER WITNESS UNIT# SEAT AIRBAG' RESTR. EJECT ' HELMET INJURY NATURE OF INJURIES
❑✓ ❑ 2 P08, 7 2 10 1 USE 2 CLASS I1
NAME
(LAST,FIRST,MIDDLE INITIAL) VANGELIS LILLIKAI V
ADDRESS&PHONE# D O B
7901 199TH ST SW EDMONDS WA 98026 SEX I F MMDDYvvv 02 _ 23 _ 2019
SEAT HELMET INJURY NATURE OF INJURIES
PASSENGER WITNESS❑ UNIT# 2 POS 9 AIRBAG 2 RESTR. 10 EJECT 1 USE 2 CLASS 1
NAME
(LAST FIRST,MIDDLE INITIAL) SJOLIN STEFANI A
ADDREss&PHONE# 24823 114TH AVE SE KENT WA 98030 2067304359 SEX F D.O.B. 08 _ 23 _ 1993
MMDDYYYY
PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET NJURY NATURE OF INJURIES
❑ Z POS. USE CLASS ----�
NARRATIVE'
On 07/24/2023 at approximately 1858 hours, I was dispatched to a two vehicle collision in the 1111
block of Carr RD S, in the City of Renton, County of King.
i arrived and spoke with the driver's of both vehicles and they agreed to move off of the roadway and
into the parking lot of KFC. The driver of Unit 1 was identified as AYDELOTTE and he was driving
vehicle license BZS4592. He said he was driving EB up Carr RD S and started to spin sideways and
lost control of his vehicle colliding with Unit 2.
The driver of Unit 2 was identified as BARRERRA AMARO with a WA State license. She confirmed
she was driving EB on Carr RD S in the curb lane when Unit 1 slid into her vehicle. She complained
of neck and back pain as a result of the collision. Renton Fire treated her at the scene and released
her. She had two small children in the back seat, both in proper car seats.
Witness Sjolin said Unit 1 started spinning and slid into Unit 2. She did not believe he did anything to
make his vehicle slide and thought it was due to the slippery roads.
The roads were wet from the first rain in over one month. The roads were very slippery and my patrol
vehicle lost traffic in the same location the collision occurred as I tried to move to the KFC parking lot.
I did not cite the driver of Unit 1 for any violations. His vehicle did slide into Unit 2's lane and collided
with Unit 2.
I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT.
J.TRADER 07-25-23 12:52 AM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
J.TRADER 4553 1 712512023 12:54:27 AM
BADGE OR ID# 4553 ORI#' WA0171300 TIME POLICE DISPATCHED 6:58 PM TIME POLICE ARRIVED]7:08 PM
PART I PAGE IT]OF 3�
REPORT NO. ED82680 CASE# ' 23-8491 DATE AND TIME 07/24/23 18:50
OF COLLISION
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