HomeMy WebLinkAbout24-1836 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 6 27c
COLLISION REP FIT 1591971
CASE 24-1836 z
INTERSTATE ❑ CITY STREET FIRE ❑RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHICI 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#
cawsloN 02 - 1-- 2024 0605 17 ❑.❑ S 8 W e IN 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 ❑ OF OFF RAMP EXIT 5/-40
0 1 29
UNIT 01 VEHICLE
MOTORCYCCLE ElYESA,G/ENHORESHOLDMET PHONE 0 4 30
6� LAST NAME KHUON FIRSTNAME PEAO MIDDLE N 1 1 2 31
INITIAL
STREET ❑ 1141 GLENNWOOD AVE NE UNIT B CITy RENTON ST WA ZIP' 980563192 z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
iNTERLOCKYEs NO INTERLOCKYEs NO YES R NO
8❑ LRIIVERS STATE WA SEX'F MM DAY' 10 1- 15 - 1970 2 32
CENSE 9 ON DUTY❑ STATUS' AIRBAG 6 RESTR 1 EJECT 1 H U EET 7 CLASS R[NATURE
UR OF INJURIES 2❑
3
10❑ PI ATNE 14 CJB6935 STATE WA u N# 4T1 BG22KOYU657427
TRAILER STATE TRAILER STATE
11 3 5 PLATE# PLATE# FROM To
TRLR. TRLR 7 3 33
12 3 5 VIN#' VIN#
ROM TO
❑ VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN T GOVT.VEHICLE 1 3 34
13 2 2000 TOYT CAMRY DAMAGE vEs 0NO f �LAWkkRS vEs❑ No✓
REGISTERED OWNER INFO BRANDON STEPHENSON 1702 MAGNOLIA ST SE APT LACEYWA98503 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
14 ABILI V INSURANCE INSURANCE CO PROGRESSIVE 926699631 4
IN EFFECT &POLICY# TOPvEBI L CHARGE 36
LEGALLY YES❑NO❑ CITATION# 4A0078039 FAIL TO OBEY TRAFFIC CONTROL <1�3
orrow
15❑ 1ND'ING 6
UNIT VE IMOTOOR CYCLE ❑ PEDESTRIAN ❑ PROPE OWNFRRTY ❑ DYES✓ NO OLDMET PHONE
16 a
LAST NAME FIAMALUA FIRST NAME JOSEPH MIDDLE I L
INITIAL
17❑ STREET ❑', 10612 SE 273RD CT CITY' KENT ST WA ZIP 980307067 37
NEW ADDRESS ❑
18� CDL IGNITION REQUIRED IGNITION PR-E-1SENT MEDICAL TRANSPORTED ❑ 38
INTERLOCKYES�NOR INTERLOCK YEs It I NOF YES t t- l NO❑
19 DRIVERS STATEASEXMo _ _ 39
# MM D.O.B.
WELMET INJURY1 NATURE OF INJURIES 40
20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 USE CLASS ❑
21❑ LICENSE I CGT1101 TATe WA VIN# KMHGC4DD8CU203236
❑ 41
PLATE#
42
22❑ PLATE# STATE PLATE# STATE
TRLR
23❑ UIN#. N#.
43
RLR
'I
VEH YEAR 2012 MAKE HYUN MODEL GENESIS STYLE VEHICLE TOWED TO BLIN TOWEDBY GOV HI 44
24❑ DAMAGE YES✓ NO BANKERS YES NO✓
REGISTERED OWNER INFO JOSEPH FIAMALUA 10612 SE 273RD CT KENT WA 98030 VEHICLE NO.2
SHADE IN DAMAGED AREA
2 3 4
INAEFFIECTTY NSURANCE INSU&POLICY#E CO SAME. 1 9TOP 5
vE""LE ❑ N`L J
,J� CITATION# CHARGE
LEG
25 i o BOTTOM
ALLY YES $
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. EE52800
COLLISION REPORT III III III III III 111
1591972 CASE# 24-1836
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'
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 02-20-24 09:57 AM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
CO.JOHNSON 0505 1
2/22/2024 8:52:58 AM
BADGE OR ID# 2517 ORI# WA0171300 TIME POLICE DISPATCHED 6:05 AM TIME POLICE ARRIVED 6:14 AM
PART I PAGE IT]OF 4�
REPORT NO. EE52800 CASE# 24-1836 OF COLLISION
02/20/24 06:05
OF CbLLI510N
NARRATIVE
slv/1 straight up hill blk2 It on green
CC
Within the city limits of Renton/King/WA I responded to a 2 car blocking crash at the intersection of
NE Sunset Blvd at the off/on ramp to 1-405.
1 contacted the driver of unit 2 who told me he was exiting the freeway onto NE Sunset Blvd on his
solid green light when he was hit by unit 1 going up the hill on Sunset. He didnt complain of injury
and damages required a tow truck.
I contacted the driver of unit 1 ID'd by picture WADL. She told me she did not run a red light and did
not crash into unit 2 She did not provide any additional information. She did complain of injury and
was checked and released on scene by Renton Fire. Her vehicle was towed for damages.
I cited unit 1 ref RCW 46.61.055 FTCWTCD-Red Light 2 car crash via complaint.
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 2/20/2024
PAGE 3 OF 4
REPORT NO. EE52800 CASE# 24-1836 DATE AND TIME 02/20/24 06:05
OF COLLISION
u.
z.
PAGE 4 OF 4