HomeMy WebLinkAbout24-2206 a POLICETRAFFic" II I f I) 11I1ll(111(111l If( f 11 REPORT NO. EE54961 170
27
COLLISION REP FIT 1591971
SASE 24-2206 2
INTERSTATE ❑ CITY STREET FIRE ❑RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHIr.I F ❑ LOCAL AOENC 4200 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 3 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#
COLLISION.. 02 - 1-— 2024 1652 17 ❑-= S 8 IN e 1070 3
4 4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
RAINIER AVE N BLOCK NO. e✓ 300 ❑
4a 2❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ �.❑ FEET e S ❑ VV a NW 3RD ST
0 4 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
✓NO D:2069928065 0 11
30
6 LAST NAME BORJA ALAS FIRST NAME JOSE MIDDLE 1 1 2 31
INITIAL
STREET ❑ 2703 S HINDS ST APT 1 CITY SEATTLE ST WA ZIP 981446820 z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
iNTERLOCKYEs NO INTERLOCKYEs NO YEs NO
8❑ LRIIVER #
ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 H USEET 2 CLASS 1 NATURE OF INJURIES z❑
3
,OF
PI ATE14 BBJ5880 JBTATIJ WA uN# 2HNYD18631H517922
TRAILER STATE TRAILER STATE
11 0 0 PLATE# PLATE# FROM TO
TRLR. TRLR 7 1 33
12 0 0 VIN#' VIN#
>; FROM TO
VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE 1 $ 34
13 2 2001 ACUR MDX UT DAMAGE YES NO YES[:] NO✓
REGISTERED OWNER INFO JOSE BORJA ALAS 2703 S HINDS ST SEATTLE WA 98144 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
14 LIABILITY INSURANCE INSURANCE CO STATEFARM 4171054-C28.47 3 4
IN EFFECT &POLICY# 9TOP
ve'CLe CHARGE 1 5 36
LEGALLv Yes❑NO❑ CITATION# 10 BOTTOM
15❑ STANDING 6
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT 02 VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES 1/ NO D:2065955028
16 a
LAST NAME BROWN FIRST NAME ANTHONY MIDDLE I D
INITIAL
17❑ STREET ❑', 21029 119TH AVE SE CITY KENT ST WA ZIP 980312185 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 WA SEX M D.C.B. 09 _ 10 _ 1963 39
LICENSE# MMDDYY
HELMET {NJURY 1 NATURE OF INJURIES 40
20❑ ON DUTY STATUS AIRBAG 6 RESTR 4 EJECT 1 USE 2 CLASS ❑
21❑ LICENSE CBX4988 TAre WA vIN# 1FMCUOGXIFUC61431
❑ 41
PLATE#
42
22❑ PLATE# STATE PLATE# STATE
23❑ VIN#. 43
TRLR RLR
'IN#.
VEH YEAR 2015 MAKE FORD MODEL ESCAPE STYLE VEHICLETOWED TO BLIN TOWEDBY GOV HI 44
24❑ DAMAGE YES NO YES NO
REGISTERED OWNER INFO ANTHONY BROWN 21029119TH AVE SE KENT WA 98031 VEHICLE NO.2
SHADEDAMAGEDAREA
3 4
LIABILITY
INSURANCE INSU&PORGY#E CO PROGRESSIVE 901514956IN STOP 5
VE""LE LEG ❑ Nu,J CITATION# CHARGE to BOTTOM
25 ALLY YES ' a
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. EE54961
COLLISION REPORT III III III III III 111
1591972 CASE# 24-2206
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 February 28, 2024, at 1652 hours dispatch requested that I respond to a collision near NW 3rd St.
and Rainier Avenue N, In the city Renton, county of king, and state of Washington.
Upon my arrival I spoke with the driver of unit 1 and he explained that he was attempting to make a
left turn from NW 3rd St. onto Rainier Avenue N to go northbound. As he waited at the stop sign,
vehicles in the number 1 southbound lane created a gap for him to proceed through. As he moved
forward, he failed to notice unit 2 in the adjacent lane. Unit 2 was in the number 2 lane going
southbound. Unit 1 was unable to move their vehicle out of the way, so unit 2 struck their driver's side
door and fender.
I then spoke with the driver unit 2 and he explain that he was going southbound number 2 lane when
the collision occurred. The driver unit 2 stated that unit 1 crossed into his lane and was unable to
bring their vehicle to a complete stop. Unit 2 sustained heavy damage to the front of the vehicle and
was undrivable at that point.
Unit 2 was towed away by Bankers Towing and I provided both drivers with an exchange of
information.
CC
I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT.
C.CATALAN 02-28-24 06:18 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
CO.JOHNSON 0505 1 2/29/2024 5:49:23 PM
BADGE OR ID# 12007 OR]# WA0171300 TIME POLICE DISPATCHED` 4:55 PM TIME POLICE ARRIVED';5:04 PM
PART I PAGE IT]OF
REPORT NO. EE54961 CASE# ' 24-2206 DATE AND TIME 02/28/24 16:52
OF COLLISION
NTS
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