HomeMy WebLinkAbout24-3033 POLICETRAFF'c" III !�� I IIIllI111IN II II I REPORT NO. EE62775 170
27
COLLISION REP FIT 1591971
CASE 24-3033 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 2 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 03 - 1-- 2024 1233 17 ❑-= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
TALBOT RD S BLOCK NO. e ❑
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ ❑ FEET e S ❑ VV e S 43RD ST
1 2 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
NO F,/ I D:2089571774 0 11
30
6� LAST NAME BIANCHI FIRSTNAME THOMAS MIDDLE T 1 2 31
INITIAL
STREET ❑ 10301 GREENWOOD AVE N APT B10 CITY SEATTLE ST WA 2jp, 981339155 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 HELMET
2 CLASS 1 NATURE OF INJURIES z❑
3
10❑ PI ATE BKZ8151 sTATI WAvIN#' 5XXGN4A74CG073829
TRAILER STATE TRAILER STATE
11 0 0 PLATE# PLATE# FROM TO
TRLR. TRLR 7 3 33
12 0 0 VIN#' VIN#
>; FROM TO
VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE 7 $ 34
13 2 2012 KIA OPTIMA DAMAGE YES NO YES[:] No
✓
REGISTERED OWNER INFO THOMAS.1.411 110301 GREENWOOD AVENAPTB10 SEATTLE WA 98133 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
14 LIABILI INSURANCE INSURANCE CO SAFECO M1891279 3 4
IN EFFECT &POLICY# 9TOP
VEHlcl.e
15❑ 5 36
LEGALLY YES❑NO❑ CITATION# CHARGE 1 o BOTTOM
STANDING 7 6
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT VEHICLE ❑ CYCLE ❑ ❑ : OWNER ❑ YES 1/ NO D:2295605702
16 a
LAST NAME ALLEN FIRST NAME GRIFFEN MIDDLE I/
INITIAL
17❑ STREET ❑', 4525 4TH AVE NE CITY SEATTLE ST WA ZIP 981054812 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 DRIVER'S STATE WA SEX M D.C.B. 04 12 _ 1994 0 39
LICENSE# MMDDYY
HELMET {NJURY 1 NATURE OF INJURIES 40
20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 USE 2 CLASS ❑
21❑ LICENSE I BZR8368 TATe WA vIN# JF2GTAEC7KH279919
❑ 41
PLATE#
42
22❑ PLATE# STATE PLATE# STATE
23❑ UIN#. 43
TRLR RLR
'IN#.
VEH YEAR 2019 MAKE SIJBA MODEL CROSST STYLE VEHICLETOWED TO BLIN TOWEDBY GOV HI 44
L4❑ DAMAGE YES NO YES NO
REGISTERED OWNER INFO RONALD ALLEN 12112TH AVE E UNIT 202 SEATTLEWA98102 VEHICLE NO.2
SHADE DAGED AREA
4
LIABILITY
INSURANCE INSU&PORGY#E CO STATEFARM 498 0665-A31-47IN IGQVE""LE
❑ ,J� CITATION# CHARGE
LEGALLY YES N`L J
25
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. EE62775
COLLISION REPORT III III III III III 111
1591972 CASE# 24-3033
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 March 20, 2024, at 1233 hours dispatch requested that I respond to a blocking collision at Talbot
Rd S and S 43rd St, in the city of Renton, county of King, and state of Washington.
Upon my arrival I spoke with the driver of unit 1 and they said they were merging left when the
collision occurred. The driver of unit 1 explained he was moving from the right turn lane to the left turn
lane on S 43rd St. As he merged left, he failed to see unit 2 in the left turn lane, striking their right
front wheel.
I then spoke with the driver of unit 2. He explained that he was in the left turn lane proceeding forward
when he was struck by unit 1. He mentioned that his vehicle became undrivable after the collision and
believes something internal was damaged. He said that his wheel prevented him from moving
forward.
An exchange of information was given to both drivers in both refused any medical attention.
Unit 2 was removed from the scene by Gene Myers towing.
I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT.
C.CATALAN 03-20-24 02:09 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
CO.JOHNSON 0505 1 3/26/2024 2:26:53 PM
BADGE OR ID# 12007 ORI# WA0171300 TIME POLICE DISPATCHED 12:35 PM TIME POLICE ARRIVED';12:45 PM
PART I PAGE IT]OF
REPORT NO. EE62775 CASE# ' 24-3033 DATE AND TIME 03/20/24 12:33
OF COLLISION
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