HomeMy WebLinkAbout24-3347 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 1 27c
COLLISION REP FIT 1591971
CASE 24-3347 z
INTERSTATE ❑ CITY STREET FIRE ❑RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHICI F ❑ LOCAL AOENC 4Y00 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 3 TOTAL#OF OBJECT 1 1 8 28
TRIBAL UNITS 02 STRUCK
RESERVATION
z
3❑ DATE OF M M D D Y Y Y Y TIME(2400) COUNTY# MILES N E IN CITY#
COLLISION.. 03 - 1-— 2024 0823 17 ❑-= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
TALBOT RD S BLOCK NO. e✓ 1400 ❑
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ �.❑ FEET e S ❑ W e S PUGET DR
0 1 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
NO F,/ I D:2062516219 0 11
30
6� LAST NAME PORTER FIRSTNAME SAMUEL MIDDLE L 1 2 31
INITIAL
STREET ❑ 611 SW 5TH CT#A107 CITY RENTON ST WA ZIP 98057 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 USE 2 1 CLASS NATURE OF INJURIES z❑
3
10 1❑ P1 ATE 14 BRK9791 STATE WA V N# 2G1WB5E35F1157548
TRAILER STATE TRAILER STATE
11 0 0 PLATE# PLATE# FROM ro
TRLR. TRLR. 5 1 33
12 0 0 VIN#' VIN#
:: FROM TO
❑ VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE 5 1 34
13 2 2015 CHEV IMPALA SD DAMAGE YES NO YES[:] NO✓
REGISTERED OWNER INFO OWNEDBYDRIVER VEHICLE NO. 1
SHADE IN DAMAGED AREA ❑ 35
14 LIABILITY INSURANCE❑ INSURANCE CO 4
IN EFFECT &POLICY# 9TOP
VEH'CLE CHARGE 5 36
LEGALLY Yes❑NO❑ CITATION# 10 BOTTOM
15❑ NDING 8 7 6
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT 02 VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES NO ,/ D:2068906219
16 a
LAST NAME WARREN FIRST NAME BOBBY MIDDLE Ij
INITIAL
17❑ STREET ❑', 25617 118TH PL SE CITY' KENT ST WA ZIP 98030 37
NEW ADDRESS ❑
18� CDL IGNITION REQUIRED IGNITION PtR-E-S1ENT MEDICAL TRANSPORTED ❑ 38
INTERLOCK YEs❑No� INTERLOCK YEs I I NOF YES
t l NO
�
19 DRIVEWS,LICENSE STATE WA SEX M M D.C.B.
02 1_ O6 _ 1954 39
WELMET {NJURY NATURE OF INJURIES 40
20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 USE 2 CLASS 1 ❑
21❑ LICENSE AXZ0318 TATe WA VIN. KMHCT4AE5CU108922
❑ 41
PLATE#
42
22❑ PLATE# STATE pLATE# STATE
23❑ 43
TRLR RLR
VIN#. IN#.
GI
VEH YEAR 2012 MAKE yyUN MODEL ACCENT STYLE $D DAMAGE TOWED NOO✓ BLIN TOWED BY ov HYES NO 44
24❑ ES
REGISTERED OWNER INFO OWNED SY DRIVER VEHICLE N0.2
SHADE IN DAMAGED AREA
2 3 4
INAEFFITY ECTNSURANCE❑ &POINSULICY#E CO I STOP 5
VE""LE ❑ ,J� CITATION# CHARGE i o BOTTOM
LEGALLY YES N 6
25 7CA
NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
26LAN 12007 WA0171300
PART A PAGE 01 OF
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EE67084
COLLISION REPORT III III III III III 111
1591972 CASE# 24-3347
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 28, 2024, at 0823 hours dispatch requested that I respond to a collision that occurred at
Talbot Rd S and S Puget Dr, in the city of Renton, county of King, and state of Washington.
Upon contact I spoke with the driver of unit 1, and he explained that the collision occurred after both
vehicles crossed the intersection and drove northbound towards 1405. Prior that, the driver of unit 1
stated that unit 2 was pacing the vehicles in the slow lane (the number 1 lane). They were both
driving in the number 2 lane. After they crossed the intersection, unit 2 began to merge right, so unit 1
drove left and around them. As unit 1 passed unit 2, the driver of unit 2 purposely swerved left and
struck his wheel.
Both then pulled into the nearest driveway and called for police assistance.
I then spoke with the driver of unit 2 and he explained a similar story. Unit 2 was driving in the 2
northbound lane, pacing traffic down the roadway. Unit 1 was tailgating them, so after they crossed
the intersection of S Puget Dr, he began to merge right to allow passage to unit 1. Unit 1 then pulled
next to unit 2 and purposely swerved right and struck his drivers side door and front fender.
Both drivers were upset about the collision, and both drivers blamed each other for the damages.
I was unable to determine who committed the traffic violation, so an exchange of information was
given to both drivers.
The damage sustained by the two vehicles was moderate and no one complained of any injuries.
I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT.
C.CATALAN 04-05-24 10:26 AM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
C.JACOBS 1953 1 411012024 3:54:56 PM
BADGE OR ID# 1Y007 ORI# WA0171300 TIME POLICE DISPATCHED 8:25 AM TIME POLICE ARRIVED';8:47 AM
PART I PAGE IT]OF 3�
REPORT NO. EE67084 CASE# 24-3347 DATE AND TIME 03/28/24 08:23
OF COLLISION
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