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I,,,; <br /> r. N STATE OF WASHINGTON <br /> S POLICE TRAFFICREPOIII 11110111111III II11111 REPORT NO. E861624 1 1 4 27 <br /> CASE# • 2018-131612 2 <br /> INTERSTATE ❑ CITY STREETI:I RESULTED ❑ <br /> 1 2 STATE ROUTE El OTHER El STOOICLE ❑ LOCAL AGENCY 3 <br /> ITS LVEDRUN CODING _ <br /> COUNTY RD ❑ PRIVATE WAY ❑ INVHO ❑ <br /> 2 2 281 OBJECT <br /> TOTAL 04 STRUCK BUILDING <br /> RESERVATION <br /> 2 <br /> 3 1 M M D D Y Y Y Y TIME(2400) COUNTY 5 MILES CITY 8 <br /> COWSION 11 16 - 2018 1514 31 S— — OF 0420 3 <br /> WON(PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON-INTERSECTION Z • <br /> 4 BLOCK NO.✓❑ <br /> LARIMER RD MILE POST❑ 6600 , ' 0 1 29 <br /> to <br /> . DISTANCE OF(REFERENCE OR CROSS STREET) <br /> 5 MILES = N — ELI <br /> FEET S_ W in <br /> UNIT Oi EDAMS THREE QLD MET PHONE <br /> HIC E CYCLE I_ YES I✓INO I I D:4258800257 30 <br /> GILVIN FIRST NAME. ALLEN 'MIDDLE - D <br /> 6 5 •LAST NAME. •INITIAL <br /> STREET105 N MCLEOD#2 <br /> NEW ADDRESf <br /> 7 <br /> CNy - ARLINGTON ST WA ZIP 98223 1 1 2 31 <br /> • <br /> 8 CDL - RESTRICTIONS ENDORSEMENTS. 2 <br /> 9 9 <br /> DRIVER'S <br /> RIILICENSE* GILV1AD238Q7 STATE WA SEX M D.O.B. 11 ." 27 - 1977 3 <br /> MMDDYYYY <br /> NATURE OF INJURIES 1 32 <br /> 10 ON DUTY In -STATUS AIRBAG. 3 RESTR. 4 EJECT I HEAT 2 (CLASS 1 <br /> 2 <br /> LICENSE BKC5956STATE WA VIN# YVILS5519P2088187 <br /> 11 3 0 PLATES <br /> 3 <br /> • <br /> TRAILER STATE • TRAILER STATE <br /> 12 PLATE S PLATE S <br /> VEH.YEARMAKE MODEL STYLE VEHICLE TOWED TOWED BY GOVT.VEHILE, FROM TO <br /> 2 1993 VOLV 850 SD YES IT/JNof • YET] NO <br /> 13 REGISTERED OWNER INFO.SHAYNA ELDRIDGE 704 87TH AVE NE N26 LAKE STEVENS WA 98258 ��� VEHICLE NO.1 <br /> 5 1 33 <br /> SHADE IN DAMAGED AREA <br /> - <br /> FROM TO <br /> UABIUTY INSURANCE INSURANCE CO 3 <br /> 14 IN ffFECT &POLICY 8 Q I _SOP 34 <br /> Q.�6a s <br /> VEHICLE CITATION 8 CHARGE BOTTOM <br /> LEGALLY YE� NCD 8Z1082665,8Z1082665, NEGLIGENT DRIVING 2ND DEGREE, `® e <br /> 15 2 STANDING <br /> MOTOA PEDAL- PROPERTY D TH OLD MET PHONE 4 35 <br /> •UNIT:02 VEHICLE �.. . CYCLE ❑ PEDESTRIAN ❑ OWNER ❑✓ YENO D:4257831000 <br /> 16 <br /> MIDDLE 36 <br /> LAST.NAME PUD FIRST NAME INITIAL <br /> 17 STREET37 <br /> NEW A0DRE8❑ 2320 CALIFORNIA ST <br /> 38 <br /> 18 CITY. EVERETT ST WA ZIP' 98201 <br /> 39 <br /> 19 CDL RESTRICTIONS ENDORSEMENTS <br /> 40 <br /> DRIVER'SU D.O.B. <br /> 20 LICENSEE STATE SEX MMDDYYYY - <br /> 21 ON DUTY ❑ STATUS AIRBAG RESTR.' EJECT HELMET INJURY NATURE OF INJURIES <br /> USE CLASS <br /> 22 LICENSE STATE VIN# <br /> PLATE 42 <br /> 23 TRAILER STATE TRAILER:•' STATE 1 <br /> PLATE S PLATE S 41 <br /> VEH.YEAR MAKE MODEL STYLE VESEHICLE NOYL1On TOWED BY YE�E NIgLEI <br /> 42 <br /> 24 <br /> REGISTERED OWNER INFO. VEHICLE NO.2 <br /> - <br /> SHADE IN DAMAGED AREA <br /> 2 3 4 <br /> UABIUTY INSURANCE Iu INSURANCE CO / <br /> IN EFFECT &POLICY 0 1 ISBDTT7OP0. <br /> S <br /> VEHICLE Y"d miu CITATION S CHARGE <br /> 25 SO% \ <br /> 6 7 6 <br /> OFFICER'S NAME PRINT) BADGE OR ID 8 AGENCY <br /> MARK GIST 9419 WA0310300 <br /> 26 ' <br /> PAGE 01 OF 14 <br />