HomeMy WebLinkAbout23-2042 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 0 27c
COLLISION REP FIT 1591971
CASE 23-2042 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 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-- 2023 1741 17 ❑-= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
SW GRADY WAY BLOCK NO. e ❑
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ ❑ FEET e S ❑ VV a OAKSDALEAVE SW
0 4 29
UNIT MOTOR
VEHICL Z CYCLE ❑ DYESA✓NOESHOLD MET PHONE 0 1 30
LAST NAME ALEJANDRE HERRERA FIRST NAME ADRIANA MIDDLE
6 INITIAL 1 9 2 31
STREET ❑ 15205 62ND AVE S CITy KENT ST WA 2jp, 98032 z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
iNTERLOCKYEs NO 1/ INTERLOCKYEs NO Z/ YES R No�/
8❑ LRIIVER #
ON DUTY❑ STATUS AIRBAG 2 RESTR 9 EJECT 1 HELMET USE 2 CLASS 1 NATURE OF INJURIES z❑
3
10❑ P1 aT�S� CFD2705 sTArI WAurN# 3N1AB8CV1tY241390
TRAILER STATE TRAILER STATE
11 3 5 PLATE# PLATE# FROM TO
TRLR. YRLR. 3 5 33
12 3 5 VIN#' VIN#
>; FROM TO
VEH.YEAR 2020 MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE 7 3 34
13 4 NISS SENTRA SD DAMAGE YES NO YES[:] No
✓
REGISTERED OWNER INFO OWNEDBYDRIVER VEHICLE NO. 1
❑
SHADE IN DAMAGED AREA ❑ 35
14 LIABILI INSURANCE INSURANCE CO STATE FARM 5238493C1347A 3
IN EFFECT &POLICY# 9TOP
vECALLv HICLe 1 5 36
Yea❑NO❑ CITATION# CHARGE 10 BOTTOM
15❑ LE STANDING 8 6
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
�NiT VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES 1/ NO D:7276781403
16 a
LAST NAME THAPA FIRST NAME GAURAV MIDDLE
INITIAL
17 STREET❑ NEW ADOREss❑' 4835 TALBOT RD S CITY RENTON ST WA ZIP 98055 37
18❑ CDL IGNITION REQUIRED IGNITION PR-E-1SENT MEDICAL-T�RANSPORTED � 38
INTERLOCKYES�NO� INTERLOCK YEs It I NOF YES
t l NOF,/
19 LDICENS STATE WA SEX M M.C.. 11 28 _ 1984 El 39
HELMET {NJURY 1 NATURE OF INJURIES 40
20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 USE 2 CLASS ❑
21❑ LICENSE I BAM0966 TAre WA vIN# KM8R7DHE8NU393980
❑ 41
PLATE#
42
22❑ PLATE# STATE PLATE# STATE
23❑ VIN#. 43
TRLR RLR
'IN#.
TOWED BY GOV HI 44
VEH YEAR 2020 MAKE yyUN MODEL pgtISAD STYLE UT DAMAGE TOWED NOO✓ BLIN YES NO 1/
24❑ REGISTERED OWNER INFO OWNED SY DRIVER VEHICLE N0.2
SHADEDAMAGEDAREA
3 4
LIABILITY
INSURANCE INSU&PORGY#E CO TRAVELERS 6107343832031IN IULlliKOTlTlfll;0-
"'-F"'vEwcLE ❑ ,J� CITATION# CHARGELEGALLYYESN`L J25 O NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
J
26
J.TRADER 4553 WA0171300
PART A PAGE 01 OF
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT No. ED35735
COLLISION REPORT III III III III III 111
1591972 CASE# 23-2042
ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY)
NAME MIDDLE INITIAL) THAPA RANJITA A
(LAST FIRST,
ADDRESS&PHONE# D O.B. '
4835 TALBOT RD S RENTON WA 98055 2533280865 SEXi F MMDDYyry 10 - 27 - 1986
PASSENGER WITNESS UNIT# 2 pEA 3 AIRBAG 2 RESTR. q EJECT ? 1 HELMET INJURY NATURE OF INJURIES
USE 1 2 CLASS 11
NAME
(LAST,FIRST,MIDDLE INITIAL) THAPA GRACIE
ADDRESS&PHONE# DOB
4835 TALBOT RD S RENTON WA 98055 SEX' F MMD.:vB v 07 _ 14 _ 2018
SEAT HELMET INJURY NATURE OF INJURIES
PASSENGER �WITNESS UNIT# 2 POS 9 AIRBAG 2 RESTR. 10 EJECT 1 USE 2 CLASS 1
NAME
(LAST FIRST 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 02-20-2023 at approximately 1741 hours, Unit 2 was driving EB on SW Grady Way and
proceeded through the intersection of SW Grady Way and Oaksdale AVE SW. The driver of Unit 2
was identified as Gaurap Thapa with a WA State driver license. Thapa said he proceeded through
the intersection on a yellow traffic signal and Unit 1 made a left turn on to SB Oaksdale AVE SW
directly in front of him. Thapa said he was not able to stop in time and collided with unit 1.
Officer Ignatov spoke with the driver of Unit 1 Alejandra-Herrera. She told Officer Ignatov she was
WB on SW Grady Way and made a left turn SB on Oaksdale. The driver of Unit 1 Alejandra said he
traffic left turn light was yellow.
Based on statements made by both drivers it appears Unit 1 Failed to Yield Right of Way while
making a left turn.
I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT.
J.TRADER 02-20-23 08:34 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
J.CHRISTIANSEN 10437 1 212112023 12:07:29 AM
BADGE OR ID# 4553 ORI# WA0171300 TIME POLICE DISPATCHED'; 5:45 PM TIME POLICE ARRIVED 5:50 PM
PART I PAGE IT]OF
REPORT NO. ED35735 CASE# ' 23-2042 DATE AND TIME 02/20/23 17:41
OF COLLISION
SW Grady Way
w;
co
Y
N
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