HomeMy WebLinkAbout24-411 POLICETRAFF'c" III !�� I IIIllI111IN II II I REPORT NO. EE42057 170
27
COLLISION REP FIT 1591971
❑ ❑ RESULTED ❑ CASE z4-411 2
INTERSTATE CITY STREET FIRE
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHIr.I F ❑ LOCAL AOENC 4900 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 4 TOTAL#OF OBJECT 1 1 8 28
TRIBAL UNITS OZ STRUCK
RESERVATION
2
3❑ DATE OF M M D D Y Y Y Y TIME(2400) COUNTY# MILES N E IN CITY# ❑
COLLISION 01 - 11 - 2024 2006 17 ❑.❑ S 8 W H OF e 1070 3
4 4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓
SUNSET BVD NE BLOCK NO. e✓ 600
4a 1❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ 200 00 FMILES EET e S B W e BRONSON WAYNE
0 $ 29
MOTOR PEDAL- DAMAGE THRESHOLDHONE
UNIT 01 VEHICLE ❑ CYCLE El MET P
YES
�/No D:6693131503 0 11
30
6� LAST NAME TRAN FIRSTNAME DUY MIDDLE I V 1 1 2 31
INITIAL
STREET ❑1 12522 80TH AVE S CITY SEATTLE ST WA ZIP 98178 2
NEW ADDRESS
]❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
1/ I INTERLOCK YES[:]NO NTERLOCKYEs NO�/ YES R No�/
8❑ LRIIVER #
ON DUTY❑ STATUS AIRBAG 6 RESTR 4 EJECT 1 HELMET 2 INJURY 6 NATURE OF INJURIES 2❑
USE CLASS COMPAINT OF HEAD PAIN DUE TO AIRBAG
3
10 9❑ Pl ATE 14 CKE1161 STATE WA u N#' 2CTFLTEC4B6379704
TRAILER STATE TRAILER STATE
11 2 5 PLATE# PLATE# FROM ro
TRLR. TRLR $ 5 33
12 2 5 VIN#j VIN#
FROM TO
VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN T v GOVT.VEHICLE 1 $ 34
13 2011 GMC TERRAI P4 DAMAGE vE6 0 NO agW�MEYERS TOWING ves❑ No
REGISTERED OWNER INFO GIANG TRAN 1252280TH AVE S SEA TTLE WA 98178 D:6693131503 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
14 LIABILI V INSURANCE INSURANCE CO STATE FARM 5464504-C18.47 4
IN EFFECT &POLICY# 9TOP
15❑ LE
vEGALLY HIa.E 5 36
res�No D CITATION# 4g0047923 CHARGE FAIL YIELD LEFT TURN MOTOR io sorroM
STANDING 8 7 6
MOTOR PEDAL-: PEDESTRIAN PROPERTY DAM THR OLD HONE
UNIT 02 VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YE MET P
S 1/ NO D:5153607926
16 a
LAST NAME DORMAN FIRST NAME MARK MIDDLE S
INITIAL
17❑ STREET NEW ADDREss❑' 424 WINDSOR WAY NE CITY RENTON ST WA ZIP 98056 37
18❑ CDL IGNITION REQUIRED IGNITION PR—E-1SENT MEDICAL—T�RANSPORTED � 38
INTERLOCK YES❑NO� INTERLOCK vEs It I NOF YES
t l NOF,/
19[—] LICENSE IVE STATE WA SEX M MMDDW 03 _ 15 _ 1987 39
20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 H U EET 2 NJAURSY 1 NATURE OF INJURIES 40
❑21❑ PLATE# CKJ6771 TATE 41
WA VIN# WAUENAF44HN038608 1
42
22❑ PLATE# STATE TILER PLATE# STATE
TRLR
23❑ UIN#. IN#.
43
RLR
'
GI
VEH /�YEAR 201] MAKE (fDl MODEL�QQ STYLE P4 DAMAGE TO WED NOO✓ BLIN TOWED By 44
Yr
ov H YES
NO 1/
24❑ REGISTERED OWNER INFO OWNED SY DRIVER VEHICLE N0.2
SHADE IN DAMAGED AREA
2 3 4
LIABILITY
INSURANCE INSU&PORGY#E CO pROGRESSIVE 935222548IN STOP 5
'E""LE ❑ ,J� CITATION# CHARGE i o BOTTOM
LEGALLY YES N J
25 a
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
26
D.NELSON 12421 WA0171300
PART A PAGE 01 OF
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EE42057
COLLISION REPORT III III III III III 111
1591972 CASE# 24-411
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'
23-411 COLL
On 1/11/2024 1 was working as a uniformed patrol officer and driving a marked patrol vehicle for the
City of Renton. I was dispatched to a report of a blocking collision near the intersection of Sunset Blvd
N and the 1405 on-ramp. This area is currently under construction for bridge maintenance and is
marked with signs, cones, and concrete barricades.
I arrived on scene and spoke with the driver of the Audi A4 (WA/CKJ6771), Mark Dorman. Mark said
that he was driving south on Sunset Blvd under the overpass when the GMC Terrain pulled out in
front of him while attempting to make a U-turn causing the collision. Mark was not injured. There was
damage to the front driver side bumper and quarter panel on the Audi. The Audi was drivable.
I then went and looked at the GMC Terrain (WA/CKE1161), 1 spoke with Sgt Trader who interviewed
the driver, Duy Tran. He told me that Duy was trying to make a U-turn when he was struck by the
Audi. There was damage to the passenger side doors from the impact. Duy had a complaint of pain
from the airbags and was evaluated by RRFA and cleared at the scene. The GMC was not drivable
and was towed by Gene Meyers Towing.
Based on Duy failing to yield to oncoming traffic from a stopped position while attempting to make a U
-turn I completed Sector Citation #4A0047923 for RCW 46.61.185 Vehicle Turning Left for Duy. This
citation should be mailed to Duy at his DOL address.
Nothing further.
I certify under penalty of perjury under the laws of the State of Washington that the foregoing is true
and correct.
D. Nelson #191 1/11/2024 Renton WA
I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT.
D.NELSON 01-11-24 09:32 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
P.SUMMERS 888 1 111912024 2:14:01 PM
BADGE OR ID# ! 12421 ORI#; 'i WA0171300 TIME POLICE DISPATCHED; 8:07 Pry TIME POLICE ARRIVED 8:10 PM
PART I PAGE IT]OF 3�
REPORT NO. EE42057 CASE# ' 24-411 DATE AND TIME 01/11/24 20:06
OF COLLISION
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