HomeMy WebLinkAbout24-1212 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 6 27c
COLLISION REP FIT 1591971
CASE 24-1212 z
INTERSTATE ❑ CITY STREET FIRE ❑RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHIr.I F ❑ LOCAL AOENC 4Y00 3
HIT 8 RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 3 TOTAL#OF OBJECT 1 1 8 28
TRIBAL UNITS O3 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-- 2024 1050 17 ❑.= S 8 IN e 1070 3
4❑ oN (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
N SOUTHPORT DR BLOCK NO. e✓ 1405 ❑
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ �,❑ FEET e S ❑ W e I405
0 1 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
�/No D:2069456044 0 7 30
6� LAST NAME BLESSING-GARCIA FIRSTNAME DYLAN MIDDLE 1 2 31
INITIAL
STREET ❑ 11847 68TH AVE S CITY SEATTLE ST WA ZIP 98178 z
NEW ADDRESS
]❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
INTERLOCK YES[:]NO INTERLOCKYEs NO YES R NO
8❑ 1 LRIIVERCENS # STATE SEX M MMDDBIY 07 - 25 - 2007 2 32
9 ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 HELMET USE 2 CLAY 1 NATURE OF INJURIES z❑
3
10❑ P1 aT�S� BRH5771 sTArI WAurN# 1J4FA49SX1P353139
5 TRAILER STATE TRAILER STATE
11 3 5 PLATE# PLATE# FROM TO
TRLR. TRLR 3 7 33
12 3 5 VIN#' VIN#
>; FROM TO
VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE J 9 34
13 2 2001 JEEP WRANG UT DAMAGE YES NO YES[:] No✓
REGISTERED OWNER INFO ELMER CARRILLOS-PORTILLO 1184768TH AVE S RENTON WA 98178 D:2069456044 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
14 LIABILITY INSURANCE❑ INSURANCE CO
IN EFFECT &POLICV# 9TOP
VE— CHARGE 10 BOTTOM 5 36
15❑ STANofNG YEs❑NO CITATION# 4A0107486,4AO107487 NO VALID OPER LICENSE W/OUT
MOTOR PEDAL- PROPERTY DAM THR OLD MET PHONE
UNIT 02 ❑✓ ❑ PEDESTRIAN ❑ ❑ YEs No ,/ D:2534399518
VEHICLE CYCLE OWNER
16 a
LAST NAME VILES FIRST NAME BLAKE MIDDLE
INITIAL
17❑ STREET ❑', 609 S 72ND ST CITY' TACOMA ST' WA ZIP 98408 37
NEW ADDRESS ❑
18� CDL IGNITION REQUIRED IGNITION PRESENT MEDICALTRANSPORTED ❑ 38
INTERLOCKYES�NOR INTERLOCK YEs❑NOF YEs❑NO❑
19 LICENSE# STATE I WA SEX M M .C.B. 02 _ 20 _ 2003 39
HELMET {NJURY 1 NATURE OF INJURIES 40
20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 USE 2 CLASS ❑
21❑ LICENSE A6998276 TAre I WA vIN1i 1HGCT1884HA009126
❑ 41
PLATE#
42
22❑ PILER LATE# STATE PLATE# STATE
TRLR
23❑ VIN#. IN#. 43
RLR
'
VEH YEAR 2017 MAKE HOND MODEL ACCORD STYLE SD VEHICLETOWED TO BLIN TOWEDBY GOV HI 44
24❑ DAMAGE YES NO YES NO
REGISTERED OWNER INFO BLAKE VILES 609 S 72ND ST TACOMA WA 98408 D:2534399518 VEHICLE NO.2
SHADE IN DAMAGEbAREA
2 3 Cd
LIABILITY
INSURANCE I PORGY#E CO PROGRESSIVE 925991783IN 1 9TOP
'E""LE CITATION# CHARGE
LEGALL
25 i o BOTTOM
Y YES Nu
❑ J s
7CA
NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY26LAN 12007 WA0171300
PART A PAGE 01 OF
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EE50251
COLLISION REPORT III III III III III 111
1591972 CASE# 24-1212
ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY)
NAME MIDDLE INITIAL) SINGH KULWINDER
(LAST FIRST,
ADDRESS&PHONE#
2821 NE 16TH ST RENTON WA 98056 SEX M MMDDYyry 03 - 11 - 1961
PASSENGER WITNESS UNIT# SEAT AIRBAG' RESTR. EJECT ' HELMET INJURY NATURE OF INJURIES
❑✓ ❑ 3 POS. 3 2 4 1 USE 2 CLASS 1
NAME
(LAST,FIRST,MIDDLE INITIAL)
ADDRESS&PHONE# D O 8
SEX' MMDDYYYV
PASSENGER ❑WITNESS❑ UNIT# SEAT AIRBAG RESTR. EJECT HELMET NJURY NATURE OF INJURIES
POS. USE CLASS
NAME
(LAST FIR57 MIDDLE INITIAL)
AppRESS R PHONE#
SEX D.O.B.MMDD -❑
YYYY.
PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET NJURY NATURE OF INJURIES
❑ ❑ POS. USE CLASS ----�
NARRATIVE'
On February 2nd, 2024, at 1050 hours dispatch requested that I respond to a collision near N
Southport Dr and southbound 1-405, in the City of Renton. Upon my arrival I spoke with the driver of
unit 2. They explained they were stopped at the intersection going westbound on NE Sunset Blvd
when the collision occurred. The driver of unit 2 stated he was struck randomly by unit 1 from behind
and then the driver proceeded to flee the location westbound towards Southport Dr.
Unit 1 drove onto oncoming traffic and failed to notice unit 3 making a left turn onto the 1-405 onramp.
Unit 1 then struck unit 3 on their driver side front fender, causing substantial damage to both vehicles.
I then spoke with the driver of unit 3 and they explained they were making a left turn from northeast
sunset blvd onto southbound 1-405. As they proceeded through the intersection and made their left
turn, unit 3 drove on to the oncoming traffic and struck the front of the vehicle.
I then spoke with the driver of unit 1 and they explained their brakes failed going westbound on NE
Sunset Blvd. They struck unit 2 from behind. They tried locating place to stop, but their brakes failed
again, they drove onto oncoming traffic and struck unit 2 as they turned left from NE Sunset Blvd to
1405.
After speaking with all the involved parties, the driver of unit 1 Dylan Blessing-Garcia, admitted that
he was uninsured and unlicensed.
A Sector citation was issued against Dylan and was sent to the Renton City Prosecutors for further
review.
I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT.
C.CATALAN 02-03-24 11:50 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
C.JACOBS 1953 1 2/14/2024 10:50:39 AM
BADGE OR ID# 12007 ORI# WA0171300 TIME POLICE DISPATCHED 10:52 AM TIME POLICE ARRIVED 10:59 AM
PART I PAGE IT]OF 4�
SUPPLEMENTAL REPORT NO. EE50251
r`) POLICE TRAFFIC 1 1 8 27
COLLISION REPORT CASE# 24-1212
1 COMMERCIAL MOTOR CARRIER INTERSTATE INTRASTATE G
UNIT'# USDOT ICC# VEHICLE TYPE CARGO BODY
;TYPE
2 ❑ 1 28
CARRIER
NAME
3 CARRIER
ADDRESS `
CITY ST ZIP—1 I '
4 ❑ NAME # PLACARD: :❑
GI PLACARD IF NO NUMBER
SOURCE AXLES +
4a ❑ ADDITIONAL UNITS
MOTOR PEDAL- PROPERTY DAMAGE THRESHOLD MET PHONE
5 ❑ UNIT# 3 VEHICLE t_"J CYCLE _) PEDESTRIAN � OWNER � YES� NO
D:2064077210
0 4 Zg
LAST NAME �(,q(JR FIRST NAME : GURMINDER MIDDLE
INITIAL
STREET 30
NEW AnDRFSP' 2821 NE 16TH ST CITY RENTON ST WA ZIP 98056
6
CDL IGNITIttN REQUIRED IGNITION PRESENT MEDICAL TAN5PORTED 1 1 2 31
INTERLOCK YEs No NTERLOCK YES[:]NO[:] YES N
DRIVER'S
LICENSE STATE I WA SEX F MMDDYYv', 02 - 15 - 1971
7
ON DUTY� STATUS AIRBAG' 2 RESTR. Q EJECT 1 HELMET 2 INJURY 1 1 NATURE OF INJURIES
USE CLASS
8 ❑ 1 32
LICENSE I CDW6998 [TAT WA VIN# 2T2HGMOA9NC087396
PLATE#
9 TRAILER TRAILER
PLATE# STATE PLATE# STATE
10 ❑ TRLR TRLR
VIN.#. VIN.#.
11 O O VEH.YEAR2022 MAKE LEXS MODELRX 300 1 STYLE UT I VEHICLE TOWS E T SABLIN TOWED BY anvi vEH1Ci P FROM TO
DAMAGE YES NO YES NO
33
REGISTERED OWNER INFOGURMINDER KAUR 2821 NE 16TH ST RENTONWA 98056 D:2064077210 $ 5
12 SHADE IN DAMAGED AREA
4 j FROM TO
LIABILITY INSURANCE INSURANCE CO ALL STATE 964 939 308 gTOp
IN EFFECT &POLICY#
VEHICLE 10 6QTTUM 34
CITATION# CHARGE
13 LEG YES NO
❑ STANDIN dRD PROPERTY Y
❑ 35GNHROE
VEHICLE CYCLE OWNER O14 UNITr
j PHONE
15 LAST NAME FIRST NAME INITIAL
36
MIDDLE ❑
STREET"[-]
16 NEW nnR CITY ST ZIP
CDL IGNITION REdUiRED IGNITION PRESENT MEDICALTANSPORTED
NTERLOCK YES No INTERLOCK YEs NO YEs NO El
17 37
LICENSE# STATE SEX MMDDDYBYY
18 ❑ ON DUTY� STATUS AIRBAG RESTR. ; EJECT HELMET INJURY NATURE of INJURIES 38
USE (CLASS
19 ❑ 39
LICENSE rnr VIN#
PLATE#
20 ❑ TRAILER' TRAILER El40
PLATE#< STATE PLATE# STATE
21 ❑ TRLR TRLR 41
VIN# YIN#i
42
22 VEH.YEAR MAKE I MODEL STYLE I VEHICLE TO DUET SABLIN TOWED BY GOVT.VEHICLE
DAMAGE YES NO YES NO
23 REGISTERED OWNER INFO_ SHADE IN DAMAGED 3 4 4 AREA F 43
z
LIABILITY INSURANCE INSURANCE CO '
VEHICLE
EFFECT &POLICY# i 970P - 4 44
24 VEHICLE YES❑ NO❑ CITATION# CHARGE iq 60TiOM
LEG E
E:l
STANDING 8 7 6
1 CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT.
C.CATALAN 02-03-24 11:50 PM
25 INVESTIGATING OFFICER'S SIGNATURE OFFICER'S PHONE UNIT OR DIST DET DATED: PLACE SIGNED
APPROVED BY DATE
26 ORID# 12007 O#I',WA0171300 JACOBS 2114/2024 PAGE F OF 4
3000-345-013(R 11118)
REPORT NO. EE50251 CASE# ' 24-1212 DATE AND TIME 02/02/24 10:50
OF COLLISION
SunsetU NE
NTS
1
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