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HomeMy WebLinkAbout24-6580 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 1 27c COLLISION REP FIT 1591971 INTERSTATE ❑ CITY STREET FIRE ❑ CASE 24-ss8o z RESULTED 1 STOLEN STATE ROUTE ❑ OTHER ❑ VFHICI F ❑ LOCAL AOENC 4150 3 HIT&RUN ✓ CODING COUNTY RD PRIVATE WAY INVOLVED 2� 1 0 1 28 TOTAL#OF OBJECT TRIBAL UNITS 03 STRUCK' RETAINING WALL RESERVATION z 3❑ DATE OF M M D D Y Y Y Y TIME(2400) COUNTY# MILES N E IN CITY# 6 6 COLLISION'. 06 - 1-- 2024 2158 17 ❑.= S 8 IN e 1070 3 4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓ BLOCK SUNSET BLVD NE ST e✓ MILEPOST 3200 4a❑ DISTANCE OF(REFERENCE OR CROSS STREET) 5 A❑ 250 00 FEET e S B W e NE 12TH ST 0 1 29 MOTOR PEDAL- DAMAGE THRESHOLDHONE UNIT 01 VEHICLE ❑ CYCLE El MET P YEs �/No D:4252874457 1 6 30 5� LAST NAME KANG FIRSTNAME JOHN MIDDLE F 2 31 INITIAL STREET ❑, 14526 38TH DR SE CITY MILL CREEK ST WA ZIP 98012 z NEW ADDRESS 7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3 INTERLOCK YES[:]No✓ INTERLOCKYEs NO✓ YES R No 8❑ DRIVERS E# ON DUTY❑ STATUS' AIRBAG 6 RESTR 4 EJECT 1 H U EETI I INJURY [NATURE OF CLASS 5 LEFT LEFT/SHINS z❑ 3 10 9� P1 AT 14 BXT6012 STATE WA VIN# 2T3A1RFV2MC173255 TRAILER STATE TRAILER STATE 11 3 5 PLATE# PLATE# FROM TO TRLR. TRLR 7 3 33 12 3 5 VIN#' VIN# >; FROM TO VEH.YEAR 2021 MAKE MODEL STYLE VEHICLE TOWED TO BLIN TR y GOVT.VEHICLE 34 13 TOYT RAV4 SV DAMAGE YES NO �MEYER 3 7 YES❑ No✓ REGISTERED OWNER INFO JOHN KANG 1112638TH DR SE MILL CREEK WA 98012 D:4252874457 VEHICLE NO. 1 ❑ SHADE IN DAMAGED AREA 35 14 LIABILI INSURANCE INSURANCE CO GEICO 6126029898 4 IN EFFECT &POLICY# 9TOP VEHICLE CHARGE 5 36 LEGALLY YES❑NO❑ CITATION# 1 o BOTTOM 15❑ STAIN.D'ING 6 UNIT 02 VE ICCLE CYCLE ❑ PEDESTRIAN ❑ OWNERMOTO PEDAL RTY ❑ DYES✓ NO OLD MET PHONE 16 a LAST NAME GARCIA SANDOVAL FIRST NAME ANTONINO MIDDLE INITIAL 17❑ STREET ❑', 1529 JONES AVE NE CITY RENTON ST WA ZIP 98056 37 NEW ADDRESS ❑ 18� CDL IGNITION REQUIRED IGNITION PR—E-1SENT MEDICAL TRANSPORTED 38 INTERLOCK YEs❑NO� INTERLOCK YEs It I NOF YES t l NOF,/ 19 DRIVER # INJURY NATURE OF INJURIES 40 20F1 ON DUTY STATUS' AIRBAG RESTR 4 EJECT '1 USE 9 6 CLASS SHOULDER ❑21❑ LICENSE TATE VIN# 41 PLATE# 42 22❑ PLATE# STATE PLATE# STATE 23❑ TRLR R 43 LR VIN#. N I #. GI VEH YEAR MAKE MODEL STYLE DAMAGE TOWED NOO✓ BLIN TOWED BY ov HyES NO✓ 44 24❑ ES REGISTERED OWNER INFO ANTONINO GARCIA SANDOVAL 1529 JONES AVE NE RENTON WA 98056 VEHICLE N0.2 SHADE DAGED AREA 4 LIABILITY INSURANCE❑ INSURANCE CO NONE IN EFFECT &POLICY# 9TOP 5 VF,A`LE YES N CITATION# 4A0505804 CHARGE DUI,HIT AND RUN Io ao-r-roM LEGALLY `c❑LJ 6 25 =HSU AME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY26 12651 WA0171300 PAGE 01 OF PART A 3000-345-159 OR 11/181 STATE OF POLICETRAFFICN CORRECTION REPORT NO. EE88951 COLLISION REPORT III III III III III 111 1591972 CASE# 24-6580 ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY) NAME MIDDLE INITIAL) SUZUKI CHELSEA N (LAST FIRST, ADDRESS&PHONE# D O.B. ' 5306 154TH AV SE BELLEVUE WA 98006 4253736786 SEXi F MMDDYyry 01 - 17 - 1993 SEAT HELMET INJURY NATURE OF INJURIES PASSENGER WITNESS❑(UNIT# 1 POS 3 AIRBAG 6 RESTR. q EJECT 1 USE CLASS 7 NECK ANDSHOULDERPAIN NAME (LAST,FIRST,MIDDLE INITIAL) BASTRO MIRLEY N ADDRESS&PHONE# D O B 4259193933 SEX U MMDbBvv PASSENGER [:]WITNESS POS. USE CLASS UNIT# SEAT AIRBAG RESTR. EJECT HELMET NJURY NATURE OF INJURIES NAME (LAST FIR57 MIDDLE INITIAL) AppRESS&PHONE# SEX D.O.B.MMDD -❑ YYYY. PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET NJURY NATURE OF INJURIES ❑ ❑ POS. USE CLASS ----� NARRATIVE' Unit 2 traveling westbound along 3200 block of Sunset Blvd NE approaching NE 12th St. Unit 1 traveling eastbound along 3200 block of Sunset Blvd NE just passed NE 12th St. Unit 2 veered into oncoming lane of travel due to suspected alcohol consumption. Unit 2 driver was proximate cause of collision as he collides glancing driver side head on to Unit 1 causing major disabling front end damage to both units just east of the driveway to the Oreilly's parking lot at 3213 Sunset Blvd NE. Unit 2 driver fled from scene and drove further west and caused secondary collision via suspected overcorrection and crashed into a retaining wall/stair and metal hand railing in front of the Rite Aid parking lot at 3116 Sunset Blvd NE. Unit 2 driver was later apprehended and arrested for DUI and hit and run. Unit 2 driver treated for shoulder pain both on scene and at hospital. Unit 1 driver treated for left leg injury and Unit 1 passenger treated for neck and shoulder pain also on scene and at hospital. Both vehicles were impounded. **** AUTO-POPULATED SECTION **** THE FOLLOWING ARE DESCRIPTIONS ENTERED FOR ITEMS SELECTED AS "OTHER": Location Character: SECONDARY COLLISION INTO STAIRS/RAILING **** END OF AUTO-POPULATED SECTION **** I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT. HANSEN HSU 06-22-24 12:27 AM INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED APPROVED BY DATE J.CHRISTIANSEN 10437 6/22/2024 2:10:07 AM BADGE OR ID# 12651 ORI# WA0171300 TIME POLICE DISPATCHED! 9:89 PM TIME POLICE ARRIVED 10:02 PM PART I PAGE IT]OF 4] SUPPLEMENTAL REPORT NO. EE88951 r` POLICE TRAFFIC 1 27 COLLISION REPORT CASE# 24-6580 1 COMMERCIAL MOTOR CARRIER INTERSTATE INTRASTATE G UNIT'# USDOT ICC# VEHICLE TYPE CARGO BODY ;TYPE 2 ❑ 1 28 CARRIER NAME 3 CARRIER L 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 I_J CYCLE u PEDESTRIAN � OWNER � YEs� IN MIDDLE' 29 LAST NAME RENTON FIRST NAME CITY OF INITIAL STREET 30 NEW AnDRFSP' 1055 S GRADY WAY CITY RENTON ST WA ZIP 98055 6 II 1 31 CDL GNITItN REQUIRED GNITION PRESENT MEDEC INTERLOCK YEsNo zERLOCK YES❑N0� T DRIVER'S STATE I SEX U M��DYSYv' -� 2 LICENSE 7F-ION DUTY STATUS AIRBAG RESTR. EJECT HELMET INJURY NATURE OF INJURIES F� USE CLASS 8 ❑ ' 1 32 LICENSE+ rar V1N.# PLATE# 9 TRAILER TRAILER PLATE# STATE PLATE# STATE 10 ❑ TRLR TRLR VIN.#. VIN.#. 11 VEH.YEAR MAKE I MODEL STYLE I VEHICLE TOWS E T SABLIN TOWED BY anvi vEHIG P FROM TO DAMAGE YES NO YES NO REGISTERED OWNER INFO. m 33 12 SHADE IN DAMAGED AREA FROM TO ((ABILITY INSURANCE❑ INSURANCE CO IN EFFECT &POLICY# tGQ VEHICLE 34 13 ❑ LEGALLY YES[:] NO❑ CITATION# CHARGE STANDING S} 8 7 6 14 ❑ UNIT Tr Vd IRE O CYDCLE OWNER YES AGE NOHRESHOLD MET PHONE El 35 PEDESTRIAN 15 LAST NAME FIRST NAME MIDDLE': INITIAL36 STREETIAL ❑ 16 NEn+AnnRFs.�' CITY'. ST ZIP CDL IGNITION REdUiRED IGNITION PRESENT MEDICALTANSPORTED INTERLOCK 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 ❑ vIN# 39 LICENSE PLATE# rnr 20 ❑ TRAILER' TRAILER ❑ 40 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 AREA 43 3 4 71 LIABILITY INSURANCE INSURANCE CO ' VEHICLE EFFECT &POLICY# I 970P - 4 44 24 VEHICLE YES NO❑ CITATION# CHARGE iq 60TiOM E:l C=DLv 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. HANSEN HSU 06-22-24 12:27 AM 25 INVESTIGATING OFFICER'S SIGNATURE OFFICER'S PHONE UNIT OR DIST DET DATED: PLACE SIGNED 26F7 OI BADGE 12651 O#I',WA0171300 APPROVE 6%2E2/2024 PAGE OF F 3000-345-013(R 11118) REPORT NO. EE88951 CASE# 24-6580 DATE AND TIME 06/21/24 21:58 OF COLLISION 4pY� f at PAGE 4 OF 4