HomeMy WebLinkAbout23-5334 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 5 27c
COLLISION REP FIT 1591971
CASE 23-5334 z
INTERSTATE ❑ CITY STREET FIRE ❑RESULTED
1 STATE ROUTE OTHER STOLEN
❑ ❑ HFHIC;I F ❑ LOCAL AOENC 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 1 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# ❑
cawsloN 05 - 11 - 2023 1850 17 ❑. S 8 W Li OF e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
BLOCK NO. e✓ --- ----�
SW 7TH ST MILEPOST
4a❑
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ ❑ FEET e S ❑ W e LIND AVE SW
0 1 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
✓NO D:2067753227 0 11
30
6❑ LAST NAME SAECHAO FIRSTNAME SAM MIDDLE 1 2 31
INITIAL
STREET ❑, 24123 130TH AVE SE CITY KENT ST WA 2jp, 98030 z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
✓ I iNTERLOCKYEs No NTERLOCKYEs NO✓ YES R No
8 LDRIVER # STATE WA SEX'M MID
-O B 11 1— 02 — 1982 2 32
9 ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 HELMET U E 2 CLASS 1 NATURE OF INJURIES 2❑
3
10 1❑ PI ATFBit C10262E sTArr~ WA urN# 187GL22X11S247772
0 TRAILER STATE TRAILED STATE
11 0 0 PLATE# PLATE# FROM TO
TRLR. YRLR. 5 1 33
12 0 0 VIN#' VIN#
>; FROM TO
❑ VEH.YEAR MAKE MODEL STYLE VEHICLE vE6 TOWED NO TO BLIN T GOVT.VEHICLE 3 ] 34
13 2 2001 DODG DAKOTA PK DAMAGE 0 f �AWkkRS YES[:] No✓
REGISTERED OWNER INFO SAANSAETEURN 11603 SE 210TH PL KENT WA 98031 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
14 LIABILI INSURANCE❑ INSURANCE CO NONE 3 4
IN EFFECT &POLICY# 9TOP
15❑ LE
vECALLv HICLE 5 36
res❑NO❑ CITATION# CHARGE 1 o BOTTOM
STAIN,DIING 8 7 6
UNIT 02 VEHIMOTCCLE CYCLE ❑ PEDESTRIAN ❑ OWNFR PEDAL RTY ❑ DYES✓ NO OLD MET PHONE
16 a
LAST NAME SINGH FIRST NAME KULDIP MIDDLE N
INITIAL
17❑ NEW STREETR 13252 S
7 E 227TH ST CITY' KENT ST WA ZIP 980423291 4❑ 37
18❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED � 38
INTERLOCK YEs❑No� INTERLOCK YEs❑NOF YES
❑NOF,/
19 DRIVER'S STATE WA SEX M D.C.B. O6 _ 10 _ 1972 39
LICENSE# MMDCDY
20❑ ON DUTY STATUS I
AIRBAG 2 RESTR 4 EJECT 1 H U EET 2 NJAURSY 1 NATURE OF INJURIES 40
❑ILICENSE 21❑ PLA E# BDV7558 TArE 41
WA VIN# JTDKN3DU3D5571161 1
42
22❑ PLATE# STATE PLATE# STATE
23❑ UIN#. 43
TRLR RLR
'IN#.
VEH YEAR 2013 MAKE TOYT MODEL PRIUS STYLE VEHICLETOWED TO BLIN TOWEDBY GOV HI 44
L4❑ DAMAGE YES NO✓ YES NO✓
REGISTERED OWNER INFO KULDIP SINGH DBA YELLOW CAB#13252 SE 227TH ST KENT WA 98042 D:2067789744 VEHICLE NO.2
SHADEDAMAGEDAREA
3 4
LIABILITY INSURANCE INSU&PORGY#E CO HUMBLE INSURANCE GROUP BAP0786584 STOP 5
IN EFFECT0(
'E""LE ❑ ,J� CITATION# CHARGE to BOTTOM
LEGALLY YES N`L J
25 ' a
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# JAGENCY
26
E.EDMUNDS 12576 WA0171300
PAGE 01 OF
PART A
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. ED60483
COLLISION REPORT III III III III III 111
1591972 CASE# 23-5334
ADDITIONAL PERSONS INVOLVED PASSENGERS AND/(OR WITNESSES ONLY)
NAME MIDDLE INITIAL) SAECHAO KOYF
(IAST FIRST,
ADDRESS&PHONE# D O.B.
24123 130TH AVE SE KENT WA 980309209 SEX F MMDDYyYv 07 - 25 - 1961
PASSENGER WITNESS❑'UNIT# 1 PSEATOS 3 AIRBAG 2 RESTR. 4 EJECT ? 1 HELMET NATURE OF INJURIES
USE 2 CLASS
'1
NAME
(LAST,FIRST,MIDDLE INITIAL)
ADDRESS&PHONE# DOB
SEX' MMDDYYYY
PASSENGER ❑WITNESS UNIT# SEAT I AIRBAG RESTR. EJECT HELMET NJURY NATURE OF INJURIES
POS. USE CLASS
NAME
(LAST FIR57 MIDDLE INITIAL)
AppRESS&PHONE#
SEX D.O.B.
MMDDYYYY.
PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET NJURY NATURE OF INJURIES
❑ ❑ POS. USE CLASS ----�
NARRATIVE'
Please see subsequent narrative pages
I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT.
E.EDMUNDS 05-11-23 08:37 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
J.TRADER 4553 1 511512023 10:25:27 PM
BADGE OR ID# 12576 OR]# WA0171300 TIME POLICE DISPATCHED 6:52 PM TIME POLICE ARRIVED',6:56 PM
PART I PAGE IT]OF 4�
TIME
REPORT NO. ED60483 CASE# 23-5334 OF COLLISION05/11/23 18:50
NARRATIVE
On 05/11/2023 1 was working a marked patrol unit in the City of Renton, County of King, State of
Washington. I was assigned to District 15. At approximately 1852 hours, I was dispatched to a two
vehicle, unknown-injury, collision near the intersection of SW 7th ST and Lind Ave SW (Renton WA,
King county).
Contact:
The involved vehicles had both pulled to a nearby parking lot. Vehicle #1 had passenger side
damage that appeared to exceed $1000. Vehicle #2 had front end damage that appeared to exceed
$1000.
The driver of vehicle #1, Sam Saechao (DOB: 11/02/1982) provided an expired vehicle registration
certificate. Saechao could not locate his driver's license or proof of insurance.
The driver of vehicle #2, Kuldip Singh (DOB: 06/10/1972) provided a WA driver license, registration
certificate and proof of insurance.
An NCIC/WACIC check was conducted with both driver's information. They returned clear.
Both drivers described the collision in the same manner. Vehicle #2 was traveling westbound on SW
7th st with the green light. Vehicle #1 drove north through the intersection, against the red light.
Vehicle #2 was unable to stop in time to avoid the collision.
Neither driver required immediate medical assistance.
I provided a copy of the TIR to both driver's. Vehicle #1 was towed by Banker's towing. Vehicle #2
called for a private tow.
This concluded my involvement with the case.
I certify (declare) under penalty of perjury under the laws of the State of Washington that the
foregoing is true and correct.
Electronically signed by E. Edmunds/12576 at 2034 hours on 05/11/2022 in the City of Renton, WA.
PAGE 3 OF 4
REPORT NO. ED60483 CASE# ' 23-5334 DATE AND TIME 05/11/23 18:50
OF COLLISION
SW 7th ST
ii�i�i�i�i � aaaaaaaaa aaaaaa„ .g B ,
r
Q
D
C
CD
Cn`
PAGE 4 OF 4