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Home My WebLink About23-11620 POLICETRAFF'c" III !�� I IIIllI111IN II II I REPORT NO. EE12094 170 27 COLLISION REP FIT 1591971 CASE 23-11620 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 2 TOTAL#OF OBJECT 1 1 8 28 TRIBAL UNITS OS STRUCK RESERVATION z 3❑ DATE OF M M D D Y Y Y Y TIME(2400) COUNTY# MILES N E IN CITY# cowsloN 10 - 10 - 2023 1912 17 �. S 8 W H OF e 1070 3 4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑ NE 4TH ST BLOCK NO. e✓ 4500 ❑ 4a❑ MILEPOST DISTANCE OF(REFERENCE OR CROSS STREET) 5❑ �,❑ FEET e S ❑ W e BREMERTON AVE NE 0 4 29 MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE UNIT 01 VEHICLE ❑ CYCLE El ,/No D:4255179966 0 11 30 LAST NAME NETALAM-VENKATA FIRST NAME JAGADEESH MIDDLE 6 INITIAL 1 2 31 STREET ❑ 10409 SE 174TH ST APT 2231 CITY RENTON ST WA ZIP 98055 z NEW ADDRESS 7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3 INTERLOCK YES[:]NO 1/ INTERLOCKYEs NO�/ YES R No�/ 8❑ LRIIVER # ON DUTY❑ STATUS AIRBAG 6 RESTR 4 EJECT 1 HELMETU E 2 CLASS 1 NATURE OF INJURIES z❑ 3 10 9❑ P1 aT�S� A6702738 sTArI WAVIN# 4T3T6RFV8PU135526 IT STATE TRAILER STATE 11 0 0 PLATE# PLATE# ROM TO TRLR. TRLR $ 7 33 12 0 0 VIN#' VIN#' >; FROM TO VEH.YEAR 2023 MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE 7 3 34 13 4 TOYT RAV4 UT DAMAGE YES NO YES[:] NO✓ REGISTERED OWNER INFO OWNEDBYDRIVER VEHICLE NO. 1 ❑ SHADE IN DAMAGED AREA ❑ 35 14 LIABILIT INSURANCE Z INSURANCE CO GEICO 6103830177 IN EFFECT &POLICY# 9TOP VE— GE CHAR 36 LEGALLY Yes❑NO❑ CITATION# BOTTOM 15❑ STANDING MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE UNIT 02 VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES 1/ NO D:2535145845 16 a LAST NAME PHILLIPS FIRST NAME BRANDON MIDDLE J INITIAL 17❑ STREET I36TH AVE NW CITY GIG HARBOR ST WA ZIP 98329 4❑ 37 NEW ADDREs�' 14303 1 18� CDL IGNITION REQUIRED IGNITION PtR-E-S1ENT MEDICAL TRANSPORTED 38 INTERLOCK YES❑No� INTERLOCK YEs I I NOF YEs t l NOF,/ 19 LDIIVER # STATE WA SEX M M .C.B. O6 _ O6 _ 1995 39 20❑ ON DUTY STATUS AIRBAG 3 RESTR 4 EJECT 1 H U EET 2 NJAURSY 1 NATURE OF INJURIES ❑ 40 ❑ILICENSE 21❑ PLA E# BUL8899 TArE 41 WA VIN# 1C4PJMBX7LD607507 1 42 22❑ PLATE# STATE PLATE# STATE 23❑ VIN#. 43 TRLR RLR 'IN#. VEH YEAR 2020 MAKE JEEP MODEL CHEROK STYLE UT VEHICLETOWED TO BLIN TOWEDBY GOV HI �44 L4❑ DAMAGE YES NO YES NO REGISTERED OWNER INFO RAYMOND SMITH 7819135TH STREET CT NW GIG HARBOR WA 98329 VEHICLE NO.2 SHADEDAMAGEDAREA 3 4 LIABILITY INSURANCE INSU8 POLICY#E CO GEICO 6134884136IN 9TOP 5 VE""LE ❑ ,J CITATION# CHARGE to BOTTOM LEGALLY YES Nu 25 ' e 7CA NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY J 26LAN 12007 WA0171300 PART A PAGE 01 OF 3000-345-159 OR 11/181 STATE OF POLICETRAFFICN CORRECTION REPORT NO. EE12094 COLLISION REPORT III III III III III 111 1591972 CASE# 23-11620 ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY) NAME MIDDLE INITIAL) SMITH ELIZABETH J (IAST FIRST, ADDRESS&PHONE# 7819 135TH ST CT NW GIG HARBOR WA 98329 SEXi F MMDovyvv 03 - 29 - 1998 PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT ' HELMET INJURY NATURE OF INJURIES ❑✓ 2 POS, 3 3 4 1 USE 2 CLASS 1 NAME (LAST,FIRST,MIDDLE INITIAL) : RASSMUSSEN BROCK ADDRESS&PHONE# D O B 7544 20TH AVE NE SEATTLE WA 98115 2063536128 SEX' M MMDDvvvv 01 _ 02 _ 2019 SEAT HELMET INJURY NATURE OF INJURIES PASSENGER WITNESS UNIT# 3 POS 9 AIRBAG 2 RESTR. 10 EJECT 1 USE 2 CLASS 1 NAME (LAST FIR57 MIDDLE INITIAL) AppRESS&PHONE# SEX D.O.B. 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. C.CATALAN 10-20-23 01:26 AM INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED APPROVED BY E DAT P.SUMMERS 8887 1012312023 2:14:49 PM BADGE OR ID# ! 12007 (DR]# WA0171300 TIME POLICE DISPATCHED! 7:13 PM TIME POLICE ARRIVED',7:23 PM PART I PAGE IT]OF 5� REPORT NO. EE12094 CASE# 23-11620 OF COLLISION 10/10/23 19:12 OF CbLLI510N NARRATIVE On October 10th, 2023 at 1912 hours, dispatch requested that I respond to a collision with injuries at the intersection of NE 4th St and Bremerton Ave NE, in the City of Renton, County of King, and State of Washington. Upon my arrival I spoke with the driver of unit 1, a 2023 Toyota Rav4 bearing temporary Washington plate A6702738. The driver, identified as Jagadeesh Netalam-Venkata, explained he was making a left turn from Bremerton Ave NE, to go westbound on NE 4th St. Another vehicle going eastbound in the number 1 lane stopped and gave unit 1 an opportunity to pass through. Unit 1 proceeded through, but failed to see unit 2 driving in the number 2 lane. Unit 1 crossed in front of unit 2, not allowing them to stop. Unit 2 struck unit 1, causing them to slide over towards oncoming traffic, causing unit 3 to strike them as well. I then spoke with the driver of unit 2, 2020 Jeep Cherokee bearing Washington plates BUL8899. The driver stated they were driving eastbound on NE 4th St in the number 2 lane when unit 1 pulled out in front of them, causing the collision. I then spoke with the driver of unit 3, a 2016 Subaru Outback bearing Washington plates BZZ6744. The driver said he observed the collision. Unit 1 drove in front of unit 2. Unit 1 was struck and pushed to the westbound lanes. Unit 3 was unable to avoid the collision, so he struck unit 1 as well. The Toyota was undrivable and needed to be towed away. The Jeep deployed some airbags, but the driver decided to drive it home, and the Subaru was drivable, so the driver took it back home. I did an exchange of information, and provided all the drivers with my contact information. PAGE 3 OF 5 SUPPLEMENTAL REPORT NO. EE12094 r`) POLICE TRAFFIC 1 1 8 27 COLLISION REPORT CASE# 23-11620 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 tSJ CYCLE I_) PEDESTRIAN OWNER YES NO D:2063536128 0 1 Zg LAST NAME RASMUSSEN FIRST NAME ROBERT MIDDLE' ',, G INITIAL STREET 30 NEW AnDRFSP. 7544 20TH AVE NE CITY SEATTLE ST WA ZIP 98115 6 ❑ 1 1 2 31 CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TAN5PORTED INTERLOCK YEs NO zERLOCK YES❑N0� YEs N DRIVER'S LICENSE STATE I WA SEX M MMDDYYv 07 TO] - 1967 7 ON DUTY� STATUS AIRBAG' 2 RESTR. Q EJECT 1 HELMET 2 INJURY 1 NATURE OF INJURIES USE CLASS 8 ❑ 1 32 LICENSE BZZ6744 TAr Wq VIN# 4S4BSACC8G3240965 PLATE# 9 9] TRAILER TRAILER PLATE# STATE PLATE# STATE 10 ❑ TRLR TRLR VIN It VIN.#. 11 0 0 VEH.YEAR2016 MAKE SUBA MODELOUTBAC STYLE 4y I VEHICLE TOME ET SABLIN TOWED BY anvi vFH1CP FROM TO DAMAGE YES NO YES NO REGISTERED OWNER INFO OWNED BY DRIVER ] 3 33 12 � SHADE IN DAMAGED AREA 4 FROM TO ((ABILITY INSURANCE INSURANCE CO GEICO 2023548205 q"i"Olx IN EFFECT &POLICY# VEHICLE 1 t7 6QTTOM 34 13 ❑ Lecnuv YES[:] NO❑ CITATION# CHARGE gg�@ STANDING S} l:9 7 6 14 ❑ UNIT Tr Vd IRE O CYDCLE OWNER RTY YES[—]AGE NOHRESHOLD MET PHONE ❑ 35 PEDESTRIAN 15 LAST NAME FIRST NAME I INITIAL ❑ 36 STREET 16 NFWAET [_% CITY ST ZIP CDL IGNITION REdUiRED IGNITtGN PRESENT MEDICALTANSPORTED INTERLOCK YES No INTERLOCK YEs NO YEs NO ❑ 17 4 37 LICENSE# STATE SEX MMDDDYBYY 18 ❑ ON DUTY� STATUS AIRBAG RESTR. ; EJECT HELMET INJURY NATURE of INJURIES 38 USE CLASS 19 ❑ LICENSE TAr VIN# 39 PLATE# 20 ❑ TRAILER' TRAILER El40 PLATE#< STATE PLATE# STATE 21 ❑ ❑ 41 TRLR TRLR 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 s a 71 LIABILITY INSURANCE INSURANCE CO ' VINE EFFECT &POLICY# i 970P _ 4 E:l 44 24 VEHICLE YES❑ NO❑ CITATION# CHARGE iq 60TiOM LEGALLv 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 10-20-23 01:26 AM 25 INVESTIGATING OFFICER'S SIGNATURE OFFICER'S PHONE UNIT OR DIST DET DATED: PLACE SIGNED APPROVED BY DATE 26 OR ID# 12007 O#I',WA0171300 SUMMERS 10123/202 PAGE 4 OF 3000-345-013 IR 11t18) REPORT NO.! EE12094 CASE# ' 23-11620 DATE AND TIME 10/10/23 19:12 OF COLLISION Bremerton Ave NE N_ NE 4th St PAGE 5 OF 5