HomeMy WebLinkAbout24-1870 a POLICETRAFFic" II I f I) 11I1ll(111(111l If( f 11 REPORT NO. EE54959 170
27
COLLISION REP FIT 1591971
SAS 24-1870 2
INTERSTATE ❑ CITY STREET FIRE ❑RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHIl.I F ❑ LOCAL AOENC 4Y00 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 3 TOTAL#OF OBJECT 1 1 8 28
TRIBAL UNITS 02 RESERVATION STRUCK
z
3❑ DATE OF M M D D Y Y Y Y TIME(2400) COUNTY# MILES N E IN CITY# ❑
COLLISION.. 02 - 1-— 2024 1530 17 ❑.= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓
S 2ND ST BLOCK e✓ 350
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ ❑ FEET e S ❑ W e 2 0 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
✓NO D:2069198152 0 11
30
6� LAST NAME NGUYEN FIRSTNAME Y MIDDLE N 1 2 31
INITIAL
STREET ❑ 3322 NE 6TH ST CITY RENTON ST WA 21p 980563951 z=
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
iNTERLOCKYEs NO INTERLOCKYEs NO YES R NO
8 LRIIVER #
ON DUTY❑ STATUS AIRBAG 6 RESTR 11 EJECT 1 H USE 2 1 CLASS NATURE OF INJURIES z❑
3
10 9❑ P1 ATE 14 CFV5809 STATE WA uN# 2TIBURHE6HC753471
TRAILER STATE TRAILER STATE
11 0 0 PLATE# PLATE# IR.. ro
TRLR. TRLR $ 7 33
12 VIN#' VIN#
FROM TO
VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE 3 ] 34
13 2 2017 TOYT COROL DAMAGE YES NO YES[:] No✓
REGISTERED OWNER INFO y NGUYEN 3322 NE 6TH ST RENTON WA 980563951 D:2069198152 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
14� LIABILITY INSURANCEz
INSURANCE CO STATE FARM 4818668 F01478 3 4
IN EFFECT &POLICY# 9TOP
VEHICLe 5 36
LEGALLY
res❑NO❑ CITATION# CHARGE BOTTOM
15❑ STANDING 6
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT 02 VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES 1/ NO D:2064308571
16 a
LAST NAME BUNGAR FIRST NAME RONEL MIDDLE 10
INITIAL
17❑ STREET ❑' 4610 S HOLDEN ST CITY' SEATTLE ST WA ZIP 98011 37
NEW ADDRESS ❑
18� CDL IGNITION REQUIRED IGNITION PtR-E-S1ENT MEDICAL t-T�RANSPORTED 38
INTERLOCKYES�NOR INTERLOCK YEs I I No� YES t l NO❑
19 DRIVER #
{NJURY NATURE OF INJURIES 40
20 ON DUTY STATUS AIRBAG,6 RESTR 4 EJECT 1 USE 2 CLASS 5 HAND INJURY
21❑ LICENSE 1 CGK1488 TATe WA vIN1i 5FNRL5H68B6064862
❑ 41
PLATE#
42
22❑ PILER LATE# STATE PLATE# STATE
TRLR
23❑ UIN#. N#.
43
RLR
'I
VEH YEAR 2011 MAKE HOND MODEL ODYSSEY STYLE VN VEHICLETOWED TO BLIN TOWEDBY GOV HI 44
L4❑ DAMAGE YES NO YES NO
REGISTERED OWNER INFO RONEL BUNGAR4610 S HOLDEN ST SEATTLE WA 98018 D:2064308571 VEHICLE NO.2
SHADE DAGED AREA
4
LIABILITY
INSURANCE &POINSURGY#E CO GE/CO 6129 81 00 05IN 0( 9TOP 5
V'""LE ❑ ,J� CITATION# CHARGE to BOTTOM
LEGALLY YES N`L J
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. EE54959
COLLISION REPORT III III III III III 111
1591972 CASE# 24-1870
ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY)
NAME MIDDLE INITIAL) ROGALSKI LIAM F
(I.P.ST FIRST,
ADDRESS&PHONE# D O.B. '
1504 17TH AVE SPOKANE WA 98203 5096883366 SEX M MMDDYyry 05 - 07 - 1995
PASSENGER WITNESS T# SEAT AIRBAG RESTR. EJECT ' HELMET INJURY NATURE OF INJURIES
❑✓ UNI POS. r USE CLASS
NAME
'(LASTr FIRS' MIDDLE INITIAL)
ADDRESS&PHONE# DOB
SEX' MMDDYVYV
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.
MMDDYYYY.
PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET NJURY NATURE OF INJURIES
❑ ❑ POS. USE CLASS ----�
NARRATIVE'
On February 20, 2024, at 1310 hours dispatch requested that I respond to a collision that occurred
near South 2nd St. and Lake Ave. South, in the city of Renton, county of king, and state of
Washington. Upon my arrival I spoke with the driver of unit 1 and they explained they were going
westbound in the number 2 lane approaching Rainier Avenue South. They stated they were following
their GPS system and it told them to turn left. As they approached the entrance to Safeway, they
made a "90"' left turn to merge into lane four. When then they merged left, they unexpectedly struck
unit 2 which was also going westbound in lane 1.
I then spoke with the driver of unit 2 and they explained they were going westbound in lane 4 when
unit 1 unexpectedly merged left into their lane.
A witness on scene also related a similar story and explained that unit 1 merged left from the number
2 lane to the number 4 lane, striking unit 2 which was also going westbound.
The driver unit 2 sustained a hand injury so he needed to be transported to Harborview Medical
Center.
Both vehicles sustained severe damage, disabling the two vehicles.
Bankers towing took custody of unit 1 and Gene Meyers towing took custody of unit 2.
An exchange of information was given to both drivers.
I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT.
C.CATALAN 02-21-24 09:35 AM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
CO.JOHNSON 0505 1 2/29/2024 5:29:25 PM
BADGE OR ID# 12007 OR]# WA0171300 TIME POLICE DISPATCHED'; 3:31 PM TIME POLICE ARRIVED 4:42 PM
PART I PAGE IT]OF
REPORT NO. EE54959 CASE# ' 24-1870 DATE AND TIME 02/20/24 15:30
OF COLLISION
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