HomeMy WebLinkAbout23-10685 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 0 27c
COLLISION REP FIT 1591971
CASE 23-10685 z
INTERSTATE ❑ CITY STREET FIRE ❑RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHICI F ❑ LOCAL AOENC 4900 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 1 TOTAL#OF OBJECT 1 1 8 28
TRIBAL UNITS 03 STRUCK
RESERVATION
z
3❑ DATE OF M M D D Y Y Y Y TIME(2400) COUNTY# MILES N E IN CITY# ❑
cawsloN 09 - 1-- 2023 1733 17 ❑.= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓
LOGAN AVE N BLOCK NO. e✓ 500
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ 200 00 FEET MILES e S B W e N 6TH ST
0 6 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
NO D:2067997475 0 7 30
6❑ LAST NAME FARAH FIRSTNAME YAHYA MIDDLE H 1 1 2 31
INITIAL
STREET ❑✓ 257 THOMAS AVE SW CITY RENTON ST WA ZIP 98057 z
NEW ADDRESS
❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
7
iNTERLOCKYEs NO 1/ INTERLOCKYEs NO�/ YES R No�/
8❑ LDRIVER # STATE WA SEX'M MID
-O B 09 1- 30 - 1996 2 32
9 ON DUTY❑ STATUS' AIRBAG 3 RESTR 4 . EJECT 1 H USE 2 CLASS 7 [NATURE OF INJURIES LEFT WRIST PAIN z❑
3
10❑ PIATE14 BLT8867 sTAr WAvN# 1G1ZC5E17BF395753
TRAILER STATE TRAILER STATE
11 3 5 PLATE# PLATE# FROM To
TRLR. TRLR. 5 1 33
12 3 5 VIN#j VIN#
FROM TO
VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE J 9 34
13 3 2011 CHEV MAL/BU SD DAMAGE YES NO YES[:] No✓
REGISTERED OWNER INFO TABARAKFARA1257 THOMAS AVESW RENTON WA 98057 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
14 LIABILITY INSURANCE z INSURANCE CO PROGRESSIVE70075749 4
LI EFFECT I POLICY# TOPVENICLE CHARGE 36
LEGALLv res❑NO❑ CITATION# <1�3
OTTOM
15❑ STANDING 7 6
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES 1/ NO D:2064760785
16 a
LAST NAME SAINT FIRST NAME KOMALJIT MIDDLE
INITIAL
17 STREET❑ NEW ADDRESS❑' 9221 S 239TH ST CITY KENT ST WA ZIP 98031 4❑ 37
18❑ CDL IGNITION REQUIRED IGNITION PtR—E—S1ENT MEDICAL—T�RANSPORTED � 38
INTERLOCKYES�NO� INTERLOCK YEs I I NOF YEs t l NOF,/
19 DRIVER'S STATE WA ]SEX IF D.O.B. 07 04 2003 39
LICENSE# MMDDYY
20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 HELMET 2 INJURY 7 NATURE OF INJURIES 40
USE CLASS LOWER BACK PAIN
❑21❑ PLATE# BKT6331 TArE 41
WA VIN# 2T3ZF4DV2CW143096 1
42
22❑ PLATE# STATE PLATE# STATE
TRLR
23❑ UIN#. IN#.
43
RLR
'
VEH YEAR 2012 MAKE TOYT MODEL RAV4 STYLE SP VEHICLE TOWED TO BLIN TOWEDBY GOV HI 44
L4❑ DAMAGE YES NO YES NO
REGISTERED OWNER INFO DEVINDER KAUR 9221 S 239TH ST KENT WA 98031 VEHICLE NO.2
SHADE IN DAMAGEbAREA
2 3 Cd
LIABILITY INSURANCE INSU8 PORGY#E CO ENCOMPASS IND CO 253003124 1U
9TOP
IN EFFECT
vE""LE CITATION# CHARGE o BOTTOMYES N�25 J
=ORAJEWSKI
(PRINT) OFFICER PHONE BADGE OR ID# AGENCY26 12399 WA0171300
PART A PAGE 01 OF C7
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. ED99668
COLLISION REPORT III III III III III 111
1591972 CASE# 23-10685
ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY)
NAME MIDDLE INITIAL) ROBINSON AJAYA J
(LAST FIRST,
ADDRESS&PHONE# D O.B.
9623 S 248TH ST#C3 KENT WA 98030 SEXi F MMDOYyry 08 - 24 - 2017
PASSENGER Z WITNESS UNIT# 3 ppS. 9 AIRBAG 2 RESTR. q EJECT ? HELMET NJURY NATURE OF INJURIES
USE 2 CLASS '1
NAME
(LAST,FIRST,MIDDLE INITIAL)
ADDRESS&PHONE# DOB
SEX MMDDYYYY
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'
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.
RAYMOND GORAJEWSK/ 09-16-23 06:30 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
P.SUMMERS 8887 1 911712023 4:41:50 PM
BADGE OR ID# ! 1Y399 OR]# WA0171300 TIME POLICE DISPATCHED'; 5:34 PM TIME POLICE ARRIVED]5:36 PM
PART I PAGE IT]OF 6�
REPORT NO. ED99668 CASE# 23-10685 OF COLLISION
09/16/23 17:33
OF CbLLI510N
NARRATIVE
ASSIGNMENT/ARRIVAL
On 09/16/2023 at approximately 1734 hours, I was dispatched to a three vehicle collision near the
intersection of Logan Avenue N and N 6th Street in the city of Renton, King County, Washington.
I arrived at approximately 1736 hours.
UNIT 1: CHEVROLET MALIBU
Upon arrival I observed a gray Chevrolet Malibu (WA/ BLT8867, Unit 1) stopped in the northbound
lane of Logan Avenue N south of the intersection of N 6th Street. Unit 1 had moderate front end
damage from the collision. Unit 1's front end was engaged with Unit 2's rear end.
The driver of Unit 1 claimed Unit 1 had brake failure. The driver claimed he replaced the front brake
pads on his own several weeks ago. The driver claimed he never had any mechanical failure with the
brakes until this collision. The driver claimed the brake pedal went to the floor, but also said the
wheels "locked up".
UNIT 2: TOYOTA RAV4
I observed a tan Toyota Rav 4 (WA/ BKT6331, Unit 2) stopped in the northbound lane of Logan
Avenue N south of the intersection of N 6th Street in front of Unit 1. Unit 2 had moderate rear end
damage and minor front end damage from the collision. Unit 2's rear end was engaged with Unit 1's
front end, and Unit 2's front end was engaged with Unit 3's rear end.
No mechanical defects were claimed or observed.
UNIT 3: TOYOTA COROLLA
I observed a black Toyota Corolla (WA/ BZX2487, Unit 3) stopped in the northbound lane of Logan
Avenue N south of the intersection of N 6th Street in front of Unit 2. Unit 3 had minor rear end
damage from the collision. Unit 3's rear end was engaged with Unit 2's front end.
No mechanical defects were claimed or observed.
DRIVER 1: FARAH, YAHYA H.
I contacted Yahya H. Farah (DOB: 09/30/1996) in a nearby parking lot after all the vehicles were
moved from the lanes of traffic. I identified Farah by his valid Washington Driver License. I
established Farah as the driver of Unit 1 by his admission.
Farah complained of pain to his left wrist from the collision. Farah refused emergency medical
services.
DRIVER 2: SAINI, KOMALJIT
I contacted Komaljit Saini (DOB: 07/04/2003) standing near Unit 2. 1 identified Saini by her valid
Washington Driver License. I established Saini as the driver of Unit 2 by her admission.
Saini complained of lower back pain from the collision. Saini admitted she had lower back surgery in
May of 2023. Saini refused emergency medical services.
DRIVER 3: ROBINSON, AJAI K.
I contacted Ajai K. Robinson (DOB: 07/19/1990) standing near Unit 3. 1 identified Robinson by his
valid Washington Driver License. I established Robinson as the driver of Unit 3 by his admission.
Robinson was not injured in the collision.
PASSENGER
Robinson's young daughter, Ajaya J.L. Robinson (DOB: 08/24/2017) was in Unit 3 during the
collision. Ajaya was not injured from the collision.
STATEMENT: DRIVER 1
1 spoke with Farah about the collision. The following is a summary of our conversation:
PAGE 3 OF 6
REPORT NO. ED99668 CASE# 23-10685 OF COLLISION
09/16/23 17:33
OF CbLLI510N
NARRATIVE
Farah drove Unit 1 north on Logan Avenue N toward N 6th Street. Farah stopped in traffic behind Unit
2. Traffic started moving, so Farah accelerated from a stop. Unit 2 suddenly stopped in front of him.
Farah applied Unit 1's brakes, but was unable to stop in time. Unit 1's front end collided with Unit 2's
rear end.
This concluded my conversation with Farah.
STATEMENT: DRIVER 2
1 spoke with Saini about the collision. The following is a summary of our conversation:
Saini drove Unit 2 north on Logan Avenue N toward N 6th Street in front of Unit 1. Saini stopped Unit
2, since she saw Unit 3, which was in front of her, stop for traffic. Unit 2's rear end was suddenly
struck by Unit 1's front end. The force of the collision caused Unit 2's front end to collide with Unit 3's
rear end.
This concluded my conversation with Saini.
STATEMENT: DRIVER 3
1 spoke with Robinson about the collision. The following is a summary of our conversation:
Robinson drove Unit 3 north on Logan Avenue N toward N 6th Street in front of Unit 2. Robinson
stopped Unit 3 for stopped traffic in front of him. Robinson looked in his rear view mirror to make sure
Unit 2 stopped behind him, which it did.
Robinson heard a collision, then Unit 2's front end collided with Unit 3's rear end.
This concluded my conversation with Robinson.
PHOTOGRAPHS
I took photographs of the vehicle with my department issued cell phone and uploaded the
photographs to Axon's Evidence.com.
DISPOSITION
I gave each driver an Exchange of Information form.
This concluded my involvement in this case.
I declare under penalty of perjury under the laws of the State of Washington that the foregoing is true
and correct.
Electronically signed by Officer R. Gorajewski, #12399, on 09/16/2023 at 1827 hours in Renton,
Washington.
PAGE 4 OF 6
SUPPLEMENTAL REPORT NO. ED99668
r`) POLICE TRAFFIC 1 1 8 27
COLLISION REPORT CASE# 23-10685
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 DAMAGETHRESHOLD MET PHONE
5 ❑ UNIT# 3 VEHICLE tSJ CYCLE I_) PEDESTRIAN OWNER YES NO
D:2539936394
0 7 29
LAST NAME ROBINSON FIRST NAME AJAI MIDDLE' ',, K r:j INITIAL
STREET 30
❑ NEW AnDRFrtP 9623 S 248TH ST#C3 CITY KENT ST WA ZIP 98030
6 CDL IGNITIttN REQUIRED IGNITION PRESENT MEDICAL TANSPORTED 1 1 2 31
INTERLOCK YEs NO NTERLOCK YES❑N0� vES N
DRIVER'S
LICENSE STATE I WA SEX M MMDDYYv', 07 - 19 - 1990
7
ON DUTY� STATUS AIRBAG' 2 RESTR. Q EJECT 1 HELMET 2 INJURY 1 1 NATURE OF INJURIES
USE CLASS
8 ❑ 1 32
LICENSE BZX2487 TAr WA VIN# JTDS4MCE5NJ088556
PLATE#
9 TRAILER TRAILER
PLATE# STATE PLATE# STATE
10 ❑ TRLR TRLR
VIN It VIN.#.
11 3 5 VEH.YEAR2022 MAKE TOYT MODEL COROLL STYLE SD I VEHICLE TOWS E T SABLIN TOWED BY anvi vFH1I' P FROM TO
DAMAGE YES NO YES NO
REGISTERED OWNER INFO OWNED BY DRIVER J 9 33
12 � SHADE IN DAMAGED AREA
7 j FROM TO
LIABILITY INSURANCE INSURANCE CO USAA 042573888C R"i"Olx
IN EFFECT &POLICY# 1
ewCLe 34
13 3 LTAGFlG YES NO❑ CITATION# CHARGE 0 BOTTUM
STANDING }EGALLY
7
14 ❑ UNIT Tr Vd I RE O CYCLE OWNERRTY YES AGE NOHRESHOLD MET PHONE ❑ 35
El PEDESTRIAN
15 LAST NAME FIRST NAME MIDDLE INITIAL
TIAL
❑
ET
16 STRETRE "F1' CITY ST ZIP
NEW CDL IGNITION REQUIRED IGNITION PRESENT MEDICALTANSPORTED
NTERLUCK YES No NTERLOCK 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 TOWED 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 '
VINE
EFFECT &POLICY# i 970P - 4 E:l
44
24 LEHIcLE 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.
RAYMOND GORAJEWSKI 09-16-23 06:30 PM
25 INVESTIGATING OFFICER'S SIGNATURE OFFICER'S PHONE UNIT OR DIST DET DATED: PLACE SIGNED
APPROVED BY DATE
26 ORID# 12399 O#I',WA0171300 SUMMERS 911712023 PAGE F OF 6
3000-345-013(R 11118)
REPORT NO. ED99668 CASE# ' 23-10685 DATE AND TIME 09/16/23 17:33
OF COLLISION
Logan Ave N
Net to Scale
t
4
k
I
N 6tF Street
PAGE 6 OF 6