HomeMy WebLinkAbout23-11146 POLICETRAFF'c" III !�� I IIIllI111IN II II I REPORT NO. EE06311 170
27
COLLISION REP FIT 1591971
CASE 23-11146 z
INTERSTATE ❑ CITY STREET FIRE ❑
RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHIC;I F ❑ LOCAL AGENCI 4200 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 TOTAL#OF OBJECT 1 1 8 28
TRIBAL UNITS 04 STRUCK
RESERVATION
z
3❑ DATE OF M M D D Y Y Y Y TIME(2400) COUNTY# MILES N E IN CITY#
CowsloN 09 - 1-- 2023 1148 17 ❑-= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
SE CARR RD BLOCK NO. e✓ 10600 ❑
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ ❑ FEET e S ❑ VV e 106TH PL
0 3 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
No ,/ I D:2068300033 0 11
30
LAST NAME RAMANATHAN FIRST NAME PRABHAKARAN MIDDLE N
6 INITIAL 1 2 31
STREET ❑ 10413 SE 174TH ST APT 4253 CITY RENTON ST WA 2jp, 980555871 z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
INTERLOCK YES[:]NO INTERLOCKYEs NO YES R NO
8❑ LRIIVER #
ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 H U SE
ICNLJAUSSY 1 NATURE OF INJURIES z❑
3
10❑ Pi aT�S� BQJ5366 sTArI WAurN# 2HGF62F50CH607231
TRAILER STATE TRAILER STATE
11 0 0 PLATE# PLATE# FROM TO
TRLR. RLR 1 7 33
12 3 5 VIN#' VIN#
>; FROM TO
VEH.YEARN MAKE HOND MODEL CIVIC STYLE VEHICLE TOWED 0NOOffBLIN TSIgWgYMEYER YOS❑ENO 3 7 34
DAMAGE ILJI (�ciV6
13 REGISTERED OWNER INFO NITHYASELVARAJ10413SE174THSTAPT4253 RENTON WA 98055 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
14❑ LIABILITY INSURANCE IN CO PROGRESSIVE 942069420 3 4
IN EFFECT &POLICY# QQ
VBwcLe CHARGE 36
LEGALLY YES❑NO CITATION# 3A0387757 FAIL TO YIELD MOTOR VEHICLE15 STANDING
MOTOR PEDAL-:. PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
�U-NIT U2 VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES,/ NO D:2067919108
16 a
LAST NAME DUFF FIRST NAME DANIEL MIDDLE JE
INITIAL
17❑ STREET ❑', 17430 AMBAUM BLVD S APT 34 CITY SEATTLE ST WA ZIP 981481779 37
NEW ADDRESS ❑
18� CDL IGNITION REQUIRED IGNITION PtR—E—S1ENT MEDICAL TRANSPORTED ❑ 38
INTERLOCKYES�NOR INTERLOCK YEs I I NOF YEs t l NO❑
19 LDI IVER # STATE WA SEX M M D.C.B. 11 11 1966 0 39
WELMET INJURY1 NATURE OF INJURIES 40
20❑ ON DUTY STATUS AIRBAG 6 RESTR 4 EJECT 1 USE CLASS ❑
21❑ LICENSE BWG3255 TAre WA VIN# 2FMDA522266A35541
❑ 41
PLATE#
42
22❑ PLATE# STATE PLATE# STATE
23❑ 43
TIN# IN RLR
#.UIN#. '
VEH YEAR 2006 MAKE FORD MODEL FREESTA STYLE VEHICLE TOWED TO BLIN TOWEDBY GOV HI 44
24❑ DAMAGE YES,� NO GENE MEYERS YES NO
REGISTERED OWNER INFO KATHRYN DUFF 17430 AMBAUM BLVD S APT 34 SEATTLEWA98148 VEHICLE NO.2
SHADEDAMAGEDAREA
3 4
LIABILITY
INSURANCE INSURANCE
#E CO USAA 0033881CIN 9TOP 5
VE""LE ❑ Nu,J CITATION# CHARGE to BOTTOM
LEGALLY YES
25 ' e
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# JAGENCY
26
J.M/TCHELL 10377 WA0171300
PART A PAGE 01 OF C7
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EE06311
COLLISION REPORT III III III III III 111
1591972 CASE# 23-11146
ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY)
NAME MIDDLE INITIAL) ROSARIO LUTGARDA L
(IAST FIRST,
ADDRESS&PHONE# D O.B.
20418 95TH AVE S KENT WA 980311464 SEXi F MMDDYyYv 12 - 19 - 1955
PASSENGER Z WITNESS❑'UNIT# 3 POS 3 AIRBAG 2 RESTR. 4 EJECT ? 1 HELMET NATURE OF INJURIES
USE CLASS
'1
NAME
(LAST,FIRST,MIDDLE INITIAL) MOBLEY ALETEENA
ADDRESS&PHONE# D O B.
2067650370 SEX: F MMDYVYY
PASSENGER []WITNESS POS. USE CLASS UNIT# SEAT AIRBAG RESTR. EJECT HELMET NJURY NATURE OF INJURIES
NAME
(LAST FIRST,MIDDLE INITIAL) GRAVES MELINDA
AooREss&PHONE# 2069138182 _
SEX U. M -❑
MDDYYYY
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.
J.MITCHELL 10-03-23 10:09 AM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
CO.JOHNSON 0505 1 101612023 6:48:43 AM
BADGE OR ID# 10377 ORI# WA0171300 TIME POLICE DISPATCHED 11:55 AM TIME POLICE ARRIVED 11:55 AM
PART I PAGE 2�OF❑
REPORT NO. EE06311 CASE# 23-11146 OF COLLISION
09/28/23 11:48
OF CbLLI510N
NARRATIVE
On 09/28/23 1 responded to a 4-vehicle non-injury/blocking collision at the intersection of SE Carr RD
and 106th PI SE.
I contacted the driver of unit 2 who told me they were traveling westbound on SE Carr in the #2 lane.
Driver says as he entered the intersection at 106th PI on a solid green light, unit 1 pulled in front of
him from southbound 106th PI and the two vehicles collided. After colliding with unit 1, unit 2
deflected into unit 3 and then deflected into unit 4. The driver did complain of injury. Damages (heavy
front-end) required a tow.
I contacted the driver of unit 3 who told me they were stopped (for solid red traffic signal) in the left-
turn only lane of eastbound SE Carr Rd when their vehicle was struck by unit 2. The driver and
passenger were not injured. Unit 3 (rear bumper damage) did not require a tow.
I contacted the driver of unit 4 who told me they were traveling in the #2 lane of eastbound SE Carr
Rd when they were involved in a collision with unit 2. The driver was not injured (but evaluated by
Renton Fire due to air bag deployment). Unit 4 (front driver side bumper damage) did not require a
tow.
I contacted the driver of unit 1, identified as P Ramanathan (dob 05-17--87) via his WA DL.
Ramanathan says he was on southbound 106th PI Se and entered the intersection at SE Carr Rd on
a green light when he was involved in a collision with unit 2. Ramanathan says he was not injured.
Unit 1 (from driver-side damage) did require a tow.
I was contacted by two witness who were stopped in front of unit 2 in the left-turn-only lane
(eastbound SE Carr Rd to northbound 106th PI Se). The witnesses claim that while their light was a
solid red, the eastbound signal for lanes 1 and 2 was solid green. Both witnesses said unit 1 had a
red light when it turned onto SE Carr from southbound 106th PI.
But not for the action of UNIT 1 DRIVER the result would not have happened.
I cited Ramanathan via SECTOR under RCW 46.61.180.1 -Failure to Yield
I declare under penalty of perjury under the laws of the State of Washington that the foregoing is true
and correct.
PAGE 3 OF 5
SUPPLEMENTAL REPORT NO. EE0631 1
r`) POLICE TRAFFIC 1 1 8 27
COLLISION REPORT CASE# 23-11146
1 COMMERCIAL MOTOR CARRIER INTERSTATE INTRASTATE G
UNIT'# USDOT ICC# VEHICLE TYPE CARGO BODY
;TYPE
2 ❑ 1 1 8 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 DAMAGE THRESHOLD MET PHONE
5 ❑ UNIT# 3 VEHICLE tSJ CYCLE I_) PEDESTRIAN � OWNER � YES NO
D:5627947035
0 8 29
LAST NAME TUNGOL FIRST NAME MARVIN MIDDLE' L
INITIAL
: :
STREET
NEW AnDRFSP 20418 95TH AVE S CITY KENT ST WA ZIP 980311464
6
CDL IGNITIttN REQUIRED IGNITION PRESENT MEDICAL TANSPORTED 1 1 2 31
INTERLOCK YEs No zERLOCK YES[:]NO[:] YES N
DRIVER'S
LICENSE STATE I WA SEX M MMDDYYv 06 - 14 - 1984
7 ❑ ON DUTY� STATUS AIRBAG' 2 RESTR. 1 EJECT 1 HELMET I INJURY 1 1 NATURE OF INJURIES
USE CLASS
8 ❑ 1 1 2 32
LICENSE B►U8510 TAr WA VIN# JTHBJ46G472056988
PLATE#
9 TRAILER TRAILER
PLATE# STATE PLATE# STATE
10 TRLR TRLR 91 VIN.It VIN.#.
11 0 0 VEH.YEAR2007 MAKE LEXS MODELES STYLE VEHICLE TOVVE E T SABLIN TOWED BY anvi vEH1G P FROM TO
DAMAGE YES 'E YES NO
REGISTERED OWNER INFOLUTGARDA ROSARIO 2041895TH AVE S KENT WA 98031 J 9 33
12 3 5 SHADE IN DAMAGED AREA
7 j FROM TO
LIABILITY INSURANCE INSURANCE CO STATE FARM 4229898 D0747 q"i"Olx
IN EFFECT &POLICY#
VEEIOL o Cairo 7 3 34
13 ❑ LEGALLY YESZ NO❑ CITATION# CHARGE
STANDING 7
4 MdTOR O PEDAL ❑ ❑ PROPERTY ❑ DAMAGETHRESHOLD MET PHONE ❑ 35
14 ❑ UNIT# VEHICLE CYCLE PEDESTRIAN OWNER YES NO D:2068999588
15 TOSTON RUSHAL MIDDLE.. G
❑ 36
LAST NAME FIRST NAME INITIAL
1 16 ❑ STREET ❑ 1711 13TH AVE S APT 101 CITY SEATTLE ST WA Z!P 981444157
NEn+AnntxFSS
CDL IGNITION REdUiRED IGNITION PRESENT MEDICALTANSPORTED
17 ❑ INTERLOCK YES No INTERLOCK YEs NC7 YEs No ❑
DRIVER'S STATE WA SEX F D.O.B 37
LICENSE# MMDDYYY` 01 - 25 - 1963
18 ❑ E
ON DUTY STATUS' AIRBAG 3 RESTR. 4 EJECT 1 HELMET INJURY 1 NATURE OF INJURIES 38
USE CLASS
19 ❑ LICENSE ❑
PLATE#
BKH5825 TAr yyq vIN# 39 1FMZU72XXYUB15901
20 ❑ TRAILER' STATE TRAILER STATE ❑ 40
PLATE#< PLATE#
21 ❑ TRLR TRLR 41❑
VIN# YIN#i
42
22 VEH.YEAR MAKE I MODEL STYLE VEHICLE TOWED DUET SABLIN TOWED BY GOVT.VEHICLE
2000 FORD EXPLOR DAMAGE YES NO YES NO
23 ❑ REGISTERED OWNER INFO RUSHAL TOSTON 171113TH AVE SAPT 101 SEATTLEWA 98144 SHADE IN DAMAGED AREA 43
z 3 4
LIABILITY INSURANCE INSURANCE CO
❑ VEHICLE
EFFECT &POLICY# <�Q
44
24 LEwcLE YES❑ NO❑ CITATION# CHARGE
LELLY �y
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.
J,MITCHELL 10-03-23 10:09 AM
25 INVESTIGATING OFFICER'S SIGNATURE OFFICER'S PHONE UNIT OR DIST DET DATED: PLACE SIGNED
APPROVED BY DATE
26 ORID# 10377 O#IL WA0171300 JOHNSON 101612023 PAGE F41 OF❑
3000-345-013(R 11118)
REPORT NO.! EE06311 CASE# ' 23-11146 DATE AND TIME 09/28/23 11:48
OF COLLISION
w
J
� o
O
O
SE CARR RD
PAGE 5 OF 5