HomeMy WebLinkAbout24-2182 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 1 27c
COLLISION REP FIT 1591971
CASE 24-2182 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 3 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#
COLLISION 02 - 1-- 2024 0906 17 ❑.❑ S 8 W e IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
SOUTH 3RD STREET BLOCK ST e✓
MILEPOST 500 ❑
4a❑
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ ❑ FEET e S ❑ VV a MORR/S AVENUE SOUTH
0 1 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
✓NO D:5099691227 0 11
30
6� LAST NAME PICARDAL FIRSTNAME ALCINDOR MIDDLE V 1 1 2 31
INITIAL
STREET ❑✓ 500 UNIVERSITY PKWY#104 CITY YAKIMA ST WA 2jp, 98901 z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
1/ I iNTERLOCKYEs NO NTERLOCKYEs NO�/ YES R No�/
8❑ LRIIVER #
ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 HELMET
2 CLASS 1 NATURE OF INJURIES z❑
3
10❑ Pi aTES� CJE7977 sTArI WAvIN# JA4ATVAAXPZ039226
TRAILER STATE TRAILER STATE
11 2 5 PLATE# PLATE# FROM TO
TRLR. TRLR 7 3 33
12 2 5 VIN#' VIN#
>; FROM TO
VEH.YEAR MAKE MITS D
MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE 5 1 34
13 1 2023 ECLIPS SV AMAGE vesNo ves❑ No
REGISTERED OWNER INFO PERLA PICARDAL 4004 W WALNUT STAPT 16 YAKIMA WA 98908 D:5099691227 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
14 LIABILI INSURANCE U INSURANCE CO STATE FARM 541 3237-F21 47 3 4
IN EFFECT &POLICY# STOP
VEHICLE 5 36
LEGALLv res❑NO❑ CITATION# CHARGE 1 o BOTTOM
15❑ STANDING 8 7 6
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
16 a UNIT 02 VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES 1/ NO D:2069462478
LAST NAME CHANDA FIRST NAME SYLVESTER MIDDLE M
INITIAL
17❑ STREET Is❑' 314 S 4TH ST CITY' RENTON ST WA ZIP 980572434 4❑ 37
NEW ADOREs
18❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL—T�RANSPORTED � 38
INTERLOCKYES�NO� INTERLOCK YES N0F YESt lNOF,/]
19[-] DRIVER #
❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 H U EET 2 NJAURSY 1 NATURE OF INJURIES ❑ 40
❑21❑ PLATE# CKX3601 TArE WA VIN 1t 4S4BTAFCXM3144341 41
1
42
22❑ PLATILER E# STATE PLATE# STATE
23❑ 43
TRLR RLR
VIN#. IN#.
VEH YEAR 2021 MAKE SUBA MODEL OUTBAC STYLE 4W VEHICLETOWED TO BLIN TOWEDBY GOV HI 44
L4❑ DAMAGE YES NO YES NO
REGISTERED OWNER INFO SYLVESTER CHANDA 314 S 4TH ST RENTON WA 98057 D:2069462478 VEHICLE NO.2
SHADE IN DAMAGED AREA
2 3 4
LIABILITY
INSURANCE INSURANCE
#E CO GEICO 6062735391IN 1UR
5
VE""LE ❑ ,J� CITATION# CHARGE LEGALLYYES N J25
=UGENT
(PRINT) OFFICER PHONE BADGE OR ID# AGENCY26 11498 WA0171300
PART A PAGE 01 OF C7
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EE54962
COLLISION REPORT III III III III III 111
1591972 CASE# 24-2182
ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY)
NAME
(LAST FIRST,MIDDLE INITIAL)_
ADDRESS&PHONE#
SEX D.O.B. - -
MMDDYYYY.
PASSENGER❑WITNESS UNIT# SEAT AIRBAG RESTR. EJECT ' HELMET INJURY NATURE OF INJURIES
POS. USE CLASS
NAME
'(LAST,FIRST MIDDLE INITIAL)
ADDRESS&PHONE# D D B
SEX MMDDYYYY
PASSENGER ❑WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET INJURY 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.
MATTHEW NUGENT 02-28-24 05:24 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
CO.JOHNSON 0505 1 2/29/2024 5:47:27 PM
BADGE OR ID# 11498 ORI# WA0171300 TIME POLICE DISPATCHED 9:10 AM TIME POLICE ARRIVED]9:12 AM
PART I PAGE IT]OF 4�
REPORT NO. EE54962 CASE# 24-2182 OF COLLISION
02/28/24 09:06
OF CbLLI510N
NARRATIVE
24-2182
On 02/28/2024 at approximately 0910 hours, I was dispatched to a non-injury and non-blocking
vehicle collision at the intersection of South 3rd Street and Morris Avenue South, within the City
Limits of Renton, County of King, State of Washington.
Upon my arrival, I confirmed there were no complaints of injury at the time of report. There, I collected
the involved parties driving documents and their independent summary of the collision.
The driver of Unit#1 stated that she and her adult passenger (Lyft Client) were traveling eastbound
on S 3rd ST approaching the intersection of Morris Ave S in lane 2 of 2 (one-way street). The driver of
Unit#1 stated that she was intending to continue straight (east) through the intersection. The driver of
Unit#1 stated that upon entering the intersection, she observed Unit#2 approach the same
intersection but from the south. Unit#1 stated that both vehicles collided in the intersection and that
Unit#1 suffered moderate damage to the front bumper of her vehicle. The driver of Unit#1 believed
the color of the traffic light for her direction of travel was green. The passenger had to leave for work
and did not remain at the scene at the time of contact.
The driver of Unit#2 stated that he was the sole occupant of his vehicle and was traveling
northbound on Morris Ave S approaching the intersection of S 3rd ST. The driver of Unit#2 stated
that he had a stale green light for his direction of travel. The driver of Unit#2 stated that he noticed
Unit#1 approach the intersection from the West, but that Unit#2 had already entered the
intersection. As a result, both vehicles collided in the intersection and Unit#2 suffered moderate
damage to the driver's side bumper/quarter panel of his vehicle.
No witnesses were immediately available at the scene.
Based on the above statements, I was not able to determine the predominant factor for the cause of
collision. Both drivers claim that to have had a green light displayed for their respective direction of
travel. I told both the involved parties to contact their respective insurance companies for filing.
Both Unit#1 and Unit#2 were able to be driven away without further incident. An exchange of
information was provided to all involved parties.
I certify (or declare) under penalty of perjury under the laws of the State of Washington that the
foregoing is true and correct.
Electronically signed by Officer M. Nugent#11498 5:05 PM 2/28/2024 Renton, King County, WA.
PAGE 3 OF 4
REPORT NO. EE54962 CASE# 24-2182 DATE AND TIME 02/28/24 09:06
OF COLLISION
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