HomeMy WebLinkAbout24-3705 POLICETRAFF'c" III !�� I IIIllI111IN II II I REPORT NO. EE69013 170
27
COLLISION REP FIT 1591971
CASE 24-3705 z
INTERSTATE ❑ CITY STREET FIRE ❑RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHIr.I F ❑ LOCAL AOENC 4200 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 2 TOTAL#OF OBJECT 1 1 8 28
TRIBAL UNITS 02 STRUCK
RESERVATION
z
3❑ DATE OF M M D D Y Y Y Y TIME(2400) COUNTY# MILES N E IN CITY#
COLLISION'. 04 - 1-— 2024 1105 17 ❑-= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
SB 1405 BLOCK NO. e --- ❑
MILEPOST
4a❑
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ �.❑ FEET e S ❑ VV e N SOUTHPORT DR
0 5 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
✓NO D:6015572926 0 11
30
6� LAST NAME BHATHAL FIRSTNAME PAWANDEEP MIDDLE K 1 2 31
INITIAL
STREET ❑ 24429 119TH PL SE CITY KENT ST WA 2jp, 980305099 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 2 RESTR 4 EJECT 1 HELMET
2 CLASS 1 NATURE OF INJURIES z❑
3
10❑ P1 aT�S� 3KAURS sTATI WAvIN# KM8RIDHEONU423197
TRAILER STATE TRAILER STATE
11 0 0 PLATE# PLATE# FROM TO
TRLR. TRLR. 3 3 33
12 0 0 VIN#' VIN#
>; FROM TO
VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE 7 $ 34
13 2 2022 HYUN PALISA UT DAMAGE YES NO YES[:] No
✓
REGISTERED OWNER INFO BIPANDEEP BHATHAL 24429119TH PL SE KENT WA 98030 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
2 INSURANCE CO 3 4
14 LIABILITY INSURANCE NATIONWIDE 7246J055357
IN EFFECT &POLICY# � 9TOP
VEHICLe 36
LEGALLY
Yes❑NO❑ CITATION# CHARGE 10 BOTTOM
15❑ STANDING 8
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT VEHICLE ❑ CYCLE ❑ ❑ : OWNER ❑ YES 1/ NO D:2532222720
16 a
LAST NAME ANDREWS FIRST NAME TARA MIDDLE I A
INITIAL
17❑ STREET ❑', 2100 LAKE WASHINGTON BLVD N A S106 CITY' RENTON ST WA ZIP 980561453 37
NEW ADDRESS ❑
18� CDL IGNITION REQUIRED IGNITION PR—E-1SENT MEDICAL TRANSPORTED ❑ 38
INTERLOCKYES�NOR INTERLOCK YEs It I NOF YES
t t— l NO❑
19 DRIVER'S STATE WA ]SEX IF D.O.B. 09 _ 07 1982 0 39
LICENSE# MMDDYY
HELMET {NJURY 1 NATURE OF INJURIES 40
20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 USE 2 CLASS ❑
21❑ LICENSE I BAK2159 TATe WA vIN# JN8AS5MTXFW152216
❑ 41
PLATE#
42
22❑ PLATE# STATE PLATE# STATE
23❑ VIN#. 43
TRLR RLR
'IN#.
VEH YEAR 2015 MAKE NISS MODEL ROGUE STYLE VEHICLETOWED TO BLIN TOWEDBY GOV HI 44
24❑ DAMAGE YES NO YES NO
REGISTERED OWNER INFO BENJAMIN ANDREWS 207 MAIN AVE S APT 412 RENTON WA 98057 VEHICLE NO.2
SHADEDAMAGEDAREA
3 4
LIABILITY
INSURANCE INSU PORGY#E CO GEIC04073003870IN 9TOP 5
0(
VE"'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. EE69013
COLLISION REPORT III III III III III 111
1591972 CASE# 24-3705
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 I 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 April 5, 2024, at 1105 hours dispatch requested that I respond to a collision that occurred at N
Southport Dr and NB 1405.
Upon my arrival I spoke with the driver of unit 1 and they explained they were approaching the
intersection of NE Sunset Blvd and NB i405 when the collision occurred. Her GPS told her she
needed to make a U-turn at the intersection, so as she proceeded, she noticed she could not make
her turn. It would be considered an improper U-turn. She stepped on her brake, but unit 1 struck the
back of her vehicle.
The driver of unit 2 stated it was her fault.
I then spoke with the driver of unit 2 and they explained they were going eastbound in the number two
lane when the collision occurred. They were entering the intersection of NE Sunset Blvd and NB 1405.
Unit 2 was following unit 1, when suddenly unit 1 stopped abruptly, and tried to make an improper U-
turn. Unit 2 was unable to bring their vehicle to a complete stop, striking the left side of unit 1's back
bumper.
Unit 2 sustained moderate damage and needed to be towed away by Bankers Towing. Unit 1
sustained moderate damage but was driveable.
No sustained any injuries.
I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT.
C.CATALAN 04-05-24 12:13 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
C.JACOBS 1953 1 411712024 2:07:50 PM
BADGE OR ID# 1Y007 ORI# WA0171300 TIME POLICE DISPATCHED', 11:05 AM TIME POLICE ARRIVED 11:05 AM
PART I PAGE IT]OF 3�
REPORT NO. EE69013 CASE# ' 24-3705 DATE AND TIME 04/05/24 11:05
OF COLLISION
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