HomeMy WebLinkAbout24-4584 POLICETRAFF'c" III !�� I IIIllI111IN II II I REPORT NO. EE72379 170
27
COLLISION REP FIT 1591971
SASE 24-4584 2
INTERSTATE ❑ CITY STREET FIRE ❑
RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHIr.I F ❑ LOCAL AOENC 4900 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 2 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'.. O4 - 1-— 2024 1041 17 ❑-❑ S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓
BLOCK
NE SUNSET BLVD MILEPOST ST e✓ 2700
4a❑
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ ❑ FEET e S ❑ W e 0 4 29
MOTOR PEDAL- DAMAGE THRESHOLDHONE
UNIT 01 VEHICLE ❑ CYCLE El MET P
YES ✓NO D:4252600997 0 11
30
6� LAST NAME WERAKE FIRSTNAME SUJATHA MIDDLE K 1 1 2 31
INITIAL
STREET 01 2417 NE 20TH ST CITy RENTON ST WA ZIP 98056 z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
iNTERLOCKYEs NO INTERLOCKYEs NO YES R NO
8❑ LRIIVERS STATE WA SEX'F MM DAY' 03 1- 26 - 1945 2 32
CENSE 9 ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 H USEET ICNLJAURY 1 NATURE OF INJURIES z❑
3
10 9� P1 ATE 14 /afY5259 STATE WA V N# 2D4GP24R35R238441
TRAILER STATE TRAILER STATE
11 3 5 PLATE# PLATE# FROM TO
TRLR. TRLR 5 7 33
12 3 5 VIN#j VIN#
FROM TO
VEH.YEAR 2005 MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED By GOVT.VEHICLE 7 3 34
13 4 DODG CARAVA VN DAMAGE YES NO YES[:] No
✓
REGISTERED OWNER INFO OWNEDBYDRIVER VEHICLE NO. 1
❑
SHADE IN DAMAGED AREA ❑ 35
14 LIABILI INSURANCE INSURANCE CO CONNECT INSURANCEA102575480 3 4
IN EFFECT &POLICY# 9TOP
vECALLv HIa.E 5 36
res❑NO❑ CITATION# CHARGE 1 o BOTTOM
15❑ LE STANDING 8 6
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES 1/ NO D:2067797046
16 a
LAST NAME VAN FIRST NAME TIFFANY MIDDLE
INITIAL
17❑ STREET ❑', 1336 E 51ST ST CITY' TACOMA ST' WA ZIP 98404 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.C.B. 07 08 _ 1999 39
LICENSE# MMDDYY
WELMET INJURY0 NATURE OF INJURIES 40
20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 USE CLASS ❑
21❑ LICENSE BPE6710 TATE WA VIN# 4T1B61HK6KU760878
❑ 41
PLATE#
42
22❑ PLATE# STATE PLATE# STATE
TRLR
23❑ UIN#. IN#.
43
RLR
'
GoI
VEH YEAR 2019 MAKE 7'Dy7- MODEL CAMRY STYLE $D —FEHICLE
TOWED NOO✓ BLIN TOWED BY v HyES NO 44
24❑ fj
REGISTERED OWNER INFO OWNED SY DRIVER VEHICLE N0.2
SHADE IN DAGELLAREA
z Cdd
LIABILITY
INSURANCE INSU&PORGY#E CO EAGLE WEST 25-PAC-2-1833273IN 1GQ'E""LE
❑ ,J� CITATION# CHARGE
LEGALLY YES N`L J
25
=Kl
(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
J
26 12598 WA0171300
PART A PAGE 01 OF C7
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EE72379
COLLISION REPORT III III III III III 111
1591972 CASE# 24-4584
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'
On Sunday, April 28, 2024 at 1043 hours, I was dispatched to a two-vehicle collision in the area of the
2700 block of NE Sunset Blvd.
The following occurred within the City of Renton, King County; Unit 1 - WA/AIY5259 was being
driven by Sujatha Werake and was turning left onto NE Sunset Blvd in the 2700 block from the
Safeway parking lot. Unit 2 - WA/ BPE6710 was driven by Tiffany Van and was traveling eastbound
on NE Sunset Blvd in the 2700 block.
Sujatha stated she was turning left out of the parking lot and thought she had enough time to make
the turn before traffic approached but she underestimated the speed of the oncoming vehicle and
ultimately collided with Unit 2 while they were driving straight. Sujatha stated she was unable to avoid
colliding with Unit 2. The front bumper of Unit 1 crashed into the passenger side rear wheel, tire,
quarter panel and bumper of Unit 2.
Tiffany stated she was driving in the lane nearest the curb and observed the Unit 1 in the parking lot
but did not think they were going to turn abruptly into traffic. Tiffany stated Unit 1 struck the rear
portion of her vehicle.
Based on both statements it appeared that Unit 1 failed to yield to oncoming traffic while making a left
turn.
Both vehicles sustained damage and neither vehicle needed to be towed.
I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT.
J.WISN/EWSKI 04-28-24 12:26 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY E
DAT
S.WOODWARD 11528 4/29/2024 11:07:59 AM
BADGE OR ID# 12598 OR]# WA0171300 TIME POLICE DISPATCHED 10:43 AM TIME POLICE ARRIVED 10:50 AM
PART I PAGE IT]OF
REPORT NO. EE72379 CASE# ' 24-4584 DATE AND TIME 04/28/24 10:41
OF COLLISION
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