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HomeMy WebLinkAbout24-5141 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 6 27c
COLLISION REP FIT 1591971
CASE 24-5141 z
INTERSTATE ❑ CITY STREET FIRE ❑RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHICI F ❑ LOCAL AOENC 4Y00 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 1 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#
cawsloN 05 - 1-- 2024 1107 17 ❑-= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
AIRPORT WAY BLOCK NO. e ----� ❑
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ �.❑ FEET e S ❑ W e LOGAN AVE N
2 3 29
MOTOR PEDAL- DAMAGEHRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El T
YES NO �/ D:6047009642 2 3 30
6❑ LAST NAME SOHI FIRSTNAME TARANJOT MIDDLE S 1 2 31
INITIAL
STREET ❑1 13132 103 AVE CITY SURREY ST BC 2jp', V3T1R5 z=
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
iNTERLOCKYEs NOWINTERLOCKYEs NO�/ YES R No�/
8❑ LDRIVER # STATE BC SEX'M MMDD� 03 - 01 1- 2007 1 2 32
9 ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 HELM
USEET I ICNLJAURY 1 NATURE OF INJURIES 2❑
3
LICENSE 66784P STATE BC VIN# 4V4NC9EHXNN308419
10 9❑ Pr ATE�
TRAILER 96380J STATE BC I TRAILER STATE
11 3 5I PLATE# PLATE# IR.. ro
TRLR. TRLR 7 1 33
12 3 5 vIN#' 1 UYVS3531 N7554331 vIN#'
FROM TO
❑ VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE 7 1 34
13 3 2022 VOLT TRUCK SE DAMAGE YES NO YES❑ NO✓
REGISTERED OWNER INFO TARANJOTSOHI 13132103 AVE SURREYBCV3T1R5 D:6047009642 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
14� LIABILITY INSURANCE INSURANCE CO INSURANCE CORP OF BRITISH COLUMBI 4lL7P2PN 2 3 4
IN EFFECT &POLICY# 9TOP
vEHlcl.e CHARGE 5 36
LECALLv Yes❑NO❑ CITATION# 10 BOTTOM
15❑ NDING 8 6
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
16 a UNIT 02 VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES 1/ NO D:2068805306
LAST NAME KENNEDY FIRST NAME AIYANA MIDDLE Ij
INITIAL
17 STREET ❑ 114 N 3RD PL APT C CITY' RENTON ST WA ZIP 98057 37
NEW ADDRESS I I I I I ❑
18� CDL IGNITION REQUIRED IGNITION PRESENT MEDICALt—T�RANSPORTED ❑ 38
INTERLOCK ES❑No� INTERLOCK YES I I NoF YES t l NOz
19 D IVEW #
INJURY NATURE OF INJURIES 40
20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 USE CLASS 1 ❑
21❑ LICENSE I BPF8842 TATe WA vIN# 1HGCR2F77GA00361
❑ 41
PLATE#
42
22❑ PLATE# STATE PLATE# STATE
23❑ 43
TRLR RLR
UIN#. 'IN#.
VEH YEAR 2016 MAKE HOND MODEL ACCORD STYLE 4D VEHICLETOWED TO BLIN TOWEDBY GOV HI 44
L4❑ DAMAGE YES NO YES NO
REGISTERED OWNER INFO IEALL DUKURAY 114 NW3RD PL APT C RENTON WA 98057 D:2065493254 VEHICLE NO.2
SHADE DAGED AREA
4
INAEFFIECTTY NSURANCE❑ &POINSULICY#E CO 9TOP 5
—e E ❑ ,J� CITATION# CHARGE
25 I C
to BOTTOM
LEGALLY YES N J
s � e
=AS
NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
26 SWAN 7 12965 WA0171300
PART A PAGE 01 OF C7
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EE80516
COLLISION REPORT III III III III III 111
1591972 CASE# 24-5141
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
PM 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.
NICHOLAS SWAN 05-14-24 02:08 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
DESIRES SCOTT 10272 5/26/2024 9:46:37 AM
BADGE OR ID# 12965 ORI#' WA0171300 TIME POLICE DISPATCHED 11:13 AM TIME POLICE ARRIVED 11:23 AM
PART Ei PAGE IT]OF
REPORT NO. EE80516 CASE# 24-5141 OF COLLISION
05/14/24 11:07
OF CbLLI510N
NARRATIVE
On 05/14/2024 at approximately 1113 hours, I was dispatched to a non-injury, blocking two-vehicle
collision at the intersection of N 3rd St and Houser Way N, within the city limits of Renton, county of
King, state of Washington.
Upon arrival, I contacted the involved parties and confirmed no injuries had occurred requiring
immediate medical response at the time of report. There, I collected the involved party's driving
documents and their independent recollection of events leading up to the collision.
The driver of Unit#1 said he was traveling eastbound on Airport Way in the center lane while
negotiating the corner to turn left from Airport Way onto Logan Ave N. The driver of Unit#1 stated he
then turned in to the right lane of Logan Ave N and took the right hand turn lane on to N 3rd St. Once
on N 3rd St, he noticed that Unit#2 was following him and attempting to flag him down. He came to a
stop at N 3rd St and Houser Way N. He did not believe he had hit anyone while making the turn and
stated if he had, he would have stopped sooner.
The driver of Unit#2 said she was the sole occupant of her vehicle and also traveling eastbound on
Airport Way and Logan Ave N in the far left hand lane. As she was going around the corner where
Airport Way turns in to Logan Ave N, the rear of the trailer from Unit#1 hit her passenger side mirror,
front passenger side tire, and the front bumper. The driver of Unit#2 stated that Unit#1 continued
driving away in what she thought was a hit and run, so she followed him and flagged him down until
he stopped.
Based on the above statements, 1 determined that the Driver of Unit#1 (Taranjot) was the
predominant factor for the collision due his trailer moving over his left hand lane divider into the lane
next to him and making contact with Unit#2.
Unit#1 was able to be driven away without further incident. Unit#2 also drove away without further
incident. No citation was given to either party. 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 N. Swan #12965 1236 hours on 05/14/2024 in Renton, King County,
WA.
PAGE 3 OF 5
SUPPLEMENTAL REPORT NO. EE80516
r`) POLICE TRAFFIC 1 27
COLLISION REPORT CASE# 24-5141
1 COMMERCIAL MOTOR CARRIER INTERSTATE INTRASTATE ✓ G
UNIT# 1 USDOT ICC# I VEHICLE TYPE 6 CARGO BODY 9
TYPE
2 ❑ 1 28
CARRIER STRYDER
NAME......
3 CARRIER
ADDRESS `
CITY ST' ZIP'
4 ❑ NAME # PLACARD: :❑
NAME IF NO NUMBER
SOURCE 3 AXLES 05 GI80000 +
4a ❑ ADDITIONAL UNITS
MOTOR PEDAL- PROPERTY DAMAGE THRESHOLD MET PHONE
5 ❑ UNIT# VEHICLE I_J CYCLE _) PEDESTRIAN � OWNER � YES NO
i MIDDLE'... 29
LAST NAME FIRST NAME INITIAL
STREET 30
NFW AnDRFrtP. CITY ST ZIP
6
CDL GNITIttN REQUIRED GNITION PRESENT MEDICAL TANSPORTED 1 31
INTERLOCK YES No zERLOCK YES❑N0� vES N
LLIICIENSE STATE I SEX M��DYRYY' 2
7 F-I
ON DUTYl STATUS AIRBAG' RESTR. EJECT HELMET INJURY NATURE OF INJURIES
USE CLASS
8 ❑ ' 1 32
LICENSE+ rar VIN.#
PLATE#
9 TRAILER TRAILER
PLATE# STATE PLATE# STATE
10 ❑ TRLR TRLR
VIN.#. VIN.#.
11 VEH.YEAR MAKE I MODEL STYLE I VEHICLE TOWS E T SABLIN TOWED BY anvi vEHII' P FROM TO
DAMAGE YES NO YES NO
REGISTERED OWNER INFO. m 33
12 � SHADE IN DAMAGED AREA
7 j 4 FROM TO
LIABILITY INSURANCE❑ INSURANCE CO
IN EFFECT &POLICY# t 9 101?
VEHICLE 1 o BarroM 34
13 ❑ LEGALLY YES[:] NO❑ CITATION# CHARGE
STANDING �} MOTOR
8 7 6
14 ❑ UNIT Tr Vd 1 RE O CYDDAL OWNERRTY YES D-AMAGE NOHRESHOLD MET PHONE ❑ 35
PEDESTRIAN
❑15 LAST NAME FIRST NAME NIDDL 35
STREET
16 NFln+Aon "F—] CITY ST I ZIP
CDL IGNITION REdUiRED IGNITION PRESENT MEDICALTANSPORTED
INTERLOCK YES No INTERLOCK YEs NO YEs NO El
17 37
LICENSE# STATE SEX MMDDDYBYY
18 ❑ ON DUTY� STATUS AIRBAG RESTR. ; EJECT HELMET INJURY' NATURE oF1NJUR1Es 38
USE (CLASS
19 ❑ vIN 39
LICENSE #
PLATE# rnr
20 ❑ TRAILER' TRAILER ❑ 40
PLATE# STATE PLATE# STATE
21 ❑ TRLR TRLR 41
VIN# YIN#i
42
22 VEH.YEAR MAKE I MODEL STYLE I VEHICLE TOWED DUE T SABLIN TOWED BY GOVT.VEHICLE
DAMAGE YES NO YES NO El
23 REGISTERED OWNER INFO_ SHADE IN DAMAGED AREA 43
3 4 71
LIABILITY INSURANCE INSURANCE CO '
IN EFFECT � &POLICY# i 970P - 4 E:l
A44
24 ....... YES❑ NO❑ CITATION# CHARGE iq 60TiOM
.Glly
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.
NICHOLAS SWAN 05-14-24 02:08 PM
25 INVESTIGATING OFFICER'S SIGNATURE OFFICER'S PHONE UNIT OR DIST DET DATED: PLACE SIGNED
APPROVED BY DATE
25 OI BADGE 12965 O#I',WA0171300 SCOTT 5/28/2024 PAGE OF F
3000-345-013(R 11118)
REPORT NO. EE80516 CASE# ' 24-5141 DATE AND TIME 05/14/24 11:07
OF COLLISION
i<
i
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PAGE 5 OF 5