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HomeMy WebLinkAbout24-6417 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 0 27c COLLISION REP FIT 1591971 CASE 24-6417 z INTERSTATE ❑ CITY STREET FIRE ❑RESULTED 1 STOLEN STATE ROUTE ❑ OTHER ❑ VFHIr.I 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 CITY# COLLISION'. 06 - 18 - 2024 1814 17 . N E IN� S 8 W H OF e 1070 3 4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑ 116TH AVE SE BLOCK NO. e✓ 16400 ❑ 4a❑ MILEPOST DISTANCE OF(REFERENCE OR CROSS STREET) 5❑ �.❑ FEET e S ❑ W e SE 164TH ST 0 1 29 MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE UNIT 01 VEHICLE ❑ CYCLE El No ,/ I D:2532778517 0 11 30 6� LAST NAME MYRAND FIRSTNAME GARY MIDDLE S 1 2 31 INITIAL STREET ❑ 24329 109TH PL SE CITY KENT ST WA 2jp, 980304926 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 HELMETU E ICNLJAUSSY 1 NATURE OF INJURIES z❑ 3 ,OF Pi ATNES# B49821X sTAr WAuN# 1FTYR10C6WUA40643 -- TRAILER STATE TRAILER STATE 11 2 5 PLATE# PLATE# FROM To TRLR. TRLR 3 7 33 12 3 5 VIN#j VIN# :: FROM TO ❑ VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED By GOVT.VEHICLE 1 $ 34 13 2 1998 FORD RANGE PK DAMAGE YES NO YES[:] NO✓ REGISTERED OWNER INFO OWNEDBYDRIVER VEHICLE NO. 1 SHADE IN DAMAGED AREA ❑ 35 14 LIABILITY INSURANCE INSURANCE CO USAA 001129372U71057 4 LI EFFECT I SUR N# TOPVEHICLE CHARGE 36 LEGALLY YES❑NO❑ CITATION# <1�3 OTTOM 15❑ STANDING 6 MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE UNIT VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES,/ NO D:2067071329 16 a LAST NAME TURCAN FIRST NAME GHEORGHE MIDDLE N INITIAL 17❑ NEW STREETR 9724 S 7 200TH ST CITY KENT ST WA ZIP 980311417 37 18❑ CDL IGNITION REQUIRED IGNITION PtR-E-S1ENT MEDICAL-T�RANSPORTED � 38 INTERLOCKYES�NO� INTERLOCK yEs I I NOF YEs t l NOF,/ 19 DRIVER # ❑ ON DUTY STATUS AIRBAG 4 RESTR 4 EJECT 1 H U EET NJAURSY 1 NATURE OF INJURIES ❑ 40 LICENSE I ❑21❑ PLA E# CKD9376 TArE 41 WA VIN 1t WBA3ASGSODNP21871 1 42 22❑ PLATE# STATE PLATE# STATE 23❑ VIN#. 43 TRLR RLR 'IN#. Gov HI VEH YEAR 2013 MAKE BMW MODEL 328 STYLE $D DAMAGE TOWED NOO✓ BLIN TOWED BY 44 ES YES NO,/ 24❑ REGISTERED OWNER INFO OWNED SY DRIVER VEHICLE N0.2 SHADE IN DAMAGED AREA 2 3 4 LIABILITY INSURANCE INSU PORGY#E CO NATIONAL GENERAL 2020996819IN I STOP 5 VEHICLE YES[:] N C[:] CITATION# CHARGE i o BOTTOM LEGALLY 25 $ OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# JAGENCY 26 STEVEN FAJARILLO 12847 WA0171300 PAGE 01 OF PART A 3000-345-159 OR 11/181 STATE OF POLICETRAFFICN CORRECTION REPORT NO. EE89141 COLLISION REPORT III III III III III 111 1591972 CASE# 24-6417 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. STEVEN FAJARILLO 06-18-24 08:41 PM NVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED APPROVED BY DATE J.THIELMAN 11462 6/22/2024 11:24:19 PM BADGE OR ID# ( 12847 ORI# WA0171300 TIME POLICE DISPATCHED; 6:16 PM TIME POLICE ARRIVED',6:19 PM PART I PAGE IT]OF 4� REPORT NO. EE89141 CASE# 24-6417 OF COLLISION 06/18/24 18:14 OF CbLLI510N NARRATIVE 24-6417 This incident was captured on my body worn video camera. This report is a summary of events that occurred and is not an exact sequencing of events. Statements have been paraphrased and summarized. On 06-18-2024 1 was working as a police officer in the city of Renton. At approximately 1816 hours I was dispatched to the report of an unknown injury collision at the intersection of 116th Ave SE/SE 164th St, City of Renton, County of King, WA. This incident was captured on my department issued Axon body camera and my vehicle's Axon dashcam. According to the notes in the call, a pickup t-boned a white sedan. There were unknown injuries, and they were blocking southbound lanes. Vehicle 1 was identified as a green 1998 Ford Ranger (WA/B49821X). Vehicle 2 was identified as a white 2013 BMW 328 (WA/CKD9376). I arrived on scene and contacted both involved parties. I first spoke with the driver, owner, and lone occupant of Vehicle 1, Gary S Myrand (11-11-1948). He stated he was stopped at the stop sign at SE 164th St facing west. He believed he was clear to continue straight through the intersection when he collided with Vehicle 2. Vehicle 1's front end collided with the driver side door of Vehicle 2. Gary said he did not see Vehicle 2. Gary was uninjured and his vehicle was still drivable. I spoke with the driver, owner, and lone occupant of Vehicle 2, Gheorghe Turcan (DOB: 09-28-1999). Gheorge had nothing else to add to the story of Gary. Gheorghe advised he was driving south on 116th Ave SE when he collided with Vehicle 1. Gheorghe was also uninjured, and his vehicle was pushed off to the side of the road. Gheorghe advised he would call his own tow. I took pictures of the scene and vehicle's and later uploaded them to Evidence.com. I provided both parties with a case number. The driver of Vehicle 1 stated he did not see Vehicle 2 before entering the intersection. Based on the investigation this action was the proximate cause for the collision. There is no further information available at this time. I certify (declare) under penalty of perjury under the laws of the state of Washington that the foregoing is true and correct. Electronically signed by S. Fajarillo #12847 on 06/18/2024 @ 2019 hours in Renton WA. PAGE 3 OF 4 REPORT NO. EE89141 CASE# ' 24-6417 DATE AND TIME 06/18/24 18:14 OF COLLISION { r r U PAGE 4 OF 4