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HomeMy WebLinkAbout24-7689 j ITFC II IIIII III IIIII II IIII IIIII I . 27I OOLCERAF EF02476 COLLISION REPRT 1591971 INTERSTATE CITY STREET FIRE ❑ CASE# 24-7689 2 RESULTED 1 STOLEN STATE ROUTE ❑ OTHER ❑ VEHICLE LOt`CO A`NG 4100 3 COUNTY RD NVOLVED CODING 2❑ PRIVATE WAY TRIBAL UNITS TOTAL#OF 28 02 STRUCK 0 4 RESERVATION 1 2 3� M M D D Y Y Y Y TIME(2400) COUNTY# MILES CITY# DATE OF'. N E coLLISION' 07 - 21 - 2024 1601 17 =.�� S WE IN OF 1070 3 4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION NE SUNSET BLVD BLOCK POST e 4a MILE POST Y800 .� ❑ ❑ DISTANCE OF(REFERENCE OR CROSS STREET) 5 200 00-1 MILES N FEET e✓ S 8✓ E e KIRKLAND AV NE 0 4 29 MOTOR PEDAL- DAM AG THRESHOLD MET PHONE UNIT 01 VEHICLE CYCLE' YES ✓NO 0 1 30 5 LAST NAME PAGDILAO FIRST NAME EVELINO MIDDLE I R 1 1 2 31 INITIAL STREET E:1 1445 PIERCE AV NE CITY RENTON ST WA ZIP 98056 2 NEW ADDRESS 7 CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3 INTERLOCKYES No�/ INTERLOCKYES NO�/ YES No�/ 8❑ DCIENSE# STATE WA SEX M MMOCSYY' 07 — 01 — 1983 1 2 32 9 ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 N USEET INJURY CLASS 1 NAruRE of INJURIES 2 LICENSE, CLZ3691 STATE WA VN# 4T1BF3EK1BU745981 3 10[9� PI ATF# 11[—j— TRAILER STATE TRAILER ,STATE ROM TO 11 3 5 PLATE# PLATE# TRLR TRLR 1 3 33 12 3 5 VIN# vI. ( FROM TO VER YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED By GOVT VEHICLE 13 4 2011 TOYT CAMRY SD DAMAGE YES�No ✓� Yes No� 5 1 34 REGISTERED OWNER INFO EVELINO PAGDILAO 1445 PIERCE AV NE RENTON WA 98056 VEHICLE NO. 1 ❑ SHADE IN DAMAGED AREA 35 4 LIABILITY INSURANCE NSURANCE CO 14 FARMERS 5631852971 IN EFFECT &POLICY# 9TOP VEHICLE CHARGE S 36 Lemur YES❑NO❑ CITATION# 7 0¢OTTOM 15❑ nNowc s e MOTOR PEDAL- PROPERTY DAM THR OLD MET PHONE VEHICLE UNIT 02 CYCLE (7WNFR Q ❑ PEDESTRIAN ❑ D:4255450251 YES NO 16� LAST NAME PINOS-ORELLANA FIRST NAME PABLO MIDDLEI E INITIAL STREET ❑ 17 ' 4308 NE SUNSET BLVD BB CITY RENTON ST, WA ZIP 98059 37 NEW ADDRESS 18� CDL IGNITION REQUIRED IGNITION PRESENT MEDICALTRANSPORTED 38 INTERLOCKYEs CKYES Nio vEs No;� 19 DRIVER'S STATE WA SEX M I D.O.B. 11 04 2005 39 LICENSE# MMDDYY - HELMET INJURY NATURE OF INJURIES 4Q 20❑ ON DUTY STATUS' AIRBAG 1 RESTR 13 EJECT '3 5 7 ❑ USE CLASS MINOR LACERATIONS FACE 21 LLCANS E 5K9104 TATE WA VIN# JKAEXMJ168DA12705 41 22❑ STATE TILER PATE# STATE ❑ 42 PLATE# 23 TRLR kRLR 43 UIN#. 'IN#. VEH.YEAR 200$ MAKE /(q yyK MODEL E250 STYLE MT VEHICLE TOWED TO BLIN TOWED BY GOV HI 44 24 DAMAGE YES NO YES NO REGISTERED OWNER INFO 1ABLOPINOS-ORELLANA4308NESUNSETBLVDBB RENTON WA 98059 D:4255450251 VEHICLE NO.2 SHADEDAMAGEDAREA 3 4 LIABILITY INSURANCE❑ INSURANCE CO NONE IN EFFECT &POLICY# vwaE CITATION11 CHARGE LecnLLYYE❑ N 25 0M OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY 26 HANSEN HSU 12651 WA0171300 PAGE 01 OF PART A 3000-345-159(R 11/18) POLIICFETRAFFICN CORRECTION REPORT NO. EF02476 COLLISION REPORT III III III III III 111 1591972 CASE# 24-7689 ADDITIONAL PERSONS INVOLVED(PASSENGERS AND/OR WITNESSES ONLY) NAME PAGDILAO SOPHIA (LAST,FIRST MIDDLE INITIAL} ADDRESS&PHONE# DOB 1445 PIERCE AV NE RENTON WA 98056 2063132798 SEX' F MMDDYYYv 02 f 06 - 2013 PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET INJURY NATURE OF INJURIES �' 1 POS. 7 1 4 1 USE CLASS '1 ---� 'NAME LAsr F RST,MIDDLE INITIAL) BRAGANZA LIANA ADDRESS&PHONE# D O B 1445 PIERCE AV NE RENTON WA 98056 2063132798 SEX' F MMDDYYYY 08 17 _ 2012_ SEAT HELMET INJURY NATURE OF INJURIES PASSENGER WITNESS UNIT# i 1 Pa5 9 AIRBAG 1 RESTR. 4 EJECT 1 USE CLASS 1 '.NAME (LAST,FIRST,MIDDLE INITIAL) : QUEZADA GARCIA ENRIQUE D ADDRESS a PHONE# 650 DUVALL AV NE J1032 RENTON WA 98059 7188830090 SEX M14 _ 1991 MMDDYYYY PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET INJURY NATURE OF INJURIES ❑ Q POS. USE CLASS �____ ---� NARRATIVE Unit 1 traveling south along 2800 block of NE Sunset Blvd. Unit 2 traveling north along 2800 block of NE Sunset Blvd. Unit 1 makes left turn into parking lot of Joann Fabric and Crafts at 2823 NE Sunset Blvd. Unit 2 collides with Unit 1 causing reportable disabling front end damage to Unit 2 and reportable non disabling damage to the rear passenger side of Unit 1. No injuries to Unit 1 driver or passengers. Unit 2 was partially knocked off motorcycle and sustained minor facial lacerations. Unit 2 driver was treated on scene by Renton Fire and determined no further immediate medical attention was needed. It appeared that the proximate cause of collision was Unit 1 failing to yield ROW left turn. I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT. HANSEN HSU 07-21-24 06:07 PM INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST.DET DATED PLACE SIGNED APPROVED BY DATE P.SUMMERS 8887 8/5/2024 2:23:01 PM BADGE OR ID# 12651 ORI# ( WA0171300 TIME POLICE DISPATCHED'; 4:03 PM TIME POLICE ARRIVED 4:05 PM PART B 3aaa-345-,aa(R11Y1s) PAGE 27OF 37 REPORT NO. E F02476 CASE# 24-7689 DATE AND TIME 07/21/24 16:01 OF COLLISION Y � t 3E: � r t z PAGE 3 OF 3