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HomeMy WebLinkAbout24-7195 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 0 27c
COLLISION REP FIT 1591971
CASE 24-7195 z
INTERSTATE ❑ CITY STREET FIRE ❑RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHIr.I F ❑ LOCAL AOENC 4Y00 3
HIT 8 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# ❑
cowsloN 07 - 10 - 2024 0553 17 ❑.❑ S 8 W H OF e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓
e✓ --- ----�
SB 1405 MILEPOST
4a❑
DISTANCE OF(REFERENCE OR CROSS STREET) BLOCK NO.
5❑ 100 00 FMILES EET e S ❑ W e N SOUTHPORT DR
0 3 29
R PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE ❑ YES
,/No D:2532138903 0 3 30
6� LAST NAME SONG FIRSTNAME PETER MIDDLE Y 1 F 2 31
INITIAL
STREET ❑, 706 137TH ST S CITY TACOMA ST WA 2jp, 984443432 z=
'NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
INTERLOCK YES[:]NO INTERLOCKYEs NO YES R NO
8❑ LRIIVERSCENSE STATE WA SEX'M MI DAY' 05 - 23 - 1997 1 2 32
9 ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 HELMET USE 2 CLASS 1 NATURE OF INJURIES z❑
3
10 9❑ P1 aT�S� BRt4354 sTArI WAurN# 1HGCR2F31HA054477
TRAILER STATE TRAILER STATE
11 0 0 PLATE# PLATE# FROM TO
TRLR. RLR 1 7 33
12 0 0 VIN#' VIN#
>; FROM TO
VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE 1 7 34
13 1 2017 HOND ACCOR DAMAGE YES NO YES❑ No✓
REGISTERED OWNER INFO JOO SONG 706137TH ST S TACOMA WA 98444 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
14 LIABILITY INSURANCE NPOLICY E CO NATION WIDE 7246J 057718 4
LI EFFECT &POLICY# TOPVEHICLE CHARGE 36
LEGALL'YYes❑NO CITATION# <1�3
OTTOM
15❑ STANDING 6
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT 02 VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES NO ,/ D:4259197780
16 a
LAST NAME CHAN FIRST NAME DANY MIDDLE N
INITIAL
17❑ STREET ❑', 23911 3OTH DR SE CITY' BOTHELL ST WA ZIP 980216953 37
NEW ADDRESS ❑
18� CDL IGNITION REQUIRED IGNITION PR—E-1SENT MEDICAL TRANSPORTED 38
INTERLOCKYES�NOF INTERLOCK YEs It I NOF YES
t t— l NO❑
19 F] LDI IVER # STATE WA ]SEX IF M DDY
D.C.B.
O6 1_ 25 _ 1976 El 39
WELMET {NJURY NATURE OF INJURIES 40
20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 USE 2 CLASS 1 ❑
21❑ LICENSE BXE1900 TAre WA VIN1t USE
❑ 41
PLATE#
42
22❑ PILER LATE# STATE PLATE# STATE
23❑ UIN#. 43
TRLR RLR
'IN#.
VEH YEAR 2021 MAKE JEEP MODEL WRANGL STYLE VEHICLETOWED TO BLIN TOWEDBY GOV HI 44
L4❑ DAMAGE YES NO YES NO
REGISTERED OWNER INFO DANYCHAN2391130THDRSE BOTHELL WA98021 VEHICLE NO.2
SHADE IN DAMAGEbAREA
2 3 Cd
LIABILITY
INSURANCE INSU PORGY#E CO STATE FARM 554 9197780IN 1 9TOP
VE""LE ❑ Nu,J CITATION# CHARGE
LEG
25 i o BOTTOM
ALLY YES $ '
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. EE97369
COLLISION REPORT III III III III III 111
1591972 CASE# 24-7195
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 July 10, 2024, at 0553 hours dispatch requested that I respond to a collision that occurred at the
off ramp of N Southport Dr and 1405, in the city of Renton.
Upon contact, I spoke with the driver of unit 2, a Jeep Wrangler (WA/BXE1900). The driver explained
they were exiting the northbound offramp from i405 to N Southport Dr. While they attempted to merge
left from the number one lane on N Southport Dr, they began to slow down in the traffic lane. While
they slowed and waited for traffic in the number 2 lane to pass by, they were rearended by unit 1. Unit
2 sustained minor damage to their rear bumper. The hanging rear tire on the back of the vehicle took
most of the damage.
I then spoke with the driver of unit 1 and they explained they were also exiting i405 to N Southport Dr.
The driver failed to see unit 2 stopped in their lane, hitting the back of the other vehicle. Unit 1
sustained moderate damage because the radiator, front bumper, and hood were pushed in towards
the center of the vehicle. Unit 1 was towed away by Bankers Towing.
Based on the information above, I believe unit 1 was either distracted by something, or he was
following to closely.
I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT.
C.CATALAN 07-19-24 12:18 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
CO.JOHNSON 0505 1 711912024 2:05:19 PM
BADGE OR ID# 12007 OR]# WA0171300 TIME POLICE DISPATCHED', 5:57 AM TIME POLICE ARRIVED',6:03 AM
PART I PAGE IT]OF
REPORT NO. EE97369 CASE# 24-7195 DATE AND TIME 07/10/24 05:53
OF COLLISION
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