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HomeMy WebLinkAbout24-10121 iiTFiNII IIIII III IIIII II IIII IIIII I . 27c REPORT NO EF19014oc� RA
COLLISION REPORT 1591971
CASE# 24-10121 2
INTERSTATE CITY STREET FIRE I
RESULTEDSTOLENSTATE ROUTE OTHER VEHICLE LDCAI-AGENCY 4100 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 TOTAL#OF OBJECT 1 8 28
TRIBAL UNITS 02 STRUCK
RESERVATION : 1 1
2
3� M M D D Y Y Y Y TIME(2400) COUNTY# MILES CITY#
eaCL s on' 09 - 27 - 2024 1153 17 =.[� S 8 W e OF IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
SW 16TH ST BLOCK NO. e 500 .�
4a❑ MILE POST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ C------ 1.1 FEET e S 8 W e LIND AVE SW
0 1 29
MOTOR ✓ PEDAL- DAM AG THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE ❑ YEs Vl No D:9044031643 0 1 30
5 LAST NAME VASOYA FIRST NAME KUSHAL MIDDLE A 1 1 2 31
INITIAL
STREET ❑ 10913 SE 187TH LN CITY; RENTON ST I WA ZIP; 980558113 2
NEW ADDRESS
7 CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
INTERLOCKYEs NO✓ INTERLOCKVEs NO✓ YES NO✓
8 DRIVER # STATE WA SEXI M MMDDYY' 09 - 14 - 1990 1 2 32
9 ON DUTY STATUS' AIRBAG 6 RESTR 4 EJECT 1 HELM
USEET 2 CLASSY 1 NATURE of INJURIES 2
LICENSE, CLV5203 STATE WA VIN# 2HKRS6H54RH807559 3
10 Fl I as ATP rt
TRAILER STATE TRAILER STATE
11 3 0 PLATE# PLATE# ROM To
TRLR TRLR. 3 7 33
12 3 5 VIN# vIN#
FROM TO
13 4 VEH.YEAR2024 MAKE HOND MODEL CR-V STYLE VEHICLE TOYED NO�iS46LIN T�VyED.6LRS CLE 1 5 34
DAMAGE IIII._IIII HHttVVii((tt
REGISTERED OWNER INFO KUSHAL VASOYA 10913 SE 187TH LN RENTON WA 980558113 D:9044031643 VEHICLE NO. 1
SHADE IN DAMAGED AREA 35
4 LIABILITY INSURANCE INSURANCE CO 14 PROGRESS/VE 971115735
IN EFFECT &POLICY#V""' CHARGE 36
LEGALLY YES❑NO❑ CITATION# <14,
15 STM ING
MOTCYR ✓ PEDAL- PEDESTRIAN1:1 PROPERTY DAM THR OLD MET PHONE
UNIT 02 VEHICLE CYCLE nWNFR YES�/ NO D:4255286800
16�
LAST NAME NALUBUULWA FIRST NAME SHAM11MA MIDDLE M
INITIAL
17
STREET ❑ 37
NEW ADORE SS❑ 16159 126TH AVE SE CITY RENTON ST, WA ZIP 980585562 4
18❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 38
INTERLOCKYES ND✓ INTERLOCI£YEs No✓ YES NO✓
19 DRIVER'S STATE WA SEX F D.O.B. 04 04 1989 39
LICENSE# MMDL}YY -
20❑ ON DUTY STATUS AIRBAG 6 RESTR 4 EJECT 1 HELMET 2 INJURY 7 NATURE OF INJURIES 40
USE CLASS KNEE PAIN
21 LICENSE CKF3305 rare WA VIN 5N1DLOMM7KC509523 41
22❑ [TILER TAILER
PLATE# STATE PLATE# STATE 42
23 TRLR r RLR 43
UIN#. 'IN#
TOWED BY GOV HI 44
VEH.YEAR 2019 MAKE /pJF/ MODEL (,�X6Q STYLE VEHICLE
TOWED✓ No BLIN BANKERS ves No✓
24
REGISTERED OWNER INFO SHAMUMA NALUBUULWA 16159126THAVE SE RENTON WA 98058 D:4255286800 VEHICLE NQ.2
SHADFjy DAMAGED AREA
3 4
LIABILITY INSURANCE INSURANCE CO THE GENERAL 53-WA6197003
IN EFFECT &POLICY# 9TOP
L'—L ❑ ,J—I CITATION11 CHARGE t080TTOM
LEGALLY YES N
25 a 7 e
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
26
P.KORDEL 9676 WA0171300
PART A PAGE 01 OF
3000-348-189(R 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EF19014
COLLISION REPORT III III III III III 111
1591972 CASE# 24-10121
E NA ADDITIONAL PERSONS INVOLVED(PASSENGERS AND/OR WITNESSES ONLY)
M
(LAST,FIRST,MIDDLE INITIAL) NOEL ANOREJ C
ADDRESS&PHONE# D O
26627 188TH AVE SE COVINGTON WA 98042 2064126373 SEXi M MMDDYYYY B. 05 — 26 — 1977
PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET INJURY NATURE OF INJURIES
POS. USE CLASS ----�
:NAME
(LAST FIFS7 MIDDLE INITIAL)
ADDRESS R PHONE#
SEX MMDDYYYY D.O.B. —
PASSENGER❑WITNESS UNIT# : SEAT AIRBAG RESTR. EJECT HELMET INJURY: NATURE CFINJURIES
POS. USE CLASS ----�
:NAME
(LOST,FIRST,MIDDLE INITIAL)
ADDRESS&PHONE#
SEX MMDDYY D.O.B.
YY
PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET NJURY NATURE OF INJURIES
POS. I 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.
P.KORDEL 09-27-24 01:36 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST.DET DATED PLAGE SIGNED
APPROVED BY DATE
G.BARFIELD 6476 1 9/27/2024 1:49:06 PM
BADGE OR ID# ; 9676 ORI# WA0171300 TIME POLICE DISPATCHED 11:54 AM TIME POLICE ARRIVED i 11:56 AM
PAST B a Do-3m5—attar(t 1Mff) PAGE 2�OF 4
REPORT NO. EF19014 CASE# 24-10121 OF DATE AND r�N + 09/27/24 11:53
O�COLLISION
NARRATIVE
On 09-27-2024 at 1154 hours, I was dispatched to a collision at SW 16th St and Lind Ave SW in the
City of Renton, King County, WA State. I activated my emergency equipment, which activated my
dash and body cams. I arrived at 1156 hours. In the southbound lane of Lind Ave SW was vehicle 2,
a silver Infinity with front left damage and airbag deployment. Just ahead of this was vehicle 1, a
white CRV with front end damage and airbag deployment. Both vehicles had been driven by solo
occupants. I identified driver 1 as Kushal Vasoya via WA DOL picture license. I identified driver 2 as
Shamiima Nalubuulwa. Both were owners of their respective vehicles, and both had valid insurance.
Driver 2 had knee pain, so I had Renton Fire assess her. They did not require/recommend
hospitalization.
I spoke with an independent witness, whom I identified verbally as Andrej Noel. He told me that he
was driving westbound on SW 16th St approaching Lind Ave SW. He was sure there was a red light
for him. He was not sure exactly how the collision occurred ahead of him, but all of a sudden the
collision occurred. Either way, he told me that the light for westbound traffic on SW 16th St at Lind
Ave SW was red.
I spoke with driver 1. He showed me that one of his shoes had untied laces. He realized this as he
was driving westbound on SW 16th St approaching Lind Ave SW. He bent down to tie his laces,
taking his sight off the roadway. This is when the collision occurred. He was not certain if he had a
red or green light.
I spoke with driver 2. She told me that she was driving southbound on Lind Ave SW, approaching SW
16th St. She told me that her light was green. When she drove through the intersection, vehicle 1 ran
the red light westbound on SW 16th St and collided with her.
Based on all the above accounts, coupled with my observation of damages to the vehicles, I
determined that vehicle 1 was the proximate cause of the collision. Driver 1 did not yield for the red
light. I gave him a verbal warning, and let both drivers know what my report/investigation would
document. They were each provided information exchange sheets.
PAGE 3 OF 4
REPORT NO. EF19014 CASE# 24-10121 DATE AND TIME 09/27/24 11:53
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PAGE 4 OF 4