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HomeMy WebLinkAbout24-10161 iiTFiNII IIIII III IIIII II IIII IIIII I . 27c REPORT NO EF19930oc� RA
COLLISION REPORT 1591971
CASE# 24-10161 2
INTERSTATE CITY STREET El
STATE ROUTE OTHER LdCCODIGENC'Y 42QQ 3
C©DIN6
COUNTY RD PRIVATE WAY
2❑ TRIBAL UN TS#OF 02 OBJESTRUCT
1 1 8 28
TREE OR STUMP
i RESERVATION : 1 2
3� M M D D Y Y Y Y TIME(2400) COUNTY# MILES CITY#
eDCL s on' 09 - 28 - 2024 1755 17 =.= S 8 W e OF IN e 1070 s
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓
SE 128TH ST BLOCK NO. e 15900 .�
4a❑ MILE POST
❑ DISTANCE OF(REFERENCE OR CROSS STREET)
5 1501.1 00 FEET e✓ S 8 W e 160TH AVE SE
0 1 29
MOTOR ✓ PEDAL- DAM AG THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE ❑ YEs Vl No D:2066837086 0 1 30
5 LAST NAME VO FIRST NAME GUI MIDDLE T 1 1 2 31
INITIAL
STREET ❑ 6619 NE 1ST ST CITY; RENTON ST I WA ZIP; 98059 2
NEW ADDRESS
7 CDL IGNITION REQUIRED IGNITION PRESENT MEDIQAL TRANSP©RTED 3
INTERLOCKYES NO✓ INTERLOCK YES N©✓ YEs NO✓
8 DRIVER # STATE WA SEXI F MMDOYY' 03 - 20 - 1948 1 2 32
-NJUR
9 ON DUTY STATUS' AIRBAG 2 RESTR 4 EJECT 1 HELMET
2 CLASSY 1 [NATURE of INJURIES 2
LICENSE, CAP9606 STATE WA VIN# JTJDARDZ6M2257117 3
10 Fq I PI ATP tt
TRAILER STATE TRAILER STATE
11 3 5 PLATE# PLATE# FROM TO
TRLR TRLR 3 1 7 33
12 3 5 VIN# vIN#
FROM TO
VEH.YEAR 2021 MAKE LEXS MODEL NX 200T STYLE P4 VEHICLE TOWED fj TO ZBLIN TOWED BY GOVT VEHICLE 3 7 34
13 DAMAGE YES II_II NO YESII_I) NO
REGISTERED OWNER INFO YENHOA TRAN6619NElSTST RENTON WA 98059 D:2066837086 VEHICLE NO. 1
SHADE IN DAMAGED AREA 35
4 LIABILITY INSURANCE INSURANCE CO 2 3 4
14 PEMCO CA1430277
IN EFFECT &POLICY# 4TOP
VEn" CHARGE 5 36
Lec Ly YES❑NO❑ CITATION# 7 o BOTTOM
15❑ STM ING 7 e
MOTOR ✓ PEDAL- PEDESTRIAN PROPERTY DAM OLD MET PHONE
UNIT 02 VEHICLE CYCLE nWNFR YES�/ THR NO D:4255591885
16�
LAST NAME VINNAKOTA FIRST NAME SAI MIDDLE B
INITIAL
STREET ❑
17 ❑ 1930 76TH AVE SE CITY LAKE STEVENS ST, Wq ZIP 98258 4 37
NEW ADORE SS
1$❑ CDL IGNITION REQUIRED3 IGNITION PRESENT MEDICAL TRANSPORTED' 38
INTERLOCK YES NO✓ INTERLOCK YES ND✓ YES ND✓
19 DRIVER'S STATE I WA SEX NI I DOB, 03 30 1994 � 39
LICENSE# MMDDYY —
20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 R USE 2 CLASSY 1 NATURE OF INJURIES 40
21 LICENSLATE E CBK9950 rare WA vIN# KNDCE3LG5K5017892 41
22❑ STATE PLAAILER TE# STATE 42
PLATE#
23 TRLR RLR 43
UIN#. 'IN#
VEH.YEAR 2Q1<J MAKE Klq MODEL NIRO STYLE p4 VEHICLE TOWED TO BLIN TOWED BY GOV HI 44
24 DAMAGE ves V/ No GENE MEYERS TOWING ves No✓
REGISTERED OWNER INFO OWNEDBYDRIVER VEHICLE NO.2
SHADE IN DAGEAREA
2
LIABILITY INSURANCE INSURANCE CO GEICO 6160715998
IN EFFECT &POLICY# 1�wl
1-1— ❑ 10CITATION# CHARGE
LE—LY YES N
25 7DNE
'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
26
SON 12421 WA0171300
PAGE 01 OF
PART A 3000-345-189(R 11/18)
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EF19930
COLLISION REPORT III III III III III 111
1591972 CASE# 24-10161
E NA ADDITIONAL PERSONS INVOLVED(PASSENGERS AND/OR WITNESSES ONLY)
M
(LAST,FIRST,MIDDLE INITIAL) KOTTI LAKSHMI D
ADDRESS&PHONE# D O
1930 76TH AVE SE LAKE STEVENS WA 98258 4255591885 SEXi F MM DDYVYY 03 — 07 — 1969
PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET INJURY NATURE OF INJURIES
2 POS. 3 2 4 1 USE 2 CLASS j 1
:NAME
(LAST EIFS7 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
:.(L4ST,FIRST,MIDDLE INITIAL)
ADDRESS&PHONE#
SEX MMDDYY D.O.B.
YY
PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET INJURY NATURE OF INJURIES
POS. I USE CLASS
NARRATIVE
24-10161 COLL
On 9/28/2024 1 was working as a uniformed patrol officer and driving a marked patrol vehicle for the
City of Renton. I was dispatched to a report of a two-vehicle, non-injury collision near the intersection
of SE 128th St and 160th Ave SE Renton/King/WA.
I arrived on scene and located an orange 2021 Lexus NX WA/CAP9606, driven by Gui T Vo DOB:
3/20/1948. Gui said that she was not injured. She told me that she was driving east in SE 128th St in
the number one lane when the Kia Niro changed lanes striking her in the driver side front quarter
panel. There was damage to the front bumper and driver side front quarter panel. The Lexus was
drivable and able to leave the location.
then spoke with the driver of the white 2019 Kia Niro WA/CBK9950, Sai B Vinnakota DOB:
3/30/1994. Sai said that he was driving east in the number two lane when the Lexus tried to make a U
-turn and struck him causing him to crash. The Kia was facing southbound with its driver side in a tree
and damage to the passenger rear quarter panel, the vehicle was also missing its passenger side
rear wheel. Neither Sai nor his passenger were injured.
Sai told me that there was a male in Gui's vehicle that was no longer on scene, neither Gui nor her
daughter (who arrived later) mentioned any passenger. The driver seat of the Lexus was very close to
the wheel which indicated to me that Gui was the driver. The passenger seat also had items on it and
the floor.
The Kia was not drivable and had to be removed from the scene by Gene Meyers Towing.
Nothing further.
I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT.
D.NELSON 09-28-24 07:43 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST.DET DATED PLACE SIGNED
APPROVED BY E
DAT
P.SUMMERS 8887 913012024 11:55:17 AM
BADGE OR ID# 12421 ORI# WA0171300 TIME POLICE DISPATCHED 1 5:58 PM TIME POLICE ARRIVED i 6:05 PM
APART B 3 Da-3m5—attar gt 1Mffp PAGE 2�OF F3
IREPORTNO. EF19930 CASE# 24-10161 DATE AND TIME 09/28/2417:55
OF COLLISION
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