HomeMy WebLinkAbout24-9744 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 0 27c
COLLISION REP FIT 1591971
CASE 24-9744 z
INTERSTATE ❑ CITY STREET FIRE ❑RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHICI 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 02 STRUCK
RESERVATION
z
3❑ DATE OF M M D D Y Y Y Y TIME(2400) COUNTY# MILES N E IN CITY# ❑
cawsloN 09 - 17 - 2024 0953 17 ❑.= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓
BLOCK
NE SUNSET BLVD MILEPOST ST e✓ 2725
4a❑
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ ❑ FEET e S ❑ W e 1 2 29
MOTOR PEDAL- DAM THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El YES
NO ,/ D:2068397753 0 11
30
6� LAST NAME PALANCIUC FIRSTNAME ION MIDDLE N 1 1 2 31
INITIAL
STREET ❑, 2007 KIRKLAND PL NE CITY RENTON ST WA Zjp, 980563240 z
NEW ADDRESS
]❑ 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 HELMET
2 CLASS 1 NATURE OF INJURIES z❑
3
10 9❑ P1 aT�S� CHT2639 sTArI WAurN# 3GNCJPSB2KL144812
TRAILER STATE TRAILER STATE
11 3 5 PLATE# PLATE# FROM TO
TRLR. TRLR 7 3 33
12 3 5 VIN#' VIN#
>; FROM TO
VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE ] $ 34
13 2 2019 CHEV TRAX DAMAGE YES NO YES[:] No
✓
REGISTERED OWNER INFO CRISTINAGLAVNENC01310 NE SUNSET BLVD RENTON WA 98056 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
14 LIABILITY INSURANCE❑ INSURANCE CO eq�T3 4
IN EFFECT &POLICY# 9TOP
VEwcLE CHARGE 5 36
LEGALLY YES❑NO❑ CITATION# 10 BOTTOM
15❑ NDING 8 7 6
MOTOR PEDAL- PEDESTRIAN PROPERTY THR OLD MET PHONE
UNIT VEHICLE ❑ CYCLE ❑ ❑ PROPOWNEERTY
[:][LAM ES 1/ NO PHONE
3108809118
16 a
LAST NAME LI FIRST NAME JAIMIE MIDDLE I Z
INITIAL
17❑ STREET ❑', 24521 SE 238TH ST CITY' MAPLE VALLEY ST WA ZIP 980388256 37
NEW ADDRESS ❑
18� CDL IGNITION REQUIRED IGNITION PR—E-1SENT MEDICAL TRANSPORTED 38
INTERLOCKYES�NOR INTERLOCK YEs It I NOF YES
t t— l NO❑ 11
19 DRIVER'S STATE WA ]SEX IF D.O.B. 02 _ 21 1989 0 39
LICENSE# MMDDYY
HELMET {NJURY 1 NATURE OF INJURIES 40
20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 USE 2 CLASS ❑
41
21❑ LICENSE CFV4128 TAre WA VIN# WBXHU7C30H5H35992
❑
PLATE#
42
22❑ PILER LATE# STATE PLATE# STATE
23❑ VIN#. 43
TRLR RLR
'IN#.
VEH YEAR 2017 MAKE BMW MODEL X1 STYLE VEHICLETOWED TO BLIN TOWEDBY GOV HI �44
L4❑ DAMAGE YES NO YES NO
REGISTERED OWNER INFO JAIMIEL124521 SE 238TH ST MAPLE VALLEY WA 98038 VEHICLE NO.2
SHADE IN DAMAGED AREA
2 3 4
LIABILITY INSURANCE I PORGY#E CO FIRST NATIONAL INSURANCE 24724 1 9TOP 5
IN EFFECT
'E""LE ❑ Nu,J CITATION# CHARGE
LEG i o BOTTOM
ALLY YES
25 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. EF17515
COLLISION REPORT III III III III III 111
1591972 CASE# 24-9744
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.
C.CATALAN 09-17-24 02:40 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
C.JACOBS 1953 9/23/2024 1:29:10 PM
BADGE OR ID# 1Y007 ORI# WA0171300 TIME POLICE DISPATCHED'; 9:88 AM TIME POLICE ARRIVED',10:10 AM
PART I PAGE IT]OF 4�
REPORT NO. EF17515 CASE# 24-9744 OF COLLISION
09/17/24 09:53
OF CbLLI510N
NARRATIVE
24-9744
On September 17, 2024, at approximately 0953 hours, I was dispatched to a non-injury and non-
blocking vehicle collision at the intersection of Union Ave NE and Tacoma Ave NE, within the City
Limits of Renton, County of King, State of Washington.
Upon my arrival, I confirmed there were no complaints of injury requiring immediate medical response
at the time of report. There, I was able to collect each involved party's information and independent
summary of the events leading up to the collision.
The driver of Unit 1 said he was traveling eastbound in about the 1000 block of NE Sunset Blvd and
passing the intersection of NE 10th St in lane 2 of 2. The driver of Unit 1 stated that another vehicle in
the center turn lane needed to get into the right lane (lane 2 of 2) to merge into eastbound traffic. The
vehicle failed to see unit 1, so the driver of unit 1 had to make an abrupt lane change to avoid striking
the other vehicle from behind. The driver of Unit 1 stated that while making the lane change, Unit 1
and Unit 2 collided in lane 1 of 2 causing minor damage to the front driver's side bumper and quarter
panel of Unit 1.
The driver of Unit 2 said she was the sole occupant of her vehicle and was also traveling eastbound
on NE Sunset Blvd. The driver of Unit 2 stated she was intending to continue straight when Unit 1
changed lanes from lane 2 of 1 and into lane 1 of 1 which Unit 2 was occupying. Unit 2 was unable to
avoid the collision and subsequently collided with Unit 1. Unit 2 suffered moderate damage to the
driver's side doors and front fender due to the collision.
Based on the above statements, 1 determined that the Driver of Unit 1 is the proximate cause for the
cause of collision as they violated RCW 46.61.140(1) which states that a vehicle shall be driven as
nearly as practicable entirely within a single lane and shall not be moved from such lane until the
driver has first ascertained that such movement can be made with safety. The driver made a lane
change into Unit 2's lane of travel which had the right of way and was underway. The driver did not
ensure that traffic in lane 1 of 2 was clear of hazard before making the unsafe lane change.
I warned the driver verbally for Improper Lane Usage causing a collision.
Both Unit 1 and Unit 2 were able to be driven away without further incident. An exchange of
information was provided to all involved parties.
PAGE 3 OF 4
REPORT NO.! EF17515 CASE# 24-9744 DATE AND TIME 09/17/24 09:53
OF COLLISION
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1
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