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Home My WebLink About24-11469 STATE OF I !�� I III I III I IIII III II I . 0 27c REPORT NO EF58304 COLLISION REP FIT 1591971 SASE 24-11469 z INTERSTATE ❑ CITY STREET FIRE ❑ RESULTED 1 STOLEN STATE ROUTE ❑ OTHER ❑ VFHICI F ❑ LOCAL AOENC 4900 3 HIT&RUN CODING COUNTY RD PRIVATE WAY INVOLVED 2 1 TOTAL#OF OBJECT 1 1 8 28 TRIBAL UNITS 03 STRUCK RESERVATION z 3❑ DATE of M M D D Y Y Y Y TIME(2400) COUNTY# MILES N E IN CITY# cowsloN 11 - 1-- 2024 0940 17 ❑-= S 8 IN e 1070 3 4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑ TALBOT RD S BLOCK NO. e✓ 900 ❑ 4a❑ MILEPOST DISTANCE OF(REFERENCE OR CROSS STREET) 5❑ MILE N�,❑ FEET e S ❑ E e S TON VILLAGE PL 0 1 29 MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE UNIT 01 VEHICLE ❑ CYCLE El �/No D:2063564189 0 4 30 6� LAST NAME HAKIMI FIRSTNAME ABDUL MIDDLE K 1 1 2 31 INITIAL STREET ❑ 20929 110TH AVE SE#1502 CITY KENT ST WA ZIP 98031 z NEW ADDRESS 7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3 ✓ I INTERLOCK YES[:]No NTERLOCKYEs NO✓ YES R No 8❑ LRIIVER # ON DUTY❑ STATUS AIRBAG 3 RESTR 4 EJECT 1 HELMET 2 CLASS 1 NATURE OF INJURIES z❑ 3 10❑ Pi aTES� CLZ2629 sTArI WAurN# JTDKN3DU8A1204923 TRAILER STATE TRAILER STATE 11 3 5 PLATE# PLATE# FROM TO TRLR. YRLR. 5 1 33 12 3 5 VIN#' VIN# >; FROM TO ❑ VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN T GOVT.VEHICLE 3 $ 34 13 2 2010 TOYT PRIUS SD DAMAGE vEs 0NO f �AWkkRS TOWING vEs❑ No✓ REGISTERED OWNER INFO OWNEDBYDRIVER VEHICLE NO. 1 SHADE IN DAMAGED AREA 35 2 INSURANCE CO 4 14 IN EF IT INSURANCE BRISTOL WEST GO1.4947981.00 IN EFFECT &POLICV# TOPVEHlcl.e CHARGE <1�3 OTTOM 5 36 LEGALLY YES❑NO❑ CITATION# 5 15❑ STAIN.D'ING 7 6 UNIT 02 VE ICCLE CYCLE ❑ PEDESTRIAN ❑ OWNERMOTO PEDAL RTY ❑ DYES✓ NO OLD MET PHONE 16 a LAST NAME 1 77771NGUYEN FIRST NAME THUY MIDDLE K INITIAL 17 STREET❑ NEW ADOREss❑' 17034 106TH AVE SE CITY RENTON ST WA ZIP 98055 37 18❑ CDL IGNITION REQUIRED IGNITION PR-E-1SENT MEDICAL-TRANSPORTED � 38 INTERLOCKYES�NO� INTERLOCK vEs It I NOF YES I�/]NO❑ 19 DRIVER'S STATE WA ]SEX IF D.C.B. 05 _ 19 _ 1974 39 LICENSE# MMDDYY 20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 HELMET 2 INJURY 7 NATURE OF INJURIES ❑ 40 USE CLASS C/O NECK PAIN ❑21❑ PLATE# CFX7618 TArE 41 WA VIN# 1HGCR3F85EA030857 1 42 22❑ PLATE# STATE PLATE# STATE TRLR 23❑ VIN#. IN#. 43 RLR ' TOWED By Gov HI 44 VEH YEAR 2014 MAKE HOND MODEL ACCORD STYLE $D -7EHICLE TOWED✓ NOO BLIN BANKERS TOWING YES No✓ 24❑ REGISTERED OWNER INFO OWNED SY DRIVER VEHICLE N0.2 SHADE IN DAMAGED AREA 2 3 4 INAEFFIECTTY NSURANCE❑ &POINSULICY#E CO STOP 5 'E""LE ❑ N,J� CITATION# CHARGE LEG i o BOTTOM ALLY YES 6 -T 25 OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY 26 J.KWAKE 12326 WA0171300 PAGE 01 OF PART A 3000-345-159 OR 11/181 STATE OF POLICETRAFFICN CORRECTION REPORT NO. EF58304 COLLISION REPORT III III III III III 111 1591972 CASE# 24-11469 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 11/05/2024 at about 0943 hours, I responded to a multiple vehicle collision at the intersection of Talbot Rd S & S Renton Village PL. I observed 3 vehicles blocking the roadway that all contained significant damage. All three drivers were identified by a WA Driver's License and advised they were the lone occupants of their vehicle at the time of the crash. Driver of Vehicle #2 complained of neck pain and was medically transported to VMC as a precaution. Driver of Vehicle #1 stated he was traveling northbound on Talbot RD S and had a green signal. Driver#2 & #3 both stated they were traveling westbound through the intersection making a left turn on a green light when they stated Vehicle #1 "ran the red" and struck Vehicle #2 causing it to spin into Vehicle #3. Please review Axon footage for further details on the vehicle damage and positioning. I was unable to review any camera footage at the intersection. I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT. J.KWAKE 01-12-25 11:32 PM INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED APPROVED BY DATE J.CHRISTIANSEN 10437 1 112212025 3:41:40 AM BADGE OR ID# 12326 ORI#' WA0171300 TIME POLICE DISPATCHED 9:43 AM TIME POLICE ARRIVED 9:46 AM PART I PAGE IT]OF 4� SUPPLEMENTAL REPORT NO. EF558304 r`I POLICE TRAFFIC 1 1 8 27 COLLISION REPORT (CASE# 24-11469 1 COMMERCIAL MOTOR CARRIER INTERSTATE INTRASTATE G UNIT'# USL70r !CC# VEHICLE TYPE CARGO BODY TYPE 2 ❑ 1 28 CARRIER NAME 3 CARRIER ADDRESS ` CITY ST' ZIP' 4 ❑ NAME # PLACARD: :❑ GINAME IF NO NUMBER SOURCE AXLES + 4a ❑ ADDITIONAL UNITS MOTOR PEDAL- PROPERTY DAMAGE THRESHOLD MET PHONE 5 ❑ UNIT# 3 VEHICLE tSJ CYCLE I_) PEDESTRIAN OWNER YES NO D:2063834650 0 1 29 LAST NAME : TIMSUWAN FIRST NAME : SAKDA MIDDLE INITIAL STREET 30 NEW AnDRFrtP 201 SW 5TH PL#L204 CITY RENTON ST WA ZIP 98057 6 ❑ 1 1 2 31 CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TANSPORTED INTERLOCK YEs NO zERLOCK YES❑N0� YEs N DRIVER'S LICENSE STATE I WA SEX M MMDDYYv 09 - 04 - 1968 7 ON DUTY� STATUS AIRBAG' g RESTR. Q EJECT 1 HELMET 2 INJURY 1 1 NATURE OF INJURIES USE CLASS 8 ❑ 1 32 LICENSE I CFY3862 [TAT WA VIN# 1HGCV1F30NA106652 PLATE# 9 TRAILER TRAILER PLATE# STATE PLATE If STATE 10 ❑ TRLR TRLR VIN.#. VIN.#. 11 3 5 VEH.YEAR2022 MAKE HOND MODELACCORD STYLE SD I VEHICLE TOWS E T SABLIN TOWED BY anvi vFH1I' P FROM TO DAMAGE YES NO YES NO REGISTERED OWNER INFO OWNED BY DRIVER 3 ] 33 SHADE IN DAMAGED AREA 12 z 3 4 FROM TO LIABILITY INSURANCE INSURANCE CO STATE FARM 076-6230-0O3.47G q"i"Olx IN EFFECT &POLICY# VEHICLE 34 13 IEcnuv YES N001 CITATION# CHARGE TT STANDING } 14 ❑ UNIT Tr Vd 1 RE O FEDDAL OWNERRTY YES AGE NOHRESHOLD MET PHONE rj 35 PEDESTRIAN 15 LAST NAME FIRST NAME MIDDLE 36 ❑ ITIAL STRE 16 NEW ETETnnR"F] CITY ST ZIP CDL IGNITION REdUiRED IGNITtGN PRESENT MEDICALTANSPORTED INTERLOCK YES No INTERLOCK YEs NO YES NO ❑ 17 4 37 LICENSE# STATE SEX MMDDDYBYY 18 ❑ ON DUTY� STATUS AIRBAG RESTR. ; EJECT HELMET INJURY NATURE of INJURIES 38 USE CLASS 19 ❑ LICENSE TAT VIN# 39 PLATE# 20 ❑ TRAILER TRAILER El40 PLATE#< STATE PLATE If STATE 21 ❑ ❑ 41 TRLR TRLR VIN# YIN#i 42 22 VEH.YEAR MAKE I MODEL STYLE I VEHICLE TOWED DUET SABLIN TOWED BY GOVT.VEHICLE DAMAGE YES NO YES NO 23 REGISTERED OWNER INFO_ SHADE IN DAMAGED AREA 43 3 4 71 LIABILITY INSURANCE INSURANCE CO ' VINE EFFECT &POLICY# i 970P - 4 E:l 44 24 VEHICLE YES❑ NO❑ CITATION# CHARGE iq 60TiOM LECALLv STANDING 8 7 6 1 CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT. J-KWAKE 01-12-25 11:32 PM 25 INVESTIGATING OFFICER'S SIGNATURE OFFICER'S PHONE UNIT OR DIST DET DATED: PLACE SIGNED 26 ORID# 12326 O#II,WA0171300 APPROVED BY 1%2E2/2025 PAGE F OF 4 3000-345-013(R 11118) REPORT NO. EF58304 CASE# ' 24-11469 DATE AND TIME 11/05/24 09:40 OF COLLISION 4 fir103 4 { r w y F t fi t r { r r �RItI iu 7 "t`€ 4 y� ff W co x PAGE 4 OF 4