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HomeMy WebLinkAbout24-9064 a ITFFi "POLCERA II IfI) 1 IlfII ('II (Illf If( fI I . 1 27c
COLLISION REP FIT 1591971
SASE 24-9064 2
INTERSTATE ❑ CITY STREET FIRE ❑RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHIr.I F ❑ LOCAL AOENC 4Y00 3
HIT&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#
COLLISION'. OS - 1-- 2024 1530 17 ❑-= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
BLOCK NO. e✓ --- ----� ❑
NE 3RD ST MILEPOST
4a❑
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ ❑ FEET e S ❑ W e SUNSET BLVD N
0 1 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
,/No D:2064232587 0 9 30
6 LAST NAME I VASQUEZ GAYTAN FIRST NAME ALEJANDRO MIDDLE N 1 1 2 31
INITIAL
STREET ❑ 14815 SE 179TH ST APT 17F CITY RENTON ST I WA 7jp, 980585634 z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
INTERLOCK YES[:]NO INTERLOCKYEs NO YES NO
8❑ LRIIVER #
ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 HELMET USE 2 CLASS 1 NATURE OF INJURIES z❑
3
10❑ P1 aT�S� CKF4629 sTArI WAurN# KNAFE121465247439
TRAILER STATE TRAILER STATE
11 3 5 PLATE# PLATE# FROM TO
TRLR. A'RLR. 1 5 33
12 3 5 VIN#j VIN#
FROM TO
❑ VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN T Y GOVT.VEHICLE 9 9 34
13 2 2006 KIA NEW DAMAGE vEs 0NO agW�MEYERS vEs❑ No
REGISTERED OWNER INFO CYNTHIA SANCHEZ 2108ABERDEEN PL SE RENTON WA 98055 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
14 LIABILI INSURANCE INSURANCE CO AMERICAN FAMILY 41101.37669.76 4
IN EFFECT &POLICY# TOPVEHICLE CHARGE 36
LEGALLY YES❑NO❑ CITATION# <1�3
OTTOM
15❑ STANDING 7 6
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT VEHICLE ❑ CYCLE ❑ ❑ OWNER [:]EA.
YES NO ,/ D:2134796538
16 a
LAST NAME SHARAN FIRST NAME KALPDISH MIDDLE N
INITIAL
17❑ STREET ❑', 9244 226TH PL NE CITY REDMOND ST WA ZIP 980532060 37
NEW ADDRESS ❑
18� CDL IGNITION REQUIRED IGNITION PtR—E—S1ENT MEDICAL TRANSPORTED ❑ 38
INTERLOCKYES�NOR INTERLOCK YEs I I NOF YEs t l NO❑
19[—] LDI IVEW # STATE WA SEX M M .C... 11 05 _ 1984 El 39
HELMET {NJURY 1 NATURE OF INJURIES 40
20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT '1 USE 2 CLASS ❑
21❑ LICENSE I CGW6375 TAre WA VIN1t 7SAYGAEE2PF775603
❑ 41
PLATE#
42
22❑ PILER LATE# STATE PLATE# STATE
23❑ UIN#. 43
TRLR RLR
'IN#.
VEH YEAR 2023 MAKE TESL MODEL MODEL Y STYLE VEHICLETOWED TO BLIN TOWEDBY GOV HI 44
L4❑ DAMAGE YES NO YES NO
REGISTERED OWNER INFO KALPDISH SHARAN 9244226TH PL NE REDMOND WA 98053 VEHICLE NO.2
SHADE IN DAMAGEbAREA
2 3 Cd
LIABILITY
INSURANCE &POINSURGY#E CO PROGRESSIVE 955423743IN 1 9TOP
'E""LE CITATION# CHARGE
LEG
25 i o BOTTOM
ALLY YES N�
❑ J s
7CA
NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY26LAN 12007 WA0171300
PART A PAGE 01 OF
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EF14457
COLLISION REPORT III III III III III 111
1591972 CASE# 24-9064
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 09-05-24 02:28 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
C.JACOBS 1953 9/12/2024 3:44:02 PM
BADGE OR ID# 1Y007 ORI# WA0171300 TIME POLICE DISPATCHED 3:33 PM TIME POLICE ARRIVED',3:42 PM
PART I PAGE IT]OF 4�
REPORT NO. EF14457 CASE# 24-9064 OF COLLISION
08/28/24 15:30
OF CbLLI510N
NARRATIVE
On August 28, 2024 at approximately 1530 hours, I was dispatched to a non-injury and non-blocking
two-vehicle collision at the intersection of NE 3rd St and Sunset Blvd N, within the City Limits of
Renton, County of King, State of Washington.
Upon arrival, I contacted the involved parties and confirmed no injuries had occurred. There, I
collected the involved parties driving documents and their independent recollection of events leading
up to the collision.
The driver of Unit 1 said they were traveling southbound in about the 280 block of Sunset Blvd N just
south of the intersection of Sunset Blvd N. The driver of Unit 1 stated he was traveling directly behind
Unit 2 and saw as Unit 2 was slowing. The driver of Unit 1 stated that the driver of Unit 2 came to a
complete stop but was unable to and subsequently collided with the rear of Unit 2 causing significant
damage to the front of Unit#1.
The driver of Unit 2 also stated he was traveling southbound in about the 280 block of Sunset Blvd N.
Unit 1 collided the rear of Unit 2 causing moderate damage to the rear of Unit 2.
Based on the above statements, I determined that the Driver of Unit 1 is the proximate cause for the
collision due to inattention causing a collision.
Unit 1 was unable to be driven away and was towed away from the scene. Unit 2 did had minor
damage and was able to drive away from the scene. An exchange of information was provided to all
involved parties.
I certify (declare) under penalty of perjury under the laws of the State of Washington that the
foregoing is true and correct.
C. Catalan 09/04/2024 Renton
PAGE 3 OF 4
REPORT NO.! EF14457 CASE# ' 24-9064 DATE AND TIME 08/28/24 15:30
OF COLLISION
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PAGE 4 OF 4