No preview available
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 ��� Ytnti yam a S� k r PAGE 4 OF 4