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HomeMy WebLinkAbout24-11623 a ITFFi "POLCERA II IfI) 1 IlfII ('II (Illf If( fI I . 1 27c COLLISION REP FIT 1591971 CASE 24-11623 z INTERSTATE ❑ CITY STREET FIRE ❑RESULTED 1 STOLEN STATE ROUTE ❑ OTHER ❑ VFHIC;I F ❑ LOCAL AGENCI 4250 3 HIT&RUN CODING COUNTY RD PRIVATE WAY INVOLVED 2 TOTAL#OF OBJECT 1 8 28 TRIBAL UNITS OZ STRUCK RESERVATION z 3❑ DATE OF M M D D Y Y Y Y TIME(2400) COUNTY# MILES CITY# ❑ COLLISION'. 11 — 08 — 2024 1750 17 ❑.❑ N E IN S 8 W H OF e 1070 3 4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓ 108TH AVE SE BLOCK NO. e✓ 17600 4a❑ MILEPOST DISTANCE OF(REFERENCE OR CROSS STREET) 5❑ ❑ FEET e S ❑ W e 2 0 29 MOTU '�01 VEHtOR Z CLE CYCCLE. El �ESAGE NHORE✓LD MET PHONE Q 1 30 6� LAST NAME UNKNOWN FIRSTNAME MIDDLE 1 1 2 31 INITIAL STREET ❑ CITY ST ZIP 2 NEW ADDRESS 7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3 iNTERLOCKYEs NO INTERLOCK YES NO YES No 8❑ LIRCIENSRE# STATE I SEX u MMDDYY - 1 1 2 32 9 ON DUTY❑ STATUS I AIRBAG 9 RESTR 9 EJECT 1 H USEEr 9 CLAY 0 NATURE OF INJURIES z❑ 3 LICENSE sTATI urN#' 10[9 PI ATE# C7 TRAILER STATE TRAILER STATE 11 3 5 PLATE# PLATE# ROM ro rRLR. TRLR 5 1. 33 12 3 5 VIN# VIN# FROM TO ❑ VEH.YEAR MAKE TOYT MODEL COROL STYLE SD VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE 5 1 34 13 2 DAMAGE YES�NO YES❑ NO✓ REGISTERED OWNER INFO UNKNOWN VEHICLE NO. 1 SHADE IN DAMAGED AREA ❑ 35 14 LIABILI INSURANCE❑ INSURANCE CO 3 4 IN EFFECT &POLICY# Q PvENICE CHARGE 36 LEcnLLv YES❑NO CITATION# TOM15❑ STAIN.D'ING 6 UNIT 02 VE IOOR CYCLE ❑ PEDESTRIAN ❑ PROPE OWNFRRTY ❑ DYES NO SOLD MET PHONE 16 a LAST NAME SINGH FIRST NAME HARPREET MIDDLE N INITIAL 17❑ STREET I S❑' 2282 54TH ST SE CITY AUBURN ST WA ZIP 980923938 � 37 ADDRES 18❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL t—T�RANSPORTED � 38 INTERLOCK YES❑No� INTERLOCK YES It1 I NoF t l YES NO 19 DRIVER'S STATE WA SEX M I D.C.B. 07 19 _ 1999 39 LICENSE# MMDDYY 20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 H U EET NJAURSY 1 NATURE OF INJURIES 40 ❑21❑ PLATE# CMS3714 TATE 41 WA VIN# 4T4BF1FK4FR468189 4 42 22 [TRAILER TILER ❑ PLATE# STATE PLATE# STATE 23❑ 43 TRLR RLR UIN#. 'IN#. VEH YEAR 2015 MAKE TOYT MODEL CAMRY STYLE SD VEHICLETOWED TO BLIN TOWEDBY GOV HI 44 24❑ DAMAGE YES NO YES NO REGISTERED OWNER INFO HARPREET SINGH 228254TH ST SE AUBURN WA 98092 D:2068511245 VEHICLE NO.2 SHADE DAGED AREA 4 LIABILITY INSURANCE INSU&PORGY#E CO PROGRESSIVE 983872138IN 1 9TOP 5 VEHICLE ❑ ,.I—I CITATION# CHARGE io BOTTOM LEGALLY YES N`LJ 25 s e OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY 26 STEVEN FAJARILLO 12847 WA0171300 PAGE 01 OF PART A 3000-345-159 OR 11/181 STATE OF POLICETRAFFICN CORRECTION REPORT NO. EF36934 COLLISION REPORT III III III III III 111 1591972 CASE# 24-11623 ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY) NAME(LAST FIRST,MIDDLE INITIAL) UNKNOWN ADDRESS&PHONE# D O.B. 4258913603 SEX' U MMDDYYYY -❑ PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT ' HELMET INJURY NATURE OF INJURIES ❑ ❑✓ POS. USE CLASS NAME '(LAST,FIRST,MIDDLE INITIAL) ADDRESS&PHONE# DOB SEX MMDDYYYY PASSENGER ❑WITNESS❑ UNIT# SEAT AIRBAG RESTR. EJECT HELMET NJURY NATURE OF INJURIES POS. USE CLASS NAME (LAST FIR57 MIDDLE INITIAL) AppRESS&PHONE# SEX D.O.B.MMDD -❑ YYYY. 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. STEVEN FAJARlLLO 11-08-24 08:17 PM NVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED APPROVED BY DATE J.THiELMAN 11462 1111812024 7:51:01 PM BADGE OR ID# ( 12847 ORI# WA0171300 TIME POLICE DISPATCHED 6:34 PM TIME POLICE ARRIVED',6:41 PM PART I PAGE IT]OF 4� REPORT NO. EF36934 CASE# 24-11623 OF COLLISION 11/08/24 17:50 OF CbLLI510N NARRATIVE 24-11623 This incident was captured on my body worn video camera. This report is a summary of events that occurred and is not an exact sequencing of events. Statements have been paraphrased and summarized. On 11-8-2024 1 was working as a police officer in the city of Renton. At approximately 1834 hours I was dispatched to the report of a recent hit and run collision at 17600 108th Ave SE, City of Renton, County of King, WA. This incident was captured on my department issued Axon body camera. According to the notes in the call, 30 minutes prior a hit and run collision occurred. There was no suspect information. I arrived on scene and contacted the driver of Vehicle 2. He said he was travelling north in the center lane at the 17600 block of 108th Ave S. The driver of Vehicle 1 was in the right lane and abruptly changed lanes into the center lane. Driver of Vehicle 1 was unable to brake in time. Vehicle 1's front driver side bumper collided with the passenger side of Vehicle 2. Driver of Vehicle 1 did not stop and was gone from location. The driver of Vehicle 2 was not able to identify the driver of Vehicle 1. Vehicle 1 was an unlicensed green 2000's Toyota Corolla. I called a witness with a phone number provided by the driver of Vehicle 2. 1 got no answer. I provided driver of Vehicle 2 with a case number. Vehicle 2 was in drivable condition. The driver of Vehicle 2 was the lone occupant and uninjured. I photographed the vehicle and uploaded them to Evidence.com. According to the facts regarding the case the driver of Vehicle 1 was the proximate cause of the collision as it abruptly changed lanes colliding with Vehicle 2. If a suspect was identified there would be probable cause for hit and run on the driver of Vehicle 1. There is no further information available at this time. I certify (declare) under penalty of perjury under the laws of the state of Washington that the foregoing is true and correct. Electronically signed by S. Fajarillo #12847 on 11/8/2024 @ 2015 hours in Renton WA. PAGE 3 OF 4 REPORT NO. EF36934 CASE# ' 24-11623 DATE AND TIME 11/08/24 17:50 OF COLLISION ti q� Y J e t: ti E a � 3 �• 7 lit }\`� .,,. PAGE 4 OF 4