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HomeMy WebLinkAbout24-11896 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 2 27c COLLISION REP FIT 1591971 SASE 24-11896 2 INTERSTATE ❑ CITY STREET FIRE ❑ RESULTED 1 STOLEN STATE ROUTE ❑ OTHER ❑ VFHIC;I F ❑ LOCAL AGENC 4100 3 HIT&RUN CODING COUNTY RD PRIVATE WAY INVOLVED 2 3 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.. 11 - 1-— 2024 1748 17 ❑.= S 8 IN e 1070 3 4 4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓ SUNSET BLVD N BLOCK NO. e✓ 1700 4a 1❑ MILEPOST DISTANCE OF(REFERENCE OR CROSS STREET) 5 2❑ 10 00 FEET MILES ❑ S ❑ W e I-405 0 $ 29 MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE UNIT 01 VEHICLE ❑ CYCLE El NO D:2069660511 0 11 30 6� LAST NAME GUNDRAM FIRSTNAME MARTIN MIDDLE L 1 2 31 INITIAL STREET ❑, 18419 SE 162ND ST CITy RENTON ST WA ZIP 98058 z NEW ADDRESS 7❑ CDL IGNITION REQUIRED IGNITIt)N PRESENT MEDICAL TRANSPORTED 3 :NTERLOCKYEs NO INTERLOCK YES NO YES No 8❑ DRIVERS # STATE WA SEX'M I ELMIDI Y' 04 — 22 — 1964 1 2 32 9 ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 HELM U EET 2 CLASS 1 NATURE OF INJURIES z❑ 3❑ 10 9❑ PI ATE 14 AKB9382 STATE WA VIN#' 1ZVHT80NX65162926 TRAILER STATE TRAILER STATE 11 0 0 PLATE# PLATE# FROM TO TRLR. A'RLR. 1 1 33 12 0 0 VIN#' VIN# FROM TO VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED By GOVT.VEHICLE $ $ 34 13 3 2006 FORD MUSTAN DAMAGE YES NO YES[:] No✓ REGISTERED OWNER INFO MARTIN..RAM 18419 SE 162ND ST RENTONWA 98058 VEHICLE NO. 1 ❑ SHADE IN DAMAGED AREA 35 14 LIABILI INSURANCE INSURANCE CO GIECO 6099-85.34.15 3 4 IN EFFECT &POLICY# 9TOP LEHA"LE 5 LEGALLY res�No D CITATION# 4A0806575 CHARGE 36 PROHIBITED U TURN )o eorrom 15❑ NDING 8 6 MOTOR PEDAL- PROPERTY DAM THR OLD MET PHONE UNIT 02 ❑ ❑ PEDESTRIAN ❑ ❑ HO 2063839216 VEHICLE CYCLE OWNER YES�/ NO 16 a LAST NAME PODOLSKE 77771 FIRST NAME EMILY MIDDLE / INITIAL 17 STREET❑ NEW ADOREss❑' 949 ABERDEEN AVE NE APT E218 CITY RENTON ST WA ZIP 98056 4❑ 37 18❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED � 38 INTERLOCK YEs❑NOR INTERLOCK yyEEsl❑NOF YES❑No❑ 19� DRIVER'S STATE WA ]SEX IF D.C.B. 01 07 1972 39 LICENSE# MMDDYY 20❑ ON DUTY STATUS AIRBAG 1 RESTR 4 EJECT 1 HELMET 2 INJURY 7 NATURE OF INJURIES 40 USE CLASS BACK AND RIGHT ARM ❑LICENSE I 21❑ PLA E# CMJ3108 TATE WA VIN 1 4S3GTA865H3742420 41 1 42 22❑ PILER LATE# STATE PLATE# STATE 23❑ UIN#. 43 TRLR RLR 'IN#. G HI 44 VEH YEAR 2017 MAKE S(JB�Q MODEL ►MPREZA STYLE 4D DAMAGE TOWED NOO✓ BLIN TOWED BY ov YES NO 24❑ ES REGISTERED OWNER INFO OWNED SY DRIVER VEHICLE N0.2 SHADE IN DAMAGED AREA 2 3 4 LIABILITY INSURANCE &POINSURGY#E CO pROGRESSIVE 901623649IN STOP 5 VEHICLE YES[:] N C[:] CITATION# CHARGE i o BOTTOM LEGALLY 0( 25 a OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# JAGENCY 26 KEITH PETTY 12809 WA0171300 PAGE 01 OF PART A 3000-345-159 OR 11/181 STATE OF POLICETRAFFICN CORRECTION REPORT NO. EF36938 COLLISION REPORT III III III III III 111 1591972 CASE# 24-11896 ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY) NAME MIDDLE INITIAL) PHILLIPS MADGE L (IAST FIRST, ADDRESS&PHONE# D O.B. ' 18419 SE 162ND ST RENTON WA 98058 4254969000 SEXi F MMDovyvv 10 - 11 - 1961 PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT ' HELMET INJURY NATURE OF INJURIES ❑✓ ❑ 1 POS, 3 2 4 1 USE 2 CLASS NAME (LAST,FIRST,MIDDLE INITIAL) PODOLSKE EDWARD G ADDRESS&PHONE# D O B 949 ABERDEEN AVE NE APT E 218 RENTON WA 98056 2063839216 SEX I M MMDDvvvv O6 _ 29 _ 1955 SEAT HELMET NJURY NATURE OF INJURIES PASSENGER Z WITNESS❑ UNIT# 2 POS 3 AIRBAG 2 RESTR. 4 EJECT 1 USE 2 CLASS 1 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. KEITH PETTY 11-16-24 08:53 PM INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED APPROVED BY DATE J.TRADER 4553 1 1111812024 7:38:21 PM BADGE OR ID# 12809 OR]# WA0171300 TIME POLICE DISPATCHED! 6:14 PM TIME POLICE ARRIVED',6:20 PM PART I PAGE IT]OF 4] REPORT NO. EF36938 CASE# 24-11896 OF COLLISION 11/16/24 17:48 OF CbLLI510N NARRATIVE 24-11896 On 11/16/2024 at approximately 1815 hours I was working for the city of Renton as a police officer. I was dispatched to the 1700 block of Sunset Blvd N in the City of Renton County of King State of Washington for vehicle collision. Upon arrival I contacted the Unit 1 driver Martin Lloyd Gundram (DOB 04/22/1964) and his passenger Madge L Phillips (DOB 10/11/1961) both identified by their WADL photo. Martin was driving his blue 2006 Ford Mustang (AKB9382/WA) VIN/1ZVHT80NX65162926. Unit 2 driver was Emily Jean Podolske (DOB 01/07/1972) and her front passenger Edward G Podolske (DOB 06/29/1955) both identified by their WADL. Emily was driving her white 2017 Subaru Impreza (CMJ3108/WA) VIN/4S3GTAB65H3742420. Unit 1 was heading north bound on Sunset Blvd N and attempted to make a U-turn at the N 1-405 entrance to head back south bound on Sunset Blvd N. When he entered the southbound lane, he was struck by Unit 2 who was traveling south on Sunset Blvd N. Unit 1 had damage to the front passenger side and unit 2 had damage to the front driver's side. Both vehicles were over the $1000 threshold but were able to drive away on their own. Unit 2 driver stated she felt like her back and right arm were soar and starting to ache. She did not want any medical attention at that time. I cited Unit 1 with RCW 46.61.295 U-Turns. Unit 1 failed to turn in the opposite direction in a safe manner without interfering with oncoming traffic. I took pictures of the damage of both vehicles and uploaded them to Axon. This incident was captured on my body worn camera. This report is a summary of the events that occurred and is not an exact sequencing of events. Statements have been paraphrased and summarized. "I certify (or declare) under penalty of perjury under the laws of the State of Washington that the foregoing is true and correct." Electronically signed: K.Petty, Date: 11/16/24 at 20 hours, Place: Renton, King County, WA PAGE 3 OF 4 REPORT NO. EF36938 CASE# ' 24-11896 DATE AND TIME 11/16/24 17:48 OF COLLISION ty i� °tlt �t"aye �c3 a� a re, Z 1 is Y' i&k s�k g PAGE 4 OF 4