HomeMy WebLinkAbout25-1614 IT si " II IIIII III IIIII II IIII IIIII I . 27c REPORT NO EF70838OLCERA
COLLISION REPORT 1591971
CASE# 25-1614 2
INTERSTATE CITY STREET FIRE ❑
RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VEHICLE ❑ LOCAI-AGENCY 4100 3
COUNTY RD NT&RUN CODING
PRIVATE WAY
2 TOTAL#OF OBJECT 28
TRIBAL i UNITS 03 STRUCK METAL SIGN POST
RESERVATION 2
3� M M D D Y Y Y Y TIME(2400) COUNTY# MILES CITY#
eaCL s on' 02 - 20 - 2025 0349 17 =.= S 8 W e OF IN e 1070 s
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
SW 16TH ST BLOCK NO. e 1300 .�
4a❑ MILE POST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ 1.1 FEET e S 8 W e LONGACRES DR SW
0 1 29
MOTOR ✓ PEDAL- DAM AG THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE ❑ YES ✓NO 30
5 LAST NAME SINGH FIRST NAME AMARPREET MIDDLE t 1 2 31
INITIAL
STREET ] 12339 SE 221ST ST CITY; RENTON ST WA ZIP; 98031 2
NEW ADDRESS
7 CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
INTERLOCK YES NO✓ INTERLOCKYEs NO✓ YES NO✓
DRIVER # STATE WA SEX M MM0,13. 10 - 02 - 1999 t 32
8❑
9 ON DUTY STATUS' AIRBAG 3 RESTR 4 EJECT 1 H U ET LA Y 1 NATURE of INJURIES 2
10 LI ENSE' AAN9023 STATE WA VIN# 5J6RE3H35AL024183 3
TRAILER STATE TRAILER STATE
11 2 5 PLATE# PLATE# ROM T.
7
TRLR TRLR 3 7 33
12 VIN#' VIN#
FROM TO
HICLE
13 2 VEH.YEAR2010 MAKE HOND MODEL CR-VSE STYLE UT VEHICLE TOYED NO�iS46LIN T� {� RS TOWING Ges❑VT ENo✓ m 34
DAMAGE IIII._IIII
REGISTERED OWNER INFO LAKHBUR BASS/12339221ST ST RENTON WA 98031 VEHICLE NO. 1
SHADE IN DAMAGED AREA 35
14❑ LIABILITY INSURANCE[%/] INSURANCE CO STATE FARM 404 1398-D17-47B 4
IN EFFECT &POLICY# 9TOP
VEn" CHARGE 5 I <l 36
LEc Ly YES❑NO❑ CITATION# 80TFOM
15❑ STANDING 7 6
. 1:1PROPERTY ✓
R PHONE PEDAL-: PEDESTRIAN OUNIT 02VMEOHTIOCRLE CYCLE OWNER
16❑
LAST NAME RENTON FIRST NAME CITY OF MIDDLE
INITIAL
17 F1 STREET ❑
❑ 1055 S GRADY WAY CITY RENTON ST, WA ZIP 98057 q 37
NEW ADDRESS
18❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED; ❑ 38
INTEt�LOCKYES NO INTERLOCI£YES Nz� YEs NO
19 DRIVER'S
# STATE SEX U MMDDYY -� E== 39
HELMET INJURY NATURE OF INJURIES 4Q
20❑ ON DUTY STATUS AIRBAG RESTR EJECT USE CLASSLICENSE
❑
21 PLATE# T-1- VIN# 41
22❑ [TILER TAILER
PLATE# STATE PLATE# STATE 42
23 TRLR RLR 43
UIN#. 'IN#
VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN
TOWED BY GOV HI 44
24 DAMAGE YES NO YES NO
REGISTERED OWNER INFO VEHICLE NO.2
SHADE IN DAMAGED AREA
2 3 4
LIABILITY INSURANCE❑ INSURANCE CO
IN EFFECT &POLICY# 9TOP
1-1— ❑ ,.I—I CITATION# CHARGE to BOTTOM
LEGALLY YES NCO
25 a s
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
26
ST
FAJARILLO 12847 WA0171300
PART A PAGE 01 OF
3000-345-189(R 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EF70838
COLLISION REPORT III III III III III 111
1591972 CASE# 25-1614
ADDITIONAL PERSONS INVOLVED(PASSENGERS AND/OR WITNESSES ONLY)
'.NAME
(LAST,FIRST,MIDDLE INITIAL)
ADDRESS&PHONE
SEXi D.O.B. —
MMDDYYYY
PASSENGERQ WITNESS� UNIT SEAT AIRBAG RESTR. EJECT ; HELMET INJURY NATURE OF INJURIES
POS. ' USE CLASS 1 ----�
:NAME
(LAST FIRST MIDDLE INITIAL)
ADDRESS&PHONE#
SEX D.O.B. —
MMDDYYYY
PASSENGER❑WITNESS UNIT# : SEAT AIRBAG RESTR. EJECT HELMET INJURY: NATURECFINJURIES
POS. USE CLASS ----�
:NAME
(LOST,FIRST,MIDDLE INITIAL)
ADDRESS&PHONE#
SEX MMDDYY D.O.B.
YY
PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET NJURY NATURE OF INJURIES
POS. I 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 FAJARILLO 02-25-25 03:58 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST.DET DATED PLAGE SIGNED
APPROVED BY DATE
J.CHRISTIANSEN 10437 31312025 8:02:06 PM
BADGE OR ID# 12847 ORI# WA0171300 TIME POLICE DISPATCHED 1 3:54 AM TIME POLICE ARRIVED i 3:59 AM
PAST B 3 Do-3mx—attar(t 1Mff) PAGE 2�OF F5
REPORT NO. EF70838 CASE# 25-1614 OF DATE AND r�N + 02/20/25 03:49
O�COLLISION
NARRATIVE
25-1614
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 02-25-2024 1 was working as a police officer in the city of Renton. At approximately 0354 hours 1
was dispatched to the report of a collision at the intersection of SW 16th St/Longacres Dr SW, City of
Renton, County of King, WA. This incident was captured on my department issued Axon body
camera and my patrol vehicle's dashcam.
Dispatch advised a one vehicle collision occurred with unknown injuries. The vehicle (Unit 1) was
identified as a silver 2010 Honda CR-V (WA/AAN9023). The driver was later identified by Department
of Licensing (DOL) photograph as Amarpreet Singh (DOB: 10-02-1999).
1 arrived on scene and contacted Amarpreet. The following is an account of events according to
Amarpreet. He was driving west on SW 16th St and admitted to driving approximately 50 mph. He did
not see the stop sign at the intersection of Longacres Dr SW. He drove over the STOP sign and then
into a jersey barrier. There was a concrete retaining wall behind the jersey barrier he damaged.
Amarpreet did not have any injuries and advised he did not drive to work this route regularly, and this
contributed to the collision. The vehicle was privately towed by Banker's towing. 1 later transported
Amarpreet to his residence.
A City of Renton Origami report was completed (#1-2025-041) for the damaged STOP sign. Security
contracted by Unico was on scene and he was notified of the damaged retaining wall. 1 provided
Amarpreet and security guard with the case number.
I completed a criminal SECTOR citation #5A0292720 for Exceeding reasonable safe speeds.
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 02/25/2024 @ 1452 hours in Renton WA.
PAGE 3 OF 5
SUPPLEMENTAL REPORT No. EF70838POLICE TRAFFIC
1 27
... ^'� COLLISION REPORT CASE# 25-1614
013197
1 COMMERCIAL MOTOR CARRIER INTERSTATE INTRASTATE
UNIT# USDOT ICC# VEHICLE TYPE CARGO BODY
TYPE
2 ❑ 1 28
CARRIER
NAME
3 CARRIER L
ADDRESS
CITY ST ZIP
4 ❑ NAME # PLACARD
GWVR NAME IF NO NUMBER
SOURCE AXLES +
4a ❑ ADDITIONAL UNITS
MOTOR PEDAL- PROPERTY DAMAGE THRESHOLD MET PHONE
UNIT# 3 PEDESTRIAN �', YES NO
5 VEHICLE CYCLE OWNER F,/
LAST NAME UN/CO PROPERTIES FIRST NAME MIDDLE 29INITIALi
STREET 30
NEW ADDRF 2101 LONGACRES DR SW CITY RENTON ST WA ZIP gg057
6 CDL GNITION REQUIRED PRESENT MEDICALTANSPORTED. 1 31
I ONCE] 1{iNi7iON ::
INTERLOCK YES ':INTERLOCK YES 0- YES N
L
DRIVER'S STATE I SEX U MD.00.6 -�-
LICENSE;
7
ON DUTY STATUS AIRBAG RESTR. EJECT HELMET INJURY; NAruREOFINJURIES
USE CLASS
8 ❑ 1 32
LICENSE rAT VIN.
PLATE#
L 9 TRAILER TRAILER
PLATE# STATE PLATE# STATE
0
10 TRLR TRLR
VIN.#. VIN#.
11 VEIL YEAR MAKE MODEL STYLE VEHICLE TOWE E T ABLIN TOWED BY GoVT.VEHICI E FROM To
REGISTERED OWNER INFO.
DAMAGE YES NO YES NO
m 33
12 � SHADE IN DAMAGED AREA
LIABILITY INSURANCE❑ INSURANCE CO 4 FROM TO
7t)P
IN EFFECT &POLICY# 34
13 YES NO CITATION# CHARGE
1080TTOM
ecauv
s-rnNoiNc
MOTOR PEDAL_ ' 1:1PROPERTYDAMAGE THRESHOLD MET PHONE 35
14 ❑ UNIT# VEHICLE CYCLE PEDESTRIAN OWNER YES NO
36
15 LAST NAME FIRST NAME NID L
16 ❑ STREET CITY ST' ZIP
NEW ADDRESS"
CDL IGNITION RE6UIRED IGNITION PRESENT MEDICAL TANSPORTED
INTERLOCK YES No INTERLOCK YEs NO YE s No ❑
17 37
LLIRIVERS ICENSE# STATE SEX MD.00.B _
18 ❑ ❑
HELMET INJURY NATURE OF INJURIES 38
ON DUTY STATUS AIRBAG RESTR. EJECT USE CLASS
19 ❑ ❑ 39
LICENSE TAT AN#
PLATE#
20 TRAILER TRAILER 40
PLATE# STATE PLATE# STATE ❑
21 ❑ TRLR TRLR 41
VIN#�, VIN#Y
42
22 VEH.YEAR MAKE I MODEL I STYLE I VEHICLE TOWED DUE T SABLIN TOWED BY GOVT.VEHICLE
DAMAGE YES NO YES NO
23 REGISTERED OWNER INFO. SHADE IN DAMAGED AREA 43
2 3 4
LIABILITY INSURANCE INSURANCE CO
IN EFFECT I &POLICY#
..
t.
E 44
24 YES❑ NO CITATION# CHARGE K-99
E
SWG 3
3 G
1 CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT.
STEVEN FAJARILLO 02-25-25 03:58 PM
25 INVESTIGATING OFFICER'S SIGNATURE OFFICER'S PHONE UNIT OR DIST DET DATED: PLACE SIGNED
26 BADGE 1 OR DD# 12847 O#RI WA0171300 APPROVED
313312025
PAGE[4 OF
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3000-345-013(R 11t18)
REPORT NO. EF70838 CASE# 25-1614 DATE AND TIME 02/20/2503:49
OF COLLISION
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PAGE 5 OF 5