HomeMy WebLinkAbout24-12096 IT si " II IIIII III IIIII II IIII IIIII I . 27c REPORT NO EF38806OLCERA COLLISION REPORT 1591971 CASE# 24-12096 2 INTERSTATE CITY STREET FIRE ❑ RESULTED 1 STATE ROUTE OTHER STOLEN ❑ ❑ VEHICLE ❑ LOCALANG 3 HIT&RUN C©DIN6 COUNTY RD PRIVATE WAY INVOLVED 2 TOTAL#OF OBJECT o 5 28 TRIBAL UNITS 02 STRUCK RESERVATION : 1 1 2 3� M M D D Y Y Y Y TIME(2400) COUNTY# MILES CITY# DATE OF N E cDLLISION' 11 - 22 - 2024 0810 17 =.�� S W e OF 1070 3 4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑ DUVALL AV NE BLOCK NO. ❑ MILE POST e 4a ❑ DISTANCE OF(REFERENCE OR CROSS STREET) 5 MILES 1. FEET e S 8 W e NE SUNSET BLVD OF1 29 MOTOR ✓ PEDAL- DAM AG THRESHOLD MET PHONE UNIT 01 VEHICLE ❑ CYCLE ❑ YEs Vl No D:6306753710 0 1 30 6❑ LAST NAME KINDRA FIRST NAME JASBIR MIDDLE S 1 2 31 INITIAL STREET ❑ 8819 138TH CT SE CITY; NEWCASTLE ST WA ZIP; 980593496 2 NEW ADDRESS 7 CDL IGN(TIUN REQUIRED IGNITION PRESENT MEDICAL TRANSSPORTED 3 INTERLOCKYES ND INTERLOCKVES NO YES F NO 8❑ DCIENSE# STATE WA SEXI M MMDDYY' 10 - 05 - 1971 1 2 32 -NJUR 9 ON DUTY STATUS' AIRBAG 2 RESTR 4 EJECT 1 HELMET 2 CLASSY 1 [NATURE of INJURES 2 10 LI ENSttEI 461ZRA STATE WA VIN# 2HNYD28298H548427 3 TRAILER STATE TRAILER STATE 11 3 5 PLATE# PLATE# FROM To rRLR rRLR. 5 1 33 12 3 5 VIN# vIN# FROM TO VEH.YEAR 2008 MAKE ACUR MODEL MDX STYLE VEHICLE TOWED TO BLIN TOWED By GOVT VEHICLE 7 $ 34 13� DAMAGE YES II_II NO `/ YESII_I) NO REGISTERED OWNER INFO JASBIR KIND RA 11819138TH CT SE NEWCASTLE WA 98059 VEHICLE NO. 1 SHADE IN DAMAGED AREA 35 2 LIABILITY INSURANCE INSURANCE CO 2 3 4 14 SAPECO 42461992 IN EFFECT &POLICY# 4TOP CHARGE t S 36 VEHICLE Lemur yes[:]NO[:] CITATION# 7 0 80TTOM 15❑ sTnNowc s 7 MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE UNIT VEHICLE CYCLE nWNFR YES�/ NO D:2067472237 16� LAST NAME PATIU FIRST NAME NIXON MIDDLE I C INITIAL 17 STREET ❑ 37 NEW ADORE SS❑ 2612 NE 9TH ST CITY RENTON ST, WA ZIP 980563035 18❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED' ❑ 38 INTERLOCKYES No GNTERLOCK YES ray YEs NO 19 DRIVERS STATE WA SEX M D.o.B. 06 22 1969 � 39 LICENSE# MMDDYY — HELMET INJURY: NATURE OF INJURIES 40 20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 USE 2 CLASS 1 ❑ 21 LICENSE BJS2676 TATE WA VIN# 5TDKZ3DC4HS848637 41 22❑ PLATE# STATE PLATE# STATE 42 23 TRLR RLR 43 UIN#. 'IN# VEH.YEAR 2017 MAKE TOYT MODEL SIENNA STYLE VEHICLE TOWED TO BLIN TOWED BY GOV HI 44 24 DAMAGE YES NO VES NO REGISTERED OWNER INFO NIXON PATIU 2612 NE 9TH ST RENTON WA 98056 VEHICLE NO.2 SHADE DAMAGED AREA 3 4 LIABILITY INSURANCE[Z INSURANCE CO NATIONAL GENERAL 2024890230 IN EFFECT &POLICY# 9TOP veHiaE ❑ ,o CITATION11 CHARGE t080TTOM L'EGn�LY YES N 25 a e OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY 26 JOSEPH MELLO 13020 WA0171300 PAGE 01 OF PART A 3000-345-189(R 11/18) STATE OF POLICETRAFFICN CORRECTION REPORT NO. EF38806 COLLISION REPORT III III III III III 111 1591972 CASE# 24-12096 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 0,SS ----� :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. JOSEPH MELLO 11-22-24 09:36 AM INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST.DET DATED PLAGE SIGNED APPROVED BY DATE DESIREE SCOTT 10272 11/23/2024 9:52:26 AM BADGE OR ID# j 13020 ORI# WA0171300 TIME POLICE DISPATCHED 6:15 AM TIME POLICE ARRIVED i 8:20 AM PAST B 3 Do-3m5—attar(t 1Mff) PAGE 2�OF 4 REPORT NO. EF38806 CASE# 24-12096 OF DATE AND r�N + 11/22/24 08:10 O�COLLISION NARRATIVE On 11/22/2024 at approximately 0815 hours, I was dispatched to a non-injury and non-blocking two- vehicle collision at the intersection of NE Sunset Boulevard and Duvall Ave NE, 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 requiring immediate medical response at the time of report. 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 he was driving north on Duvall Ave NE in lane one, and stated that the traffic lights at the intersection of NE Sunset Blvd and Duvall Ave NE. The driver stopped and waited for his turn to continue to drive north on Duvall Ave NE, and when it was his turn, he continued to drive north. As the driver drove north, he heard the driver of Unit#2 honk is horn at him. The driver of Unit#1 said that the driver of Unit#2 struck the rear driver's side of his vehicle in the middle of the intersection. There was moderate damage to the rear driver's side of his vehicle. The driver of Unit#2 said he was driving east on NE Sunset Blvd in lane 2, and stopped right before the intersection where the traffic lights were not operating. The driver said that he made a complete stop, and when it was his turn to go, he continued east on NE Sunset Blvd. The driver then stated that the driver of Unit#1 went through the intersection failing to stop while he continued east on NE Sunset Blvd. Unit# 2 struck the driver of Unit#1 and suffered moderate damage to the front passenger fender. Based on the above statements, I am unable to determine which Unit caused the collision because of the traffic lights not operating correctly. Unit#1 and Unit#2 were able to drive away from the scene. An exchange of information was provided to all involved parties. 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 by Officer J. Mello #13020 09:24 hours 11/22/2024 Renton, King County, WA. PAGE 3 OF 4 REPORT NO. EF38806 CASE# 24-12096 DATE AND TIME 11/22/24 08:10 OF COLLISION k hs, Kt� � 3t � �v S5 st 1 >�A t 1 L L c �r Y 5 k jfs k 1� x ah PAGE 4 OF 4