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HomeMy WebLinkAbout24-12164 ("7— STATE.w,-" .:.. TFFiNCERA �I I ��� III I I Iil I I�I1 II{ II I 1 27c . COLLISION REP F 1591971 CASE 24-12164 2 INTERSTATE CITY STREET FIRE ❑ RESULTED STOLEN 1 2 STATE ROUTE OTHER VFHICI F LOCAL AGENCY 4200 3[� HIT 8 RUN CODING COUNTY RD PRIVATE WAY INVOLVED 2 TRIBAL UN 75 TOTAL#OF STRUCK OBJECT 11 8 2$ RESERVATION 2 3 M M D D Y Y Y Y TIME I2400) COUNTY# MILES CITY# coAT sloN 11 - 24 - 2024 1520 17 a. e W 8 OF IN 8 1070 3 S 4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓ 108THAVESE BLOCK NO. 8 17800 4a❑ MILEPOST DISTANCE OF(REFERENCE OR CROSS STREET) 5❑ 100 00 FEET e S e W 8 SE PETROVITSKYRD 2 0 29 MOTOR PEDAL- DAM ETHRESHOLD MET PHONE UNIT 01 VEHICLE CYCLE YE ,/NO D:9375540357 1 2 30 6 LAST NAME KANDUKURI FIRST NAME MONOHAR MIDDLE R 1 2 31 INITIAL STREET 22921 POPLAR AVE SE CITY BLACK DIAMOND WA NEWADDREss S7 ZIP 98010 z 7❑ CDL IGNITION REQUI �RED IGNITION PRESENT MEDICAL TRANSPORTED 3 INTERLOCK YEs No / INTERLOCK YEs No�/ YES NO,/ 8❑ LDIRIVER' STATE WA SEX'M MM,:B 05 - 17 - 1998 1 2 32 9 ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 HELMET E7 2 ��SS I 1 NATURE OF INJURIES 2 LICn NSE CNG7400 STATE WA WIN# KNMAT2MTXGP636244 3 10 9❑ 11 3 5 PLATE# STATE PLATE#TRAILER STATE FROM TO TRAILER TRLR TRLR.# 1 5 33 12 3 5 VIN#' VIN FROM TO 13 4 VEH.YEAR2016 MAKE NISS MODEL ROGUE STYLE UT VEHICLE TOWED 2NODi�ABLIN TvR EBYMEYER GOVV�EHI LE 1 $ 34 ❑ DAMAGE II1I._IIII -IIJJ REGISTERED OWNER INFO OWNED BY DRIVER VEHICLE NO. 1 SHADE 1N DAMAGED AREA ❑ 35 4 LIABILITY INSURANCE INSURANCE CO ft 14 PROGRESSIVE 950760303 IN EFFECT &POLICY# STOP VEHICLE YES CHARGE ❑ 36 EGnu v ❑NO❑ CITATION# 10 ftOTTOM 1 S❑ srAnomc 7 6 MOTOR � PEDAL PROPERTY M THR OLD MET PHONE UNIT ICJ ❑ PEDESTRIAN ❑ OIL HO 7147579562 VEHICLE CYCLE OWNER S NO 16� LAST NAME DAVIDSON FIRST NAME ' SAMEEN MIDDLE ' R INITIAL 17 STREET El 11235 SE 186TH ST CITY RENTON ST', WA ZIP 98055 4 NEW ADDRESS ❑ 37 18❑ CDL IGNITION REQUIRED IGNITION pRESEIJT MEDfCALTRANSPORTED 3$ W7ERLOCKvE No INTERLOCkCvEs no ves No,� 19[ DRIVER'# ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 H U E7 2 INJURYNATURE OF INJURIES 40 ❑21❑ LICENSE 41 ,BKP1274 TATf'WA vIN 2T36F4DV3CW261708 1 PLATE# # 42 22 PLATE#TRAILER STATE PLATE TRAILER STATE 23 43 TRLR RLR VIN#. '[N#, 44 VEH.YEAR 2012 MAKE 7'OYT MODEL RAV4 STYLE UT DAMIAGE TOWED NO✓O BLIN TOWED BY GO YES N HI O�/ 24 YES REGISTERED OWNER INFO OWNED BYDRIVER VEHICLE NQ.2 SHADE IN DAMAGED AREA 2 3 4 LIABILITY INSURANCE INSURANCECO AMERICAN HOME CONNECT BX13273826 IN EFFECT &POLICY# t 4TOP 5 Venice YES❑ N U CITATION# CHARGE tOBOTTQM LEGALLY 25 e OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# JAGENCY 26 JAREN JOKELA I i 12805 WA0171300 PART A . PAGE 01 OF 9000-345-159(R 11(181 STATE OF POLICETRAFFICN CORRECTION REPORT NO. EF44867 COLLISION REPORT III III III III III 111 1591972 CASE# 24-12164 ADDITIONAL PERSONS INVOLVED(PASSENGERS AND/OR WITNESSES ONLY) '.NAME (LAST,FIRST,MIDDLE INITIAL) ADDRESS&PHONE SEXi D.O.B. - MMDDYYYY PASSENGER❑WITNESS❑;UNIT# SEAT AIRBAG RESTR. EJECT HELMET INJURY NATURECFINJURIES 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 NJU S' NATURE OF INJURIES ❑ ❑ PC& 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. JAREN JOKELA 11-24-24 05:00 PM INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST.DET DATED PLACE SIGNED APPROVED BY DATE QUINT TIBEAU 07691 1 1211112024 3:24:27 PM BADGE OR ID# 12805 ORI# WA0171300 TIME POLICE DISPATCHED 1 3:23 Pry/ TIME POLICE ARRIVED i 3:29 PM PART B 3000-345.160(R1Vt8) PAGE F2 --]OF F5 E AND REPORT NO. EF44867 CASE# 24-12164 OFCOLLIION 11/2412415:20 OF COLLISION NARRATIVE Renton Case #24-12164 On 11/24/2024 at 1523 hours I was dispatched to the 17800 block of 108th Ave Se, in the City of Renton, King County, Washington. I was responding to a call of non-injury, blocking accident. This incident was captured on my body worn video camera. This report is a summation of events that occurred and is not an exact sequence of events. While en route, dispatch advised the following: Two motor vehicle collision, no injuries, blocking southbound on 108th. At approximately 1528 hours, I arrived on scene located the two involved vehicles. Unit 1 and Unit 2 vehicles were blocking the number 2 lane of southbound travel on 108th Ave SE, just south of SE Petrovitsky RD. I identified Unit 1 as a white 2016 Nissan Rogue (WA LIC # CNG7400) being driven by the registered owner of the vehicle, identified by his WA DL as Manohar R Kandukuri (DOB 05/17/1998). Unit 1 driver told me he was not injured. I asked Unit 1 driver what happened, he stated that he was traveling southbound on 108th Ave SE in the number 2 lane of travel. Unit 1 driver said that as he continued southbound, Unit 2 vehicle exited the Fred Meyer parking lot (located at 17801 108th Ave SE), into his lane of travel, striking the side of his vehicle. Unit 1 said that after being struck by Unit 2 vehicle, he then lost control of his vehicle, resulting in him veering partially off the roadway and into a small landscape hedge. I observed a right rear flat tire, and minor body damage as a result of the collision. Unit 1 driver provided me with his WADL, registration and proof of insurance. I identified Unit 2 as a gray 2012 Toyota Rav4 (WA LIC # BKP1274) being driven by Unit 2 driver, identified by her WA DL as Sameen R Davidson (DOB 09/25/1985). No other occupants were in the vehicle of Unit 2. Unit 2 driver told me she was not injured. I asked Unit 2 driver what happened, she stated that she was exiting the Fred Meyer parking lot, setting up to go southbound on 108th Ave SE. Unit 2 driver said that when she started her initial turn onto 108th, lane number 2 was clear and no oncoming traffic occupied the lane of travel. Unit 2 driver continued stating that as she continued her turn, Unit 1 vehicle merged from the number 1 lane of travel, into the number 2 lane of travel, in which she had started her turn into. Unit 2 driver said that Unit 1 vehicle collided with the left front of her vehicle, causing Unit 1 vehicle to lose control, ending up partially off the roadway in front of her. I observed damage to the front left of Unit 2 vehicle, consistent with the information provided by Unit 2 driver. Unit 2 driver provided me with her WADL, registration and proof of insurance. Photographs of both vehicles were taken at the scene along with the sustained vehicle damage to each unit. All photos were later uploaded to Axon Evidence. I provided each involved unit with a business card, case number and answered their remaining questions. Gene Meyer Towing was dispatched and removed Unit 1 from the scene. Unit 2 cleared the scene PAGE 3 OF 5 E AND REPORT NO. EF44867 CASE# 24-12164 OFCOLLIION 11/2412415:20 OF COLLISION NARRATIVE unassisted. I then cleared the scene. This ends my report. I certify under penalty of perjury under the laws of the State of Washington that the foregoing is true and correct. Electronically signed by Ofc. Jaren Jokela #12805, 11/24/2024 at 1651 hours in Renton, Washington. PAGE 4 OF 5 REPORT NO. EF44867 CASE# 24-12164 DATE AND TIME 11/24/2415:20 OF COLLISION �s m Y �r 1 �b y �Va1r1 t S t s 4 A �r nxy r } u PAGE 5 OF 5