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Home My WebLink About25-1665 IT si " II IIIII III IIIII II IIII IIIII I . 27c REPORT NO EF68549OLCERA COLLISION REPORT 1591971 CASE# 25-1665 2 INTERSTATE CITY STREET FIRE I RESULTED STOLENSTATE ROUTE OTHER VEHICLE LDCCODICENC'Y 4200 3 COUNTY RD NT&RUN CODING PRIVATE WAY 2 TOTAL#OF OBJECT 1 s 28 TRIBAL UNITS 03 STRUCK RESERVATION : 1 1 2 3� M M D D Y Y Y Y TIME(2400) COUNTY# MILES CITY# eaCL s on' 02 - 21 - 2025 1444 17 =.= S 8 W e OF IN e 1070 3 4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓ N 6TH ST BLOCK NO. e 800 .� 4a❑ MILE POST ❑ DISTANCE OF(REFERENCE OR CROSS STREET) 5 MILES 1.1 FEET B S B W e 1 2 29 MOTOR PEDAL- DAMAG THRESHOLD MET PHONE UNIT 01 VEHICLE ❑ CYCLE ❑ YES No �/ D:4258290357 0 1 30 5 LAST NAME ZHANG FIRST NAME YU MIDDLE t 1 2 31 INITIAL STREET ❑ 5119 153RD PL SW CITY; EDMONDS ST I WA ZIP; 98026 2 NEW ADDRESS 7 CDL IGN(TIUN REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3 INTERLOCKYES No INTERLOCKYES NO YES NO✓ 8❑ DRIVER # STATE WA SEXI F MMDDYY' 03 - 27 - 1984 t 1 2 32 -NJUR 9 ON DUTY STATUS' AIRBAG 2 RESTR 4 EJECT 1 HELMET 2 CLASSY 1 [NATURE of INJURIES 2 10 LI ENSE' BBB1971 STATE WA VIN# 5YJSA1E26GF144329 3 TRAILER STATE TRAILER STATE ROM To 11 0 0 PLATE# PLATE# TRLR zRLR. 1 1 5 33 12 3 0 VIN#' VIN# FROM TO VEH.YEAR ZOI6 MAKE TESL MODEL MODEL STYLE 4H VEHICLE TOWED[n TO ZBLIN TOWEDBY GOVT VEHICLE 3 7 34 13� DAMAGE YES II_II NO YESII_I) NO✓ REGISTERED OWNER INFO OWNEDBYDRIVER VEHICLE NO. 1 SHADE IN DAMAGED AREA 35 14 LIABILITY INSURANCE NSURANCE CO COUNTRY FINANCIAL P46A4973054 2 3 4 IN EFFECT &POLICY# CDQG ❑ ❑ 5A0297073 CHARGE FLD TO YIELD FROM DRIVEWAY OR 36 VEHICLE YES NO CITATION# 15 MOTOR ✓ PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE UNIT VEHICLE CYCLE nWNFR YES�/ NO D:3215057365 16� LAST NAME KANE FIRST NAME MOUHAMADOU MIDDLE' B INITIAL 17 F1 STREET ❑ ❑ 3266 SW AVAtON WAY#C101 CITY SEATTLE ST, WA ZIP 98126 37 NEW ADDRESS 1$❑ IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED ❑ 38 CDL INTERLOCKYES NO INTERLOCK YES No YES No,✓ 19 DRIVERS STATE WA SEX M I D.o.a. 11 30 1995 � 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 PATE# 9GDZ726 TATE CA VIN# 3KPF24AD4PE629694 41 22❑ PLAILER TE# STATE PLATE# STATE 42 23 TRLR RLR 43 UIN#. 'IN# VEH.YEAR 2023 MAKE I(IA MODEL FORTE STYLE VEHICLE TOWED TO BLIN TOWED BY GOV HI 44 24 DAMAGE YES NO✓ VES NO✓ REGISTERED OWNER INFO CORP PV HOLDING 5721 W 96TH ST LOS ANGELES CA 90045 VEHICLE NO.2 SHADE IN DAGED AREA 2 4 LIABILITY INSURANCE INSURANCECO CONTINENTAL CASUALTY CO BUA 7001700830 IN EFFECT &POLICY# t 9TOP 'EIL YES❑ NC[] CITATION# CHARGE to BOTTOM VEHICLE L 25 s OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY 26 K.LANE 10008 WA0171300 PART A PAGE 01 OF 3000-345-189(R 11/181 STATE OF POLICETRAFFICN CORRECTION REPORT NO. EF68549 COLLISION REPORT III III III III III 111 1591972 CASE# 25-1665 E NA ADDITIONAL PERSONS INVOLVED(PASSENGERS AND/OR WITNESSES ONLY) M (LAST,FIRST,MIDDLE INITIAL) CHAKKALAKKAL JOVIAL P ADDRESS&PHONE# D —= 21626 13TH DR S DES MOINES WA 98198 2063516204 SEXi M MMDDYYYY PASSENGERF�WITNESSZ UNIT# SEAT AIRBAG RESTR. EJECT HELMET NJURY NATURE OF INJURIES POS. USE CLASS ----� :NAME (LAST FIRST MIDDLE INITIAL) ADDRESS R 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 Unit 1 was attempting to exit out of a parking lot driveway on the north side of the 800 blk of N 6th ST, onto N 6th ST, and was facing south. Unit 2 was traveling westbound on N 6th ST approaching the 800 blk and Unit 1. Unit 3 was in the left turn lane in the 800 blk of N 6th ST facing east and planning to turn left into the parking lot Unit 1 was exiting out of. Driver 1 states that she was inching forward and had trouble viewing the traffic approaching from westbound N 6th ST which included Unit 2. Unit 1 failed to yield the right of way to Unit 2 and began to enter the roadway just as Unit 2 was passing. The front end of Unit 1 struck the passenger side of Unit 2. This collision caused Unit 2 to rotate clockwise and the rear driver's side of Unit 2 impacted the front end of Unit 3. Unit 1 sustained minor/moderate damage. Unit 2 sustained moderate damage. Unit 3 sustained moderate but disabling damage. Driver 1 was cited for failure to yield the right of way when entering from a driveway or alleyway by entering N 6th ST from the private driveway and failing to yield the right of way to Unit 2 which was the proximate cause of the collision. I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT. K.LANE 02-21-25 05:06 PM INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST.DET DATED PLACE SIGNED APPROVED BY DATE C.JACOBS 1953 212412025 1:38:25 PM BADGE OR ID# j 10008 ORI# WA0171300 TIME POLICE DISPATCHED 1 2:56 PM TIME POLICE ARRIVED i 3:04 PM PAST B 3 Da-3mx—attar(t 1Mff) PAGE 2�OF 4 SUPPLEMENTAL REPORT No. EF68549 POLICE TRAFFIC 1 1 8 27 COLLISION REPORT CASE# 25-1665 t113197 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 AME I GWVR NF NO NUMBER SOURCE AXLES + 4a ❑ ADDITIONAL UNITS PEDAL- PROPERTY DAMAGE THRESHOLD MET PHONE UNIT# 3 MOTOR �✓ PEDESTRIAN ❑', YEs� No D:2063358091 5 VEHICLE CYCLE OWNER 0 7 29 LAST NAME TO FIRST NAME TORN MIDDLE. O INITIAL STREET 30 NEW ADORFs pj 5450 REFLECTION ST E CITY FIFE I ST WA ZIP I 1 98424 6 ❑ CDL GNITION REQUIRED PRESENT MEDICALTANSPORTED. 1 1 2 31 I I{iNi7ION INTERLOCK YES D NO INTERLOCK YES No YES N L DRIVERS STATE WA SEX M D.O.B 04 LICENSE MMDDWY - 07 - 1984 7 ON DUTY STATUS AIRBAG 2 RESTR. 4 EJECT 9 HELMET 2 INJURY 1 NAruRE of INJURIEs USE ;CLASS ; 8 ❑ 1 32 LICENSE CHS6564 TAT WA VIN 7SAYGAEE6PF835690 PLATE# 9 TRAILER TRAILER L PLATE# STATE PLATE# STATE 0 10 ❑ TRLR TRLR VIN.# VIN#. 11 3 0 VEH.YEAR2023 MAKE TESL MODELMODEL Y STYLE VEHICLE TOWE E T ABLI y19r Y'ERS GOVT VFHCI F FROM TO DAMAGE YES�/ NO YES NO REGISTERED OWNER INFOOWNED SYDRIVER 9 9 33 12 � SHADE IN DAMAGED AREA 4 FROM TO INSURANCE CO LIABILITY INSURANCE STATE FARM 542 6330 A15-47 IN EFFECT � &POLICY# � J7t1P--'.S m 34 13 ❑ vewc�e YES NO CITATION# CHARGE 1080TTOM .. ecauv sTnNoiNc 7 6.. MOTOR PEDAL_ ' 1:1PROPERTY DAMAGE THRESHOLD MET PHONE 35 14 ❑ UNIT# VEHICLE CYCLE PEDESTRIAN OWNER YEEF-1 NO 36 15 LAST NAME FIRST NAME NIT AL 16 ❑ STREET �' CITY ST ZIP n>EW AODRFSS CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TANSPORTED. INTERLOCK YES NO INTERLOCK YES No :YES NO' ❑ 17 37 RIVERSLLIICENSE# STATE SEX M DDY _ C-----� 18 ❑ ❑ HELMET 'INJURY NATURE OF INJURIES 38 ON DUTY STATUS' AIRBAG RESTR. EJECT USE CLASS. 19 ❑ ❑ 39 LICENSE TAT viN# PLATE# 20 TRAILER' TRAILER 40 PLATE#. STATE PLATE# - STATE ❑ 21 ❑ TRLR TRLR 41 VIN# VIN#:' 42 22 VEH.YEAR MAKE I MODEL I STYLE VEHICLE TOWED DUET ABLIN TOWED BY GOVT.VEHICLE DAMAGE YES NO YES NO 23 REGISTERED OWNER INFO. SHADE IN DAMAC ED AREA 43 2 3 4 LIABILITY INSURANCE INSURANCE CO IN EFFECT I &POLICY# ).c;Q 6. 44 vewc�e ❑ ❑ CITATION# CHARGE 24 I..EGALLY YES NO STIWDING 8 3 G 1 CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT. K.LANE 02-21-25 05:06 PM 25 INVESTIGATING OFFICER'S SIGNATURE OFFICER'S PHONE UNIT OR DIST DET DATED: PLACE SIGNED APPROVED 12 BADGE 1 �26 10008 ORIWA0171300 ACOBS 22412025PAGE OF ORID# # 3000-345-013(R 11t18) REPORT NO. E F68549 CASE# 25-1665 DATE AND TIME 02/21/25 14:44 OF COLLISION n l.; t .. 3r �.. I I y j {4 Y r a pW�,l a� u PAGE 4 OF 4