HomeMy WebLinkAbout25-1667 IT si " II IIIII III IIIII II IIII IIIII I . 27c REPORT NO EF68550OLCERA
COLLISION REPORT 1591971
INTERSTATE CITY STREET FIRE I
CASE# 25-1667 2
RESULTED STOLENSTATE ROUTE OTHER VEHICLE LOCALANG 4100 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 TOTAL#OF OBJECT 1 s 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 IN eDLLISION' 02 - 21 - 2025 1543 17 =.= S 8 W E OF M 1070 a
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
NE SUNSET BLVD BLOCK POST
e
4a MILE POST 0 .�
❑
❑ DISTANCE OF(REFERENCE OR CROSS STREET)
5 . FEET e S 8 W e ANACORTES AVE NE
OF 4 29
MOTOR ✓ PEDAL- DAM AG THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE ❑ YEs Vl No D:2068598045 0 1 30
6 LAST NAME PHAN FIRST NAME JUSTIN MIDDLE Q 1 2 31
INITIAL
STREET ❑ 220ILWACO PL SE CITY; RENTON I ST WA ZIP; 980594928 2
NEW ADDRESS
7 CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
INTERLOCK YES NO INTERLOCKYES .- YES NOr,/
8❑ DRIVER # STATE WA SEXI M MMDDYY' 07 — 31 — 2006 1 2 32
-NJUR
9 ON DUTY STATUS' AIRBAG 3 RESTR 4 EJECT 1 HELMET
2 CLASSY 1 [NATURE of INJURIES 2
10 PI ENSttEI ADH9779 STATE WA VIN# 2T2BK1BA4AC016834 3
TRAILER STATE TRAILER STATE
11 3 5 PLATE# PLATE# ROM To
TRLR TRLR 3 5 33
12 3 5 VIN# vIN#
FROM TO
13 2 VER YEAR 2010 MAKE LEXS MODEL RX STYLE VEHICLE TO YED NO fj'4 IN TgAWIZLRS GES❑END 7 3 34
DAMAGE IIII._IIII HHttVVii((tt
REGISTERED OWNER INFO LA PHAN 220ILWACO PL SE RENTON WA 98059 VEHICLE NO. 1
SHADE IN DAMAGED AREA 35
3 14 LIABILITY INSURANCE� INSURANCE CO AMERICAN FAMILY A100578978 4
IN EFFECT &POLICY# 4TOP _
srg NOLNG Yes❑NO❑ CITATION# 5A0297074 CHARGE FAIL YIELD LEFT TURN MOTOR $ taooTro�m z 36
15
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT 02 VEHICLE CYCLE nWNFR D:5592604597
16�
LAST NAME BRAUN FIRST NAME CRAIG MIDDLE' A
INITIAL
17 F1 STREET ❑ 4409 NE 6TH CT CITY RENTON ST, WA ZIP 98059 37
NEW ADDRESS I I I I I 1
❑
1$❑ IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTEDI ❑ 38
CDL INTERLOCKYES NO INTERLOCK YESEl
NO YES NO
19 DRIVER'S STATE WA SEX M I D.O.B. 01 17 1959 39
LICENSE# MMDDYY -
HELMET INJURY: NATURE OF INJURIES 4Q
20❑ ON DUTY STATUS AIRBAG 3 RESTR 4 EJECT 1 2 6 ❑
USE CLASS RIGHT KNEE(LEG INJURY
21 LICENSE AXZ2374 rarE WA vIN# KMHGC4DH9DU220373 41
22❑ STATE PLAAILER TE# STATE 42
PLATE#
23 TRLR RLR 43
UIN#. 'IN#
VEH.YEAR 2013 MAKE HYUN MODEL GENESIS STYLE VEHICLE TOWED TO BLIN TOWED BY GOV HI 44
24 DAMAGE YES NO BANKERS YES NO
REGISTERED OWNER INFO OWNEDBYDRIVER VEHICLE NO.2
SHADE IN DAMAGED AREA
2 3 4
LIABILITY INSURANCE INSURANCE CO GEIC04270-68.40.97
IN EFFECT &POLICY# 9TOP
vewaE ❑ N,J—I CITATION#
25 CHARGE tO BOTTOM
LEGALLY YES a a
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
26
K.LANE 10008 WA0171300
PAGE 01 OF
PART A 3000-345-189(R 11/18)
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EF68550
COLLISION REPORT III III III III III 111
1591972 CASE# 25-1667
E NA ADDITIONAL PERSONS INVOLVED(PASSENGERS AND/OR WITNESSES ONLY)
M
(LAST,FIRST,MIDDLE INITIAL) BEALS BRITNEYT
ADDRESS&PHONE#
5440 NE 2ND CT RENTON WA 98059 4259996410 SEXi F MMDDD BYYY 09 — 10 — 1998
PASSENGER WITNESS UNIT SEAT AIRBAG RESTR. EJECT HELMET INJURY NRE OF INJURIES
POS. USE :CLASS � ATU ----�
:NAME
(LAST EIRS7 MIDDLE INITIAL}
ADDRESS R PHONE#
SEX MMDDYYYY D.O.B. —
PASSENGER❑WITNESS UNIT# : SEAT AIRBAG RESTR. EJECT HELMET INJURY: NATURECFINJURIES
POS. USE O'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
Unit 2 was traveling eastbound on NE Sunset BLVD approaching Anacortes AVE NE with a green
light and the right of way. Unit 1 was in the left turn lane from westbound NE Sunset BLVD intending
to turn left onto southbound Anacortes AVE NE. Unit 1 had a flashing yellow light indicating it must
yield the right of way to the oncoming eastbound traffic which included Unit 2. Unit 1 failed to yield
this right of way and initiated the left turn, turning into the path of Unit 2. The front end of Unit 1 struck
the front end of Unit 2 causing heavy and disabling damage to include airbag deployment to both
vehicles. Driver 2 sustained an injury to his right leg/knee which required him to be transported to
Valley Medical Center for treatment. Both vehicles towed by Bankers Tow.
Driver 1 was cited for failing to yield the right of way when making a left turn by, failing to yield the
right of way to Unit 2, approaching with the right of way, and making a left turn into Unit 2's path 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 1:34:33 PM
BADGE OR ID# j 10008 ORI# WA0171300 TIME POLICE DISPATCHED 1 3:46 PM TIME POLICE ARRIVED i 3:50 PM
PAST B 3 Da-3mx—attar(t 1Mff) PAGE 2�OF F3
REPORT NO. E F68550 CASE# 25-1667 DATE AND TIME 02/21/25 15:43
OF COLLISION
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