HomeMy WebLinkAbout25-3499 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 0 27c
COLLISION REP FIT 1591971
CASE 25-3499 z
INTERSTATE ❑ CITY STREET FIRE ❑RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHICI F ❑ LOCAL AOENC 4Y00 3
HIT 8 RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 1 TOTAL#OF OBJECT 1 1 8 28
TRIBAL UNITS OZ STRUCK
RESERVATION
z
3❑ DATE of M M D D Y Y Y Y TIME(2400) COUNTY# MILES CITY#
COLLISION'. 04 — 18 — 2025 1912 17 . N E IN� S 8 W H OF e 1070 3
4❑ oN (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
SUNSET BLVD NE BLOCK NO. e ❑
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ �,❑ FEET e S ❑ W e /405 NB ON-RAMP
0 1 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
NO F,/ I D:6176060905 0 11
30
6� LAST NAME RATHI FIRSTNAME TEJESH MIDDLE 1 2 31
INITIAL
STREET ❑, 17325 NE 85TH PL#G114 CITY REDMOND ST WA ZIP 98052 z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
1/ I iNTERLOCKYEs NO NTERLOCKYEs NO�/ YES R No�/
8 LRIIVERCENS # STATE SEX'M MDMDo 07 - 11 - 1991 1 2 32
9 ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 H U EET ICNIJAU RY 1 NATURE OF INJURIES z❑
3
LICENSE CMU8693 sTArI WAVIN# 3FMTK3R44PMA92683
10 F91 PI ATE#
0 TRAILER STATE TRAILER STATE
11 0 0 PLATE# PLATE# FROM TO
TRLR. TRLR 6 2 33
12 0 0 VIN#' VIN#'
>; FROM TO
VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED By GOVT.VEHICLE 2 6 34
13 1 2023 FORD MUSTAN UT DAMAGE YES NO ves❑ No
REGISTEREDOWNERINFO pURVA BUNDELA 17325 NE 85TH PL APT G114 REDMOND WA 98052 D:6176060905 VEHICLE NO. 1
SHADE IN DAMAGED AREA 35
14 ❑ NSURANCECO 3 4
LIABILITY INSURANCE
IN EFFECT &POLICY# 9TOP
VEwcLE CHARGE 10BOTTOM 5 36
LEGALLv res❑NO❑ CITATION# 5
15❑ STANDING 8 7 6
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT VEHICLE ❑ CYCLE ❑ ❑ : OWNER ❑ YES 1/ No D:7783164634
16 a
LAST NAME VILLANUEVA FIRST NAME GENESIS MIDDLE I D
INITIAL
17 F1 NEW STREETREs7' 3508 PORTER ST CITY VANCOUVER ST BC ZIP V5N2K4 4❑ 37
18� CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL t—TRANSPORTED 38
INTERLOCK YEs❑No� INTERLOCK yEEsIII I I NOF YES
t l NO�
19 LICENSE# STATE SEX U Mr D.C.B. 01 26 _ 1993 39
20❑ ON DUTY STATUS AIRBAG,2 RESTR 4 EJECT 1 WEB MEET LASSY 6 [NATURE OF INJURIES
COMPLAINT OF SHIN PAIN ❑ 40
LICENSE I ❑21❑ PLA E# WD537K TArE 41
WA YIN# JMIDKFC7XL1462894 1
42
22❑ PLATE# STATE PLATE# STATE
23❑ UIN#. 43
TRLR RLR
'IN#.
TOWED By Gov HI 44
VEH YEAR 2020 MAKE IlggZp MODEL CX-3 STYLE UT —FEHICLE
TOWED✓ NOO BLIN BANKERS YES No�/
24❑ REGISTERED OWNER INFO OWNED SY DRIVER VEHICLE N0.2
SHADEDAMAGEDAREA
3 4
LIABILITY INSURANCE INSU&PORGY#ECO INSURANCECORPERATIONOFBCAO.NHJ STOP 5
IN EFFECT
VE"LE ❑ Nu,J CITATION# CHARGE
25 to BOTTOM
LEGALLY YES ' a
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
J
26
RYAN KARLO RIVERA 1
12649 WA0171300
PART A PAGE 01 OF
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EF85879
COLLISION REPORT III III III III III 111
1591972 CASE# 25-3499
ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY)
NAME MIDDLE INITIAL) LALRATHL SAMPAE
(I.P.ST FIRST,
ADDRESS&PHONE#
17325 NE 85TH PL#G114 REDMOND WA 98052 6176060905 SEX i X MMDOYyry 03 - 20 - 1962
PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT ' HELMET INJURY NATURE OF INJURIES
❑✓ : 1 POS. 3 2 4 1 USE CLASS 1
NAME
(LAST,FIRST,MIDDLE INITIAL) RAEHI SUMARY
ADDRESS&PHONE# DOB
17325 NE 85TH PL#G114 REDMOND WA 98052 6176060905 SEX' MMDDYvvv 10 _ 15 _ 1969
SEAT HELMET INJURY NATURE OF INJURIES
PASSENGER WITNESS UNIT# 1 POS 7 AIRBAG 2 RESTR. 4 EJECT 1 USE CLASS 1
NAME
(LAST FIRST,MIDDLE INITIAL) BUNDELA PURVA
AooREss PHONE# 17325 NE 85TH PL#G114 REDMOND WA 98052 6176060905 SEX F D.O.B. 05 23 _ 1991
MMDDYYYY _
PASSENGER WITNESS UNIT# ! 1 SEAT g AIRBAG 2 RESTR. 4 EJECT 1 HELMET NJURY 1 NATURE OF INJURIES
❑ POS. 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.
RYAN KARLO R/VERA 04-19-25 01:10 AM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY E
CASEY PROCTER 12123 DAT 4/25/2025 9:29:33 PM
BADGE OR ID# 12649 OR]# WA0171300 TIME POLICE DISPATCHED 7:17 Pry TIME POLICE ARRIVED]7:22 Pry
PART I PAGE IT]OF 6�
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EF85879
COLLISION REPORT III III III III III 111
1591972 CASE# 25-3499
ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY)
NAME MIDDLE INITIAL) RASH/ RAOYSH
(I.P.ST FIRST,
ADDRESS&PHONE#
17325 NE 85TH PL#G114 REDMOND WA 98052 SEX i X MMDOYyvv 11 - 22 - 2023
PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT ' HELMET INJURY NATURE OF INJURIES
❑✓ : 1 POS. 9 2 11 1 USE CLASS 11
NAME
LAST,FIRs MIDDLE INITIAL) JACKSON-EDDINS DJONNE R
ADDRESS&PHONE# D O B
1100 SUNSET BLVD NE RENTON WA 98056 4809387970 SEX' U MMDovvvv 10 _ 29 _ 1990
SEAT HELMET INJURY NATURE OF INJURIES
PASSENGER WITNESS UNIT# 2 POS 3 AIRBAG 2 RESTR. 4 EJECT 1 USE CLASS 1
NAME
(LAST FIR57 MIDDLE INITIAL)
AppRESS&PHONE#
SEX D.O.B.
MMDDYYYY. _
PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET NJURY URE OF INJURIES
NAT
❑ ❑ POS. 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.
RYAN KARLO RIVERA 04-19-25 01:10 AM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
CASEY PROCTER 12123 4/25/2025 9:29:33 PM
BADGE OR ID# 12649 OR]# WA0171300 TIME POLICE DISPATCHED 7:97 PM TIME POLICE ARRIVED]7:22 PM
PART I PAGE 3�OF 6�
REPORT NO. EF85879 CASE# 25-3499 OF COLLISION
04/18/25 19:12
OF CbLLI510N
NARRATIVE
On 04/18/2025, 1 was working uniformed patrol in a marked police car as 3R23. At approximately
1917 hours, I was dispatched to a blocking accident at Sunset Blvd NE at the 1-405N on-ramp which
is located within the city limits of Renton, County of King, Washington. Dispatch advised that an
involved party had called in to report a blocking collision at the location.
I arrived at the call location and was able to locate the accident. I was able to identify the two involved
units and their associated occupants as listed above. The collision was partially blocking the
northbound 1-405N on-ramp from northbound Sunset Blvd NE.
I went to speak to the driver of Unit 1. My conversation with him is summarized as follows:
Unit 1 explained that he was traveling northeastbound on Sunset Blvd NE approaching the
northbound 1-405N on-ramp. Unit 1 stated he had stopped before entering the intersection where the
yield sign was located before entering the on-ramp. Unit 1 saw Unit 2 headed southwestbound on
Sunset Blvd NE. Unit 1 believed he had enough time to cross through the intersection to proceed
onto the 1 405 NB. Unit 1 ended up not making it through the intersection in time. This resulted in the
front end of Unit 1 to collide with the front end of Unit 2.
Unit 1 stated that he and all his occupants were wearing his seatbelt. Unit 1 and its occupants did not
mention any injuries at the time of the collision.
I took a look around Unit 1 and saw that the front passenger side of the vehicle was slightly dented. It
did not appear that any airbags deployed inside of his vehicle.
Unit 1's driver also stated that he had insurance for the vehicle, however, was not able to access the
updated insurance card at the time of the collision.
I was then able to speak to the driver of Unit 2 and the occupants of her vehicle. My conversation with
her is summarized as follows:
Unit 2 stated she was heading southwestbound on Sunset Blvd NE approaching the northbound I-
405N on-ramp to continue going straight. She stated that Unit 1 had entered the intersection as she
was continuing straight down Sunset Blvd NE. This resulted in the front end of Unit 2 colliding with the
front passenger side of Unit 1.
Unit 2 stated that she and her other occupant was wearing her seatbelt. Unit 2 stated she had some
pain in her shin but declined to see aid at the time of the collision. Unit 2's occupant stated that he
was uninjured.
I took a look around Unit 2 and saw that the entire front end of the vehicle was dented. I saw that the
front bumper was pushed far enough for part of the bumper to push up against the two front wheels of
Unit 2. It did not appear any airbags had deployed inside of her vehicle.
The driver of Unit 2 left the location with a friend a short time later.
The driver of Unit 1 left the location in his vehicle a short time later.
Unit 2 was towed by Bankers tow from the location.
Based on the circumstances described above, it appears that Unit 1 is the proximate cause of the
collision.
This concludes my report.
I certify (declare) under penalty of perjury under the laws of the State of Washington that the
foregoing is true and correct.
Signature: Ryan Rivera (#12649) Date and Place: 04/18/2025 @ Renton, WA
PAGE 4 OF 6
REPORT NO. EF85879 CASE# 25-3499 OF COLLISION
04/18/25 19:12
OF CbLLI510N
NARRATIVE
PAGE 5 OF 6
REPORT NO. EF85879 CASE# ' 25-3499 DATE AND TIME 04/18/25 19:12
OF COLLISION
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