HomeMy WebLinkAbout25-9720 OLICETRAFFIC II I III I III I I III I I IIII III III REPORT NO. EG46639 0 5 27
j COLLISION REPORT 1591971
INTERSTATE CITY STREET FIRE ❑
CASE# 25-9720 2
RESULTED
1 STATE ROUTE OTHER STOLEN
VEHICLE ❑ LOCAL AGENCY 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2❑ BJECT 1
TRIBAL TOTAL UNITS#OF TRUCK 1 8 28
03 WOOD SIGN POST
RESERVATION ". 2
3� M M D D Y Y Y Y TIME(2400) COUNTY# MILES CITY#
DATE OF'. N E
coLLISION' 11 - 08 - 2025 1716 17 =.�� S 8 W OF 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION
EASTVALLEYROAD MILE POST
e 3650 .�
4a❑ MILE POST
❑ DISTANCE OF(REFERENCE OR CROSS STREET)
5 1150 MILES N FEET S 8✓ W e SW 41ST ST
1 2 29
MOTtlR PEDAL- DAM AG THRESHOLD MET PHONE
UNIT 01 VEHICLE CYCLE' YES Vl NO D:2066949805 0 1 30
6 LAST NAME SINGH FIRST NAME GURPREET MIDDLE 1 1 2 31
INITIAL
STREET 11731 SE 249TH ST CITY KENT ST WA ZIP 98030 2
NEW AbDRESS
7 CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
INTERLOCKYEs NO W/ INTERLOC YES D NoF,/
8 DCIENS # STATE WA SEX M MMDO
OCSYY' O6 - 26 - 1990 1 2 32
9 ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 H USEET CLASS 1 NAruRE of INJURES 2
10 LI ENSE' D38903H STATE WA VIN# 1GT40BDD7SU116379 3
11[—j— TRAILER STATE TRAILER ,STATE ROM TO
11 3 5 PLATE# PLATE#
TRLR TRL.R 5 1 33
12 3 5 vIN# vIN#
FROM TO
VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN GOVT VEHICLE 5 3 34
13 4 2025 GMC HUMME TR DAMAGE YES ONO IMIZZ RS YEs_ No
REGISTERED OWNER INFO GURPREET SINGH 11731 SE 249TH ST KENT WA 98030 D:2066949805 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
LIABILITY INSURANCE❑ INSURANCE CO 4
14 STATEFARM 494068fF09478
IN EFFECT &POLICY# 9TOP
vEn ' CHARGE I 5 36
IALL� yes❑NO❑ CITATION# 70 80TTOM
15❑ sTnNowc s 7 e
III MOTCYR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT Q2 VEHICLE CYCLE nWNFR YES,/ NO D:2064769625
16�
LAST NAME SWANK FIRST NAME RASHAD MIDDLE I A
INITIAL
STREET ❑
17 6040 S 118TH PL CITY SEATTLE ST, WA ZIP 98178 37
NEW ADORE SS
1 g CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED: 38
INTERLOCKYES No INTERLOCKYES NO es Nai
19 DRIVER'S STATE WA SEXI M I D.O.B. 03 13 2002 39
LICENSE# MMDDYY -
HELMET INJURY' NATURE OF INJURIES 40
LATE
20❑ ON DUTY STATUS' AIRBAG 2 RESTR 4 EJECT 1 USE CLASS 1 ❑
21 LICEN� CTZ1686 rare WA vIN# 5XYAB5S19TG007688 41
22❑ PLATE# STATE PAAILER
TE# STATE ❑ 42
23 TRLR kRLR 43
UIN#. 'IN#.
VEH.YEAR 2026 MAKE IpA MODEL EI/9 STYLE $P VEHICLE TOWED TO BLIN
TOWED BY GOV HI 44
24 DAMAGE YES NO�/ YES NO 1/
REGISTERED OWNER INFO YII.S GEBREGIORGIS 7035 S 133RD ST SEATTLEWA 98178 D:9999999999 VEHICLE NO.2
SHADEDAMAGEDAREA
3 4
LIABILITY INSURANCE INSURANCE CO PROGRESSIVE 861220848
IN EFFECT &POLICY# 9TOP
1-1— ❑ ,.I—I CITATION11 CHARGE iCD 80TTOM
LecnLLy YES N J
25 OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
26
ROGER RANAN 13156 WA0171300
PAGE 01 OF
PART A 3000-345-159(R 11/18)
POLIICFETRAFFICN CORRECTION REPORT NO. EG46639
COLLISION REPORT III III III III III 111
1591972 CASE# 25-9720
ADDITIONAL PERSONS INVOLVED(PASSENGERS AND/OR WITNESSES ONLY)
NAME MIDDLE INITIAL) JACKSON CRAIG L
(LAST,FIRST
ADDRESS&PHONE# DOB
13445 MARTIN LUTHER KING JR W UNIT L407$EATTLE WA 98178 SEX' M MMDDYYYY 07 - 16 - 1994
PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET INJURY NATURE OF INJURIES
z �' 2 POS. 3 2 4 1 USE CLASS '1
'NAME
LAsr F RST,MIDDLE INITIAL) GILLIS KING JOSIAH I
ADDRESS&PHONE# D(�B
2009 BREMERTON AVE NE RENTON WA 98059 SEX U MMDDVVYv O6 _ 28 2013_
SEAT HELMET INJURY NATURE OF INJURIES
PASSENGER �WITNESS UNIT# i 2 Pas 9 AIRBAG 2 RESTR. 4 EJECT 1 USE CLASS 1
NAME MIDDLE INITIAL) MCCOY AAJON M
',(LAST,FIRST,
AOQREss&PHONE# 2009 BREMERTON AVE NE RENTON WA 98059 SEX M D.O.B. 03 _ 26 _ 2022
MMDDYYYY
PASSENGER Z WITNESSQ POS. USE CLASS UNIT# 2 SEAT 7 AIRBAG 2 RESTR. 11 EJECT 1 HELMET NJURY 1 NATURE OF INJURIFS
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.
ROGER RANAN 11-09-25 01:09 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST.DET DATED PLACE SIGNED
APPROVED BY DATE
P.KORDEL 9676 11/9/2025 5:27:57 PM
BADGE OR ID# 13156 ORI# ( WA0171300 TIME POLICE DISPATCHED'; 5:18 PM TIME POLICE ARRIVED 5:20 PM
PART B 3 Do-3mx-,ao(Rtrras) PAGE 27 OF 67
POLIICFETRAFFICN CORRECTION REPORT NO. EG46639
COLLISION REPORT III III III III III 111
1591972 CASE# 25-9720
ADDITIONAL PERSONS INVOLVED(PASSENGERS AND/OR WITNESSES ONLY)
NAME GILLIS ANTRA C
(LAST,FIRST MIDDLE INITIAL}
ADDRESS&PHONE# DOB
2009 SREMERTON AVE NE RENTON WA 98059 SEX' F MMDDYYYY 06 — 26 1— 1991
PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET NJURY NATURE OF INJURIES
z �, 2 POS. 8 2 4 1 USE CLASS 1 --�
'NAME
(LAST FIRS,MIDDLE INITIAL)
ADDRESS&PHONE#
S ' D.O
EX .B.MMDD —F L----------�
YYYY
EAT HELMETNJURY URE OF
PASSENGER ❑WITNESS UNIT# S AIRBAG RESTR. EJECT NAT INJURIESPOS. : USE CLASS ----�
'.NAME
(LAST,FIRST,MIDDLE INITIAL)
ADDRESS&PHONE#
SEX' D.O.B.M —T L----------�
MDDYYYY
PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET INJURY NATURE OF INJURIES
❑ Q 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.
ROGER RANAN 11-09-25 01:09 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST.DET DATED PLACE SIGNED
APPROVED BY DATE
P.KORDEL 9676 11/9/2025 5:27:57 PM
BADGE OR ID# 13156 ORI# ( WA0171300 TIME POLICE DISPATCHED'; 5:18 PM TIME POLICE ARRIVED 5:20 PM
PART B 3 Do-3mx-,ao(Rtrras) PAGE 37 OF 67
REPORT NO.` EG46639 CASE# 25-9720 O COLLI COLLISION TIME
OF 11/08/25 17:16
COLLI
NARRATIVE
Case 25-9720
Unless otherwise noted, all events took place in the City of Renton, in the County of King, in the State
of Washington.
This incident was captured on my body worn video camera and in-car cameras. This report is a
summary of events that occurred and is not necessarily an exact sequencing of events.
On 11/08/2025 at approximately 1716 hours, I was dispatched to a three-vehicle collision with injuries
located on East Valley Road in front of Fortune Poker located at 3650 East Valley Road.
Upon arrival, I observed three vehicles that had been involved in the collision. I contacted the
involved parties, and the front right passenger of Unit#2 had a complaint of head injuries. Fire
personnel responded and cleared the passenger post evaluation. There, I collected the involved
parties' documents and their recollection of events of the incident.
The driver of Unit#1 identified himself as Gurpreet Singh DOB 06/26/1990 (verified WADL). The
driver of Unit#2 identified himself as Rashad A. Swank DOB 03/13/2002 (verified WADL). The owner
of the involved parked vehicle identified himself as Keith A. Becker DOB 03/29/1988 (verified WADL).
The driver of Unit 2 (Rashad) stated he was traveling northbound on East Valley Road when Unit 1,
which was in the median lane, merged into the northbound lane and collided with his vehicle. Rashad
reported that he reacted by turning his steering wheel to the right in an attempt to avoid further
damage. This action caused Unit 2 to leave the roadway, drive onto the landscaped portion of the
Fortune Poker parking lot, run over a wooden signpost and subsequently collide with Unit 3. Unit 3
was parked in the first parking stall on the west side of Fortune Poker.
The driver of Unit 1 (Gurpreet) stated he was traveling northbound on East Valley Road when Unit 2
appeared out of nowhere and collided with his vehicle.
The owner of Unit 3 (Keith) was not inside the vehicle at the time of the collision. Unit 3 was parked
and unoccupied in the above listed parking spot.
A Fortune Poker employee provided surveillance footage of the incident. Upon review of the video I
observed that Unit 1 was traveling in the median lane of East Valley Road. Unit 2 was traveling
northbound in the adjacent lane and had the right of way. Unit 1 then merged into Unit 2's lane of
travel, colliding with the left side of Unit 2.
Based on the involved parties' statements and video surveillance footage, I determined the proximate
cause of the collision was determined to be Unit 1. The driver of Unit 1 made an unsafe lane change
from the median lane into the northbound lane, causing the initial collision with Unit 2, which led to
Unit 2 colliding into Unit 3.
All involved parties received an exchange of information.
This concludes my involvement with this case.
I certify (declare) under penalty of perjury under the laws of the State of Washington that the
foregoing is true and correct.
Electronically signed by Officer R. Ranan #13156 11/09/2025 at 1242 Hours in Renton, King County,
Washington
PAGE 4 OF 6
SUPPLEMENTAL REPORT No. EG46639
POLICE TRAFFIC
1 1 8 27
µ ^'� COLLISION REPORT CASE#+ 25-9720
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 #ES PLACARD
GWVR NAME IF� NO NUMBER
SOURCE' AXL +
4a ❑ ADDITIONAL UNITS
'J ,µ MOTOR PEDAL- PROPERTY DAMAGE THRESHOLD MET PHONE
UNIT# 3 PEDESTRIAN �', YES NO
5 VEHICLE CYCLE OWNER F,/
1 4 29
LAST NAME UNKNOWN FIRST NAME MIDDLE'.
INITIAL
STREET 30
CITY SEATTLE ST ZIP
NFW ADDRFS '
6
CDL
IGMTIL7N REtJUIREb IGNi710N PRESENT MEDICALTANSPOR7ED' 1 31
INTERLOCK YES NO� ;INTERLOCK YES N4� YES[]N„Z
DRIVER'S STATE SEX LICENSE; U M�DDWv -F-1-
7
ON DUTY STATUS: AIRBAG 2 RESTR. 1 EJECT g HELMET 9 INJURY 1 NATUREOFINJURIES
USE CLASS
8 ❑ I ,. ,:, 1 32
LICENSE CCX4718 TAT WA VIN# JF2SJAGC2JH464567
PLATE#
9 TRAILER TRAILER 2
PLATE#r STATE PLATE# STATE
10 ❑ TRLR TRLR
VIN.# VIN.#.
11 0 0 VEH.YEAR2018 I MAKE SUBA MODELFORESTE STYLE GA VEHICLE TOWE E T ABLIN TOWED BY GOVT.VFHICI F FROM TO
DAMAGE YES NO ✓ YES NO
KEITH BECKER 4715 42ND AVE SW APT 227 SEATTLE WA 98116 D:9013564367 m 33
REGISTERED OWNER INFO. SHADE IN DAMAGED AREA
12
LIABILITY INSURANCE INSURANCE CO T 4 FROM TO
O
IN EFFECT &POLICY# � ' 5 m 34
13 vEnICEE YES NO[jj CITATION# CHARGE
108C)1`IOM
ecauv
sTANoINc 3
MOTOR PEDAL_ ' PROPERTY DAMAGE THRESHOLD MET 35
PHONE 1:1
14 ❑ UNIT# VEHICLE CYCLE PEDESTRIAN OWNER YES NO
15 LAST NAME FIRST NAME ❑INITMIDDL
ALE 36
16 ❑ STREET CITY ST! ZIP
NEW ADDRESS"
CDL IGNITION REOUIRED .IGNITION PRESENT MED'CALTANSPORTED
INTERLOCK YES NO INTERLOCK YES NO 'YES NO.
17 37
LICENSE#RIVERS STATE SEX MD,O _ I
18 ❑ URE OF INJURIES 38
❑
HELMET INJURY NAT
ON DUTY STATUS AIRBAG RESTR. EJECT USE CLASS
19 ❑ LICENSE TAT viN ❑ 39
PLATE# #
20 ❑ TRAILER TRAILER ❑ 40
PLATE#. STATE PLATE# STATE
21 ❑ TRLR TRLR 41
VIN#; VIN#:
42
22 VEH.YEAR MAKE I MODEL I STYLE I VEHICLE TOWED DUE T SABLIN TOWED BY GOVT.VEHICLE
DAMAGE YES NO YES NO
23 REGISTERED OWNER INFO. SHADE IN DAMAGED AREA 43
2 3 4
LIABILITY INSURANCE[—] INSURANCE CO
IN EFFECT &POLICY# t.K-99
5 44
vEHICEE ❑ ❑ CITATION# CHARGE 24 IEGALLY VES NO3 3 6
I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT.
ROGER RANAN 11-09-25 01:09 PM
25 INVESTIGATING OFFICER'S SIGNATURE OFFICER'S PHONE UNIT OR DIST DET DATED: PLACE SIGNED
26 BADGE
A G# 13156 O#RI WA0171300 APPROVED BY
111912025
PAGE OF
D
3000-345-013(R 11l18)
REPORT NO. EG46639 CASE# 25-9720 DATE AND TIME i 11/08/25 17:16
OF COLLISION
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