HomeMy WebLinkAbout23-11875 POLICETRAFF'c" III !�� I IIIllI111IN II II I REPORT NO. EE10274 170
27
COLLISION REP FIT 1591971
CASE 23-11875 z
INTERSTATE ❑ CITY STREET FIRE ❑RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHICI F ❑ LOCAL AOENC 4200 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 3 TOTAL#OF OBJECT 1 1 8 28
TRIBAL UNITS OZ RESERVATION STRUCK
z
3❑ DATE OF M M D D Y Y Y Y TIME(2400) COUNTY# MILES N E IN CITY# ❑
CowsloN 10 - 1-- 2023 1613 17 ❑.= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓
SW 7TH ST BLOCK NO. e✓ 300
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ 500 00 FMILES EET e S ❑ E e HARDIEAVESW
2 0 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
,/No D:4254782266 0 11
30
6� LAST NAME BRAR FIRSTNAME GURSEWAK MIDDLE 1 2 31
INITIAL
STREET ❑1 11706 164TH AVE SE CITY RENTON ST WA ZIP 98059 z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
iNTERLOCKYEs NO 1/ INTERLOCKYEs NO�/ YEs No�/
8❑ DRIVERS
# STATE WA SEX'M I D-MIDI Y' 07 - 14 - 1962 1 2 32
9 ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 H USE CLASS 2 CLASS 1 NATURE OF INJURIES 2❑
3
10 9❑ LICENS P1 ATE 14 CDU5481 sTAr WAu N# JTJAM76XOM5284571
5 TRAILER STATE TRAILER STATE
11 3 5 PLATE# PLATE# FROM TO
TRLR. TRLR. 3 5 33
12 3 5 VIN#' VIN#
>; FROM TO
VEH.YEAR 2021 MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE 7 3 34
13 LEXS GX 460 UT DAMAGE YES NO YES[:] NO✓
REGISTERED OWNER INFO G(IRSEWAK BRAR 11706164TH AVE SE RENTON WA 98059 D:4254782266 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
14 LIABILI INSURANCE INSURANCE CO FARMERS 187839605 3 4
IN EFFECT &POLICY# 9TOP
VE—L'
15❑ EC 1 5 36
LALLv YES❑NO❑ CITATION# CHARGE 1 o BOTTOM
STANDING 8 7 6
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OL PHONE
UNIT VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES 1/ D MET NO D:9195278923
16 a
LAST NAME CROMARTIE FIRST NAME JASMINE MIDDLE R
INITIAL
17❑ STREET Is❑' 6600 ROSEVELT WAY NE CITY SEATTLE ST' WA ZIP 98115 4❑ 37
NEW ADOREs
18❑ CDL IGNITION REQUIRED IGNITION PtR-E-S1ENT MEDICAL-T�RANSPORTED � 38
INTERLOCKYES�NO INTERLOCK YEs I I NOF YEs t l NOF,/
19 DIVER #
❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 H U EET 2 NJAURSY 1 NATURE OF INJURIES 40
❑ 41
21❑ PLATE# PLD3044 TArE NC vIN1 ML32F3FJ4KHF07017 1
42
22❑ PLATE# STATE PLATE# STATE
TRLR
23❑ VIN#. IN#. 43
RLR
'
VEH YEAR 2019 MAKE MITS MODEL MIRAGE STYLE SD VEHICLE TOWED TO BLIN TOWEDBY GOV HI 44
L4❑ DAMAGE YES NO YES NO
REGISTERED OWNER INFO JASMINE CROMARTIE 6600 ROSEVELT WAYNE SEATTLE WA 98115 D:9195278923 VEHICLE NO.2
SHADE IN DAMAGEbAREA
2 3 Cd
LIABILITY INSURANCE INSU&PORGY#E CO NATIONAL GENERAL 2018221501 I STOP
IN EFFECT
'E""LE ❑ Nu,J CITATION# CHARGE
LEGAL i o BOTTOM
LY YES
25 $ '
7TRADER
NAME(PRINT) OFFICER PHONE BADGE OR ID# JAGENCY
26 4553 WA0171300
PART A PAGE 01 OF
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EE10274
COLLISION REPORT III III III III III 111
1591972 CASE# 23-11875
ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY)
NAME MIDDLE INITIAL) RAUR GURDIP
(I.P.ST FIRST,
ADDRESS&PHONE# D O.B. '
11706 164TH AVE SE RENTON WA 98059 4254782266 SEXi F MMDDYyry 10 - 09 SEAT - 1964
PASSENGER L,WITNESS❑+UNIT# 1 POS. 3 AIRBAG 2 RESTR. 9 EJECT ? 1 HELMET USE 2 CLASS LASS NATURE OF INJURIES
- '1
NAME
(LAST,FIRST,MIDDLE INITIAL)
ADDRESS&PHONE# DOB
SEXI MMDDYYYY
PASSENGER ❑WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET NJURY NATURE OF INJURIES
POS. USE
CLASS
NAME
(LAST FIR57 MIDDLE INITIAL)
AppRESS R PHONE#
SEX D.O.B.
MMDDYYYY. -
PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET NJURY NATURE OF INJURIES
❑ ❑ POS. USE CLASS ----�
NARRATIVE'
On 10/17/2023 at approximately 1626 hours, I was dispatched to a non injury collision in the 300
block of SW 7th ST, in the City of Renton, County of King.
I arrived and spoke with the driver of Unit 1 who was identified as a Brar with a WA State license. I
also spoke with the driver of Unit 2 who was identified as Cromartie.
Cromartie told me she was driving EB in the 300 block of SW 7th ST in the right curb lane when Unit
1 came into her lane and struck the rear driver side bumper of her vehicle causing damage.
Brar told me he was driving EB in the 300 block of SW 7th STin the number two lane. At first he
indicated Unit 2 was speeding and then he said she changed lanes into him.
Cromartie said Unit 1 changed lanes colliding with her vehicle. There was damage to the front driver
side bumper of Unit 1.
Due to conflicting statements and no witness information I was not able to cite the driver of Unit 1.
Cromartie was consistent in her account of what occurred and the damage was consistent with her
account of what occurred.
I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT.
J.TRADER 10-17-23 05:51 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
J.TRADER 4553 1 1011712023 6:24:53 PM
BADGE OR ID# 4553 OR]# WA0171300 TIME POLICE DISPATCHED 4:26 PM TIME POLICE ARRIVED'4:31 PM
PART I PAGE IT]OF 3�
REPORT NO.! EE10274 CASE# ' 23-11875 DATE AND TIME 10/17/23 16:13
OF COLLISION
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