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COLLISION REP FIT 1591971
CASE 24-2042 z
INTERSTATE ❑ CITY STREET FIRE ❑RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHIr.I F ❑ LOCAL AOENC 4Y00 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 2 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 N E IN CITY#
COLLISION 02 - 1-- 2024 2000 17 ❑.❑ S 8 W e IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
BLOCK
SUNSET BLVD NE ST e✓
MILEPOST 200 ❑
4a❑
DISTANCE OF(REFERENCE OR CROSS STREET)
5 ❑ FEET e S ❑ W e 405 NB ON-RAMP
❑
0 4 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
,/No D:4042420502 0 11
30
6� LAST NAME MUTHU FIRSTNAME CHIDAMBARAM MIDDLE 1 2 31
INITIAL
STREET ❑1 18128 40TH DR SE CITY BOTHELL ST WA Zip, 98012 z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
INTERLOCK YES[:]NO 1/ INTERLOCKYEs NO Z/ YES R No�/
$F-I LRIIVERCENS # STATE WA SEX'M MI 07 - 18 - 1983 1 2 32
9 ON DUTY❑ STATUS AIRBAG 9 RESTR 9 EJECT 1 HELMET USE 2 CLASS 1 NATURE OF INJURIES z❑
3
10 9❑ P1 aTES� BHL0158 sTArI WAurN# JTDKN3DU1F0435210
5 TRAILER STATE TRAILER STATE
11 3 5 PLATE# PLATE# FROM TO
TRLR. TRLR 7 1 33
12 3 5 VIN#' VIN#
>; FROM TO
VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE 1 $ 34
13 3 2015 TOYT PRIUS SD DAMAGE YES NO YES[:] No
✓
REGISTERED OWNER INFO OWNEDBYDRIVER VEHICLE NO. 1
SHADE IN DAMAGED AREA 35
3 INSURANCE CO 4
14 LIABILITY INSURANCE PEMCO CA 1229597
LI EFFECT I SUR N# TOPVEHlcl.e CHARGE <1�3
OTTOM 5 36
LEGALLY YES❑NO❑ CITATION# 5
15❑ STANDING 7 6
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES 1/ NO D:2068875387
16 a
LAST NAME BHUVA FIRST NAME YASH MIDDLE IR
INITIAL
17❑ NEW ADDRE— 24042 2STREET 6TH PL S CITY DES MOINES ST WA Zip 98198 37
18❑ CDL IGNITION REQUIRED IGNITION PR-E-1SENT MEDICAL-T�RANSPORTED � 38
INTERLOCK YES❑NO� INTERLOCK YEs It I NOF YES
t l NOF,/
19 LDI IVER # STATE WA SEX M M .C... 12 _ 18 _ 1998 39
20❑ ON DUTY STATUS AIRBAG 6 RESTR g EJECT 1 H U EET 2 NJAURSY 1 NATURE OF INJURIES ❑ 40
❑21❑ PLATE# ICES 1149 TArE 41
WA vIN# 1HGCV3F2XNA036371 1
42
22❑ PLATE# STATE PLATE# STATE
23❑ VIN#. 43
TRLR RLR
'IN#.
TOWED BY GOV HI 44
VEH YEAR 2022 MAKE HOND MODEL ACCORD STYLE $D DAMAGE TOWED NOO✓ BLIN YES NO 1/
24❑ REGISTERED OWNER INFO OWNED SY DRIVER VEHICLE N0.2
SHADE IN DAMAGED AREA
2 3 4
LIABILITY
INSURANCE INSU PORGY#E CO PROGRESSIVE 973666997IN STOP 5
IEwGLE ❑ ,J� CITATION# CHARGE
25 0( ' a i o BOTTOM
LEGALLY YES N`L J
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
J
26
C.ARNOLD 12509 WA0171300
PAGE 01 OF
PART A
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EE56484
COLLISION REPORT III III III III III 111
1591972 CASE# 24-2042
ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY)
NAME MIDDLE INITIAL) KARUPPAN CHETTI KARTH/KA N
(LAST FIRST,
ADDRESS&PHONE# D.0.B.
18128 40TH DR SE BOTHELL WA 980127514 SEX F MMDDYyYY 09
PASSENGER Z WITNESS❑ UNIT# i 1 SEA 3 AIRBAG 9 RESTR. 9 EJECT ? 1 HELMET LASS NATURE OF INJURIES
POS. USE 2 CLASS 1
NAME
(LAST,FIRST,MIDDLE INITIAL) CHIDAMBARAM MEDHA
ADDRESS&PHONE# DOB
18128 40TH DR SE BOTHELL WA 98012 SEX IF IF71 01 _ 04 _ 2017
SEAT HELMET INJURY NATURE OF INJURIES
PASSENGER Z WITNESS UNIT# 1 POS 9 AIRBAG 9 RESTR. 9 EJECT 1 USE 2 CLASS 1
NAME
(LAST FIR57 MIDDLE INITIAL)
AppRESS&PHONE#
SEX D.O.B.
MMDDYYYY. -
PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET NJURY 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.
C.ARNOLD 02-24-24 09:18 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
D.MOYNIHAN 11288 1 31612024 12:10:15 AM
BADGE OR ID# 112509 ORI#' WA0171300 TIME POLICE DISPATCHED'; 8:03 PSI TIME POLICE ARRIVED:8:06 PM
PART I PAGE IT]OF 4�
REPORT NO. EE56484 CASE# 24-2042 OF COLLISION
02/24/24 20:00
OF CbLLI510N
NARRATIVE
24-2042
On 2/24/2024 at 2003 hours I was dispatched to a collision at 200 block of Sunset Blvd NE located in
the City of Renton, King County, Washington. I arrived on scene at 20:33 and met with Drivers' 1 and
2. The following information is based off of the statements of Drivers' 1 and 2.
Unit 1 was traveling North on Sunset Blvd N approaching the 200 block. Unit 1 was traveling in the
number 2 lane which turns left to the on-ramp to 40 North.
Unit 2 was traveling South on Sunset Blvd NE approaching the 200 block in the number 1 lane.
Unit 1's driver stated that he approached the 200 block and prepared to turn onto the on-ramp for 405
North, crossing over the Southbound lanes of travel. It should be noted that Unit 1 has a Yield sign
that is displayed on the right side of the roadway at the intersection, directing Northbound traffic to
yield to Southbound traffic. Unit 1's driver stated that the front bumper of Unit 1 made contact with the
front driver side bumper of Unit 2.
Unit 2's driver stated that he was traveling South on Sunset Blvd NE approaching the 200 block in the
number 1 lane. Unit 2 does not have any traffic control device at the intersection where Northbound
traffic merges to the on-ramp. Unit 2's driver stated that Unit 1 failed to yield at the intersection, and
began to cross the Southbound lanes of travel. Unit 2's driver stated that the front bumper of Unit 1
made contact with the front drivers side bumper of Unit 2.
Collision description:
Injuries:
Renton Fire Authority (RFA) responded to the scene as Unit 2's airbags deployed and evaluated all
parties on scene. All parties were medically cleared and declined transport to the hospital.
Dispositions:
Unit's 1 and 2 were both towed from the scene.
Proximate Cause:
If not for Unit 1 failing to yield to the right of way of Southbound travel, then Unit 1 would not have
collided with Unit 2 and this collision would not have occurred.
This report is to document the circumstances of the collision, damage to vehicles, and both drivers'.
I certify (declare) ender penalty of perjury under the laws of the State of Washington that the
foregoing is true and correct.
Electronically signed by Officer C. Arnold #12509 at 20:59 hours on 2/24/2024, in the City of Renton,
King County, Washington.
PAGE 3 OF 4
REPORT NO. EE56484 CASE# 24-2042 DATE AND TIME 02/24/24 20:00
OF COLLISION
PAGE 4 OF 4