HomeMy WebLinkAbout24-3113 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 1 27c
COLLISION REP FIT 1591971
CASE 24-3113 z
INTERSTATE ❑ CITY STREET FIRE ❑RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHIC;I F ❑ LOCAL AOENC WA171.300 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#
COLLISION.. 03 - 1-— 2024 1257 17 ❑-= S 8 IN e 1070 3
4 4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
SUNSET BLVD N BLOCK NO. e✓ 470 ❑
4a 1❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ 1.❑ FEET e S ❑ W e I"405 0 4 29
MOTOR PEDAL- DAM THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El YES
NO ,/ D:2066372455 0 11
30
g� LAST NAME SAENGPRASEUTH FIRSTNAME JAY MIDDLE 1 2 31
INITIAL
STREET ❑ 9000 20TH AVE SW APT 101 CITY SEATTLE ST WA Zjp, 981062324 z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
INTERLOCK YES[:]NO 1/ INTERLOCKYEs NO�/ YES R No�/
8❑ LRIIVER #
ON DUTY❑ STATUS AIRBAG 2 RESTR 9 EJECT 1 HELMET INJURY 7 NATURE OF INJURIES z❑
USE CLASS COMPLAINT OF LOWER BACK PAIN
3
10 9❑ LI ENSE ATE 14 A 7105696 sTArE WA u N#' WBA2J3C50JVD48318
TRAILER STATE TRAILER STATE
11 0 0 PLATE# PLATE# FROM TO
TRLR. TRLR. 3 5 33
12 0 0 VIN#' VIN#
>; FROM TO
❑ VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN T Y GOVT.VEHICLE 1 $ 34
13 3 2018 BMW 230XI SD vE8 0NO agW�MEYERS TOWING ves❑ No
DAMAGE
REGISTERED OWNER INFO OWNEDBYDRIVER VEHICLE NO. 1
SHADE IN DAMAGED AREA ❑ 35
3 INSURANCE CO 3
14 LIABILITY INSURANCE STATE FARM 3957594E2547A
IN EFFECT &POLICY# 9TOP
vEHlcl.e CHARGE 10 BOTTOM 5 36
LECALLv res❑NO❑ CITATION# $
15❑ STANDING 8 7 6
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT VEHICLE ❑ CYCLE ❑ ❑ : OWNER ❑ YES NO ,/ D:4252727519
16 a
LAST NAME STONE FIRST NAME KENNETH MIDDLE W
INITIAL
17 STREET NEW ADDREs�' 807 JEFFERSON AVE NE CITY RENTON ST WA ZIP 980563721 4❑ 37
18� CDL ., IGNITION REQUIRED IGNITION PtR-E-S1ENT MEDICAL t-TRANSPORTED 38
INTERLOCKYES�NO� INTERLOCK YEs I I NOF YES
t l NOF,/
19[ DRIVER# STATE WA SEX M M DDY
D.C.B.
10 _ 14 1955 39
20❑ ON DUTY STATUS AIRBAG 2 RESTR 9 EJECT 1 HEJ MET NJAURSY 1 NATURE OF INJURIES ❑ 40
LICENSE I ❑21❑ PLA E# C661128 TArE WA VIN# 41
SFNYF6H59JB013353 1
42
22❑ PLATE# STATE PLATE# STATE
23❑ VIN#. 43
TRLR RLR
'IN#.
VEH YEAR 2018 MAKE HOND MODEL PILOT STYLE VEHICLETOWED TO BLIN TOWED BY GOV HI 44
24❑ DAMAGE YES NO YES NO
REGISTERED OWNER INFO KENNETH STONE 807 JEFFERSON AVE NERENTONWA98056 D:4252727519 VEHICLE NO.2
SHADEDAMAGEDAREA
3 4
LIABILITY
INSURANCE &POINSURGY#E CO PROGRESSIVE 940324564IN STOP 5
"'CLe ❑ ,J� CITATION# CHARGE to BOTTOM
LEGALLY YES N`L J
25 ' a
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
26
ROBE SLINKMAN 11618 WA0171300
PART A PAGE 01 OF
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EE61619
COLLISION REPORT III III III III III 111
1591972 CASE# 24-3113
ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY)
NAME
(LAST FIRST,MIDDLE INITIAL)_
ADDRESS&PHONE#
SEX D.O.B. - -
MMDDYYYY.
PASSENGER❑WITNESS UNIT# SEAT AIRBAG RESTR. EJECT ' HELMET INJURY NATURE OF INJURIES
POS. USE CLASS
NAME
'(LAST,FIRST MIDDLE INITIAL)
ADDRESS&PHONE# D D B
SEX MMDDYYYY
PASSENGER ❑WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET INJURY 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 URE OF INJURIES
NAT
❑ ❑ POS. USE CLASS ----�
NARRATIVE'
Unit 2 was traveling southbound on Sunset Blvd N through an area where roadwork was being
conducted. Unit 1 had been traveling northbound on Sunset Blvd N before turning westbound onto a
cut through street which allows for U-turns. While stopped at the yield sign, the driver of unit 1 looked
both ways and then turned southbound onto Sunset Blvd N. Unit 1 did not see unit 2 before making
the turn. Due to the fact that this is a busy work zone with a lot of materials and equipment, unit 1's
vision was likely partially blocked. That area made it difficult to see oncoming vehicles. Unit 1 pulled
out and onto the street and unit 2 was unable to stop in time and collided with unit 1.
I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT.
ROBERT SL/NKMAN 03-22-24 04:45 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
P.KORDEL 9676 1 312212024 5:55:02 PM
BADGE OR ID# 11618 OR]# WA0171300 TIME POLICE DISPATCHED 1:01 Pry] TIME POLICE ARRIVED';1:04 PM
PART I PAGE IT]OF 3�
REPORT NO. EE61619 CASE# ' 24-3113 DATE AND TIME 03/22/24 12:57
OF COLLISION
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