HomeMy WebLinkAbout23-577 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 0 27c
COLLISION REP FIT 1591971
❑ ❑ 23-577 z
RESULTED ❑ CASE
INTERSTATE CITY STREET FIRE
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHICI F ❑ LOCAL AGENCI 4250 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 TOTAL#OF OBJECT 1 8 28
TRIBAL UNITS OZ STRUCK
RESERVATION
2
3❑ DATE OF M M D D Y Y Y Y TIME(2400) COUNTY# MILES N E IN CITY# ❑
cawsloN 01 - 15 - 2023 1625 17 ❑.= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓
BLAINE AVE NE BLOCK NO. e✓ 1612
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ ❑ FEET e S ❑ W e 0 1 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
✓NO D:2063029398 2 2 30
6 LAST NAME JIMENEZ CRUZ FIRST NAME BIANCA MIDDLE R 1 1 2 31
INITIAL
STREET ❑ 1207 DAYTON AVE NE CITY RENTON ST WA ZIP' 98056 2
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
1/ I iNTERLOCKYEs NO NTERLOCKYEs NO�/ YES R No�/
8❑ LRIIVER #
ON DUTY❑ STATUS AIRBAG 2 RESTR 9 EJECT 1 HELMETU E 2 CLASS 1 NATURE OF INJURIES 2❑
3
10❑ P1 ATNES# KMHD84LF5HU164474 sTAr WAv N# KMHD84LF5HU164474
TRAILER TRAILER
STATE STATE
11 2 5 PLATE# PLATE# FROM TO
rRLR. TRLR. 1 5 33
12 0 0 VIN#' VIN#
2017 HYUN ELANTR P4YES[:]
❑ FROM
34
13 4 VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE
DAMAGE YES �/ NO YES NO
REGISTERED OWNER INFO UGHN FISHER 114 MST SE AUBURN WA 98002 VEHICLE NO. 1
❑ ❑
SHADE IN DAMAGED AREA 35
14❑ LIABILITY INSURANCE❑ INSURANCE CO 4
IN EFFECT &POLICY# 9TOP
VEHicLE CHARGE 5 36
LEGALLv res❑NO❑ CITATION# 1 o BOTTOM
1 5❑ STAIN."' 8 6
UNIT 02 VE ICCLE CYCLE ❑ PEDESTRIAN ❑ OWNER YES
[:]I DYES NO SOLD MET PHONE
16❑
LAST NAME UNKNOWN FIRST NAME MIDDLE
17
INITIAL
STREET CITY AUBURN ST ZIP 4
17❑ NEW ADDRESS❑ ❑ 37
18❑ CDL IGNITION REQUIRED IGNITION PtR—E—S1ENT MEDICAL—T�RANSPORTED � 38
INTERLOCKYES�NOR INTERLOCK YEs I I NOF YEs t l NO❑
19 LLIICENS # STATE SEX U MMDDYY —�_ 39
WELMET INJURY NATURE OF INJURIES 40
20❑ ON DUTY STATUS' AIRBAG 9 RESTR 9 EJECT ''1 USE 9 CLASS 0 ❑
❑LICENSE I 21❑ PLA E# C94197F TAre WA VIN 1 1(BBHG39U431218712 41
1
42
22❑ PILER LATE# STATE PLATE# STATE
23❑ 43
TRLR RLR
UIN#. 'IN#.
YEAR 2003 MAKE CHEV MODEL EXPRESS STYLE VN VEHICLETOWED TO BLIN TOWEDBY GOV HI 44
VEH
L4❑ DAMAGE YES NO YES NO
REGISTERED OWNER INFO FLOORING LLC WRIGHTWAY 28543 W VALLEY HWY S.AUBURN WA 98001 D:2533345791 VEHICLE NO.2
SHADE IN DAMAGED AREA
2 3 4
INAEFFIECTTY NSURANCE❑ &POINSULICY#E CO STOP 5
"'LE LEGALY YES❑ N J,.I— CITATION# CHARGE i o BOTTOM
L 6
—T
25 =SCOTT
AME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
26 10272 WA0171300
PAGE 01 OF
PART A
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. ED25204
COLLISION REPORT III III III III III 111
1591972 CASE# 23-577
ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY)
NAME(LAST FIRST,MIDDLE INITIAL) VAN LILY
ADDRESS&PHONE#
858 ABERDEEN AVE NE RENTON WA 98056 4253368591 SEXi F MMDDvyvv 11 - 15 - 2010
PASSENGER Z WITNESS❑ UNIT# 1 PEAT oi 9 AIRBAG 19 RESTR. 9 EJECT ? 1 HELMET NATURE OF INJURIES
USE 2 CLASS
11
NAME
(LAST,FIRST,MIDDLE INITIAL) WILLIAMS CODY L
ADDRESS&PHONE# D O 8
1612 BLAINE AVE NE RENTON WA 98056 2533448607 SEX M MMDDvvvv 04 _ 11 _ 1978
PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET INJURY NATURE OF INJURIES
❑ POS. USE CLASS
NAME
(LAST FIRST,MIDDLE INITIAL) GILBERT EM1LY R
ADDRESS&PHONE# 1612 BLAINE AVE NE RENTON WA 98056 4252800439 MMDDYYYY
SEX F D.O.B. 10 _ 16 _ 2004
PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET INJURY 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.
DESIRES SCOTT 01-15-23 08:31 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY E
DAT
C.TOLLIVER 10540 111512023 11:18:43 PM
BADGE OR ID# 10272 ORI# WA0171300 TIME POLICE DISPATCHED 4:35 PM TIME POLICE ARRIVED',4:39 PM
PART I PAGE IT]OF 4�
REPORT NO. ED25204 CASE# 23-577 OF COLLISION
01/15/23 16:25
OF CbLLI510N
NARRATIVE
On 1/25/23 at approximately 1635 hours I was dispatched to 1600 Blaine AVE NE (City of Renton,
County of King and State of Washington) due to a report of a Hit and Run collision where a silver
2017 Hyundai, Washington license CAC7536 had struck a legally parked 2003 Chevy Express Van,
Washington license C94197F.
Upon arrival I contacted Witness, Emily R. Gilbert (10/16/04) who stated that she was parked in her
driveway located at 1612 Blaine AVE NE, Renton WA. Gilbert saw Vehicle #1, the Hyundai driving
south bound in the 1600 bock of Blaine AVE NE when it struck Vehicle #2 the Chevy that was parked
in front of her house. Gilbert got out of her vehicle to check on the driver when she saw a female get
out of the drivers seat and took off running south bound on Blaine. Gilbert said the female was
wearing a blue sweatshirt. I asked Gilbert if she would be able to identify the driver of the vehicle and
she said no. Gilbert then said a young juvenile exited the rear passenger seat of the vehicle. Gilbert
contacted the girl, who was identified as Lily Van (11/15/2010). Gilbert asked her if she was okay and
who the driver was. Van told Gilbert that the driver was her uber driver that her mother, Ngoc Thao T.
Nguyen (12/28/1981) had called for her.
Gilbert pointed to Van and said that Nguyen, Van's mother had just arrived and said that she had not
called an Uber for Van. I could see that vehicle #1, the Hyundai was running with out a key in the
ignition. The ignition had been torn out. The rear passenger window was broken out. A WACIC
check on the vehicle shows that it is registered to a FISHER, JOHN RAY out of Olympia. I asked
Olympia PD to go to the location and try and contact Fisher. Olympia PD went to the address and
contacted Fisher's mother, who stated she did not have any way of contacting Fisher. Fisher's
drivers license shows he lives in Auburn. I requested Auburn PD go out and try and contact him at
his residential address. Auburn Police went to the address and learned that Fisher no longer lives at
that address and lives out of his vehicle. Vehicle #1 was blocking the road and abandon after a
collision so it was towed by Bankers Towing.
I spoke to Cody L Williams (4/11/1978) who said that vehicle #2 was his work van. I gave Williams
the case number to submit for his insurance claim.
I then spoke to Van and told her to tell me the truth. Van said she was with her friend Diane when her
older sister, Destiny told her to come with her so she could show her something. While en-route they
ended up in a collision and Destiny ran. Van was unsure of Diane's sisters name but thought it was
Destiny.
Officer Chang was doing an area check and saw someone enter a residence at 1207 Dayton AVE
NE, Renton. Officer Chang made contact at that house and contacted a Bianca Jimenez Cruz
(12/11/07) he asked her if she was alright and she said yes. Officer Chang stood by with Jimenez
Cruz while Officer Lamothe came to my scene to see if I had any witnesses. I asked Nguyen if she
and Van would be able to go with Officer Lamothe and identify the driver of the vehicle. Nguyen said
yes. Nguyen and Van left with Officer Lamothe. See Officer Lamothe's report for further details.
Van was able to identify Jimenez Cruz as the driver of Vehicle #1. No questions were asked of
Jimenez Cruz as her parents were not home at the time. See Officer Chang's report for further
details.
Vehicle #1 sustained damage to its front passenger side bumper and quarter panel. Vehicle #2
sustained damage to its front drivers side bumper and quarter panel. No injuries were reported. This
case will be forwarded to the traffic division for further investigation. It is unknown that this time if
Vehicle #1 is an unreported stolen.
PAGE 3 OF 4
REPORT NO. ED25204 CASE# ' 23-577 DATE AND TIME 01/15/23 16:25
OF COLLISION
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