HomeMy WebLinkAbout23-4255 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 0 27c
COLLISION REP FIT 1591971
CASE 23-4255 z
INTERSTATE ❑ CITY STREET FIRE ❑
RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHICI F ❑ LOCAL AGENCI 4200 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 TOTAL#OF OBJECT 2$
TRIBAL UNITS 01 STRUCK ROCK BANK OR LEDGE
RESERVATION
z
3❑ DATE OF M M D D Y Y Y Y TIME(2400) COUNTY# MILES N E IN CITY# ❑
GawsloN 04 - 16 - 2023 0101 17 ❑.= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓
BLOCK
275 RAINIER AVE S MILEPOST ST e✓ 200
4a❑
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ 20 00 FEET MILES e S B W e S 3RD PL
0 1 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
✓NO D:2062514085 30
6❑ LAST NAME ALLAH FIRSTNAME TRUTH MIDDLE 1 2 31
INITIAL
STREET ❑, 6626 CHAPEL HILL BLVD APT L206 FT
PASCID ST WA 2jp, 99301 z=
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
iNTERLOCKYEs NO 1/ INTERLOCKYEs NO�/ YES R No�/
8❑ LDRIVER # STATE WA SEX' ID
M MD-O B 10 32
9 ON DUTY❑ STATUS' AIRBAG 6 RESTR 4 EJECT 1 HELMETU E 2 CLASS 7 [NATURE OF INJURIES
MINOR SCRAPES AND SCRATCHES z❑
3
10❑ PI ATNE 14 CBC5396 sTAr WAvN# 2G1FG1ED369113692
TRAILER STATE TRAILER STATE
11 0 0 PLATE# PLATE# FROM TO
TRLR. TRLR 5 1 33
12❑ vIN#' VIN#
FROM
34
13 4 VEH.YEAR2O11 MAKE CHEV MODEL CAMAR STYLE CP VEHICLE TOWED NOOpLSABLIN TSIYYEp9vMEYERS VEHICLE
❑ DAMAGE IILLJJII (5ciV6
REGISTERED OWNER INFO NOE MONDRAGON RAMIREZ 2305W1STAVE KENNEWICK WA 99336 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
14❑ LIABILI INSURANCE INSURANCE CO GEICO 4578381602 4
IN EFFECT &POLICY#
VEHCLE CHARGE 5 ❑ 36
LEGALLY YES❑NO❑ CITATION# 1 o BOTTOM
15❑ STAIN,DIING 6
UNIT 02 VEHICCLE ❑ CYCLE PEDAL- ❑ PEDESTRIAN ❑ OWNER
❑ DYES NO OLD MET PHONE
16❑
LAST NAME FIRST NAME MIDDLE
INITIAL
STREET
CITY' ST ZIP 4❑ 37
17❑ NEW ADDRESS❑'
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 MMDDYY —�_ 39
HELMET INJURY NATURE OF INJURIES 40
20❑ ON DUTY STATUS' AIRBAG RESTR EJECT USE CLASS ❑
❑21❑ LICENSE TArE IN# 41
V 1
PLATE#
42
22❑ PLATE# STATE PLATE# STATE
23❑ 43
TRLR RLR
UIN#. 'IN#.
VEH YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN
TOWED BY Gov HI 44
L4❑ DAMAGE YES NO YES NO
REGISTERED OWNER INFO VEHICLE NO.2
SHADE IN DAMAGED AREA
2 3 4
INAEFFIECTTY NSURANCE❑ &POINSULICY#E CO VE."LE ❑ ,J� CITATION# CHARGE
25 GQ
LEGALLY YES N J
s � e
7BRYAN
NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
J
26GROZAV 1 12489 WA0171300
PART A PAGE 01 OF C7
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. ED52131
COLLISION REPORT III III III III III 111
1591972 CASE# 23-4255
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
PM 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 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.
BRYAN GROZAV 04-16-23 10:39 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
DESIRES SCOTT 10272 411712023 5:43:09 PM
BADGE OR ID# 12489 ORI# WA0171300 TIME POLICE DISPATCHED 4:09 AM TIME POLICE ARRIVED',1:01 AM
PART Ei PAGE IT]OF 4�
REPORT NO. ED52131 CASE# 23-4255 OF COLLISION
04/16/23 01:01
OF CbLLI510N
NARRATIVE
CASE 23-4255
This incident was captured on my body worn video camera. This report is a summary of events that
occurred and is not an exact sequencing of events.
On Sunday April 16th, 2023, at approximately 01:09, 1 responded to a single vehicle rollover collision
in the parking lot of Walgreens located at 275 Rainer Ave S in the City of Renton, King County,
Washington.
-UNIT ONE: black 2011 CHEVROLET CAMERO WASHINGTON LICENSE: CBC5396
-UNIT ONE DRIVER: TRUTH ALLAH (DOB: 10.31.1970)
There were several officers in the area that heard a loud crash and located the unit 1 in the parking
lot on its roof. I was on an unrelated traffic stop when the collision was located and responded to the
scene. I contacted Truth who said he was traveling north on Rainier Ave S and the clutch slipped
causing him to lose control of the vehicle. Truth entered the ditch on the west side of Rainer Ave S
causing his vehicle to flip and land on its roof in the parking lot where the vehicle came to a rest.
Truth was able to self-extricate from the vehicle and was not injured. Truth was screened by aid on
scene and released. Unit 1 was later towed by Banker's towing.
Due to the circumstances of the collision, time of night, I examined Truth to see if he was impaired,
but I was not able to notice any signs of impairment. Truth did refuse to participate in SFST's saying
he was not impaired and did not see why he would need to conduct SFST's.
It should be noted, once the vehicle was flipped over on its tires, I located Truth's cell phone on the
passenger side floorboard illumined and on the texting screen. It appeared Truth may have been
texting before the collision, but I was not able to confirm if he was or not.
I provided Truth a business card with the case number.
This concludes my involvement in 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 B. Grozav #12489 on 04.16.2023 at 19:15 hours in Renton, WA.
PAGE 3 OF 4
REPORT NO. ED52131 CASE# 23-4255 DATE AND TIME 04/16/23 01:01
OF COLLISION
p' k N
( Y
4ILP
NOT TO SCALE
SW Sunset Blvd
S3'St
Rainier Ave S
PAGE 4 OF 4