HomeMy WebLinkAbout22-13579 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 0 27c
COLLISION REP FIT 1591971
CASE 22-13579 z
INTERSTATE ❑ CITY STREET FIRE ❑RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHIC;I F ❑ LOCAL AOENC 4900 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.. 12 - 1-— 2022 1816 17 ❑.= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓
SW 43RD ST BLOCK NO. e✓ 800
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ 1000 FMILES EET e S ❑ E e LIND AVE SW
0 1 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
✓NO D:2065107865 0 11
30
6❑ LAST NAME FLORES FIRSTNAME MAIKOL MIDDLE 1 2 31
INITIAL
STREET 01 21606 PACIFIC HWY S,APT 201 CITY DES MOINES ST WA 2jp, 98198 z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
iNTERLOCKYEs NO INTERLOCKYEs NO YES R NO
8❑ DRIVER'S STATE SEX'M D.o.6. 12 - 13 - 1994 1 2 32
LICENSE# MMD)3YY
9 ON DUTY❑ STATUS AIRBAG 3 RESTR 3 EJECT 1 HELMET U S 2 CLASRuY 1 NATURE OF INJURIES 2❑
3
LICENSE CFG8504 sTArI WAvIN# JTHBD192340083919
10 F91 PI ATE#
TRAILER STATE TRAILER STATE
11 3 5 PLATE# PLATE# FROM To
TRLR. TRLR 7 3 33
12 3 5 VIN#' VIN#'
FROM TO
VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TR Y GOVT.VEHICLE 7 3 34
13 2004 LEXS IS-F SD DAMAGE YES NO �MEYER YES❑ No✓
REGISTERED OWNER INFO JONATHAN DELGADO QUINTANA 371042ND AVE NE TACOMA WA 98422 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
14 ❑ INSURANCE CO 3 4
LIABILITY INSURANCE
IN EFFECT &POLICY# 9TOP 5
ve'CLE CHARGE 1 o BOTTOM 36
LEGALLY YES No CITATION 2A0060417,2AO060418 NO VALID OPER LICENSE W/OUT
15❑ NDING 8 6
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT 02 VEHICLE ❑ CYCLE El ❑ OWNER ❑ YES 1/ NO D:2066572048
16 a
LAST NAME MARQUEZ FIRST NAME GYPSY MIDDLE G
INITIAL
17❑ STREET �', 2224 165TH AVE CT E CITY LAKE TAPPS ST WA ZIP 98311 37
NEW ADDRESS ❑
18� CDL IGNITION REQUIRED IGNITION PR-E-1SENT MEDICAL TRANSPORTED 38
INTERLOCKYES�NOF INTERLOCK YEs It I NOF YES
t t- l No❑
19 F] DRIVERS#
USE ET LAU SY RIGHT ARM PAIN.UNABLE TO MOVE ARM 40
20 ON DUTY F—NATURE OF INJURE
STATUS AIRBAG,3 RESTR 4 EJECT 1 2 5
21❑ LICENSE I CCN3245 TAre WA vIN# JF1GV8J61DL014663
❑ 41
PLATE#
42
22❑ PLATE# STATE PLATE# STATE
23❑ VIN#. 43
TRLR RLR
'IN#.
roweD By Gov HI 44
VEH YEAR 2013 MAKE $(JB�4 MODEL ►MPREZA STYLE $D DAMAGE TOWED✓ NOO BLIN GENEMEYER YES No�/
24❑ REGISTERED OWNER INFO OWNED SY DRIVER VEHICLE N0.2
SHADEDAMAGEDAREA
3 4
LIABILITY
INSURANCE I PORGY#E CO PROGRESSIVE 930924174IN STOP 5
VE"ICLE ❑ ,J� CITATION# CHARGE
25 to BOTTOM
LEGALLY YES Nu
J
' a
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# JAGENCY
26
D.LA; HE 1
11677 WA0171300
PART A PAGE 01 OF
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. ED20662
COLLISION REPORT III III III III III 111
1591972 CASE# 22-13579
ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY)
NAME MIDDLE INITIAL) NGUYEN NICHOLAS
(LAST FIRST,
ADDRESS&PHONE#
17656 112TH AVE SE RENTON WA 98057 2067080457 SEX M MMDOYyvv 10 - 02 - 1997
PASSENGER UNIT# SEAT AIRBAG RESTR. EJECT ' HELMET INJURY NATURE OF INJURIES
[:]WITNESS❑✓ POS. USE CLASS
NAME
(LAST,FIRST,MIDDLE INITIAL) ' HART BRYAN D
ADDRESS&PHONE# D B B -
10900 NE 8TH ST STE 1000#13 BELLEVUE WA 98004 2067990302 M MMDovvvv
PASSENGER []WITNESS UNIT# : SEAT AIRBAG RESTR. EJECT HELMET NJURY
POS. NATURE OF INJURIES
USE CLASS
NAME
(LAST FIR57 MIDDLE INITIAL)
AppRESS&PHONE#
SEX D.O.B.MMDD -❑
YYYY.
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.
D.LAMOTHE 12-22-22 10:27 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
J.CHRISTIANSEN 10437 1 12/31/2022 7:03:19 PM
BADGE OR ID# 11677 OR]#' WA0171300 TIME POLICE DISPATCHED 6:18 PM TIME POLICE ARRIVED',6:27 PM
PART I PAGE 2�OF❑
REPORT NO. ED20662 CASE# 22-13579 OF COLLISION
12/22/22 18:16
OF CbLLI510N
NARRATIVE
On the above listed date and time, I was dispatched to a collision that occurred in the 800 block of
SW 43rd St, in the City of Renton, County of King, State of Washington.
I arrived on scene and observed Vehicle #1 in the Mor parking lot sitting diagonally across the
entrance. There were tire tracks that lead from SW 43rd St that went over the sidewalk and through
the grass in the Mor parking lot to Vehicle #1. 1 observed Vehicle two resting diagonally across the
eastbound lanes of SW 43rd St with heavy front end damage.
I checked on Driver#2 who stated his right arm was injured and he was unable to move it. I had
dispatch start Renton Fire Department to evaluate the driver. I checked on Driver#1, who only
speaks spanish, who stated via translation app that he was shaken up but not injured. Driver#2 was
evaluated and decided to have a friend drive him to the hospital.
I then spoke to Driver#2 who stated he was traveling straight eastbound in the #1 lane (closest to the
curb) when Vehicle #1 entered his lane in front of him. He stated that he did not know where Vehicle
#1 came from, but his vehicle impacted the front passenger side of Vehicle #1.
Officer Adam informed me that he had spoke to Witness #1 who stated that they were driving directly
behind Vehicle #2. Witness #1 observed Vehicle #1 passing Vehicle #2 in the #2 lane and then enter
into the center turn lane. When Vehcle #1 entered the center turn lane, it lost control on a patch of ice
and spun towards the curb and slid in front of Vehicle #2 causing Vehicle #2 to collide with Vehicle
#1. Witness #1 stated Vehicle #1 was driving too fast and was passing Vehicle #2.
1 then spoke to Driver#1 via the language line translation app. Driver#1 stated he was traveling
eastbound in the #2 lane and he did not know what happened but he ended up in lane #1.
I returned to my vehicle to prepare the change of information paperwork. I then provided both parties
with an exchange of information form. When I returned to Driver#1, he now had a friend with him that
spoke english and translated our conversation. Driver#1 stated now that Vehicle #2 had entered his
lane and hit his vehicle, causing him to lose control. I explained that I had spoken to all involved
parties and observed the damage and stated that this did not appear to be possible.
Vehicle #1 had impact damage to the front passenger quarter panel and damage to the front
passenger wheel. The damage to the wheel was likely from Vehicle #1 striking the curbs in the
parking lot. Vehicle #2 only had damage to the front of the vehicle. If Vehicle #2 had entered lane #2
and struck Vehicle #1, Vehicle #2 would have had damage to the front passenger side bumper corner
and quarter panel. Based on the impact damage, it is clear that Vehicle #2 impacted Vehicle #1 head
on. By the fact that Vehicle #1 had driven over the curb bordering lane #1 and then continued 100-
200 feet through the grass in the Mor parking lot and over a second curb, Vehicle #1 would have to
have been traveling south/south east at the time of the impact.
By operating a motor vehicle at a speed too fast for the icy conditions, which caused him to lose
control on an ice patch and cause a collision, Driver#1 was issued a citation for Driving Too Fast For
Conditions.
Driver#1 stated he did not have a driver's license. A WADOL record check on his name also listed
that he did not have a license and there was no WADOL ID photograph assigned. Driver#1 had no
government issued identification, but provided an arrest form from US Immigration Services with
listed his name and a photograph. By operating a motor vehicle without a valid operator's license and
without valid identification, Driver#1 was issued a citation for No Valid Operator's License Without ID.
PAGE 3 OF 5
REPORT NO. ED20662 CASE# 22-13579 OF COLLISION
12/22/22 18:16
OF CbLLI510N
NARRATIVE
Driver#1 also had no insurance on his vehicle. He was issued a verbal warning for no insurance.
This concludes my involvement in this case.
PAGE 4 OF 5
REPORT NO. ED20662 CASE# ' 22-13579 DATE AND TIME 12/22/22 18:16
OF COLLISION
N ,
"Vehicle#1
M'ar Parking Lot(Grass)
Diagram Not To Scale
PAGE 5 OF 5