HomeMy WebLinkAbout23-883 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 6 27c
COLLISION REP FIT 1591971
❑ ❑ FIRE RESULTED ❑ CASE 23-883 z
INTERSTATE CITY STREET FIRE
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHIC;I F ❑ LOCAL AOENC 4900 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 1 TOTAL#OF OBJECT 1 1 8 28
TRIBAL UNITS OZ STRUCK
RESERVATION
z
3❑ DArE of M M D D Y Y Y Y TIME(2400) COUNTY# MILES N E IN CITY# ❑
cowsloN 01 - 21 - 2023 0008 17 ❑.= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
N SOUTHPORT DR BLOCK NO. e✓ 1300
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ �,❑ FEET e S ❑ W e I405 SB
0 1 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
�/No D:2062934485 0 4 30
6� LAST NAME OJEDA-PACHECO FIRSTNAME ISMAEL MIDDLE 1 2 31
INITIAL
STREET ❑ 13708 12TH AVE SW APT 21 CITY BURIEN ST WA ZIP' 98166 z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
INTERLOCK YES[:]NO 1/ INTERLOCKYEs NO�/ YES 1/ NO
8❑ LRIIVERS STATE WA SEX'M MM DAY' 06 1— 17 — 1973 2 32
CENSE 9 ON DUTY❑ STATUS' AIRBAG 3 RESTR 4 EJECT 1 H U EELMET 2 CLASS 7 I INJURY [NATURE OF INJURIES
HEAD AND CHEST PAIN 2❑
3
10❑ P1 AT J4 BNW2065 STATE WA VIN# 2C4GP24323R242664
----� 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 T /g[AWk GOVT.VEHICLE 34
13 4 2003 CHRY TOWN VN DAMAG 3 5 E YES NO YES[:] No
REGISTERED OWNER INFO OWNEDBYDRIVER VEHICLE NO. 1
❑
SHADE IN DAMAGED AREA ❑ 35
14 ❑ INSURANCE CO <53 4
LIABILITY INSURANCEIN EFFECT &POLICV# TOPVEwcLE CHARGE TTOM 5 36
LEGALLY YES❑NO CITATION# 3A0064269,3A0064269, OP MOT VEH W/OUT INSURANCE,NO
15❑ STANDING 6
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT VEHICLE ❑ CYCLE ❑ OWNER ❑ YES 1/ NO D:2064273646
16 a
LAST NAME NGUYEN FIRST NAME BINH MIDDLE T
INITIAL
17❑ STREET NEW ADDREss❑' 3819 NE 23RD PL CITY RENTON ST WA ZIP 98056 4❑ 37
18❑ CDL IGNITION REQUIRED IGNITION PR—E-1SENT MEDICAL—T�RANSPORTED � 38
INTERLOCKYES�NO� INTERLOCK YEs It I NOF YES
t l NOF,/
19 F] DRIVER'S STATE WA SEX M D.Q.B. 03 �_ 17 1979 39
LICENSE# MMDDYY
20❑ ON DUTY STATUS AIRBAG 4 RESTR 4 EJECT 1 H U EET 2 NJAU EY 1 NATURE OF INJURIES 40
❑ILICENSE 21❑ PLA E# BND9087 TATE 41
WA VIN# 5TDYZ3DC8JS955190 1
42
22❑ PLATE# STATE PLATE# STATE
23❑ VIN#. 43
TRLR RLR
'IN#.
Gov HI
VEH YEAR 2018 MAKE 7'Dy7' MODEL SIENNA STYLE VN DAMAGE TO ✓WED N
24 OO BLIN TOWED BY 44
Yr
BANKERS YES No
❑ REGISTERED OWNER INFO OWNED SY DRIVER VEHICLE N0.2
SHADE DAGELLAREA
LIABILITY
INSURANCE INSU PORGY#E CO METLIFE 5192814130IN 5
VEwGLE ❑ ,J� CITATION# CHARGE GQ
LEGALLY YES N`L J
25 s � e
7HAL
S NAME(PRINT) OFFICER PHONE BADGE OR ID# JAGENCY
26
Y BRUS 11663 WA0171300
PART A PAGE 01 OF
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. ED31196
COLLISION REPORT III III III III III 111
1591972 CASE# 23-883
ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY)
NAME MIDDLE INITIAL) MCCULLOGH ELLSWORTH
(LAST FIRST,
ADDRESS&PHONE#
UNKNOWN 4252683120 SEX M MMDOYyry -�-
PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT ' HELMET INJURY NATURE OF INJURIES
❑ ❑✓ POS. USE CLASS
NAME
'(LAST,FIRST MIDDLE INITIAL)
ADDRESS&PHONE# DOB
SEXI MMDDYVYV
PASSENGER ❑WITNESS❑ UNIT# SEAT AIRBAG RESTR. EJECT HELMET NJURY NATURE OF INJURIES
POS. 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.
HALLEY BRUS 01-21-23 01:44 AM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
P.SUMMERS 8887 1 2/4/2023 4:17.38 PM
BADGE OR ID# ! 11663 ORI#' WA0171300 TIME POLICE DISPATCHED', 12:10 AM TIME POLICE ARRIVED',12:18 AM
PART I PAGE IT]0F 4�
TIME
REPORT NO. ED31196 CASE# 23-883 OF COLLISION01/21/23 00:08
NARRATIVE
Assignment:
On 1-21-23, 1 was working uniformed patrol in a marked Renton PD unit. At approximately 0010
hours, I was dispatched to investigate a traffic collision that occurred in the 1300 block of N Southport
Dr at the intersection of the 1405 SB On Ramp, in the City of Renton, County of King (WA).
Scene:
The 1300 block of N Southport Dr is a two-way east-west bound street with a westbound left turn lane
onto the 1405 SB on ramp.
Arrival:
Upon arrival, I saw a dark blue Toyota Sienna (WALic#BND9087, Unit#2) with heavy damage to the
passenger side. There was also a tan Chrysler Town and Country (WALic#BNW2065, Unit#1) with
heavy front-end damage. Both drivers were with their respective vehicles.
Statement of Binh Nguyen:
Nguyen (identified by WADL) was driving Unit#2 westbound in the 1300 block of N Southport Dr.
Nguyen stated he had a green left turn arrow, so he proceeded to turn left (southbound) onto the 1405
SB on ramp when Unit#1 drove through the intersection driving eastbound on N Southport Dr.
Unit#1 then collided with the passenger side of#2. Nguyen stated he was not injured and there were
no defects to the vehicle prior to this incident. Unit#2 had side air bags deployed. Fire assessed
Nguyen and determined he did not need further medical attention.
Statement of Ismael Ojeda-Pacheco:
Ojeda-Pacheco (identified by WADL) spoke only Spanish. Officer Catalan interpreted for the
interview. Ojeda-Pacheco stated he was going straight ahead, eastbound, on N Southport Dr through
the intersection with the 1405 SB on ramp when he collided with Unit#2. Ojeda-Pacheco stated he
had a green light.
A DOL records check of Ojeda-Pacheco showed his status as "Not Licensed -Eligible." Ojeda-
Pacheco stated he did not have auto insurance.
Ojeda-Pacheco complained of head and chest pain. Fire arrived on scene and advised he be
transported to the hospital. Ojeda-Pacheco was transported to the hospital via ambulance.
Statement of Ellmsworth McCullogh:
McCullogh stated he was a witness to the collision. McCullough stated he was driving behind Unit#1
and Unit#1 ran a red light, causing the collision.
Damage:
The damage on both vehicles on scene matched all statements.
Tow:
Bankers Towing company arrived on scene and towed both vehicles off location. I completed a
vehicle impound form for Unit#1 since Ojeda-Pacheco was transported to the hospital.
Summary:
Based on statements provided and the supporting physical evidence, I determined Ojeda-Pacheco
caused the collision by failing to yield the right of way to Unit#2 and stop at a red traffic light. 1 issued
Ojeda-Pacheco RPD Citation #3A0064269 for Operating a Motor Vehicle without Liability Insurance,
No Valid Operator's License with Valid ID, and Failure to Obey a Traffic Control Device.
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 H.Brus/11663 at 0142 hours on 1-21-23, in the City of Renton, WA.
PAGE 3 OF 4
REPORT NO. ED31196 CASE# ' 23-883 DATE AND TIME 01/21/23 00:08
OF COLLISION
i
�Soathpatt Rr
PAGE 4 OF 4