HomeMy WebLinkAbout23-525 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 6 27c
COLLISION REP FIT 1591971
❑ ❑ RESULTED ❑ CASE z3-szs 2
INTERSTATE CITY STREET FIRE
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHICI F ❑ LOCAL AOENC 4200 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 3 TOTAL#OF OBJECT 1 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 - 1-- 2023 2216 17 ❑-= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
NE
BLOCK NO.
MONROE AVE e✓ --- ----� ❑
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ �,❑ FEET e S ❑ We NE7THST
0 1 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
✓NO D:5092081658 0 11
30
6❑ LAST NAME WILLIARMS FIRSTNAME JANIQUA MIDDLE 1 2 31
INITIAL
STREET ❑ 1317 EDMONDS AVE NE APT 8 CITY RENTON ST WA ZIP 98056 2
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
iNTERLOCKYEs NO 1/ INTERLOCKYEs NO�/ YES R No�/
8❑ LDRIVER # STATE WA SEX'U MID
-O B 04 1— 29 — 1999 2 32
9 ON DUTY❑ STATUS AIRBAG 3 RESTR 4 EJECT 1 H USE 2 1 CLASS NATURE OF INJURIES 2❑
3
10 2❑ P1 ATE 14 CFG0897 STATE WA v N# KNDJT2A23A7045353
-- TRAILER STATE TRAILER STATE
11 0 0 PLATE# PLATE# FROM ro
TRLR. A'RLR. 1 5 33
12 0 0 VIN#' VIN#
:: FROM TO
VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN T /g[ GOVT.VEHICLE 3 7 34
13 2010 KIA SOUL DAMAGE YES NO � '` RS YES❑ No✓
REGISTERED OWNER INFO JANIQUA WILLIARMS 1317 EDMONDS AVE NE APT 8 RENTON WA 98056 D:5092081658 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
14 ABILI V INSURANCE INSURANCE CO GENERAL WA9898900 3 4
IN EFFECT &POLICY# 9TOP
VEHCLE CHARGE 5 36
LEGALLY YES❑NO❑ CITATION# 3AO113488 FAIL STOP AT STOP o eorrom
15❑ NDING 6
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT VEHICLE ❑ CYCLE ❑ ❑ : OWNER ❑ YES 1/ NO D:2064879549
16 a
LAST NAME MORALES COTO 77771 FIRST NAME EVELIN MIDDLE
INITIAL
17 STREET❑ NEW ADORE57 677 HARRINGTON AVE NE CITY RENTON ST WA ZIP 98056 4❑ 37
18❑ CDL IGNITION REQUIRED IGNITION PtR—E—S1ENT MEDICAL—T�RANSPORTED � 38
INTERLOCKYES�NO� INTERLOCK YEs I I NOF YES t l NOF,/
19 DRIVERS
❑ ON DUTY STATUS AIRBAG 3 RESTR 4 EJECT 1 H U EET 2 NJAU EY 1 NATURE OF INJURIES ❑ 40
LICENSE I ❑21❑ PLA E# BZY6614 TATE 41
WA VIN# JF1GE61659H511441 1
42
22❑ PLATE# STATE PLATE# STATE
T
23❑ VIN 43
IN##. IN RLR
' #.
VEH YEAR 2009 MAKE SUBA MODEL ►MPREZA STYLE I VEHICLE TOWED TO BLIN TOWEDBY GOV HI 44
24❑ DAMAGE YES NO BANKERS YES NO
REGISTERED OWNER INFO EVELIN MORALES COTO 677 HARRINGTON AVE NE RENTON WA 980563735 D:2064879549 VEHICLE NO.2
SHADE DAGED AREA
4
INAEFFIECTTY NSURANCE❑ &POINSULICY#E CO 9TOP 5
Le L,,ALLY YES❑ N J CE] CITATION# CHARGE to BOTTOM
LEGA
25 e
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
J
26
JAKE GALL 12617 WA0171300
PAGE 01 OF
PART A
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. ED32891
COLLISION REPORT III III III III III 111
1591972 CASE# 23-525
ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY)
NAME MIDDLE INITIAL) BARJAS BEOTRAN DIEGO
(IAST FIRST,
ADDRESS&PHONE# D O.B. '
UNK RENTON WA 98056 SEX M MMDOYyry 05 - 24 - 2007
PASSENGER I�I WITNESS❑'UNIT# 2 SE 3 AIRBAG 3 RESTR. q EJECT ? 1 HELMET INJURY NATURE OF INJURIES
L`!1 USE 1 2 1 CLASS ;1
NAME
(LAST,FIRST,MIDDLE INITIAL)
ADDRESS&PHONE# DOB
SEX MMDDYI'YY
PASSENGER ❑WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET NJURY 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.
JAKE GALL 01-14-23 12:24 AM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
C.TOLLIVER 10540 211112023 1:52:25 AM
BADGE OR ID# 12617 OR]#' WA0171300 TIME POLICE DISPATCHED 10:17 PM TIME POLICE ARRIVED]10:19 PM
PART I PAGE IT]OF 4�
REPORT NO. ED32891 CASE# 23-525 OF COLLISION
01/13/23 22:16
OF CbLLI510N
NARRATIVE
The following occurred within the City of Renton, King County WA and was recorded on my Body
Worn Camera.
On 01/13/2023 at around 2217 hours, I was dispatched to an unknown injury accident located at the
intersection of Monroe Ave NE and NE 7th St.
I arrived on scene and observed heavy damage to both vehicle 1 and vehicle 2 and blocking the
entire intersection.
I spoke with the driver and sole occupant of vehicle 1. She was able to provide me with all her
necessary documents. Driver 1 stated that it was all her fault. She said that she was traveling around
30 MPH South bound on Monroe Ave NE. Driver 1 said she did not see the 4-way stop sign at the
intersection of Monroe Ave NE and NE 7th St. Driver 1 made no attempt to stop and impacted
Vehicle 2. This caused heavy damage vehicle 1's front end.
It should be noted the weather was dark and rainy at the time of the collision.
I spoke with two occupants of vehicle 2. Driver 2 stated that she was on NE 7th St facing Westbound.
She stopped at the 4-way stop and proceeded to drive Westbound on NE 7th St through the
intersection. As she was halfway through the intersection, Vehicle 1 impacted vehicle 2 on the front
passenger quarter panel causing significant damage. Driver 2 provided her information but stated she
did not have insurance.
Both vehicle's airbags deployed. Aid was summoned to the scene. Driver 1 denied any medical aid.
Driver 2 and her passenger also denied any medical attention.
Banker's tow arrived on scene and took possession of both vehicles.
I confirmed with Driver 1 that her DOL address was correct. I informed her that she would be
receiving a infraction in the mail for failing to stop at the 4-way intersection. She understood and did
not have any questions.
I late completed infraction # 3A011348 for RCW: 46.61.190 (Failure to stop at intersection)
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 J. Gall/12617
01/13/23 at 1136 hours, Renton, Washington
PAGE 3 OF 4
REPORT NO. ED32891 CASE# ' 23-525 DATE AND TIME 01/13/23 22:16
OF COLLISION
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NE 7TH ST
`NOT TO SCALE'
PAGE 4 OF 4