HomeMy WebLinkAbout23-2202 POLICETRAFF'c" III !�� I IIIllI111IN II II I REPORT NO. ED38471 170
27
COLLISION REP FIT 1591971
CASE 23-2202 z
INTERSTATE ❑ CITY STREET FIRE ❑RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHIr.I F ❑ LOCAL AOENC 4Y00 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❑ DATE OF M M D D Y Y Y Y TIME(2400) COUNTY# MILES N E IN CITY# ❑
cowsloN 02 - 1-- 2023 1349 17 ❑.= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓
PARK AVE N BLOCK NO. e✓ 1000
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ ❑ FEET e S ❑ W e Fill
1 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
,/No D:5307883900 0 11
30
6❑ LAST NAME VAZQUEZ FIRSTNAME LUIS MIDDLE E 1 1 2 31
INITIAL
STREET ❑, 1913 NE 21ST ST CITY RENTON ST WA Zlp' 980562615 z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
1/ I INTERLOCK YES[:]NO NTERLOCKYEs NO Z/ YES R No�/
8❑ LDRIVER # STATE WA SEX'M MID
LOB 12 1— 27 — 1986 1 2 32
9 ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 H USEET ICNLJAURY 1 NATURE OF INJURIES z❑
3
10 9❑ p7 ATE 14 BMV2546 STATE WA V N# JF2GTAMCOJH319483
TRAILER STATE TRAILER STATE
11 0 0 PLATE# PLATE# FROM TO
TRLR. TRLR 3 7 33
12 0 0 VIN#' VIN#
FROM TO
❑ VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE 5 1 34
13 4 2018 SUBA CROSST DAMAGE ves NO ves❑ No
REGISTERED OWNER INFO ..VAZQUEZ 1113 NE21STST RENTON WA 98056 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
14 LIABILITY INSURANCE INSURANCE CO USAA 02363 93 20G 7104 3 3 4
IN EFFECT &POLICY# 9TOP
VE—L' CHARGE 1 5 36
LEGALLY
Yes❑NO❑ CITATION# 10 BOTTOM
15❑ NDING 6
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT 02 VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES 1/ NO D:2067725477
16 a
LAST NAME BETEL FIRST NAME JEAN MIDDLE M
INITIAL
17❑ STREET ❑' 11717 62ND AVE S CITY SEATTLE ST WA ZIP 98178 37
NEW ADDRESS ❑
18� CDL IGNITION REQUIRED IGNITION PtR—E—S1ENT MEDICAL TRANSPORTED 38
INTERLOCKYES�NO� INTERLOCK YEs I I NOF YEs t l NOF,/
19 DRIVERS#
INJURY1 NATURE OF INJURIES 40
20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 USE CLASS ❑
21❑ LICENSE AJX5059 TATe WA VIN1i 3GNBACFU1BS608162
❑ 41
PLATE#
42
22❑ PILER LATE# STATE PLATE# STATE
23❑ UIN#. 43
TRLR RLR
'IN#.
VEH YEAR 2011 MAKE CHEV MODEL HHR STYLE VEHICLE TOWED TO BLIN TOWEDBY GOV HI 44
L4❑ DAMAGE YES NO,/ YES NO
REGISTERED OWNER INFO JACK RETEL 1171762ND AVE S SEATTLE WA 98178 VEHICLE NO.2
SHADE DAGELLAREA
LIABILITY
INSURANCE INSU&PORGY#E CO NATIONWIDE 7246JO36543IN 1GQI
VE"'LE ❑ ,J� CITATION# CHARGE
LEGALLY YES N`L J
25
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
J
26
S.MORR/S 2613 WA0171300
PART A PAGE 01 OF C7
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. ED38471
COLLISION REPORT III III III III III 111
1591972 CASE# 23-2202
ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY)
NAME MIDDLE INITIAL) VASQUEZ MARIA D
(LAST FIRST,
ADDRESS&PHONE# D O.B. '
1913 NE 21ST ST RENTON WA 980562615 5307883900 SEXi F MMDDYyrY 01 - 03 - 1987
PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT ' HELMET INJURY NATURE OF INJURIES
❑✓ ❑ 1 POS. 3 2 4 1 USE CLASS 1
NAME
(LAST,FIRST,MIDDLE INITIAL) VASQUEZ LUCAS
ADDRESS&PHONE# D O B 12 _ 15 _1913 NE 21 ST ST RENTON WA 980562615 SEX M MMDDYYYY 2018
SEAT HELMET INJURY NATURE OF INJURIES
PASSENGER WITNESS❑ UNIT# 1 POS 9 AIRBAG 2 RESTR. 10 EJECT 1 USE CLASS 1
NAME
(LAST FIRST,MIDDLE INITIAL) RETEL DUANE
AppREss&PHONE# 11717 62ND AVE S SEATTLE WA 9817H M 05 29 _ 1962
SEX. D.O.B. _
MMDDYYYY
PASSENGER WITNESS UNIT# ! 2 SEAT 3 AIRBAG 2 RESTR. 4 EJECT 1 HELMET NJURY 1 NATURE OF INJURIES
❑ POS. USE CLASS --- ----�
NARRATIVE'
On 02/23/2023 at 1408 hours I arrived in the 1000 block of Park Ave N in Renton Washington, King
County for a two car non injury accident.
Both drivers were identified by Washington State drivers licenses. U2 was confirmed via DOL photo
as she could not find her license. U1 had two passengers and U2 had one passenger. On one
complained of injury. Both vehicles were able to be driven away from the scene.
U2 was driving straight ahead but she was not sure exactly how the collision occurred. U1 told me he
was coming from a parked position and pulled out with his nose into the lane a little bit. He could see
no one was coming yet he could not just go because he was parked between two vehicles and he did
not have the room so he had to jockey back and forth to get room to pull out into the lane. As he did
this U2 was driving straight in her lane and the nose of U1 hit and scraped down the passenger side
of U2 causing moderate damage. U1 had minor damage to the front drivers side. In looking at U2
the damage was not in the front of the front bumper but started right at the front side area.
Since U1 was coming from a parked position, he did not have enough time distance and space to get
out into the lane of travel before the collision occurred. Due to this U1 is the proximate cause of this
collision.
I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT.
S.MORRIS 02-23-23 03:06 PM
NVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
S.MORRIS 2613 1 31112023 8:57.17 AM
BADGE OR ID# 2613 ORI# WA0171300 TIME POLICE DISPATCHED Y:02 PSI TIME POLICE ARRIVED Y:08 PM
PART I PAGE IT]OF 3�
REPORT NO. ED38471 CASE# ' 23-2202 DATE AND TIME 02/23/23 13:49
OF COLLISION
Z
Park Ave N
s
-f-
1000 Block
U1
U2
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