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COLLISION REP FIT 1591971
CASE 23-00075 z
INTERSTATE ❑ CITY STREET FIRE ❑RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHIC;I F ❑ LOCAL AOENC 4Y00 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# ❑
GawsloN 01 - 1-- 2023 0005 17 ❑.= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓
SE 168TH ST BLOCK NO. e✓ 12258
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
6❑ 300 00 FEET e S ❑ W e 123RDAVE
0 1 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
✓NO D:2063030762 1 4 30
6� LAST NAME KAIFOTO FIRSTNAME ANGALYN MIDDLE M 1 1 2 31
INITIAL
STREET 0113445 MARTIN LUTHER KING JR IN CITY SEATTLE ST WA ZIP 98178 z
NEW ADDRESS
]❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
✓ I iNTERLOCKYEs No NTERLOCKYEs NO✓ YES R No
8❑ LRIIVERS STATE WA SEX'F MID
.O B 01 - 21 - 2000 1 32
CENSE 9 ON DUTY❑ STATUS AIRBAG 3 RESTR 4 EJECT 1 HELMET U E 2 1 CLASS NATURE OF INJURIES z❑
3
10❑ PI ATE 14 BRU1258 JBTATIJ WA V N#' 1G1BC5SM3K7128023
TRAILER STATE TRAILER STATE
11 0 0 PLATE# PLATE# FROM ro
TRLR. TRLR, 3 7 33
12 0 0 VIN#' VIN#
FROM
34
13� VEH.YEAR2019 MAKE CHEV MODEL CRUZE STYLE 36 VEHICLE TOWEDNOOpLSABLIN TOyED.BLRS yOES❑ENO✓
HICLE
DAMAGE IILLJJII ttSSAA1IVV/it�66
REGISTERED OWNER INFO OWNEDBYDRIVER VEHICLE NO. 1
SHADE IN DAMAGED AREA ❑ 35
14❑ LIABILITY INSURANCE❑ INSURANCE CO <53 4
IN EFFECT &POLICY# TOPVEHICL CHARGE 36
LEGALLv YEs❑NO CITATION# 3AO072216 OP MOT VEH W/OUT INSURANCEorroM
15❑ �STA""
G 6
UNIT U2 VEHIMOTCCLE z CYCLE ❑ PEDESTRIAN ❑ OWNER ❑TY DYES✓ NO OLD MET PHONE
16❑
LAST NAME LE FIRST NAME BAN MIDDLE V
INITIAL
17❑ NEW STREETREs7 12220 SE 168TH ST CITY' RENTON ST WA ZIP 98058 37
18❑ CDL IGNITION REQUIRED IGNITION PtR-E-S1ENT MEDICAL-T�RANSPORTED ❑ 38
INTERLOCK YEs❑No� INTERLOCK YEs I I NOF YEs t l NOF,/
19 DRIVER # STATE WA SEX M M.C.B. 04 11 1982 39
HELMET INJURY NATURE OF INJURIES 40
20❑ ON DUTY STATUS' AIRBAG g RESTR 9 EJECT ''9 USE 9 CLASS 0 ❑
LICENSE I ❑21❑ PLA E# CBL5416 TAre 41
WA VIN# 1N46L21E37C177324 1
42
22❑ PLATE# STATE PLATE# STATE
23❑ VIN#. 43
TRLR RLR
'IN#.
TOWED BY Gov HI 44
VEH YEAR 2007 MAKE jy/$$ MODEL SQL)'/Nj�Q STYLE 4C —FEHICLE
TOWED✓ NOO BLIN BANKERS YES NO✓
24❑ REGISTERED OWNER INFO OWNED SY DRIVER VEHICLE N0.2
SHADE IN DAMAGEbAREA
2 3 Cd
LIABILITY
INSURANCE INSU PORGY#E CO NATIONWIDE 7246JO62160IN 1 9TOP
VE""LE ❑ N`L J
,J� CITATION# CHARGE
LEG
25 i o BOTTOM
ALLY YES $ '
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
J
26
N AAH G/RELLO 12607 WA0171300
PAGE 01 OF
PART A
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. ED23088
COLLISION REPORT III III III III III 111
1591972 CASE# 23-00075
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.
NOAH GIRELLO 01-03-23 02:40 AM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
G.BARFIELD 6476 1/9/2023 3:29:17 AM
BADGE OR ID# 12607 OR]# WA0171300 TIME POLICE DISPATCHED 4Y:08 AM TIME POLICE ARRIVED',12:14 AM
PART I PAGE IT]OF 4]
REPORT NO. ED23088 CASE# 23-00075 OF COLLISION
01/03/23 00:05
OF CbLLI510N
NARRATIVE
23-00075
At about 0010 hours on 1/3/2023 1 was dispatched an accident with unknown injuries at, 12258 SE
168th ST, in the city of Renton, King County, Washington. Dispatch advised me that this accident was
called in by an automated messaging system and the details of the accident were unknown.
Vehicle 1: 2019 Red Chevy Cruze (LIC/BRU1258) (VIN/1G1BC5SM3K7128023)
Registered owner/Driver: Angalyn M Kaifoto (DOB 01/21/2000)
Vehicle 2: 2007 Silver Nissan Altima (LIC/CBL5416) (VIN/1 N4BL21 E37C177324)
Registered owner: Ban Van Le (DOB 04/11/1982)
Upon my arrival I observed vehicle 1 on the sidewalk on the north side of SE 168th ST, while vehicle
2 was located just west of vehicle 1 on the shoulder. I first checked on the driver of vehicle 1. The
driver was grabbing items out of her vehicle and had no apparent injuries. Because of the nature of
the crash and there being airbag deployment, I called for the Renton Fire Department to do an
evaluation of the driver of vehicle 1. The driver of vehicle 1 was later cleared by Renton Fire. I then
went to go check on the driver of vehicle 2 when I realized that it was an unoccupied parked vehicle.
My initial observation of vehicle 1 is as follows: Vehicle 1 was up on the sidewalk on the north side of
SE 168TH ST, facing south. Vehicle 1 had severe damage to the front of the vehicle and had airbag
deployment. Due to the damage, the vehicle was left inoperable.
I then contacted the driver of vehicle 1. The following is what she explained happened. The driver of
vehicle 1 said she was leaving a family members house that was just around the corner. Vehicle 1
said she turned left from 123rd Ave SE and began traveling west on SE 168th ST. The driver of
vehicle 1 said shortly after she made that left turn, she lost control of the vehicle and slammed on the
accelerator. Vehicle 1 said she lost control and swerved into vehicle 2, that was parked on the
shoulder just in front of 12258 SE 168th ST. The driver of vehicle 1 said the reason she lost control of
her vehicle was because her tire pressure was low on the front passenger side tire.
My initial observation of vehicle 2 is as follows: Vehicle 2 was on the shoulder of SE 168th ST,
pushed forward about 10 yards from where it was originally parked. Vehicle 2 had severe damage
and was also left inoperable.
The owner of vehicle 2 was later contacted at his home which is also the location of this collision. The
owner of vehicle 2 did not see or hear the crash and he did not have any video footage of the
collision. There was also no other witnesses of this crash.
Based on the information above and my observations of the accident, I believe the distance between
123rd Ave SE and location of vehicle 2 at the point of collision was to close for vehicle 1 to generate
enough speed to cause the amount of damage that was caused. I believe vehicle 1 was the at fault
diver and the reason for this collision to be excessive speed and inattention.
Both vehicles required tows, and both were towed by Bankers Towing Company. The driver of vehicle
1 was cited for operating a motor vehicle without insurance. (Infraction #3A0072216)
This concludes my involvement with this case.
I declare under penalty of perjury under the laws of the State of Washington that the foregoing is true
and correct.
Electronically signed by N. GIRELLO #12607 on 1/3/2023 at 0200 hours Renton, WA
PAGE 3 OF 4
REPORT NO. ED23 8 RASE# 2y0 0 5 A m°M\ 013±23 0 95
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