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HomeMy WebLinkAbout23-3444 ITFF' "POLCERA II I !�� I III I III I IIII III II I . $ 27c COLLISION REP FIT 1591971 CASE 23-3444 z INTERSTATE ❑ CITY STREET FIRE ❑RESULTED 1 STOLEN STATE ROUTE ❑ OTHER ❑ VFHIr.I F ❑ LOCAL AGENCI 4900 3 HIT&RUN CODING COUNTY RD PRIVATE WAY INVOLVED 2 TOTAL#OF OBJECT 28 $ RESERVATION 1 TRIBAL UNITS 02 STRUCK z 3❑ DATE of M M D D Y Y Y Y TIME(2400) COUNTY# MILES N E IN CITY# CowsloN 03 - 26 - 2023 1532 17 ❑-= S 8 IN e 1070 3 4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑ S 3RD ST BLOCK e✓ 500 ❑ 4a❑ MILEPOST DISTANCE OF(REFERENCE OR CROSS STREET) 5❑ ❑ FEET e S ❑ VV a MORR/S AVE S 0 1 29 MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE UNIT 01 VEHICLE ❑ CYCLE El ,/No D:2065125573 0 11 30 6❑ LAST NAME MONTALVAN FIRSTNAME RODRIGO MIDDLE D 1 2 31 INITIAL STREET ❑ 701 SW 5TH CT B307 CITY RENTON ST WA ZIP 98057 z NEW ADDRESS 7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3 INTERLOCK YES[:]NO 1/ INTERLOCKYEs NO�/ YES R No�/ 8❑ LDRIVER # STATE WA SEX'M MID -O B 10 1- 09 - 1969 2 32 9 ON DUTY❑ STATUS AIRBAG 6 RESTR I [NATURE OF INJURIES 4 EJECT 1 H U EET 2 1 INJURY CLASS ju BRUISE TO RIGHT FOREARM z❑ 3 10❑ P1 ATNES# CCt 5228 sTAr WAV N# JTEHH2OV410031476 TRAILER STATE TRAILER STATE 11 2 5 PLATE# I PLATE# I I FROM To TRLR. TRLR. 7 3 33 12 2 5 VIN#' VIN#I FROM TO VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE 1 $ 34 13 1 2001 TOYT RAV4 SV DAMAGE YES NO YES❑ No✓ REGISTEREDOWNERINFO OWNEDBYDRIVER VEHICLE NO. 1 SHADE IN DAMAGED AREA ❑ 35 14 LIABILI INSURANCE U INSURANCE CO PROGRESSIVE 957233378 3 4 IN EFFECT &POLICY# 9TOP VEHICLE 5 36 LEGALLv res❑NO❑ CITATION# CHARGE 1 o BOTTOM 15❑ STANDING 8 7 6 MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE 16 a UNIT 02 VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES 1/ NO D:2063841782 LAST NAME GASTELUM SERVIN FIRST NAME JOVAN MIDDLE INITIAL 17 STREET I❑ s❑' 310 WHITWORTH AVE S CITY' RENTON ST WA ZIP 98057 4❑ 37 NEW ADOREs 18❑ CDL IGNITION REQUIRED IGNITION PtR-E-S1ENT MEDICAL t-T�RANSPORTED � 38 INTERLOCKYES�NO� INTERLOCK YYEEsI I I NoF YES t l NO� 19 LICENSE# STATE WA SEX M M D.C.B. O6 �_ 24 _ 1992 39 20❑ ON DUTY STATUS AIRBAG 6 RESTR 4 EJECT 1 H U EET 2 NJAURSY 1 NATURE OF INJURIES ❑ 40 ❑ILICENSE 21❑ PLA E# BGU4812 TArE 41 WA VINI 1J4HASH136L615163 1 42 22❑ PLATILER E# STATE PLATE# STATE 23❑ 43 TRLR RLR VIN#. IN#. TOWED BY Gov HI 44 VEH YEAR 2011 MAKE JEEP MODEL WRANGL STYLE $P DAMAGE TOWED NOO✓ BLIN YES NO 1/ 24❑ REGISTERED OWNER INFO OWNED SY DRIVER VEHICLE N0.2 SHADE IN DAMAGEbAREA 2 3 Cd LIABILITY INSURANCE INSU PORGY#E CO FIRST NATIONAL H2331409IN Cal VE""LE ❑ ,J� CITATION# CHARGE LEGALLY YES N`L J 25 =ORAJEWSKI (PRINT) OFFICER PHONE BADGE OR ID# AGENCY J 26 12399 WA0171300 PART A PAGE 01 OF C7 3000-345-159 OR 11/181 STATE OF POLICETRAFFICN CORRECTION REPORT NO. ED45803 COLLISION REPORT III III III III III 111 1591972 CASE# 23-3444 ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY) NAME (/AST FIRST,MIDDLE INITIAL)_ ADDRESS&PHONE# SEX D.O.B. - - MMDDYYYY. PASSENGER❑WITNESS UNIT# SEAT AIRBAG RESTR. EJECT ' HELMET INJURY NATURE OF INJURIES POS. 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. RAYMOND GORAJEWSK/ 03-26-23 05:27 PM INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED APPROVED BY DATE J.TRADER 4553 312712023 2:07:05 AM BADGE OR ID# 12399 OR]# WA0171300 TIME POLICE DISPATCHED; 3:34 PM TIME POLICE ARRIVED 3:35 PM PART I PAGE IT]OF 5� REPORT NO. ED45803 CASE# 23-3444 OF COLLISION 03/26/23 15:32 OF CbLLI510N NARRATIVE ASSIGNMENT/ARRIVAL On 03/26/2023 at approximately 1534 hours, I was dispatched to a two-vehicle traffic collision at the intersection of S 3rd Street and Morris Avenue S in the city of Renton, King County, Washington. I arrived at approximately 1535 hours. UNIT 1: TOYOTA RAV4 Upon arrival I observed a white Toyota Rav4 (WA/ CCL5228, Unit 1) stopped in the intersection of S 3rd Street and Morris Avenue S, on all four wheels, facing southeast. Unit 1 had moderate front end damage to the front, passenger side. UNIT 2: JEEP WRANGLER I observed a black Jeep Wrangler (WA/ BGU4812, Unit 2) on the southeast corner of S 3rd Street and Morris Avenue S rolled on its driver side. Unit 2 nearly struck a City of Renton traffic signal. Unit 2 had moderate damage to the rear passenger wheel. DRIVER 1: MONTALVAN, RODRIGO D. I contacted Rodrigo D. Montalvan (DOB: 10/09/1969) sitting on the curb near Unit 2. 1 identified Montalvan by his valid Washington Driver License. I established Montalvan as the driver of Unit 1 by his admission. INJURIES: MONTALVAN, RODRIGO D. Montalvan had a large bruise to his right forearm. The Renton Fire Authority responded and evaluated Montalvan on scene. DRIVER 2: GASTELUM SERVIN, JOVAN I contacted Jovan Gastelum Servin (DOB: 06/24/1992) standing near Unit 2. 1 identified Gastelum Servin by his valid Washington Driver License. I established Gastelum Servin as the driver of Unit 2 by his admission. INJURIES: GASTELUM SERVIN, JOVAN Gastelum Servin's left elbow was red from the collision. The Renton Fire Authority responded and evaluated Gastelum Servin on scene. STATEMENT: MONTALVAN, RODRIGO D. I spoke with Montalvan about the collision. The following is a summary of our recorded conversation: Montalvan drove Unit 1 east on S 3rd Street in the number 1 lane (closest to south curb) toward Morris Avenue S at approximately 40 miles per hour. Montalvan believed the traffic signal was green, indicating for him to enter the intersection. As Unit 1 entered the intersection, Unit 2 drove south on Morris Avenue S into the intersection, colliding with Unit 1's front end. Montalvan was not sure the condition of the traffic signal, but "believed" it was green. This concluded my conversation with Montalvan. STATEMENT: GASTELUM SERVIN, JOVAN I spoke with Gastelum Servin about the collision. The following is a summary of our conversation: Gastelum Servin drove Unit 2 south on Morris Avenue S toward S 3rd Street at approximately 20 miles per hour. Gastelum Servin looked at the traffic signal and saw it was green, indicating for him to enter the intersection. As Unit 2 was in the intersection, Unit 1 entered the intersection from the west, driving eastbound on S 3rd Street. Gastelum Servin swerved Unit 2 to the left (east), but was unable to avoid a collision. Unit 1's front end collided with Unit 2's rear end, rolling the vehicle which came to rest on its driver side. PAGE 3 OF 5 REPORT NO. ED45803 CASE# 23-3444 OF COLLISION 03/26/23 15:32 OF CbLLI510N NARRATIVE Gastelum Servin had video of the collision from a dash camera mounted on Unit 2, but he was unable to access it at the time. This concluded my conversation with Gastelum Servin. PHOTOGRAPHS Officer J. Christiansen took photographs of the vehicles and the scene with her department issued cell phone and uploaded the photographs to Axon's Evidence.com. DISPOSITION I was unable to determine the condition of the traffic signal when the vehicles entered the intersection. Both vehicles were towed away at the owners' request. I gave both drivers an Exchange of Information form. This concluded my involvement in 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 Officer R. Gorajewski, #12399, on 03/26/2023 at 1726 hours in Renton, Washington. PAGE 4 OF 5 REPORT NO. ED45803 CASE# ' 23-3444 DATE AND TIME 03/26/23 15:32 OF COLLISION Morris Avenue S N Not to Scale S$rd Street PAGE 5 OF 5