HomeMy WebLinkAbout23-3993 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 1 27c
COLLISION REP FIT 1591971
CASE 23-3993 z
INTERSTATE ❑ CITY STREET FIRE ❑RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHICI F E: LOCAL AGENCI 4150 3
HIT&RUN ✓ CODING
COUNTY RD PRIVATE WAY INVOLVED
2 TOTAL#OF OBJECT 0 1 28
TRIBAL UNITS OZ STRUCK
RESERVATION
z
3❑ DATE of M M D D Y Y Y Y TIME(2400) COUNTY# MILES CITY# ❑
COLLISION.. 04 — 08 — 2023 2307 17 ❑.❑ N E IN S 8 W H OF e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION
108TH AVE SE BLOCK NO. e✓ 17500
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ 25 00 FMILES N EET e S B E e SEPETROVITSKYRD
0 1 29
UNIT
MMO tOR� Z PEDAL- ElDAMAGE THRESHOLD MET PHONE
01 CYCLE YES NO 30
6� LAST NAME UNKNOWN FIRSTNAME MIDDLE 1 1 2 31
INITIAL
STREET ❑ CITY ST zIP z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
iNTERLOCKYEs NO INTERLOCK YES NO YES No
DRIVERS
STATE SEX D - 328 LICENSE MMDYY❑
9 ON DUTY❑ STATUS I
AIRBAG 9 RESTR 9 EJECT 1 H USEEr 9 CLAY 0 NATURE OF INJURIES z❑
3
LICENSE sTATI urN#'
10[ PI ATE#
C7
TRAILER STATE TRAILER STATE
11 3 5 PLATE# PLATE# ROM ro
rRLR. TRLR. 5 1 33
12❑ VIN# VIN# fn
FROM TO
❑ VEH.YEAR MAKE MODEL STYLE UT VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE J 9 34
13 $ DAMAGE YES NO ✓ YES❑ NO✓
REGISTERED OWNER INFO (NEW] VEHICLE NO. 1
SHADE IN DAMAGED AREA ❑ 35
14 LABILI INSURANCE❑ NSURANCE CO 3 4
IN EFFECT &POLICY# 9TOP
VEwcLE 5 36
LECALLv Yes❑NO❑ CITATION# CHARGE 10 BOTTOM
15❑ STANDING 8 6
UNIT 02 VE IOOR ❑ CYCLE ❑ PEDESTRIAN ❑✓ OWNER
❑ DYES✓ NO�TFIRrI.LDMET PHONE
16 a
LAST NAME ROMO BOIZO FIRST NAME JOSE MIDDLE R
INITIAL
17 STREET I❑ 17020 108TH AVE SE CITY RENTON ST WA ZIP 98055 37
NEW ADOREss❑'
18❑ CDL IGNITION REQUIRED IGNITION PtR-E-S1ENT MEDICAL t—T�RANSPORTED � 38
INTERLOCKYES�NO� INTERLOCK YEs I I No� YES t l NO❑
19 DRIVE # STATE SEX M M D.C.B. 04 28 _ 1989 El 39
ON DUTY STATUS 3 AIRBAG RESTR EJECT HELMET 2 INJURY 5 NATURE of INJURIES 40
USE CLASS UNKNOWN
❑21❑ LICENSE TATE 41
VIN# `1
PLATE#
42
22 [TRAILER TILER
❑ PLATE# STATE PLATE# STATE
23❑ 43
TRLR RLR
VIN#. IN#.
VEH YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN
TOWED BY Gov HI 44
24 1 5 DAMAGE YES NO YES NO
REGISTERED OWNER INFO VEHICLE NO.2
SHADE IN DAMAGED AREA
2 3 4
INAEFFIECTTY NSURANCE❑ &POINSULICY#E CO 1 9TOP 5
VEHICLE ❑ C[:] CITATION# CHARGE i o BOTTOM
LEGALLY YES N
25
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
26
JASON JONES 11535 WA0171300
PAGE 01 OF
PART A
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT No. ED52145
COLLISION REPORT III III III III III 111
1591972 CASE# 23-3993
ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY)
NAME MIDDLE INITIAL) LASH RILEYN
(I.P.ST FIRST,
ADDRESS&PHONE#
6949 B/RDSEYE AVE NE,APT 411 OLYMP/A WA 98516 3603100120 SEXi F MMDDvyvv 12 - 12 - 1992
PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT ' HELMET INJURY NATURE OF INJURIES
❑ ❑✓ POS. USE CLASS
NAME
(LAST,FIRST,MIDDLE INITIAL) FRANKLIN// JOSEPH L
ADDRESS&PHONE# Ly O
13618 SE 272 CT KENT WA 98042 3605007488 SEX' M W11
20 _ 1978
PASSENGER UNIT# SEAT AIRBAG RESTR. EJECT HELMET INJURY NATURE OF INJURIES
[]WITNESS 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'
On 4-8-23 at about 2308 hours I was dispatched to just north of the intersection of 108th AVE SE and
SE Petrovitsky RD (17500 block of 108th AVE SE) for a vehicle and pedestrian collision.
Upon arrival I witnessed a male on the ground at the above located. The male, later identified as
Romo Boizo, Jose Reynaldo (DOB 4-28-89) using his WADL, was not responsive. Romo Boizo was
treated by fire and medics on scene and transported to Harbor View Medical Center for further
possibly life-threatening injuries. Further, a case of beer was located next to Romo Boizo indicating
he was most likely intoxicated.
I spoke with a witness, Riley N. Lash (DOB 12-12-92). Lash stated she was traveling north on 108th
AVE SE and observed Romo Boizo laying down in the right lane closest to the curb. Lash said a
black SUV (possibly a Toyota Rav4) drover over Romo Boizo and continued driving north without
stopping to check on Romo Boizo. Lash told me the vehicle was going about 10 MPH and she did not
observe the driver or know what the license plate was. Lash further told me the vehicle she is driving
is equipped with some sort of onboard camera and would contact PD if there was any footage of the
incident at a later date.
Lash provided a written statement.
The black SUV was not located or further identified.
Officer Paget contacted witness 2 and Officer Adam took pictures of the scene.
Officer Matsukawa also came to the scene and took measurements.
I spoke with Romo Boizo's family members Eduardo G. Oivares (DOB 7-12-06) and Boyso Franco,
Alejandro (DOB 4-10-71) and advised them what happened to Romo Boizo and where he was
transported to.
I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT.
JASON JONES O4-09-23 01:43 AM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
DESIREE SCOTT 10272 1 411712023 5:44:32 PM
BADGE OR ID# 11635 ORI#' WA0171300 TIME POLICE DISPATCHED; 11:08 PM TIME POLICE ARRIVED';11:09 PM
PART Ei PAGE 2�OF❑
REPORT NO. EU52145 CASE# 23-3083 DATE AND TIME 04/08/2323:07