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HomeMy WebLinkAbout23-5014 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 0 27c COLLISION REP FIT 1591971 CASE 23-5014 z INTERSTATE ❑ CITY STREET FIRE ❑RESULTED 1 STOLEN STATE ROUTE ❑ OTHER ❑ VFHIl.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 RESERVATION STRUCK z 3 DATE OF M M D D Y Y Y Y TIME(2400) COUNTY# MILES N E IN CITY# CowsloN 05 - 1-- 2023 2004 17 =.= S IN 1070 3 4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑ KIRKLAND AVE NE BLOCK NO. e✓ --- ----� 4a❑ MILEPOST DISTANCE OF(REFERENCE OR CROSS STREET) 5❑ FEET e S ❑ W e NE 14TH ST 0 4 29 MOTOR PEDAL- DAMETHRESHOLD MET PHONE UNIT 01 VEHICLE ❑ CYCLE ElYES AG�/No D:4253369810 0 1 30 6❑ LAST NAME SUT FIRSTNAME MIRIAM MIDDLE J 1 1 2 31 INITIAL STREET ❑, 3109 NE 14TH ST APT#3 CITY RENTON ST WA 2jp, 98056 z NEW ADDRESS 7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3 1/ I iNTERLOCKYEs NO NTERLOCKYEs NO Z/ YES R No�/ 8❑ LDRIVER # STATE WA SEX'F MID .O B 04 - 14 - 1997 1 2 32 9 ON DUTY❑ STATUS AIRBAG 6 RESTR 4 EJECT 1 HELMET USE 2 CLASS 1 NATURE OF INJURIES 2 3 10 9❑ P1 aTES� BYF5160 sTArI WAurN# 1FADP3K22GL363962 TRAILER STATE TRAILER STATE 11 0 0 PLATE# PLATE# FROM TO TRLR. TRLR. 3 5 33 12 0 0 VIN#' VIN# >; FROM TO ❑ VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN T v GOVT.VEHICLE 5 1 34 13 2 2016 FORD FOCUS HB DAMAGE YES NO � g MEYERS vEs❑ No REGISTEREDOWNERINFO OWNEDBYDRIVER VEHICLE NO. 1 SHADE IN DAMAGED AREA ❑ 35 14rI LIABILITY INSURANCE U INSURANCE CO STATE FARM 489 9229 D06 47A IN EFFECT &POLICY# 9TOP ve EFFECT CHARGE 1 5 36 LEGAL Lv YES❑NO❑ CITATION# 10 BOTTOM 15❑ STANDING 8 7 6 MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE 16 UNIT 02 VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES NO ,/ D:2063083698 a LAST NAME SANCHEZ FIRST NAME ARGENTINA MIDDLE M INITIAL 17 STREET❑ NEW ADDRESS❑' 1837 HARRINGTON AVE NE CITY RENTON ST WA ZIP 98056 4❑ 37 18❑ CDL IGNITION REQUIRED IGNITION PtR-E-S1ENT MEDICAL-T�RANSPORTED � 38 INTERLOCK YEs❑NO� INTERLOCK vEs I I NOF YEs t l NOF,/ 19 DRIVER'S STATE I TX ]SEX IF I D.C... 07 07 1993 39 LICENSE# MMDDYY 20❑ ON DUTY STATUS AIRBAG 1 RESTR 4 EJECT 1 H U EET 2 NJAU EY 1 NATURE OF INJURIES 40 ❑21❑ PLATE# CFD4965 TArE 41 WA VIN# 1GIPESSBSG7211345 1 42 22❑ PLATE# STATE PLATE# STATE 23 43 TRLR IN VIN#. 'IN#. GI VEH YEAR 2016 MAKE CHEV MODEL CRUZE STYLE $D DAMAGE TOWED NOO✓ BLIN TOWED By ov HyES NO 1/ 44 24 REGISTERED OWNER INFO OWNED SY DRIVER ES VEHICLE N0.2 SHADE IN DAMAGED AREA 2 3 4 LIABILITY INSURANCE &POINSURGY#E CO pROGRESSIVE 961864687IN STOP 5 VE—LE ❑ ,J� CITATION# CHARGE 25 ' a i o BOTTOM LEGALLY YES N`L J 7BRYAN NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY J 26GROZAV 12489 WA0171300 PAGE 01 OF PART A 3000-345-159 OR 11/181 STATE OF POLICETRAFFICN CORRECTION REPORT NO. ED57084 COLLISION REPORT III III III III III 111 1591972 CASE# 23-5014 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. BRYAN GROZAV 05-04-23 02:16 AM INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED APPROVED BY DATE D.MOYNIHAN 11288 5/4/2023 11:31:31 AM BADGE OR ID# 112489 ORI# WA0171300 TIME POLICE DISPATCHED 8:05 PM TIME POLICE ARRIVED:8:08 pry] PART B PAGE IT]OF 4� REPORT NO. ED57084 CASE# 23-5014 FC LNaoy L isI©�ON O 05/03/23 20:04 F cu NARRATIVE CASE 23-5014 This incident was captured on my body worn video camera. This report is a summary of events that occurred and is not an exact sequencing of events. On Wednesday May 3rd, 2023, at approximately 20:05, 1 responded to a 911 call regarding a two- vehicle collision in the area of Kirkland Ave Ne and Ne 14th St within the City limits of Renton, King County, Washington. *** CALL REMARKS: FROM LAT LONG, UNC 8...SIDE CRASH HAS OCC'D IN FORD VEH, AIRBAGS DEPLOYED, SEATBELT FASTENED, MAXIMUM SPEED CHANGE 9 MPH. 2 VEHS, SPOKE TO FEM INVLD IN FORD FOCUS, ADVSD AIRBAGS DEPLOYED IN HER VEH AND NI IN HER VEH. LINE DISC, VM ON CB. 2 MVA... RP SPEAKING TO INV PARTIES, N1... BLKING NB LANES. RP CB GOT DISCN..SMOKE COMING FROM AIRBAG.. STARTING TO HURT TO BREATHE..AID DECLINED. -UNIT ONE: GOLD 2016 FORD FOCUS WASHINGTON LICENSE: BYF5160 -UNIT ONE DRIVER: MIRIAM J. SUT (DOB: 04.14.1997) -UNIT TWO: SILVER 2016 CHEVROLET CRUZE WASHINGTON LICENSE: CFD4965 -UNIT TWO DRIVER: ARGENTINA M. SANCHEZ (DOB: 7.07.1993) 1 arrived on scene and contacted the involved parties and confirmed there were no injuries. Miriam said she was not injured but shaken up and did not need aid. Miriam reported she was attempting to take a left turn onto Kirkland Ave Ne to head south when she was hit by unit two. Miriam said she checked for traffic but couldn't see around the parked cars. Miriam's vehicle was later towed from the scene due to the damages. I contacted Argentina who said she was traveling north on Kirkland Ave Ne when unit one pulled in front of her causing the collision. Argentina was not injured and there were minor damages to her vehicle. I provided all involved parties a copy of the SECTOR exchange of information form This concludes my involvement in this case. 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 B. Grozav #12489 on 5.04.2023 at 02:15 hours in Renton, WA. PAGE 3 OF 4 REPORT NO. ED57084 CASE# 23-5014 DATE AND TIME 05/03/23 20:04 OF COLLISION NOT TO SACLE KIRKLAND AVE NE NE 14TH ST PAGE 4 OF 4