HomeMy WebLinkAbout23-5513 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 5 27c
COLLISION REP FIT 1591971
CASE 23-5513 z
INTERSTATE ❑ CITY STREET FIRE ❑
RESULTED
1 STATE ROUTE OTHER STOLEN
❑ ❑ H F ❑ LOCAL AOENC 3
HIT IT&RUN � CODING
COUNTY RD PRIVATE WAY INVOLVED
2 TOTAL#OF OBJECT 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 05 - 16 - 2023 0600 17 ❑-= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
NE 4TH ST BLOCK NO. e
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ �.❑ FEET e S ❑ W e JEFFERSON AVE NE
0 4 29
UNIT MOTOR
Z PEDAL-
CYCLE ❑ YESAGE NHORE✓LD MET PHONE 30
6� LAST NAME UNKNOWN FIRSTNAME UNKNOWN MIDDLE 1 2 31
INITIAL
STREET CITY RENTON ST zIP z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
iNTERLOCKYEs NO INTERLOCK YES No YES No
8❑ DRIVERS
STATE SEX N1 MMDOOYY 32
9 ON DUTY❑ STATUS AIRBAG 9 RESTR 9 EJECT 1 HELMET USE 2 CLAY S:R0 NATURE OF INJURIES z❑
3
10 1❑ P1 ATNES# BfT8686 sTAT WA uN# JN16J1CR3HW134213
TRAILER STATE TRAILER STATE
11 0 0 PLATE# PLATE# FROM ro
TRLR. TRLR. 1 3 33
12❑ VIN# VIN#
FROM TO
❑ VEH.YEAR 2017 NISS ROGUE GA MAKE M DAMAGE YES NO YES[:] NO✓
ODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE 5 1 34
13 4
REGISTERED OWNER INFO ERIKNIBARGER 517KIRKLAND AVE NE RENTON WA 98056 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
14 LIABILI INSURANCE❑ INSURANCE CO 3 4
IN EFFECT &POLICY# 9TOP
LEECH 5 36
LEGALLY YES❑NO❑ CITATION# CHARGE 10 BOTTOM
15❑ NDING 8 6
MOTOR PEDAL- PEDESTRIAN ✓ PROPERTY DAM THR OLD MET PHONE
UNIT 02 VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES 1/ No D:4259194465
16 a
LAST NAME NOEL FIRST NAME NICHOLAS MIDDLE T
INITIAL
17❑ STREET ❑', 2307 NE 4TH ST G-201 CITY RENTON ST WA ZIP 98056 37
NEW ADDRESS ❑
18� CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 38
INTERLOCK YEs❑NOR INTERLOCK YEs❑NOF YES
❑NO❑
19[—] LICENSE# STATE WA SEX M M D.C.B. 12 _ 17 1980 El 39
20 ON DUTY❑ STATUS 3 AIRBAG RESTR EJECT WEB MEET 2 LASSYNATURE OF INJURIES
6 SCRAPE,LACERATIONS,BRUISES 40
❑21❑ LICENSE TATE VIN# 41
PLATE#
42
22❑ PLATE# STATE PLATE# STATE
TRLR
23❑ VIN#. IN#. 43
RLR
'
VEH YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN
TOWED BY Gov HI 44
24 1 9 DAMAGE YES NO YES NO
REGISTERED OWNER INFO VEHICLE NO.2
SHADE IN DAMAGED AREA
2 3 4
INAEFFIECTTY NSURANCE❑ &POINSULICY#E CO I 9TOP 5
VEHICLE ❑ ,.I—I CITATION# CHARGE i o BOTTOM
LEGALLY YES N
25 s e
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
J
26
ROSEANNE HYNES 12612 WA0171300
PAGE 01 OF
PART A
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. ED61818
COLLISION REPORT III III III III III 111
1591972 CASE# 23-5513
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
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.
ROSEANNE HYNES 05-19-23 06:50 AM
NVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
D.SKELTON 9139 512012023 4:09:09 AM
BADGE OR ID# 12612 ORI# WA0171300 TIME POLICE DISPATCHED 6:14 AM TIME POLICE ARRIVED i 6:14 AM
PART I PAGE IT]OF 4�
REPORT NO. ED61818 CASE# 23-5513 OF COLLISION
05/16/23 06:00
OF CbLLI510N
NARRATIVE
On 05/16/2023 at 0614 hours, I was in full patrol uniform and driving a marked Renton Police patrol
vehicle when I responded to NE 4th St & Jefferson Ave NE in the city of Renton, County of King,
State of Washington regarding an accident report. The caller requested contact by telephone.
I called Victim Nicholas T. Noel and he told me in summary: He was walking on the southeast corner
of the intersection of NE 4th St & Jefferson Ave NE when he began crossing the intersection at the
crosswalk (Google Maps does not show a crosswalk on this side of the roadway). He was crossing
north across NE 4th St toward Renton Technical College when V1 (Suspect Vehicle) drove south on
Jefferson Ave NE and made a left turn (east onto NE 4th St). Victim Noel said the front end of V1
struck the left side of his body, causing him to fall down to the ground. He received injury to his left
leg (scrape and bruising) and a scrape to his left elbow. The Suspect driver of V1 stopped and asked
him (Victim) if he was okay. Victim Noel told the Suspect driver that he needed to get his information.
The Suspect gave him a pen and paper to write the information down. The Suspect told Victim Noel
that he needed to get to work. Victim Noel said he wrote the Suspect's license plate down on the
paper. As he did so, the Suspect fled the scene and drove east on NE 4th St.
Victim Noel said the Suspect's license plate was WA BIT8686. A record check showed that WA LIC#
BIT8686 returned to a 2017 Nissan Rogue Sport that was registered to Erik D. Nibarger (DOB
03/06/1970) with address 517 Kirkland Ave NE, Renton, WA 98056. Victim Noel described the
Suspect vehicle as a smaller compact copper colored Toyota. Victim Noel described the driver as a
White/Hispanic male, tan complexion, 35-45 years of age and dressed in all white like a painter.
Victim Noel believed he could identify the Suspect if seen again. Victim Noel said he was not sure if
he wanted to press charges against the Suspect. He expressed that while he did not wish for this to
happen to anyone else, he did not wish to go through the court process. Victim Noel said he would
notify police if he wished to move forward in pursuing this case.
I have nothing further at this time.
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. Statements have been paraphrased and
summarized.
I certify (declare) under penalty of perjury under the laws of the State of Washington that the
foregoing is true and correct.
Electronically signed: R. Hynes #12612 Date & Place: 05/19/2023 @ 0645 hrs Renton, WA
PAGE 3 OF 4
REPORT NO. ED61818 CASE# 23-5513 DATE AND TIME 05/16/23 06:00
OF COLLISION
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PAGE 4 OF 4