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Home My WebLink About23-6254 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 6 27c COLLISION REP FIT 1591971 CASE 23-6254 z INTERSTATE ❑ CITY STREET FIRE ❑ RESULTED 1 STOLEN STATE ROUTE ❑ OTHER ❑ VFHICI F ❑ LOCAL AGENCI 4Y00 3 HIT&RUN CODING COUNTY RD PRIVATE WAY INVOLVED 2 TOTAL#OF OBJECT 1 28 TRIBAL UNITS 03 STRUCK' FENCE RESERVATION z 3❑ DATE OF M M D D Y Y Y Y TIME(2400) COUNTY# MILES N E IN CITY# ❑ CowsloN 06 - 1-- 2023 0617 17 ❑.= S 8 IN e 1070 3 4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓ SE PETROVITSKY RD BLOCK NO. e✓ 12711 4a❑ MILEPOST DISTANCE OF(REFERENCE OR CROSS STREET) 5❑ 150 00 FEET MILES e S ❑ W e 128THAVESE 0 1 29 MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE UNIT 01 VEHICLE ❑ CYCLE El ,/No D:2537338723 30 6� LAST NAME TORRES FIRSTNAME ELENA MIDDLE / 1 2 31 INITIAL STREET ❑ 12210 SE PETROVITSKY RD#K202 CITY RENTON ST WA Zjp, 98058 z NEW ADDRESS 7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3 INTERLOCK YES[:]NO 1/ INTERLOCKYEs NO�/ YES R No�/ 8 LRIIVER # STATE SEX'F MI 10 - 30 - 2007 32 ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 HELMET USE 2 CLAY 1 NATURE OF INJURIES z❑ 3 10❑ Pi aT�S� BUC7739 sTArI WAvrN# 1HGCG5647WA017690 5 TRAILER STATE TRAILER STATE 11 3 5 PLATE# PLATE# FROM TO TRLR. TRLR 7 3 33 12❑ VIN#j UIN# 1998 HOND ACCOR P4 I FROM 34 ❑ VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO u BLIN TOWED BY GOVT.VEHICLE 13 4 DAMAGE YES �/ NO YES[:] NO REGISTERED OWNER INFO pRANCISCO MORGA DOMINGUEZ 17033116TH AVE SE RENTON WA 98058 D:2067518765 VEHICLE NO. 1 ❑ SHADE IN DAMAGED AREA 35 14❑ LIABILIT INSURANCE❑ INSURANCE CO 3 IN EFFECT &POLICY# 912P VEI" CHARGE 36 LEGALLY res❑NO❑ CITATION# 1 o BOTTOM 15❑ STANDING MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE UNIT VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES 1/ NO D:2062182998 16❑ LAST NAME CABRERA FIRST NAME ROLANDA MIDDLE INITIAL 17❑ STREET ❑', 22307 132ND AVE SE CITY' KENT ST WA ZIP 98031 37 NEW ADDRESS ❑ 18� CDL IGNITION REQUIRED IGNITION PR—E-1SENT MEDICAL TRANSPORTED 38 INTERLOCKYES�NOR INTERLOCK YEs It I NOF YES t t— l NO❑ 19 DRIVE # INJURY NATURE OF INJURIES 40 20❑ ON DUTY STATUS' AIRBAG RESTR EJECT USE CLASS ❑ ❑21❑ TArE LICENSE vIN# 41 PLATE# 42 22❑ PR TRAILER LATE# STATE PLATE# STATE 23❑ 43 TRLR RLR UIN#. 'IN#. VEH YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWEDBY Gov HI 44 L4❑ DAMAGE YES NO YES NO REGISTERED OWNER INFO VEHICLE NO.2 SHADE IN DAMAGED AREA 2 3 4 INAEFFIECTTY NSURANCE❑ &POINSULICY#E CO IGQ VEHICLE ❑ C[:] CITATION# CHARGE LEGALLY YES N`LJ 25 s � e OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY IQU/NT TIBEAU 07691 WA0171300 26 PART A PAGE 01 OF C7 3000-345-159 OR 11/181 STATE OF POLICETRAFFICN CORRECTION REPORT NO. ED66531 COLLISION REPORT III III III III III 111 1591972 CASE# 23-6254 ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY) NAME MIDDLE INITIAL) STRUBLE LEANNE R (I.P.ST FIRST, ADDRESS&PHONE# D O.B. ' 17634 143RD AVE SE,APT C106 RENTON WA 98058 2065504732 SEXi F MMDOYyry 03 - 09 - 1967 PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT ' HELMET INJURY NATURE OF INJURIES ❑✓ POS. USE CLASS NAME (LAST,FIRST,MIDDLE INITIAL) ADDRESS&PHONE# DOB SEX MMDDYYYY PASSENGER ❑WITNESS UNIT# SEAT I AIRBAG RESTR. EJECT HELMET NJURY 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. QUINT TIBEAU 06-02-23 03:11 PM INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED APPROVED BY E DAT D.SKELTON 9139 6/3/2023 8:05:14 AM BADGE OR ID# 07691 OR]# ! WA0171300 TIME POLICE DISPATCHED 6:19 AM TIME POLICE ARRIVED',6:26 AM PART I PAGE IT]OF 5� REPORT NO. ED66531 CASE# 23-6254 OF COLLISION 06/02/23 06:17 OF CbLLI510N NARRATIVE 23-6254 Narrative The following occurred in the City of Renton, County of King, State of Washington. On 06/02/2023 at about 0819 hours I was dispatched to a single vehicle collision near SE Petrovitsky RD and 128th Ave SE. I located the collision in the front yard of 12711 SE Petrovitsky RD. The vehicle was a silver Honda Accord, WA license (BUC7739). It was sitting on its roof in the yard about 9 feet below street level. The driver was already out of the vehicle and sitting on the side of the house. She stated that she was the driver and sole occupant. She identified herself verbally as Elena I Torres (10/30/2007) and stated that she was not injured. She later complained of neck pain. Torres stated that she does not have a driver license and did not have an identification card either. She told me that the vehicle belongs to her father. She was not supposed to drive it, but she missed the bus and was late to school. While she was driving in lane #2 she tried pushing the brake. She believes that she accidentally hit the gas instead. She lost control of the vehicle when the backend came around. She then drove off of the roadway, striking the fence and rolling the vehicle over. I could see that the vehicle broke several lawn chairs, a table, and a BBQ as well as the chain-link fence it went through. Witness Struble stated that she was driving behind Torres, who was not speeding at the time. Then suddenly the vehicle began to fish-tail and drove off the roadway. When Torres' father Victor Marin Mejia showed up Torres explained that the vehicle actually belonged to her father's girlfriend, who she called mom. When she arrived, she identified herself as Dania Noyola-Camacho, and stated that the vehicle actually belonged to her cousin. They did not have insurance on the vehicle. This incident was captured on my Axon 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. Nothing further at this time. 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 Q. Tibeau 06/02/23 0957 hours, Renton, WA. PAGE 3 OF 5 SUPPLEMENTAL REPORT No. ED66531 r`) POLICE TRAFFIC 1 27 COLLISION REPORT CASE# 23-6254 1 COMMERCIAL MOTOR CARRIER INTERSTATE INTRASTATE G UNIT'# USDOT ICC# VEHICLE TYPE CARGO BODY ;TYPE 2 ❑ 1 28 CARRIER NAME 3 CARRIER ADDRESS ` CITY ST ZIP—1 I ' 4 ❑ NAME # PLACARD: :❑ GI PLACARD IF NO NUMBER SOURCE AXLES + 4a ❑ ADDITIONAL UNITS MOTOR PEDAL- PROPERTY DAMAGE THRESHOLD MET PHONE 5 ❑ UNIT# 3 VEHICLE I_J CYCLE _) PEDESTRIAN � OWNER � YES NO D:2064687829 MIDDLE.. 29 LAST NAME MOREIRA FIRST NAME JUAN INITIAL M STREET 30 NEW AnDRFSP' 12711 SE PETROVITSKY RD CITY RENTON ST WA ZIP 98058 6 CDL IGNITIttN REQUIRED IGNITION PRESENT MEDICAL TANSPORTED 1 31 INTERLOCK YEs No zERLOCK YES❑N0� YES N L DRIVER'S STATE SEX M M�DDYBYv 10 - 02 - 2004 LICENSE 7 F-ION DUTY STATUS AIRBAG RESTR. EJECT HELMET INJURY NATURE OF INJURIES F� USE CLASS 8 ❑ ' 1 32 LICENSE+ rar V1N.# PLATE# 9 TRAILER TRAILER PLATE# STATE PLATE# STATE 10 ❑ TRLR TRLR VIN.#. VIN.#. 11 VEH.YEAR MAKE I MODEL STYLE I VEHICLE TOWS E T SABLIN TOWED BY anvi vEHIC P FROM TO DAMAGE YES NO YES NO REGISTERED OWNER INFO. m 33 12 SHADE IN DAMAGED AREA FROM TO LIABILITY INSURANCE❑ INSURANCE CO IN EFFECT &POLICY# tGQ EHILLE 34 13 ❑ LEGALLY YES[:] NO❑ CITATION# CHARGE STANDING } 8 7 6 14 ❑ UNIT Tr Vd IRE O CYDCLE OWNERRTY YES AGE NOHRESHOLD MET PHONE ❑ 35 PEDESTRIAN 15 LAST NAME FIRST NAME MIDDLE': INITIAL ❑ 36 STREET 16 NEW AnnRFs.�' CITY'. ST ZIP CDL IGNITION REQUIRED IGNITION PRESENT MEDICALTANSPORTED INTERLOCK YES No INTERLOCK YEs NO YEs NO El 17 37 LICENSE# STATE SEX MMDDDYBYY 18 ❑ ON DUTY� STATUS AIRBAG RESTR. ; EJECT HELMET INJURY NATURE of INJURIES 38 USE (CLASS 19 ❑ vIN 39 LICENSE # PLATE# rnr 20 ❑ TRAILER' TRAILER ❑ 40 PLATE# STATE PLATE# STATE 21 ❑ TRLR TRLR 41 VIN# YIN#i 42 22 VEH.YEAR MAKE I MODEL STYLE I VEHICLE TO DUET SABLIN TOWED BY GOVT.VEHICLE DAMAGE YES NO YES NO 23 REGISTERED OWNER INFO_ SHADE IN DAMAGED AREA 43 3 4 71 LIABILITY INSURANCE INSURANCE CO ' VEHICLE EFFECT &POLICY# I 970P - 4 44 24 LEwGLE YES NO❑ CITATION# CHARGE iq 60TiOM E:l C=DLv STANDING 8 7 6 1 CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT. QUINT TIBEAU 06-02-23 03:11 PM 25 INVESTIGATING OFFICER'S SIGNATURE OFFICER'S PHONE UNIT OR DIST DET DATED: PLACE SIGNED APPROVED BY DATE 26 OR ID# 07691 O#IL WA0171300 SKELTON 6/3/2023 PAGE F OF 3000-345-013(R 11118) REPORT NO. ED66531 CASE# 23-6254 DATE AND TIME 06/02/23 06:17 OF COLLISION ti. ~ ..: k. PAGE 5 OF 5