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HomeMy WebLinkAbout23-12645 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 1 27c COLLISION REP FIT 1591971 CASE 23-12645 z INTERSTATE ❑ CITY STREET FIRE ❑RESULTED 1 STOLEN STATE ROUTE ❑ OTHER ❑ VFHICI F ❑ LOCAL AOENC 4250 3 HIT&RUN CODING' COUNTY RD PRIVATE WAY INVOLVED 2 TOTAL#OF OBJECT 1 28 TRIBAL UNITS . 02 STRUCK TREE OR STUMP RESERVATION z 3❑ DATE OF M M D D Y Y Y Y TIME(2400) COUNTY# MILES N E IN CITY# ❑ GawsloN 11 - 03 - 2023 0239 17 ❑.= S 8 IN e 1070 3 4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓ SE 192ND ST BLOCK NO. e✓ 10421 4a❑ MILEPOST DISTANCE OF(REFERENCE OR CROSS STREET) 5❑ ❑ FEET e S ❑ W e OF, 1 29 MOTUNIT VEHR Z PEDAL-ICLE CYCLE ElDYESA�NO GE THRESHOLD MET PHONE 30 6❑ LAST NAME UNKNOWN FIRSTNAME MIDDLE 1 2 31 INITIAL STREET ❑ CITY Sr 21P 2 NEW ADDRESS 7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3 iNTERLOCKYEs NO INTERLOCK YES NO YES No 8 DRIVER'S. STATE SEX.U D.Q.B. 1 32 ❑ :LICENSE# MMDDYY -= 9 ON DUTY❑ STATUS I AIRBAG 9 RESTR 9 EJECT 1 H USEEr 9 CLAY 0 NATURE OF INJURIES z❑ 3 10❑ P1 ATF 14 CDt 5288 JBTATIJ WA v N# 3N1AB7APXGY234281 TRAILER STATE TRAILER STATE 11 0 0 PLATE# PLATE# IR.. ro TRLR. TRLR 3 7 33 12❑ vIN#' UIN# Rom 34 13A VEH.YEAR2016 MAKE NISS MODEL SENTRA STYLE VEHICLETOWED0NOOffBLIN TSIgWgYMEYERS vOs❑ENo� DAMAGE IILLJJII (5�IV6 REGISTERED OWNER INFO THERESA AHLGREN 19235108THAVESEAPT 104 RENTON WA 98055 VEHICLE NO. 1 ❑ SHADE IN DAMAGED AREA 35 14❑ ABILIT INSURANCE❑ INSURANCE CO 3 4 IN EFFECT &POLICY# VE 9TOP HICLE CHARGE 5 36 LEGALLv res❑NO❑ CITATION# 10 BOTTOM 15❑ AN" 7 6 MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE 16 UNIT 02 VEHICLE ❑ CYCLE ❑ ❑ OWNFR ❑ YES NO ,/ D:2063727292 ❑ LAST NAME INGRAM FIRST NAME DAVID MIDDLE INITIAL 17❑ ST EETREs7 10421 SE 192ND ST CITY RENTON ST WA ZIP 98055 37 18❑ CDL IGNITION REQUIRED IGNITION PR-E-1SENT MEDICAL-T�RANSPORTED ❑ 38 INTERLOCKYES�NOR INTERLOCK YEs It I NOF YES t l NO❑ 19 LLIICENS # STATE SEX U MMDDYY -�_ 39 HELMET INJURY NATURE OF INJURIES 40 20❑ ON DUTY STATUS' AIRBAG RESTR EJECT USE CLASS ❑ ❑21❑ TATE 41 IN#LICENSE V 4 PLATE# 42 22❑ PLATE# STATE PLATE# STATE 23❑ 43 TRLR RLR UIN#. 'IN#. VEH YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY Gov HI 44 24❑ DAMAGE YES NO YES NO REGISTERED OWNER INFO VEHICLE NO.2 SHADE IN DAMAGED AREA 2 3 4 LIABILITY INSURANCE❑ INSURANCE #E CO IN EFFECT &PO IGQVE""LE ❑ ,J� CITATION# CHARGE LEGALLY YES N`L J 25 OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# 777T�NCY 26 N AAH GIRELLO 12607 0171300 PART A PAGE 01 OF 3000-345-159 OR 11/181 STATE OF POLICETRAFFICN CORRECTION REPORT NO. EE37965 COLLISION REPORT III III III III III 111 1591972 CASE# 23-12645 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. NOAH GIRELLO 11-03-23 03:58 AM INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED APPROVED BY DATE J.THiELMAN 11462 1/7/2024 3:39:38 AM BADGE OR ID# 12607 ORI# WA0171300 TIME POLICE DISPATCHED; 2:39 AM TIME POLICE ARRIVED',2:46 AM PART B PAGE IT]OF 4] AND REPORT NO. EE37965 CASE# 23-12645 DATE dF coyL� aE 11/03/23 02:39 LISIO isi©�u NARRATIVE 23-12645 At about 0239 hours on 11/03/2023 1 was dispatched to an unknown injury accident at, Springbrook Church of Christ 10421 SE 192ND ST, in the city of Renton, King County, Washington. Dispatch advised me that a passerby saw a 1 motor vehicle accident into the front yard of the above location and the passerby did not see anyone in or around the vehicle and was unsure how long the vehicle had been there. Vehicle information: White 2016 Nissan Sentra (WALIC/CDL5288) (VIN/3N1AB7APXGY234281). Upon my arrival I located the vehicle unoccupied off the roadway and into a tree in the front yard of the call location. The vehicle hit the tree head on, uprooting the tree and causing severe damage to the front end of the vehicle. The vehicle had airbag deployment on the front and passenger side and the keys were still in the ignition with no obvious sings of the vehicle being stolen. The vehicle was cold to the touch around what was left of the engine, implying that it may have been there for a while. Based on my observations of the scene, it would appear that the vehicle was traveling west bound on SE 192nd ST and veered off the roadway into the front yard of the church. There were obvious tire marks in the grass leading up to the tree confirming the facts above. There were no other vehicles involved in the accident and the only damage to the property was to the tree. The driver of the vehicle was nowhere to be found and I was also unable to reach anyone regarding the church. The vehicle was impounded by Gene Meyers Towing and 1 left a business card with a case number at the front door of the church. There are no further details due to the involved being GOA and there being no witnesses to the accident. I did not observe any video cameras at the church or any other cameras in that area. This concludes my involvement with 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 N. GIRELLO #12607 on 11/03/2023 at 0400 Renton, WA PAGE 3 OF 4 REPORT NO. EE37965 CASE# 23-12645 DATE AND TIME 11/03/2302:39 OF COLLISION 1 sy' NEM== SE 192ND ST PAGE 4 OF 4