HomeMy WebLinkAbout24-2033 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 0 27c
COLLISION REP FIT 1591971
❑ ❑ FIRE ❑ CASE## 24-2033 2 676
INTERSTATE CITY STREET RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHIC;I F ❑ LOCAL AOENC 4900 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 3 TOTAL#OF OBJECT 1 1 8 28
TRIBAL UNITS 03 STRUCK
RESERVATION
2
3❑ DATE OF M M D D Y Y Y Y TIME(2400) COUNTY# MILES N E IN CITY# ❑
COLLISION.. 02 - 1-— 2024 1653 17 ❑.= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓
S.CARR ROAD BLOCK NO. e✓ 611
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5 A❑ 750 00 FMILES EET e S ❑ E e TALBOT ROADS.
1 9 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
✓NO D:2064829100 0 11
30
LAST NAME FAUVET RODRIGUEZ FIRST NAME EDGAR MIDDLE
6 INITIAL 1 2 31
STREET ❑ 2162 NW FAR COUNTRY LN APT.202 CITY ISSAQUAH ST WA ZIP, 98027 II
2
NEW ADDRESS
]❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
iNTERLOCKYEs NO�/ INTERLOCK YES NoF,/I YES R No�/
8❑ LRIIVER #
ON DUTY❑ STATUS AIRBAG 6 RESTR 4 EJECT 1 H USE 2 1 CLASS NATURE OF INJURIES 2❑
3
10 9❑ P1 ATE 14 CDl7240 STATE WA JTLKE50E891073129
TRAILER STATE TRAILER STATE
11 3 5 PLATE# PLATE# FROM To
TRLR. TRLR 7 3 33
12 3 5 VIN#' VIN#
FROM TO
❑ VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TAW/g[ GOVT.VEHICLE 34
13 4 2009 TOYT SCION UT DAMAG 3 7 E YES NO TOWING YES❑ No✓
REGISTERED OWNER INFO OWNEDBYDRIVER VEHICLE NO. 1
SHADE IN DAMAGED AREA ❑ 35
<� 3 4
14 4 LIABILI INSURANCE❑ INSURANCE CO NONE NONE �p�q
IN EFFECT &POLICY# M'eTOP
VE"'CLE CHARGE BOTTOM 5 ❑ 36
15❑ LEGALLY YES❑NO❑ CITATION# 4g0014445,4A0014445, NO VALID OPER LICENSE W/OUT e
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
16
UNIT 02 VEHICLE ❑ CYCLE' ❑ ❑ OWNER ❑ YES 1/ NO D:2066173919
a
LAST NAME JONES FIRST NAME STEPHANIE MIDDLE IN
INITIAL
17❑ NEW STREETRE— 14815 SE 179TH ST APT.17F CITY' RENTON ST WA ZIP 98058 4❑ 37
18❑ CDL IGNITION REQUIRED IGNITION PtR-E-S1ENT MEDICAL-T�RANSPORTED � 38
INTERLOCK YEs❑No� INTERLOCK YEs I I NOF YES I'✓ NO❑
19 RRS LDI IVE STATE WA ]SEX IF M .C.B. 12 _ 15 _ 1983 39
20 ON DUTY STATUS AIRBAG,6 RESTR 4 EJECT 1 WEB SET 2 NJAURSY 5 BROKEN LEFT ARM/BROKEN LEFT WRIST F—NATURE OF INJURIES 40
❑ 41
21❑ LICENSE I PLA E# BFR7194 TATE WA VIN# 2TIBURHE1HC813639 1
42
22❑ PLATE# STATE PLATE# STATE
TRLR
23❑ VIN#. IN#. 43
RLR
'
Yr
N I BANKERS TOWING YES No
VEH YEAR 2017 MAKE 7'Dy7' MODEL CORO!! STYLE $D DAMAGE TO WED✓ OOBLIN TOWED BY Gov 44
H
24❑ REGISTERED OWNER INFO OWNED SY DRIVER VEHICLE N0.2
SHADEDAMAGEDAREA
3 4
LIABILITY
INSURANCE &POLICY#E CO GEICO UNKNOWN
IN 9TOP
VEHICLE YES N� CITATION# NONE CHARGE NIA GD BOTTOM
LecnLLY `LJ
25 OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# JAGENCY
26
J.CHRISTIANSEN 10437 WA0171300
PART A PAGE 01 OF
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EE53527
COLLISION REPORT III III III III III 111
1591972 CASE# 24-2033
ADDITIONAL PERSONS INVOLVED PASSENGERS AND/(OR WITNESSES ONLY)
NAME MIDDLE INITIAL) BALLENA SKYLARE M
(LAST FIRST,
ADDRESS&PHONE# D O.B.
14815 SE 179TH ST APT.17F RENTON WA 98058 SEXi F MMDOYyry 07 - 28 - 2020
PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT ' HELMET INJURY NATURE OF INJURIES
❑✓ ❑ 2 POS. 8 6 10 1 USE 2 1 CLASS 1
NAME
(LAST,FIRST,MIDDLE INITIAL)
ADDRESS&PHONE# D O B
sE MMDDYYYY
PASSENGER ❑WITNESS❑ UNIT# SEAT AIRBAG RESTR. EJECT HELMET NJURY NATURE OF INJURIES
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'
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.
J.CHRISTIANSEN 02-24-24 07:39 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
J.TRADER 4553 1 2/24/2024 8:11:44 PM
BADGE OR ID# 10437 OR]# WA0171300 TIME POLICE DISPATCHED 4:55 PM TIME POLICE ARRIVED',4:59 PM
PART I PAGE ❑OF❑
REPORT NO. EE53527 CASE# 24-2033 OF COLLISION
02/24/24 16:53
OF CbLLI510N
NARRATIVE
RENTON POLICE CASE #: 24-2033
RECORDED ON AXON
*Unit 01: Purple in color Toyota Scion bearing expired WA/CDL7240 (expired 07.14.2023) Vehicle
impounded by Bankers towing.
*Unit 01's driver: NO ID, NO VOL, No insurance, Suspended in the 3rd degree with driver restriction:
Financial responsibility. Identified via DOL photo and AFIS as FAUVET RODRIGUEZ, EDGAR
ISAAC (DOB: 08.06.1998). No obvious injuries.
*Unit 02: Gray in color Toyota Corolla bearing WA/BFR7194. Vehicle impounded by Bankers towing.
*Unit 02's driver: JONES, STEPHANIE NICOLE (DOB: 12.15.1983). Possible broken left arm and
broken left wrist-medically transported to Valley Medical Center.
*Unit 03: Light blue in color Lexus IS bearing WA/BTZ3929. Vehicle impounded by Bankers towing.
*Unit 03's driver: DUONG, KOBE JAYDEN (DOB: 09.17.2005): DRIVER HAD DASHCAM VIDEO OF
COLLISION which has been uploaded into Axon evidence.
*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. *
On 02.24.2024, at approximately 1656 hours, I was dispatched to a three-vehicle, blocking, unknown
if injury collision near Pacific Medical Center, located at 601 S. Carr Road, in the City of Renton, WA,
the County of King.
I was assigned to uniformed marked patrol in the City of Renton, WA, the County of King. I was
operating a fully marked Renton Police Tahoe #304, equipped with "POLICE" markings, overhead
exterior lights, and audible siren. I was wearing my department-issued uniform, including a fully
equipped duty belt, exterior ballistic vest with "POLICE" stenciled on the front and back and Renton
Police badge affixed to the left breast. I was also wearing my department-issued jumpsuit with
"POLICE" patches on both shoulders and across the rear shoulders. It would be immediately obvious
to any reasonable person I was a police officer. I was assigned as 302.
At the time of this collision, it was overcast and raining, the roadways were wet with standing water
and the temperature was approximately 44 degrees. It was daylight, no streetlights were illuminated.
I arrived on scene at approximately 1659 hours, and observed a significant collision, blocking both
east and west bound lanes of S. Carr Road. I updated dispatch and requested 3 tows for impound
and additional units for traffic control.
Unit 01 was identified as a Purple in color Toyota Scion bearing expired WA/CDL7240 (expired
07.14.2023) Unit 01 had substantial front end/body damage and was leaking fluids; further, Unit 01
was blocking eastbound lanes of traffic. The driver of Unit 01, who did not have any identification on
his person, did not have insurance for the vehicle and did not have the registration, was verbally
identified below. He did not have any apparent injuries.
Unit 01's driver was identified via DOL photo and AFIS as FAUVET RODRIGUEZ, EDGAR ISAAC
(DOB: 08.06.1998). FAUVET RODRIGUEZ could not provide a lot of information regarding what led
up to the collision, but he confirmed he was traveling eastbound on S. Carr Road, "up the hill," when
he collided with Unit 02, who was traveling `down the hill.' A WACIC/NCIC query on FAUVET
RODRIGUEZ returned with a driving status of suspended/revoked in the third degree and a driver
restriction for financial responsibility. FAUVET RODRIGUEZ did not have identification on his person,
did not have insurance for the vehicle, did not have the registration.
Unit 02 was identified as a Gray in color Toyota Corolla bearing WA/BFR7194. Unit 02 had extensive
damage to the front bumper/undercarriage, had a combination of airbag deployments and was
leaking fluids. Unit 02 was inoperable.
Unit 02's driver was identified by her WADL as JONES, STEPHANIE NICOLE (DOB: 12.15.1983).
Jones was trapped inside the vehicle as she collided with Unit 01, her vehicle rotated in the roadway,
and she had a secondary collision with Unit 03. Unit 02's driver side door was wedged against Unit
03's driver side door and Jones could not exit the vehicle. Further, Jones complained of significant
PAGE 3 OF 7
REPORT NO. EE53527 CASE# 24-2033 OF COLLISION
02/24/24 16:53
OF CbLLI510N
NARRATIVE
pain to her left arm, and she has a suspected left arm and left wrist fracture. Renton Fire Authority
arrived on scene and Jones was extricated from the vehicle and medically transported to Valley
Medical Center for further medical treatment. Jones young daughter, Skylare M. Ballena (DOB:
07.28.2020) was in the rear passenger seat behind the passenger, restrained in a child restraint seat.
Skylare had no apparent injury, but she was also transported to Valley Medical Center by her father,
who arrived on scene after the collision (Joebie -206/396-9786) and I suggested she was also
medically evaluated.
A WACIC/NCIC query on Jones revealed she was clear and valid.
Unit 03 was identified as a Light blue in color Lexus IS bearing WA/BTZ3929. Unit 03 had damage to
the driver's side body and passenger side body and was pinned between Unit 02's driver side and a
concrete barrier on the passenger side.
Unit 03's driver was identified by his WADL as DUONG, KOBE JAYDEN (DOB: 09.17.2005). Duong
was `shaken up' and was medically evaluated on scene. Duong stated he was traveling westbound
on S. Carr Road, occupying the right lane of travel and was approximately 10-15 feet behind Unit 02,
as she was traveling westbound on S. Carr Road, occupying the left lane of travel. Both vehicles
were traveling straight ahead when Unit 01's driver crossed over the center lane, into Unit 02's lane
and struck her in the front driver's side, causing Unit 02 to life and rotate in the roadway, pushing Unit
02 into Unit 03's lane and causing a secondary collision between Unit 02 and Unit 03.
Unit 03's driver, Duong had dash cam video in his vehicle that captured the collision. I reviewed the
video on scene, and it clearly shows Unit 01, for an unknown reason, cross over into oncoming lanes
of traffic and strike Unit 02, causing Unit 02 to life and rotate in the roadway, moving into Unit 03's
lane. Unit 03 did not have time to apply his brakes and he collided with Unit 02 in a secondary
collision. I sent Duong a link through Axon Evidence, and he submitted the collision dash cam under
this case number. I reviewed the collision footage again at approximately 1930 hours.
A WACIC/NCIC query on Duong revealed he was clear and valid.
Unit 01's driver, FAUVET RODRIGUEZ, EDGAR ISAAC (DOB: 08.06.1998), is the causing party in
the collision and was issued the following citations via SECTOR for the following violations:
Citation 4AO014445: Violation of RCW 46.20.005: NO VOL with No Identification and violation of
RCW 46.20.342.1.C: Driving While License Suspended in the 3rd Degree (CRIMINAL CITATION
WILL BE FORWARDED TO THE CITY OF RENTON PROSECUTING ATTORNEY'S OFFICE FOR
REVIEW).
Citation 4AO014446: Violation of RCW 46.61.400.1: Speed too fast for conditions; violation of RCW
46.30.020: Operating a motor vehicle without proof of insurance; violation of RCW 46.16A.030.5.0:
Fail to renew expired vehicle registration, greater than two months; and violation of RCW 46.20.041:
Violation of license restriction (Financial Responsibility).
All vehicles were impounded by Bankers towing.
Unit 02's driver, Jones was transported to Valley Medical Center with non-life-threatening, but
significant bodily injury (suspected broken arm and broken wrist).
I certify (or declare) under penalty of perjury under the laws of the State of Washington that the
foregoing is true and correct.
Electronically signed by Officer J. Christiansen #10437, on February 24, 2024, at approximately 1937
hours, in Renton, WA.
**** AUTO-POPULATED SECTION ****
THE FOLLOWING ARE DESCRIPTIONS ENTERED FOR ITEMS SELECTED AS "OTHER":
Location Character: CITY STREET
Motor Vehicle Unit 1
Action Code: CROSSED INTO ONCOMING LANES OF TRAFFIC
**** END OF AUTO-POPULATED SECTION ****
PAGE 4 OF 7
REPORT NO. EE53527 CASE# 24-2033 OF COLLISION
02/24/24 16:53
OF CbLLI510N
NARRATIVE
PAGE 5 OF 7
SUPPLEMENTAL REPORT NO. EE5535527
r`) POLICE TRAFFIC 1 1 8 27
COLLISION REPORT CASE# 24-2033
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 DAMAGETHRESHOLD MET PHONE
UNIT# 3 �✓ � PEDESTRIAN YEs NO
5 VEHICLE CYCLE OWNER ✓ D:2066653341
rF0 1 Zg
LAST NAME DUONG FIRST NAME KOBE MIDDLE' ''I J
INITIAL
STREET 30
NFW Anr)RFg 10216 E.WALTON CT CITY SPOKANE ST WA ZIP 99206
6 ❑ 1 1 2 31
CDL IGNITIttN REQUIRED IGNITION PRESENT MEDICAL TANSPORTED
INTERLOCK YEs NO✓ zERLOCK YEs❑N0 f✓ YEs N ✓
DRIVER'S
LICENSE STATE I WA SEX M MMDDYYv 09 - 17 - 2005
7
ON DUTY� STATUS AIRBAG' g RESTR. Q EJECT 1 HELMET 2 INJURY 1 NATURE OF INJURIES
USE CLASS
8 ❑ 1 32
LICENSE BTZ3929 [TAT WA VIN# JTHBF5C24C5168358
PLATE#
9 9] TRAILER TRAILER
PLATE# STATE PLATE# STATE
10 ❑ TRLR TRLR
VIN It VIN.#.
11 3 5 VEH.YEAR2012 MAKE LEXS MODELIS_F STYLE SD VEHICLE TOWS ET SABLI T�f°E TOWING Gf1VT VFHII' FROM TO
DAMAGE YES✓NO YES NO ✓
REGISTERED OWNER INFO OWNED BY DRIVER 3 ] 33
12 � SHADE IN DAMAGED AREA
� 4 FROM TO
LIABILITY INSURANCE INSURANCE CO GEIC04593701560 91"OI'
IN EFFECT &POLICY# _
13 LE LY YES[:] NO❑ CITATION# NONE CHARGE NSA O
BDrroM 34
LEGAGA LLY
STANDING �} MOTOR � 7 6
14 ❑ UNIT Tr MO TORE O CYCLE ❑ POPOWNER PROPERTY
YES AGE NOHRESHOLD MET PHONE ❑ 35
PEDESTRIAN
15 LAST NAME FIRST NAME MIDDLE 36
INITIAL
❑
STREET
16 NFW STnnRREET
CITY ST I ZIP
CDL IGNITION REOUIREE7 IGNITION PRESENT MEDICALTANSPORTED
INTERLOCK YES No NTERLOCK YEs NO YEs NO ❑
17 4 37
LICENSE# STATE SEX MMDDDYBYY
18 ❑ ON DUTY� STATUS AIRBAG RESTR. ; EJECT HELMET INJURY NATURE of INJURIES 38
USE CLASS
19 ❑ LICENSE TAr VIN# 39
PLATE#
20 ❑ TRAILER' TRAILER El40
PLATE#< STATE PLATE# STATE
21 ❑ ❑ 41
TRLR TRLR
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 '
VINE
EFFECT &POLICY# i 970P - 4 E:l
44
24 LEwcLE YES❑ NO❑ CITATION# CHARGE iq 60TiOM
Lec E
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.
J,CHRISTIANSEN 02-24-24 07:39 PM
25 INVESTIGATING OFFICER'S SIGNATURE OFFICER'S PHONE UNIT OR DIST DET DATED: PLACE SIGNED
26 ORID# 10437 O#I',WA0171300 APPROVED ER 2/24/2024 PAGE F OF 7
3000-345-013(R 11118)
REPORT NO. EE53527 CASE# ' 24-2033 DATE AND TIME 02/24/24 16:53
OF COLLISION
Renton Polfe'e CaSe#-' 24-2033
, .. . , ..
Chnstlansen #10437
Eno=
1
a
a
r *,ir�t5q�i " rti 4
n
PAGE 7 OF 7