HomeMy WebLinkAbout23-13692 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 1 27c
COLLISION REP FIT 1591971
❑ ❑ FIRE ❑ CASE$# 23-13692 2 0 4
INTERSTATE CITY STREET RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHICI F ❑ LOCAL AGENCI 4150 3 6 0
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 TOTAL#OF OBJECT 1 8 28
TRIBAL UNITS OZ STRUCK
RESERVATION
2
3❑ DATE of M M D D Y Y Y Y TIME(2400) COUNTY# MILES N E IN CITY#
CowsloN 11 - 1-- 2023 1902 17 ❑-= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
BLOCK
OAKESDALEAVESW ST e✓
MILEPOST 4100 ❑
4a❑
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ 1.❑ FEET e S ❑ W e SW41ST ST 0 1 29
UNIT MOTOR
E Z CYVEHICCLE ElDDAMYESA✓NGE THR OESHOLDMET PHONE 0 11
30
6� LAST NAME UNKNOWN FIRSTNAME MIDDLE 1 2 31
INITIAL
STREET ❑ CITY ST ZIP 2
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
iNTERLOCKYEs NO 1/ INTERLOCKYEs NO�/ YES No�/
8❑ LIRCIENSRE#
STATE I
SEX u MMDDYY '❑- 1 1 2 32
9 ON DUTY❑ STATUS I
AIRBAG 3 RESTR 9 EJECT 1 H U EEr 9 CLAY 0 NATURE OF INJURIES 2❑
3
10 9❑ Pi AT 14 A6784094 STATE WA VIN# 1 N4AL3AP3GC135917
TRAILER STATE TRAILER STATE
11 3 5 PLATE# PLATE# FR.. ro
TRLR. TRLR 3 7 33
12 3 5 VIN#' VIN#
>; FROM TO
VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN T GOVT.VEHICLE 5 1 34
13 2016 NISS ALTIMA SD DAMAGE YES NO �LII� RS YES❑ No
REGISTERED OWNER INFO JOHN MATHESON 1817 S 281STPL APT 125 FEDERAL WAY WA 98003 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
14 LIABILI INSURANCE❑ INSURANCE CO UNKNOWN <�g34
IN EFFECT &POLICY# OPVE"'CLE CHARGE 36
LEGALLYYES❑NO❑ CITATION# TTOM
15❑ STANDING 6
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT 02 VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES 1/ NO D:2067796817
16 a
LAST NAME SAMARIO SIERRA FIRST NAME FERMIN MIDDLE
INITIAL
17 STREET I❑ 220 SW CLARK ST APT B101 CITY' ISSAQUAH ST WA ZIP 98027 37
NEW ADOREss❑'
18❑ CDL IGNITION REQUIRED IGNITION PtR-E-S1ENT MEDICAL-T�RANSPORTED � 38
INTERLOCK YEs❑No� INTERLOCK YEs I I NOF YES t l NO
�
19[—] DRIVER'S STATE WA SEX M D.C.B. 05 _ 05 _ 1991 39
LICENSE# MMDDYY
20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 H U EET 2 NJAURSY 7 PAIN IN LEFT HIP/LEG,DECLINED TRANSPORT ❑F—NATURE OF INJURIES 40
❑LICENSE I 21❑ PLA E# CGJ0256 TATE 41
WA VIN# JM1BJ222210462299 4
42
22❑ PLATE# STATE PLATE# STATE
TRLR
23❑ UIN#. IN#.
43
RLR
'
TOWED BY Gov HI 44
VEH YEAR 2001 MAKE IlggZp MODEL pROTEG STYLE $D —FEHICLE
TOWED✓ NOO BLIN BANKERS TOWING YES No�/
24❑ REGISTERED OWNER INFO OWNED SY DRIVER VEHICLE N0.2
SHADE DA GEbAREA
LIABILITY INSURANCE❑ INSURANCE CO NONE CCdd
IN EFFECT &POLICY# I 9TOP 5
VEHICLE Yes N CITATION# NONE CHARGE to BOTTOM
LecnLLY `LJ
25 s e
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
26
J.CHRISTIANSEN 10437 WA0171300
PART A PAGE 01 OF
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EE24362
COLLISION REPORT III III III III III 111
1591972 CASE# 23-13692
ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY)
NAME MIDDLE INITIAL) PIERSON COLLEEN M
(LAST FIRST,
ADDRESS&PHONE# D O.B.
604 NE 165TH ST,APT 101 SHORELINE WA 98155 3609325314 SEXi F MMDDYyry 01 - 26 - 1955
PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT ' HELMET INJURY NATURE OF INJURIES
�; POS. USE CLASS
NAME
'(LAST,FIRS' MIDDLE INITIAL)
ADDRESS&PHONE# D.08
SEXI 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.
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.
J.CHRISTIANSEN 11-28-23 08:58 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
J.CHRISTIANSEN 10437 1 11/28/2023 9:04:06 PM
BADGE OR ID# 10437 OR]#' WA0171300 TIME POLICE DISPATCHED! 7:03 PM TIME POLICE ARRIVED',7:07 Pm
PART I PAGE IT]OF
REPORT NO. EE24362 CASE# 23-13692 OF COLLISION
11/28/23 19:02
OF CbLLI510N
NARRATIVE
RPD CASE#: 23-13692
RECORDED ON AXON
Suspect Vehicle: 2016 white in color Nissan Altima bearing WA TEMP TAG/A6784094: Damage to
the front bumper/undercarriage/hood. Impounded by Bankers towing.
Suspect Vehicle Registered Owner: MATHESON, JOHN or ROACH, ALLAN: 1817 S 281ST PL;
APT 125; Federal Way, WA 98003
Suspect Driver: UNKNOWN
VICTIM VEHICLE #1: 2001 white in color Mazda Protege bearing WA/CGJ0256. Damage to
passenger side body, rear passenger side axel broken; inoperable. Impounded by Bankers towing.
VICTIM Driver: SAMARIO SIERRA, FERMIN; 220 SW CLARK ST; APT B101; Issaquah, WA 98027
WITNESS: PIERSON, COLLEEN MARY; 604 NE 165TH ST, APT 101, SHORELINE WA, 98155-
5808
*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 11.28.2023, at approximately 1904 hours, I was dispatched to a unknown-if-injury, blocking
collision in the intersection of SW 41st ST and Oakesdale Ave SW, in the City of Renton, WA, the
County of King.
At the time of dispatch, 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 #355, 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 1 was a police officer. I was assigned as 3r16.
Prior to my arrival, dispatch advised injuries were unknown, but both north and southbound lanes on
Oakesdale Ave SW were blocked. At the time of this collision, it was approximately 35 degrees, there
was heavy fog and visibility was decreased. It was dark and streetlights were illuminated.
I arrived on scene at approximately 1908 hours, and met with the witness, later identified as Pierson,
Colleen M. (DOB: 01.26.1955; 360/932-5314). Pierson stated she was traveling northbound on
Oakesdale Ave SW, occupying the right lane of travel. As Pierson approached the intersection with
SW 41 st ST, she states she was `a little bit behind' Unit 02 (victim vehicle), which was traveling
northbound on Oakesdale Ave SW, occupying the left lane of travel. As Unit 02 approached SW 41 st
ST, the suspect driver of Unit 01, which was traveling westbound on SW 41st ST., failed to stop at the
clearly posted stop sign, went through the intersection and struck Unit 02 on the passenger side body
of the vehicle. After the collision, the suspect driver removed something from the vehicle, placed it
into a white bag and ran southbound on Oakesdale Ave SW, on foot.
Unit 01 was identified as a 2016 white in color Nissan Altima bearing WA TEMP TAG/A6784094.
Unit 01 was unoccupied at the time of my arrival, and 1 observed there was front air bag deployment
with extensive front end/hood/undercarriage damage. There was a blue in color iPhone cellular
phone left on the front dashboard of the suspect vehicle. I took custody of the cell phone and placed
it into evidence under this case number. While in custody of the cell phone, numerous calls were
placed to this phone, including "Jimmy Goodson Text Number," one from "My Wifey" and another
caller who was asking for"Ryan." A WACIC/DOL query on the suspect vehicle returned to the
following registered owners:
MATHESON, JOHN or ROACH, ALLAN: 1817 S 281ST PL; APT 125; Federal Way, WA 98003
1 asked dispatch to request Federal Way PD attempt to contact the registered owners and determine
who may have been driving the vehicle at the time of the collision. Further, the suspect vehicle was
impounded by Bankers towing under this case number.
Unit 02 was identified as a 2001 white in color Mazda Protege bearing WA/CGJ0256. Unit 02 had
extensive damage to the passenger side body of the vehicle and the rear passenger side tire, which
PAGE 3 OF 6
REPORT NO. EE24362 CASE# 23-13692 OF COLLISION
11/28/23 19:02
OF CbLLI510N
NARRATIVE
had the axle broken and it was inoperable. Bankers towing was notified for a second tow.
Unit 02's driver was identified by his WADL as SAMARIO SIERRA, FERMIN (DOB: 05.05.1991).
SAMARIO SIERRA complained of pain to his left side, but he declined aid. He stated he was
traveling northbound on Oakesdale Ave SW, and as he approached the intersection with SW 41st ST,
he was struck by the driver of the suspect vehicle. SAMARIO SIERRA does not have insurance on
his vehicle.
Bankers towing impounded both vehicles, Unit 02 was a private impound. I completed the SECTOR
impound for Unit 01 and placed the cell phone into evidence.
At the time of this report, Federal Way police had not made contact at the suspect residence.
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 November 28, 2023, at approximately
2022 hours, in Renton, WA.
**** AUTO-POPULATED SECTION ****
THE FOLLOWING ARE DESCRIPTIONS ENTERED FOR ITEMS SELECTED AS "OTHER":
Location Character: CITY STREET
Weather: EXTREME FOG, DECREASED VISIBILTY
**** END OF AUTO-POPULATED SECTION ****
PAGE 4 OF 6
REPORT NO. EE24362 CASE# ' 23-13692 DATE AND TIME 11/28/23 19:02
OF COLLISION
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PAGE 5 OF 6
REPORT NO. EE24362 CASE# ' 23-13692 DATE AND TIME 11/28/23 19:02
OF COLLISION
REFER -11-0 ATTACHED COLLISION DIAGRAM
PAGE 6 OF 6