HomeMy WebLinkAbout24-82 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 5 27c
COLLISION REP FIT 1591971
❑ ❑ RESULTED ❑ CASE# z4-sz 2
INTERSTATE CITY STREET FIRE
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHICCI F ❑ LOCAL AOENC 4200 3
HIT 8 RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 2 TOTAL#OF OBJECT 1 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#
COLLISION'. 01 - 1-— 2024 1059 17 ❑-= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
S GRADY WAY BLOCK NO. e✓ 0000 ❑
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ ❑ FEET e S ❑ W e RAINIER AVE S
0 1 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
✓NO D:2067505800 0 11
30
6� LAST NAME MARTIN-PABLO FIRSTNAME JORGE MIDDLE T 1 1 2 31
INITIAL
STREET ❑ 13218 AMBAUM BLVD SW#201 CITY BURIEN ST WA Zip 98142 2
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
iNTERLOCKYEs NO INTERLOCKYEs NO YES R NO
8 LRIIVERCENS # STATE SEX'M MDMDD 03 - 30 - 2005 1 2 32
9 ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 HELMET USE 2 CLASRuY 1 NATURE OF INJURIES 2❑
3
10❑ P1 aT�S� CKH3653 sTArI WAvIN# 1 FAHP3FNOBW190391
5 TRAILER STATE TRAILER STATE
11 3 5 PLATE# PLATE# FROM TO
TRLR. A'RLR. 1 5 33
12 3 5 VIN#j VIN#
FROM TO
VEH.YEAR 2011 MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE 7 3 34
13 4 FORD FOCUS DAMAGE YES NO YES[:] No
✓
REGISTERED OWNER INFO PRANYMARTIN-LUCAS 13218 AMBAUM BLVD SW BURIEN WA 98142 VEHICLE NO. 1
❑ ❑
SHADE IN DAMAGED AREA 35
14 LIABILITY INSURANCE❑ INSURANCE CO
IN EFFECT &POLICY# 9TOP
vewcLE CHARGE 10BOTTOM 5 36
LEGALLY YES NO CITATION# 4A0092646,4AO092648 NO VALID OPER LICENSE W/OUT
15❑ STANDING 8 7 6
MOTOR PEDAL-: PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT a2 VEHICLE ❑ CYCLE ❑ OWNER ❑ YES 1/ NO D:4252358022
16 a
LAST NAME RICHMOND FIRST NAME JACQUELINE MIDDLE I S
INITIAL
17❑ STREET ❑', 15934 SE 176TH PL CITY RENTON ST WA ZIP 980589112 37
NEW ADDRESS ❑
18� CDL IGNITION REQUIRED IGNITION PtR-E-S1ENT MEDICAL TRANSPORTED ❑ 38
INTERLOCKYES�NOF INTERLOCK YEs I I NOF YES
t l NO❑
19 F] DRIVER'S STATE I WA ]SEX IF I D.O.B. 05 _ 27 1948 El 39
LICENSE# MMDDYY
WELMET {NJURY NATURE OF INJURIES 40
20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 USE 2 CLASS 1 ❑
21❑ LICENSE CGL7737 TAre WA VIN# USE
❑ 41
PLATE#
42
22❑ PLATE# STATE PLATE# STATE
23❑ 43
TRLR RLR
UIN#. 'IN#.
VEH YEAR 2023 MAKE SUB,Q MODEL OUTBAC STYLE VEHICLE TOWED TO BLIN TOWEDeY GOV HI 44
24❑ DAMAGE YES NO YES NO
REGISTERED OWNER INFO JACQUELINE RICHMOND 15934 SE 176TH PL RENTON INA 980589112 VEHICLE NO.2
SHADEDAMAGEDAREA
3 4
LIABILITY
INSURANCE I PORGY#E CO AARP 55PHG557353IN STOP 5
VE""LE ❑ Nu,J CITATION# CHARGE
LEGAL io BOTTOM
LY YES
25 ' a
7CA
NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
J
26LAN 12007 WA0171300
PART A PAGE 01 OF
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EE39521
COLLISION REPORT III III III III III 111
1591972 CASE# 1 24-82
ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY)
NAME MIDDLE INITIAL) CHO FRANKIE
(LAST FIRST,
ADDRESS&PHONE#
RENTON WA 98055 2063835849 SEX M MMDOYyry - -
PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT ' HELMET INJURY NATURE OF INJURIES
�✓ POS. USE CLASS
NAME
'(LAST,FIRST MIDDLE INITIAL)
ADDRESS&PHONE# D O B
SEX MMDDYYYV
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.
C.CATALAN 01-03-24 02:33 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
C.JACOBS 1953 1 1/1112024 2:21:34 PM
BADGE OR ID# 1Y007 ORI#' WA0171300 TIME POLICE DISPATCHED 10:59 AM TIME POLICE ARRIVED',11:01 AM
PART I PAGE IT]OF 4]
E AND
REPORT NO. EE39521 CASE# 24-82 OF COLLISION 01/03/24 10:59
OF COLLISION
NARRATIVE
On January 3, 2024 at 1059 hours dispatch requested that I respond to a collision at S Grady Way
and Rainier Ave S, in the City of Renton/King/WA.
Upon my arrival I spoke with the driver of unit 2. The driver explained she was proceeding eastbound
on S Grady way from Rainier Ave S when the collision occurred. She proceeded forward when the
traffic light turned green, but unit 1 ran a red light going southbound from Rainier Ave S through S
Grady way. Unit 1 struck unit's 2's front bumper, damaging the entire passenger side of their vehicle.
I then spoke with the driver of unit 1. He explained he was going southbound on Rainier Ave S when
the traffic light turned yellow. He thought he could make it, but ran into unit 2 as they proceeded
through the intersection.
Both drivers refused any medical attention, and unit 1's vehicle needed to be removed from the
location by Bankers Towing.
The witness also recounted a simlar story as unit 2. They stated unit 1 ran the red light.
While interviewing the driver of unit 1, identified by his Guatemalan passport as Jorge T. Martin-Pablo
(03/30/2005), he stated he did not have a valid drivers license and did not have insurance on his
vehicle.
I issued Jorge T. Martin-Pablo (03/30/2005) 1 Sector infraction for operating a motor vehicle without
insurance, RCW 46.30.020.
1 also issued Martin-Pablo (03/30/2005) 1 Sector citation for not having a valid operators license.
RCW 46.20.005
CC.
PAGE 3 OF 4
REPORT NO. EE39521 CASE# ' 24-82 DATE AND TIME 01/03/24 10:59
OF COLLISION
NTS
Rainier Ave S
PAGE 4 OF 4