HomeMy WebLinkAbout23-2934 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 5 27c
COLLISION REP FIT 1591971
CASE 23-2934 z
INTERSTATE ❑ CITY STREET FIRE ❑RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHIr.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 OZ STRUCK
RESERVATION
z
3❑ DATE of M M D D Y Y Y Y TIME(2400) COUNTY# MILES N E IN CITY# ❑
cowsloN 03 - 1-- 2023 1930 17 ❑.= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓
SUNSET BLVD N BLOCK NO. e
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ 2001. 00 FEET MILES e S B W e N 3RD ST
0 1 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
No ,/ I D:4255247081 0 11
30
LAST NAME FUENTES GUERRERO FIRST NAME JUAN MANUEL MIDDLE
6 INITIAL 1 2 31
STREET ❑✓ 4146 NE 117TH ST CITy RENTON ST WA ZIP 98059 z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
INTERLOCK YES[:]NO,/ INTERLOCKYEs NO�/ YES R No�/
8❑ LRIIVER #
ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 HELMETU E 2 'NJUR 5Y 1 NATURE OF INJURIES z❑
3
10❑ Pi aT�S� BBH5211 sTAr� WAurN# 5N3AA08C34N802635
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 MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED By GOVT.VEHICLE 1 5
004 34
13 4 2 INFI QX56 DAMAGE YES NO YES[:] ✓
REGISTERED OWNER INFO LOURDES VASQUEZ 1011014THAVE S SEATTLE WA 98168 D:2066974042 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
14 LIABILITY INSURANCE❑ INSURANCE CO NONE NONE <1�3 4
LI EFFECT I SUR N# TOPvEHCLE CHARGE 36
EGHALLY YES❑NO clTAnoN# 3A0210360 NO VALID OPER LICENSE WITHorrom
15❑ STANDING 7 6
MOTOR ✓ PEDAL- 'PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES NO ,/ D:2068176954
16 a
LAST NAME NEECE FIRST NAME CHRISTOPHER MIDDLE IL
INITIAL
17❑ NEW STREETR 18025 S
7 E 272ND ST APT F104 CITY KENT ST WA ZIP 98042 37
18❑ CDL IGNITION REQUIRED IGNITION PR-E-1SENT MEDICAL—T�RANSPORTED � 38
INTERLOCK YEs❑NO� INTERLOCK yEs It I NOF YES
t l NOF,/
19 LDI IVER # STATE WA SEX U M D.C.B. 03 _ 07 1996 39
20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 H U EET 2 NJAURSY 1 NATURE OF INJURIES 40
LICENSE I ❑21❑ PLA E# CF(a0772 TArE 41
WA vIN# JM3KFBCMOP0128662 1
42
22❑ PLATE# STATE PLATE# STATE
23❑ VIN#. 43
TRLR RLR
'IN#.
GoI
VEH YEAR 2023 MAKE IlggZp MODEL CX-5 STYLE 5D DAMAGE TOWED NOO✓ BLIN TOWED BY v HyES NO,/ 44
24❑ ES
REGISTERED OWNER INFO OWNED SY DRIVER VEHICLE N0.2
SHADE IN DAMAGEbAREA
2 3 Cd
LIABILITY
INSURANCE INSU POLICY#E CO SAFECOX6261051IN I STOP
—e E YES❑ N J
,J� CITATION# CHARGE i o BOTTOM
LEGALLY
25 $ '
=TURNER
NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
J
26 12650 WA0171300
PAGE 01 OF
PART A
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. ED56942
COLLISION REPORT III III III III III 111
1591972 CASE# 23-2934
ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY)
NAME MIDDLE INITIAL) NEECE PAISLEY
(LAST FIRST,
ADDRESS&PHONE# D O.B. '
18025 SE 272ND ST APT F104 KENT WA 98042 SEXi F MMDOYyry 10 - 15 - 2018
SEAT ' HELMET NJURY NATURE OF INJURIES
PASSENGER�WITNESS� UNIT# 2 POS 7 AIRBAG 2 RESTR. 10 EJECT 1 USE 2 CLASS 7 NECKPA/N
NAME
(LAST,FIRST,MIDDLE INITIAL) NEECE JASON L
ADDRESS&PHONE# D O B
18025 SE 272ND ST APT F104 KENT 98042 SEX M MMDDYyvv O6 _ 30 _ 2020
SEAT HELMET NJURY NATURE OF INJURIES
PASSENGER
Z WITNESS� UNIT# 2 PGS 9 AIRBAG'2 RESTR. 11 EJECT 1 USE 2 CLASS 7 NECK PAIN
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.
JASON TURNER 03-12-23 09:52 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
C.TOLLIVER 10540 1 5/4/2023 3:11:04 AM
BADGE OR ID# 12650 OR]#' WA0171300 TIME POLICE DISPATCHED 7:37 Pry TIME POLICE ARRIVED',7:40 PM
PART I PAGE IT]OF 4]
REPORT NO. ED56942 CASE# 23-2934 OF COLLISION
03/12/23 19:30
OF CbLLI510N
NARRATIVE
23-2934
On 03/12/2023 at approximately 1937 hours I was working as a Police Officer for the city of Renton.
While working I was dispatched to an injury motor vehicle collision at the intersection of Sunset Blvd
N and N3rdSt.
The notes of the call stated that it was a two-motor vehicle collision with two children in one of the
vehicles.
Unit 1 Driver: Christopher L. Neece (DOB: 03/07/1996)
Passengers: Paisley R. Neece (DOB: 10/15/2018) and Jaxon L. Neece (DOB: 06/30/2020)
Vehicle: 2023 Silver Mazda CX-5 (WA LIC: CFG0772).
Unit 2 Driver: Juan-Manuel Fuentes-Guerrero (DOB: 11/28/1985)
Vehicle: 2004 Black Infiniti QX56 (WA LIC: BBH5211)
The accident occurred as followed:
Unit 2 was stopped at a red light on Sunset Blvd N and N 3rd ST facing south in the 2nd lane of
Sunset Blvd N. Unit 1 was driving in a straight line south in the number 2 lane of Sunset Blvd N at
approximately 25mph. Unit 1 approached the above intersection but failed to slow down approaching
Unit 2's vehicle, causing a collision.
Unit 1 had minor damage to their front bumper and unit 2 had minor damage to their rear bumper.
Both vehicles had damage under $1000.
Unit 2's passengers Paisley and Jaxon both reported pain to their neck. No injuries were reported by
either driver. Fire was called to the scene and evaluated the passengers.
Juan-Manuel did not have valid insurance on the vehicle and did not have a valid driver's license. He
was cited for Driving Without a License with valid ID (RCW 46.20.015) as his license expired on
03/17/2022.
1 provided both drivers with an exchange of information.
There is no further information at this time.
I declare under penalty of perjury under the laws of the State of Washington that the foregoing is true
and correct.
Electronically signed by J. Turner 12650 on 03/12/2023 at 2151 hours.
PAGE 3 OF 4
REPORT NO. ED56942 CASE# ' 23-2934 DATE AND TIME 03/12/23 19:30
OF COLLISION
NJIF
PAGE 4 OF 4