HomeMy WebLinkAbout23-5620 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 0 27c
COLLISION REP FIT 1591971
CASE 23-5620 z
INTERSTATE ❑ CITY STREET FIRE ❑RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHIC;I F ❑ LOCAL AOENC 4Y00 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 1 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 CITY#
cowsloN 05 - 18 - 2023 1404 17 . N E IN� S 8 W H OF e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
SW43RD BLOCK e✓ 100 ❑
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ �.❑ FEET e S ❑ W e EAST VALLEYRD
0 4 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
�/No D:5014868258 0 3 30
6� LAST NAME SANTOS FIRSTNAME OSBALDO MIDDLE 1 2 31
INITIAL
STREET ❑ 4600 DAVIS AVE S G204 CITY RENTON ST WA ZIP 98055 z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
INTERLOCK YES[:]NO INTERLOCKYEs NO YES R NO
❑ DRIVER'S' STATE MM SEX'M MELO B 10 1- 31 - 2005 2 32
8 LICENSE#
9 ON DUTY❑ STATUS AIRBAG 2 RESTR 1 EJECT 1 HELM
U EET 2 CLASS 1 NATURE OF INJURIES 2❑
3
10 1❑ P1 ATE 14 D00969C STATE WA VIN# 1 D7HE22K66S614410
TRAILER STATE TRAILER STATE
11 3 5 PLATE# PLATE# ROM To
TRLR. TRLR 3 5 33
12 3 5 VIN#' VIN#
ROM TO
VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE 5 3 34
13 3 2006 DODG DAKOTA PK DAMAGE YES NO YES[:] No✓
REGISTERED OWNER INFO ARTEMIO SANTOS A.4600 DAVIS AVE S APT G204 RENTON WA 98055 D:7089703353 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
14 LIABILITY INSURANCE❑ INSURANCE CO 4
IN EFFECT &POLICY# 9TOP
VEwcLe CHARGE 1 5 36
LEGALLv Ye8❑NO❑ CITATION# 10 BOTTOM
15❑ STANDING 8 7 6
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT 02 VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES 1/ NO D:2064683389
16 a
LAST NAME ENAMORADO SUAREZ FIRST NAME ANYY MIDDLE S
INITIAL
17❑ STREET NEW ADDREss❑' 23616 58TH AVE S APT W104 CITY KENT ST WA ZIP 980323742 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 LICENSE# STATE WA SEX F M .C.B. 03 _ 28 _ 1995 39
20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 H U EET 2 NJAURSY 1 NATURE OF INJURIES ❑ 40
❑21❑ PLA E# CBL7973 TATE 41
WA vIN# 1FMCU931X8KA66738 1
42
22❑ PLATE# STATE PLATE# STATE
23❑ UIN#. 43
TRLR RLR
'IN#.
VEH YEAR 2008 MAKE FORD MODEL ESCAPE STYLE UT VEHICLE TOWED TO BLIN TOWEDBY GOV HI 44
L4❑ DAMAGE YES NO YES NO
REGISTERED OWNER INFO ANYY ENAMORADO SUAREZ 2361658TH AVE S APT W104 KENTWA98032 VEHICLE NO.2
SHADEDAMAGEDAREA
3 4
LIABILITY
INSURANCE INSU PORGY#E CO PROGRESSIVE 964478903IN STOP 5
'E""LE ❑ ,J� CITATION# CHARGE to BOTTOM
LEGALLY YES N`L J
25 ' a
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
J
26
C.JACOBS 1953 WA0171300
PART A PAGE 01 OF C7
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. ED74270
COLLISION REPORT III III III III III 111
1591972 CASE# 23-5620
ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY)
NAME MIDDLE INITIAL) SUAREZ PAD/LLA BEATR/Z N
(IAST FIRST,
ADDRESS&PHONE# D O.B. '
23616 58TH AVE S APT W104 KENT WA 980323742 SEXi F MMDOYyry 01 - 19 - 1967
PASSENGER Z WITNESS❑ UNIT# 2 Pas, 3 AIRBAG 2 RESTR. 4 EJECT ? 1 HELMET USE 2 INJURY
CLASS LASS NATURE OF INJURIES
' 11
NAME
(LAST,FIRST,MIDDLE INITIAL) TURCIOUS SIRLENY
ADDRESS&PHONE# D O B
�� F MMDDYVYY 09 _ 15 _ 2021
SEAT HELMET INJURY NATURE OF INJURIES
PASSENGER WITNESS UNIT# 2 PGS 7 AIRBAG 2 RESTR. 4 EJECT 1 USE 2 CLASS 1
NAME
(LAST FIR57 MIDDLE INITIAL)
AppRESS&PHONE#
SEX D.Q.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.JACOBS 05-22-23 11:42 AM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
C.JACOBS 1953 1 612712023 2:16:20 PM
BADGE OR ID# 1953 ORI# WA0171300 TIME POLICE DISPATCHED 3:23 PM TIME POLICE ARRIVED',3:48 PM
PART I PAGE IT]OF 4�
REPORT NO. ED74270 CASE# 23-5620 OF COLLISION
05/18/23 14:04
OF CbLLI510N
NARRATIVE
On 5-18-23 at about 1548 1 arrived at the intersection of SW 43rd and East Valley Rd for 2 vehicle
collision. I contacted both vehicles in the parking lot just southeast of the intersection. Driver 1 had
no identification or insurance. He verbally identified himself as Santos Osbaldo (10-31-2005).
Osbaldo did not speak English. I spoke to him in Spanish and via his cousin who had arrived at the
scene after the collision, but prior to my arrival. Via our communication I learned;
Osbaldo is not licensed and is a juvenile.
The truck belongs to his uncle, Artemio Santos Avino.
His uncle knew he was driving the truck.
He does not have insurance.
He was turning left from the left turn lane into the parking lot when the collision occurred.
He was not injured.
Driver 2, Anyy Suarez told me;
She had just made a right turn from East Valley Rd when the collision occurred.
She did not see unit 1 making the turn from the turn lane.
She nor her children were injured.
She felt sorry for driver 1 and did not want him cited, but she did want to have her car fixed.
Investigation revealed that the proximate cause of the collision was Osbaldo making the left turn from
the left turn lane into a driveway when the roadway was not clear. The area he made the turn is not
designed for turn to be made into the driveway. There are plastic posts put up to deter that type of
turn. Osbaldo also is unlicensed and uninsured. Osbaldo's identity was verified by his adult cousin
at the scene. A records check of Osbaldo's name met with negative results. Both vehicles were
released to the drivers at the scene.
This incident occurred in the city of Renton, County of King.
I declare under penalty of perjury under Washington state law that the foregoing is true and correct.
C. Jacobs/1953
PAGE 3 OF 4
REPORT NO. ED74270 CASE# ' 23-5620 DATE AND TIME 05/18/23 14:04
OF COLLISION
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PAGE 4 OF 4