HomeMy WebLinkAbout23-5634 POLICETRAFF'c" III !�� I IIIllI111IN II II I REPORT NO. ED61936 170
27
COLLISION REP FIT 1591971
CASE 23-5634 z
INTERSTATE ❑ CITY STREET FIRE ❑RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHICI 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 N E IN CITY# ❑
cowsloN 05 - 19 - 2023 0000 17 ❑.= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓
S 3RD ST BLOCK e✓ 100
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ 200 00 FMILES EET e S ❑ E e RAINIER AVE S
2 0 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
,/No D:2062345658 0 11
30
6❑ LAST NAME ABDISALAN FIRSTNAME ABDULLAHI MIDDLE 1 2 31
INITIAL
STREET ❑, 6119 S 240TH CT APT 22-104 CITY KENT ST WA ZIP 98032 z
NEW ADDRESS
7❑ CDL INTERLOCKYEs NOGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
i 1/ INTERLOCKYEs NO�/ YEs No�/
8❑ LICENSE# STATE WA SEX'M I D-MMDDYY 01 — 16 — 1983 1 2 32
9 ON DUTY❑ STATUS AIRBAG 6 RESTR 4 EJECT 1 H USE CLASS 2 CLASS 1 NATURE OF INJURIES 2❑
3
10 9❑ LICENS Pi ATE 14 BZD4004 sTAr WAu N# JTDKBRFUOJ3058336
5 TRAILER STATE TRAILER STATE
11 2 5 PLATE# PLATE# FROM TO
TRLR. TRLR 7 3 33
12 2 5 VIN#' VIN#
>; FROM TO
VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE 7 $ 34
13 1 2018 TOYT PRIUS SD DAMAGE YES NO ves❑ No
REGISTEREDOWNERINFO OWNEDBYDRIVER VEHICLE NO. 1
SHADE IN DAMAGED AREA ❑ 35
14 LIABILI INSURANCE INSURANCECO GEIC06065-54.85.36 3 4
IN EFFECT &POLICY# 9TOP
ve'CLe CHARGE 1 5 36
LEGALLv Yes❑NO❑ CITATION# 10 BOTTOM
15❑ STANDING 8 6
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES 1/ NO D:2063192118
16 a
LAST NAME AGUILAR-ORRELLANA FIRST NAME JOSSELYN MIDDLE IM
INITIAL
17 STREET I❑ s❑' 13445 MARTIN LUTHER KING JR W#D-301 CITY' SEATTLE ST' WA ZIP 98178 4❑ 37
NEW ADOREs
18❑ CDL IGNITION REQUIRED IGNITION PtR—E—S1ENT MEDICAL—T�RANSPORTED � 38
INTERLOCKYES�NO INTERLOCK YEs I I NOF YEs t l NOF,/
19 DRIVER'S STATE WA ]SEX IF D.C.B. 07 31 1993 39
LICENSE# MMDDYY
20❑ ON DUTY STATUS AIRBAG 6 RESTR 4 EJECT 1 H U EET 2 NJAURSY 1 NATURE OF INJURIES 40
❑21❑ PLATE# CFU5691 TArE 41
WA VIN# 5NPE24AFOGH263614 1
42
22❑ PLATE# STATE PLATE# STATE
TRLR
23❑ VIN#. IN#. 43
RLR
'
VEH YEAR 2016 MAKE HYUN MODEL ELANTRA STYLE SD VEHICLETOWED TO BLIN TOWEDBY GOV HI 44
L4❑ DAMAGE YES NO YES NO
REGISTERED OWNER INFO CECILIA GOMEZ PEREZ 626 S 150TH ST BURIEN WA 98148 VEHICLE NO.2
SHADE DAGED AREA
4
LIABILITY INSURANCE❑ INSURANCE CO
IN EFFECT &POLICY# 9TOP 5
vEDICLELecnLLv IEsF] N`LJ� CITATION# 3AO141414 CHARGE OP MOT VEH W/OUT INSURANCE Io ao-r-roM
25 s � e
=ORAJEWSKI
(PRINT) OFFICER PHONE BADGE OR ID# JAGENCY
26 12399 WA0171300
PAGE 01 OF
PART A
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. ED61936
COLLISION REPORT III III III III III 111
1591972 CASE# 23-5634
ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY)
NAME MIDDLE INITIAL) SEVILLA ARGUETA WALTER Y
(LAST FIRST,
ADDRESS&PHONE#
4376 S 179TH ST SEATAC WA 98188 2063192118 SEX M MMDDYyvv 04 - 30 - 1997
PASSENGER{�WITNESS UNIT# SEAT AIRBAG RESTR. EJECT ' HELMET LASS NaruRE of INJURIEs
Lr 1 ❑ 2 SOS. 3 6 4 1 USE 2 CLASS
1
NAME
(LAST,FIRST,MIDDLE INITIAL) ADAMS CHRISTINA A
ADDRESS&PHONE# DOBYvvv
10024 112 DES MOINES MEMORIAL BURIEN WA 98168 2062351743 SEX: F MMDD 03 _ 02 _ 1979
PASSENGER WITNESSZ UNIT# SEAT AIRBAG RESTR. EJECT HELMET INJURY NATURE OF INJURIES
❑ POS. USE CLASS
NAME
(LAST FIR57 MIDDLE INITIAL)
AppRESS R PHONE#
SEX D.Q.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.
RAYMOND GORAJEWSK/ 05-19-23 01:22 AM
INVESTIGATING QFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
DESIRES SCOTT 10272 1 512012023 11:31:52 AM
BADGE OR ID# 12399 ORI# WA0171300 TIME POLICE DISPATCHED! 12:01 AM TIME POLICE ARRIVED',12:06 AM
PART Ei PAGE 2�0F❑
REPORT NO. ED61936 CASE# 23-5634 OF COLLISION
05/19/23 00:00
OF CbLLI510N
NARRATIVE
ASSIGNMENT/ARRIVAL
On 05/19/2023 at approximately 0001 hours, I was dispatched to a collision in the 100 block of S 3rd
Street in the city of Renton, King County, Washington.
I arrived at approximately 0008 hours.
UNIT 1: TOYOTA PRIUS
Upon arrival I observed a silver Toyota Prius (WA/ BZD4004, Unit 1) stopped facing northeast in the
south entrance of Safeway (200 S 3rd Street) closest to the building off S 3rd Street. Unit 1 had
moderate damage to the front driver door.
UNIT 2: HYUNDAI SONATA
I observed a red Hyundai Sonata (WA/ CFU5691, Unit 2) stopped facing northeast in the south
entrance of Safeway closest to the building off S 3rd Street. Unit 2 was just to the northwest of Unit 1.
Unit 2 had moderate front end damage.
DRIVER 1: ABDISALAN, ABDULLAHI M.
I contacted Abdullahi M. Abdisalan (DOB: 01/16/1983) standing near Unit 2. Officer J. Raygoza
identified Abdisalan by his Washington Driver License. Officer Raygoza established Abdisalan as the
driver of Unit 1 by his admission.
Abdisalan complained of pain to his head from the driver airbag deploying. The Renton Fire Authority
responded to evaluate Abdisalan.
DRIVER 2: AGUILAR-ORRELLANA, JOSSELYN M.
I contacted Josselyn M. Aguilar-Orrellana (DOB: 07/31/1993) standing near Unit 1. Officer J.
Raygoza identified Josselyn by her Washington Driver License. I established Josselyn as the driver of
Unit 2 by her admission. Josselyn was not injured from the collision.
PASSENGER
I contacted Walter Y. Sevilla Argueta (DOB: 04/30/1997) standing near Unit 1. Walter was identified
as Unit 2's front passenger by his admission. Sevilla was not injured from the collision.
STATEMENT: DRIVER 1
Officer Raygoza spoke with Abdisalan about the collision and relayed the following to me:
Abdisalan drove Unit 1 east on S 3rd Street in the north-most (number 2) lane. Unit 2 drove behind
Unit 1. Abdisalan saw Unit 2 merge to the south-most (number 1) lane. Unit 2 accelerated, nearly
passed Unit 1, then "cut off" Unit 1, causing a collision.
This concluded Abdisalan's statement.
STATEMENT: DRIVER 2
1 spoke with Josselyn about the collision and the following is a summary of our conversation:
Josselyn drove Unit 2 east on S 3rd Street in the north-most (number 2) lane. Unit 1 drove beside
Unit 2 in the south-most (number 1) lane. Unit 1 accelerated then merged into the number 2 lane,
seemingly to turn into the Safeway driveway.
Unit 2's front end collided with Unit 1's front driver door.
This concluded my conversation with Josselyn.
WITNESS: ADAMS, CHRISTIANA A.
I located an independent witness, Christiana A. Adams (DOB: 03/02/1979), in front of Safeway. The
following is a summary of our collision.
Unit 2 drove east on S 3rd Street in the north-most (number 2) lane. Unit 1 drove beside Unit 2 in the
south-most (number 1) lane. Unit 1 accelerated, then merged into the number 2 lane, seemingly to
PAGE 3 OF 5
REPORT NO. ED61936 CASE# 23-5634 OF COLLISION
05/19/23 00:00
OF CbLLI510N
NARRATIVE
turn into the Safeway driveway.
This concluded my conversation with Adams.
PHOTOGRAPHS
I took photographs of Unit 1 and Unit 2 with my department issued cell phone and uploaded the
photographs to Axon's Evidence.com.
CITATION
Josselyn, the driver of Unit 2, was unable to provide proof of insurance. Josselyn claimed she did not
have insurance. Josselyn said Unit 2 belonged to her cousin, who was not at the scene.
I issued Josselyn a citation for operating a motor vehicle without insurance (Citation #3A0141414).
DISPOSITION
This concluded my involvement in this case.
I declare under penalty of perjury under the laws of the State of Washington that the foregoing is true
and correct.
Electronically signed by Officer R. Gorajewski, #12399, on 05/19/2023 at 0119 hours in Renton,
Washington.
PAGE 4 OF 5
REPORT NO. ED61936 CASE# 23-5634 DATE AND TIME 05/19/23 00:00
OF COLLISION
Not to Scale
S 3rd St
PAGE 5 OF 5