HomeMy WebLinkAbout23-5956 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 1 27c
COLLISION REP FIT 1591971
CASE 23-5956 z
INTERSTATE ❑ CITY STREET FIRE ❑RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHIr.I F ❑ LOCAL AOENC 4200 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 1 TOTAL#OF OBJECT 1 6 6 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 - 1-- 2023 1513 17 ❑.= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓
HARRINGTON AVE NE BLOCK NO. e✓ 700
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ ❑ FEET e S ❑ W e 1 3 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
No ,/ I D:4255177983 0 11
30
LAST NAME GONZALEZ MACEDA FIRST NAME CATARINO MIDDLE T
6 INITIAL 31
STREET ❑1 466 INDEX AVE NE CITY RENTON ST WA 2jp, 98056 z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
INTERLOCK YES[:]NO INTERLOCKYEs NO YES NO
LRIIVER # STATE WA SEX'U MI MIT Y
8❑ ' 04 — 16 — 1960 1 2 32
9❑ ON DUTY❑ STATUS AIRBAG 9 RESTR 9 EJECT 9 HELMET
9 CLASS 0 NATURE OF INJURIES z❑
3
10 9❑ PI ATE 14 CCN8947 STATE WA VIN# 1J4GL58KX5W701412
TRAILER STATE TRAILER STATE
11 0 0 PLATE# PLATE# FROM TO
TRLR. TRLR m 33
12 0 0 VIN#' VIN#'
FROM TO
VEH.YEAR ZOOS MAKE JEEP MODEL LIBERT STYLE UT VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE 1 5 34
13❑ DAMAGE YES NO YES[:] NO✓
REGISTERED OWNER INFO OWNEDBYDRIVER VEHICLE NO. 1
SHADE IN DAMAGED AREA ❑ 35
14 LIABILI INSURANCE❑ INSURANCE CO 3 4
IN EFFECT &POLICY# 9TOP
VEH" CHARGE 1 5 36
LEGALLY YES❑NO❑ CITATION# 10 BOTTOM
15❑ STANDING 6
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT 02 VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES NO ,/ D:2066933709
16 a
LAST NAME KATERS FIRST NAME JEFFREY MIDDLE J
INITIAL
17❑ STREET ❑', 3117 SE 6TH ST CITY' RENTON ST WA ZIP 98058 37
NEW ADDRESS ❑
18� CDL ., IGNITION REQUIRED IGNITION PtR—E—S1ENT MEDICAL TRANSPORTED 38
INTERLOCKYES�NOR INTERLOCK YEs I I NOF YES
t l NO❑
19[ LICENSE# STATE WA SEX M M DDY
D.C.B.
01 1 29]_ 1955 El 39
WELMET INJURY1 NATURE OF INJURIES 40
20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 USE CLASS ❑
21❑ LICENSE A6136C TATe WA VINE 1BAKCCPA7FF311439
❑ 41
PLATE#
42
22❑ PILER LATE# STATE PLATE# STATE
23❑ UIN#. 43
TRLR RLR
'IN#.
VEH YEAR 2015 MAKE BLUE MODEL SCHOOL/ STYLE BU VEHICLETOWED TO BLIN TOWEDBY GOV HI 44
24❑ DAMAGE YES NO,� YES NO
REGISTERED OWNER INFO RENTON SCHOOL DISTRICT 300 SW 7TH ST RENTON WA 98057 D:4252044462 VEHICLE NO.2
SHADE IN DAMAGEbAREA
2 3 Cd
LIABILITY
INSURANCE I PORGY#ECO SIAWSIAW222334033IN I 5
VE LEGwcLE ❑ ,J� CITATION# CHARGE
25 GQ
ALLY YES N`L J
s � a
=Kl
(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
J
26 12598 WA0171300
PART A PAGE 01 OF C7
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT No. ED65893
COLLISION REPORT III III III III III 111
1591972 CASE# 23-5956
ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY)
NAME MIDDLE INITIAL) CONTRERAS ELIEL A
(LAST FIRST,
ADDRESS&PHONE# D O.B. '
446 WELLS AVE N APT#3 RENTON WA 98057 2068568551 SEX M MMDDYyvv 06 -Di]
04 - 2015
PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT ' HELMET INJURY NATURE OF INJURIES
❑✓ ❑ 2 POS. 10 1 USE CLASS 1
NAME
(LAST,FIRST,MIDDLE INITIAL) MENDOZA BRUCE Q
ADDRESS&PHONE# D O E4
2715 NE 2ND ST RENTON WA 98056 4259027037 SEX I M MMDDYvvv 09 _ 15 _ 2015
SEAT HELMET I INJURY NATURE of INJURIES
PASSENGER P]WITNESS❑ UNIT# 2 pOS 10 AIRBAG 2 RESTR. 3 EJECT 1 USE CLASS 1
NAME
(LAST FIRST,MIDDLE INITIAL) NGUYEN MASON V
ADDREss&PHONE# 2410 SE 2ND PL RENTON WA 98056 4257935531 SEX M D.O•B. 04 _I. 26 _ 2016
MDDYYYY
PASSENGER WITNESS UNIT# ! 2 SEAT 10 AIRBAG 2 RESTR. 3 EJECT 1 HELMET INJURY 1 NATURE OF INJURIES
❑ POS. USE CLASS
NARRATIVE'
On Friday, May 26, 2023, at 1515 hours, I was dispatched to a two-vehicle collision in the area of the
700 block of Harrington Ave NE.
The following occurred within the City of Renton, King County; Unit 1 - WA/ CCN8947 was parked in
the 700 block of Harrington Ave NE and occupied by Catarino Gonzalez. Unit 2 - WA/A6136C was
driven by Jeffrey Katers and had turned right onto Harrington Ave NE from Highlands Elementary
School with 6 students on board. Jeffrey stated he was unable to avoid colliding with Unit 1 because
he did not think he was that close to the other vehicle. The driver side rear quarter panel of Unit 2
collided with the front driver side mirror of Unit 1.
Both vehicles sustained non reportable damage and did not need to be towed.
**** AUTO-POPULATED SECTION ****
THE FOLLOWING ARE DESCRIPTIONS ENTERED FOR ITEMS SELECTED AS "OTHER":
Motor Vehicle Unit 2
Seat Position (Passenger ELIEL CONTRERAS): ROW 1, RT SIDE, SEAT 2
Seat Position (Passenger BRUCE MENDOZA): ROW 1, RT SIDE, SEAT 1
Seat Position (Passenger MASON NGUYEN): ROW 2, RT SIDE
Seat Position (Passenger DIEGO HAUSE): ROW 5, RT SIDE
Seat Position (Passenger MUSE MUSE): ROW 2, LT SIDE
Seat Position (Passenger PAISLEY PATERNOSTER): ROW 5 LT SIDE
**** END OF AUTO-POPULATED SECTION ****
I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT.
J.WISNIEWSKI 05-26-23 04:39 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
D.MOYNIHAN 11288 6/1/2023 5:52:36 AM
BADGE OR ID# 112598 OR]#` WA0171300 TIME POLICE DISPATCHED! 3:15 PM TIME POLICE ARRIVED 3:20 PM
PART I PAGE IT]OF 5�
STATE OF
POLICETRAFFICN CORRECTION REPORT No. ED65893
COLLISION REPORT III III III III III 111
1591972 CASE# 23-5956
ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY)
NAME MIDDLE INITIAL) HAUSE DIEGO L
(LAST FIRST,
ADDRESS&PHONE# D O.B. '
1901 NE 3RD ST APT 401 RENTON WA 98056 5512555727 SEX M MMDDYyvv 02 - 03 - 2015
PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT ' HELMET INJURY NATURE OF INJURIES
❑✓ ❑ 2 POS. 10 2 3 1 USE CLASS 11
NAME
(LAST,FIRST,MIDDLE INITIAL) MUSE MUSE M
ADDRESS&PHONE# D O B
313 FERNDALE AVE SE RENTON WA 98056 2064666823 SEX I M MMDDYvvv 03 _ 20 _ 2015
SEAT HELMET INJURY NATURE OF INJURIES
PASSENGER WITNESS❑ UNIT# 2 POS 10 AIRBAG 2 RESTR. 3 EJECT 1 USE CLASS 1
NAME
(LAST FIRST,MIDDLE INITIAL) PATERNOSTER PAISLEY O
ADDREss&PHONE# 5518 SE 2ND CT RENTON WA 98059 2088414146 SEX F D.o.E. O6 _ 25 _ 2014
MMDDYYYY
PASSENGER WITNESS UNIT# ! 2 SEAT 10 AIRBAG 2 RESTR. 3 EJECT 1 HELMET INJURY 1 NATURE OF INJURIES
❑ POS. USE CLASS
NARRATIVE'
On Friday, May 26, 2023, at 1515 hours, I was dispatched to a two-vehicle collision in the area of the
700 block of Harrington Ave NE.
The following occurred within the City of Renton, King County; Unit 1 - WA/ CCN8947 was parked in
the 700 block of Harrington Ave NE and occupied by Catarino Gonzalez. Unit 2 - WA/A6136C was
driven by Jeffrey Katers and had turned right onto Harrington Ave NE from Highlands Elementary
School with 6 students on board. Jeffrey stated he was unable to avoid colliding with Unit 1 because
he did not think he was that close to the other vehicle. The driver side rear quarter panel of Unit 2
collided with the front driver side mirror of Unit 1.
Both vehicles sustained non reportable damage and did not need to be towed.
**** AUTO-POPULATED SECTION ****
THE FOLLOWING ARE DESCRIPTIONS ENTERED FOR ITEMS SELECTED AS "OTHER":
Motor Vehicle Unit 2
Seat Position (Passenger ELIEL CONTRERAS): ROW 1, RT SIDE, SEAT 2
Seat Position (Passenger BRUCE MENDOZA): ROW 1, RT SIDE, SEAT 1
Seat Position (Passenger MASON NGUYEN): ROW 2, RT SIDE
Seat Position (Passenger DIEGO HAUSE): ROW 5, RT SIDE
Seat Position (Passenger MUSE MUSE): ROW 2, LT SIDE
Seat Position (Passenger PAISLEY PATERNOSTER): ROW 5 LT SIDE
**** END OF AUTO-POPULATED SECTION ****
I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT.
J.WISNIEWSKI 05-26-23 04:39 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
D.MOYNIHAN 11288 6/1/2023 5:52:36 AM
BADGE OR ID# 112598 OR]#` WA0171300 TIME POLICE DISPATCHED! 3:15 PM TIME POLICE ARRIVED 3:20 PM
PART I PAGE 3�OF 5�
SUPPLEMENTAL REPORT NO. ED65893
r`) POLICE TRAFFIC 1 27
COLLISION REPORT CASE# 23-5956
1 COMMERCIAL MOTOR CARRIER INTERSTATE INTRASTATE ✓ G
UNIT'# 2 USDOT ICC# ' VEHICLE TYPE 1 CARGO 6ODY 1
;TYPE
2 ❑ 1 28
CARRIER RENTON SCHOOL DISTRICT
NAME
3 CARRIER
ADDRESS 300 SW 7TH ST
CITY RENTON ST WA ZIP'', 98057
4 ❑ NAME # PLACARD: :❑
NAME IF NO NUMBER
SOURCE 1 AXLES 02 GI14500 +
4a ❑ ADDITIONAL UNITS
MOTOR PEDAL- PROPERTY DAMAGE THRESHOLD MET PHONE
5 ❑ UNIT# VEHICLE I_J CYCLE _) PEDESTRIAN � OWNER � YES NO
i MIDDLE'... 29
LAST NAME FIRST NAME INITIAL
STREET 30
NFW AnnRFrtP. CITY ST ZIP
6 �
CDL GNITIttN REQUIRED GNITION PRESENT MEDICAL TANSPORTED 1 31
INTERLOCK YES No NTERLOCK YES❑N0� vES N
LLIICIENSE STATE I SEX M��DYRYY' 2
7 F-1
ON DUTYl STATUS AIRBAG' RESTR. EJECT HELMET INJURY NATURE OF INJURIES
USE CLASS
8 ❑ ' 1 32
LICENSE+ rar VIN.#
PLATE#
9 TRAILER TRAILER
PLATE# STATE PLATE# STATE
10 ❑ TRLR TRLR
VIN.#. VIN.#.
11 VEH.YEAR MAKE MODEL STYLE VEHICLE TOWS T SABLIN TOWED BY anvi vEHIG P FROM TO
DAMAGE Y EES NO YES NO
REGISTERED OWNER INFO. m 33
12 SHADE IN DAMAGED AREA
FROM TO
LIABILITY INSURANCE❑ INSURANCE CO
IN EFFECT &POLICY# t 9 1"01?
VEHICLE 1 o BarroM 34
13 ❑ LEGALLY YES❑ NO❑ CITATION# CHARGE
STANDING S} 8 7 6
14 ❑ UNIT Tr Vd 1 RE O CYCLE OWNER
YES AGE NOHRESHOLD MET PHONE El
35
El PEDESTRIAN
15 LAST NAME FIRST NAME INITIALMIDDLE
TIAL
❑
STR
16 NFlEETEET"F-] CITY ST ZIP
AnnRCDL IGNITION REDUIREE7 IGNITION PRESENT MEDICALTANSPORTED
NTERLUCK YES NO NTERLOCK YES NO 'YES NO El
17 37
LICENSE# STATE SEX MMDDDYBYY
18 ❑ ON DUTY� STATUS AIRBAG RESTR. ; EJECT HELMET INJURY NATURE of INJURIES 38
USE (CLASS
19 ❑ vIN# 39
LICENSE
PLATE# rnr
20 ❑ TRAILER TRAILER ❑ 40
PLATE# STATE PLATE# STATE
21 ❑ TRLR TRR 41
VIN# YIN#i
42
22 VEH.YEAR MAKE I MODEL STYLE I VEHICLE TO DUET SABLIN TOWED BY GOVT.VEHICLE
DAMAGE YES NO YES NO
23 REGISTERED OWNER INFO SHADE IN DAMAGED 3 4 4 AREA F 43
z
LIABILITY INSURANCE INSURANCE CO '
VINE
EFFECT &POLICY# i 970P - 4 E:l
44
24 LEHIcLE YES❑ NO❑ CITATION# CHARGE iq 60TiOM
LeGALLv
STANDING S 7 6
1 CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT.
J,WISNIEWSKI 05-26-23 04:39 PM
25 INVESTIGATING OFFICER'S SIGNATURE OFFICER'S PHONE UNIT OR DIST DET DATED: PLACE SIGNED
APPROVED BY DATE
26 ORID# 12598 O#I,WA0171300 MOYNIHAN 6/1/2023 PAGE OF 5
3000-345-013(R 11118)
REPORT NO. ED65893 CASE# ' 23-5956 DATE AND TIME 05/26/23 15:13
OF COLLISION
S
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{,7
UNIT 1 p NOT TO SCALE
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PAGE 5 OF 5