HomeMy WebLinkAbout23-7775 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 4 27c
COLLISION REP FIT 1591971
CASE 23-7775 z
INTERSTATE ❑ CITY STREET FIRE ❑RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHICI F ❑ LOCAL AOENC 4Y99 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# ❑
cawsloN 07 - 08 - 2023 0342 17 ❑.❑ N E IN S 8 W H OF e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓
613 UNION AVE NE BLOCK NO. e✓ 600
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ ❑ FEET e S ❑ W e 0 1 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
✓NO D:2069465601 1 4 30
6❑ LAST NAME LOPEZ-PEREZ FIRSTNAME DANIA MIDDLE I G 1 1 2 31
INITIAL
STREET ❑, 20831 103RD CT SE CITY KENT ST WA Zjp, 98031 z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
iNTERLOCKYEs NO 1/ INTERLOCKYEs NO�/ YEs No�/
8❑ LDRIVER # STATE WA SEX'F MMDDYY 05 — 23 — 2000 32
9 ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 1HELM
U EET 2 CLASS 1 NATURE OF INJURIES z❑
3
10❑ P1 ATE 14 BVK3293 STATE WA V N# JTDEPRAE4LJ050107
TRAILER STATE TRAILER STATE
11 0 0 PLATE# PLATE# FROM TO
TRLR. TRLR 1 5 33
12 0 0 VIN#' VIN#
FROM
34
13❑ VEH.YEAR 2020 MAKE TOYT MODEL COROL STYLE 4C VEHICLE TOWED Z NOO pLSSBLIN T,QVyWkRS VEHICLE
DAMAGE ILJI tSA1Vi�6
REGISTERED OWNER INFO OWNEDBYDRIVER VEHICLE NO. 1
SHADE IN DAMAGED AREA ❑ 35
3 4
14 LIABILITY INSURANCE❑ INSURANCE CO
IN EFFECT &POLICY# 9TOP
VE— CHARGE to BOTTOM 5 36
LEGALLY YEs❑NO CITATION# 3A0493206,3AO493206 PER ELECTRONIC DEVICE WHILE
15❑ STANDING 8 6
UNIT MOTOVEHIOR Z CYCLE ❑ PEDESTRIAN ❑ PROPERTY ❑ DOWNER YES NO OLD Mj PHONE
16❑
LAST NAME UNKNOWN FIRST NAME MIDDLE
INITIAL
STREET CITY KENT ST ZIP $
17❑ NEW ADDRESS❑ ❑ 37
18❑ CDL IGNITION REQUIRED IGNITION PtR—E—S1ENT MEDICAL—T�RANSPORTED � 38
INTERLOCKYES�NOR INTERLOCK YEs I I NOF YES t l NO❑
19 LLIICENS# STATE SEX U MMDDYY —�_ 39
WELMET INJURY NATURE OF INJURIES 40
20❑ ON DUTY STATUS' AIRBAG 9 RESTR 9 EJECT ''1 USE 9 CLASS 0 ❑
LICENSE ❑21❑ PLA E# CEV5498 TATe 41
WA VIN# WMZ838R08P3P59920 1
42
22❑ PLATE# STATE PLATE# STATE
23❑ 43
TRLR RLR
VIN#. IN#.
VEH YEAR 2023 MAKE MNNI MODEL COOPER STYLE 4C VEHICLETOWED TO BLIN TOWEDBY GOV HI 44
L4❑ DAMAGE YES NO YES NO
REGISTERED OWNER INFO MABEL CAPACHO 613 UNION AVE NE RENTON WA 98059 D:2064130945 VEHICLE NO.2
SHADE IN DAMAGED AREA
2 3 4
LIABILITY
INSURANCE INSU&PORGY#E CO GEICO 6110013312IN 1U�VE""LE
❑ ,J� CITATION# CHARGE
LEGALLY YES N`L J
25 OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
J
26
N AAH GIRELLO 12607 WA0171300
PART A PAGE 01 OF C7
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. ED80071
COLLISION REPORT III III III III III 111
1591972 CASE# 23-7775
ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY)
NAME
(LAST FIRST,MIDDLE INITIAL)_
ADDRESS&PHONE#
SEX D.O.B. - -
MMDDYYYY.
PASSENGER❑WITNESS UNIT# SEAT AIRBAG RESTR. EJECT ' HELMET INJURY NATURE OF INJURIES
POS. USE CLASS
NAME
'(LAST,FIRST MIDDLE INITIAL)
ADDRESS&PHONE# D D B
SEX MMDDYYYY
PASSENGER ❑WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET INJURY NATURE OF INJURIES
POS. USE CLASS
NAME
(LAST FIR57 MIDDLE INITIAL)
AppRESS R 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.
NOAH GIRELLO 07-09-23 05:14 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
DESIRES SCOTT 10272 711612023 2:33:07 PM
BADGE OR ID# 12607 ORI# WA0171300 TIME POLICE DISPATCHED 3:46 AM TIME POLICE ARRIVED]3:58 AM
PART Ei PAGE IT]OF 4]
REPORT NO. ED80071 CASE# 23-7775 OF COLLISION
07/08/23 03:42
OF CbLLI510N
NARRATIVE
23-7775
At about 0346 hours on 07/08/2023 1 was dispatched to a blocking accident at, 613 Union Ave NE, in
the city of Renton, King County, Washington. Dispatch advised me that this was a 2-motor vehicle
accident with no injuries, and they were blocking the south bound lane.
Unit 1: Black 2020 Toyota Corolla (WALIC/BVK3293) (VIN/JTDEPRAE4LJ050107)
Driver: Dania G Lopez-Perez (DOB 05/23/2000) via WADL
Unit 2: Grey 2023 Mini Cooper (WALIC/CEV5498) (VIN/WMZ83BR08P3P59920)
Owner: Mabel R Capacho (DOB 12/28/1992) via WADL
Upon my arrival I observed unit 1 blocking the south bound lane facing south and unit 2 was on the
shoulder facing south. Unit 2 was off the roadway and was parked in front of the above listed address
and it was unoccupied at the time of the crash.
I then contacted the driver of unit 1. The following is a summary of what unit 1 told me happened. Unit
1 said she was on her way home trying to get home to Kent. Unit 1 said she was traveling south
bound in the south bound lane on Union Ave NE. The driver of unit 1 said she was on her phone
trying to send her friend a text saying she was on her way home. Unit 1 admitted to being distracted
on her personal electronic device at the time of the accident. While traveling south bound unit 1
swerved and hit unit 2 which was parked and unoccupied on the shoulder. Unit 1 hit unit 2 on the
driver's side of the vehicle with the front passenger side of her vehicle. Unit 1 had extensive damage
to the front passenger side of the vehicle. The driver of unit 1 also informed me that she did not have
insurance for the vehicle and was unable to provide me and form of insurance for the vehicle.
I then contacted the owner of unit 2 who lives at the call location. The owner confirmed no one was
inside the vehicle at the time of the accident and they just heard the crash and came outside to see
what happened. Unit 2 had severe body damage on the driver's side of the vehicle, however the
vehicle is still drivable. In addition, there are no witnesses to the accident and there were no video
cameras in that area.
Unit 1 needed to be towed and was towed by Bankers towing at the owner's expense. Unit 1 was
cited for using a personal cellular device while driving and failure to provide proof of insurance.
(CITE #3A0493206).
This concludes my involvement with 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 N. GIRELLO #12607 on 07/08/2023 at 0400 Renton, WA
PAGE 3 OF 4
REPORT NO. ED80071 CASE# 23-7775 DATE AND TIME 07/08/23 03:42
OF COLLISION
UNIT
UNION AVE NE
Z
PAGE 4 OF 4