HomeMy WebLinkAbout23-6930 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 5 27c
COLLISION REP FIT 1591971
❑ ❑ FIRE ❑ CASE$# 23-6930 2 573
INTERSTATE CITY STREET RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHIC;I F ❑ LOCAL AOENC 4Y00 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 2 TOTAL#OF OBJECT 1 1 8 28
TRIBAL UNITS OZ STRUCK
RESERVATION
2
3❑ DATE OF M M D D Y Y Y Y TIME(2400) COUNTY# MILES CITY# ❑
cawsloN 06 - 18 - 2023 1456 17 ❑.❑ N E IN S 8 W H OF e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓
LOGAN AVE N BLOCK NO. e✓ 900
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ 100 00 FEET MILES e S B W e N 10TH ST
0 1 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
NO D:2069449857 0 11
30
6 LAST NAME REYES CASTILLOI FIRST NAME NEPTALI MIDDLE 1 1 2 31
INITIAL
STREET ❑✓ 3102 NE 15TH PL#1 CITY RENTON ST WA 7jp, 98056 2
NEW ADDRESS
]❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
1/ I iNTERLOCKYEs NO NTERLOCKYEs NO Z/ YES R No�/
8 LRIIVERCENS # STATE SEX'M MDMDD 06 - 01 - 1994 1 2 32
9 ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 HELMET USE 2 1 CLAY NATURE OF INJURIES 2❑
3
10 9❑ Pi aTES� CFY6024 sTArI WAVIN# 2HGFG128X8H510153
-- TRAILER STATE TRAILER STATE
11 3 5 PLATE# PLATE# FROM To
TRLR. TRLR 5 1 33
12 3 5 VIN#j VIN#
FROM TO
VEH.YEAR 2008 HOND CIVIC CP MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED By GOVT.VEHICLE 5 1 34
13 DAMAGE YES NO YES❑ No✓
REGISTERED OWNER INFO GUSTAVO GARCIA VILLANUEVA 3102 NE 15TH PL APT I RENTON WA 98056 D:2064682567 VEHICLE NO. 1 ❑
SHADE IN DAMAGEDAREA 35
14 ❑ INSURANCE CO <53 4LIABILITY INSURANCEIN EFFECT &POLICV# TOPvewc CHARGE OTTOM 5 36
LEGALLY YES❑NO CITATION# 3A0318967,3A0318967, INATTENTIVE DRIVING,OP MOT VEH
15❑ STANDING 7 6
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT a2 VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES NO ,/ D:2532666739
16 a
LAST NAME ZEPEDA AVILA FIRST NAME ADRIAN MIDDLE N
INITIAL
17 STREET❑ NEW ADOREss❑' 1905 HARRINGTON AVE NE CITY RENTON ST WA ZIP 980562324 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 F] DRIVER'S STATE WA SEX M D.C... 10 _ 29 _ 1962 39
LICENSE# MMDDYY
WELMET {NJURY RE OF INJURIES 40
20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 USE 2 CLASS 1 NATU ❑
❑21❑ PLATE# C40623X TAre 41
WA vINIi 1GCVKNEC8HZ131104 1
42
22❑ PILER LATE# STATE PLATE# STATE
23❑ VIN#. 43
TRLR RLR
'IN#.
G
VEH
YEAR 201] MAKE CHEV MODEL SILVERA STYLE TR DAMAGE TOWED NOO✓ BLIN TOWED BY OV YES
NHIO 44
24❑ YES
REGISTERED OWNER INFO OWNED SY DRIVER VEHICLE N0.2
SHADE IN DAMAGED AREA
2 3 4
LIABILITY
INSURANCE INSU8 PORGY#E CO GEIC04283-96-48-66IN 1GQO`
VEwCLE ❑ ,J� CITATION# CHARGE
LEGALLY YES N`L J
25 s 7 6
=WARD
AME(PRINT) OFFICER PHONE BADGE OR ID# JAGENCY
26 11528 WA0171300
PART A PAGE 01 OF C7
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. ED71257
COLLISION REPORT III III III III III 111
1591972 CASE# 23-6930
ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY)
NAME MIDDLE INITIAL) LOPEZ VELASQUEZ SAMIRA
(LAST FIRST,
ADDRESS&PHONE#
1905 HARR/NGTON AVE NE RENTON WA 98056 SEXi F MMDOYyvv 05 - 29 - 1974
PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT ' HELMET INJURY NATURE OF INJURIES
❑✓ ❑ 2 POS, 3 2 4 1 USE 2 CLASS 1
NAME
(LAST,FIRST,MIDDLE INITIAL) ZEPEDA BRISEYDA
ADDRESS&PHONE# D O B
1905 HARRINGTON AVE NE RENTON WA 98056 SEX F MMDovvvv 01 _ 27 _ 2015
SEAT HELMET INJURY NATURE OF INJURIES
PASSENGER WITNESS❑ UNIT# 2 PGS 7 AIRBAG 2 RESTR. 10 EJECT 1 USE 2 CLASS 1
NAME
(LAST FIR57 MIDDLE INITIAL)
AppRESS&PHONE#
SEX D.O.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.
S.WOODWARD 06-18-23 04:21 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
S.WOODWARD 11528 1 611812023 4:29:50 PM
BADGE OR ID# 11528 OR]4f WA0171300 TIME POLICE DISPATCHED; 3:12 PM TIME POLICE ARRIVED',3:15 PM
PART I PAGE IT]OF 4�
REPORT NO. ED71257 CASE# 23-6930 OF COLLISION
06/18/23 14:56
OF CbLLI510N
NARRATIVE
All addresses listed herein, unless otherwise noted, are within the limits of the city of Renton King
County WA. This report is a summation of events that occurred and is not an exact sequence of
events.
On arrival in the 900 block of Logan Ave N, I found both vehicles in the northbound lane, blocking
traffic. After confirming there was no injuries, we pulled off to a side parking lot. Veh 1 had moderate
damage to the front end and Veh 2 had minor damage to the tow hitch and bumper.
Driv 1 provided only a Nicaraguan ID card and the registration for the vehicle, failing to provide any
proof of insurance for the car which belonged to his friend.
Driv 2 provided all necessary paperwork.
Driv 1 said he was driving north and wasn't paying attention to the other cars. He didn't see the truck
in front of him for some unk reason and hit it. He couldn't explain further how this happened and how
he didn't see the big black truck right in front of him. He said he had not been drinking.
Driv 2 said he was just driving along normally when the truck was hit from behind by the other car. He
wasn't stopped or slowing for the light and has no idea how it happened.
When checked, I found no record of Driv 1. 1 did not smell any odor of alcohol or marijuana on him
and did not detect any signs of him being impaired.
I provided the exchange of information form to both parties. I determined Driv 1 was the proximate
cause of the collision so I completed a Sector citation for Driv 1 for Inattentive Driving, no Insurance
and Driving without a valid operator's license -no ID. I sent it to the prosecutor to be mailed to him. He
was advised of the citation coming and told to respond to it.
Nothing further.
PAGE 3 OF 4
REPORT NO. ED71257 CASE# ' 23-6930 DATE AND TIME 06/18/23 14:56
OF COLLISION
Logan Ave N
PAGE 4 OF 4