HomeMy WebLinkAbout23-7541 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 0 27c
COLLISION REP FIT 1591971
CASE 23-7541 z
INTERSTATE ❑ CITY STREET FIRE ❑RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHICI F ❑ LOCAL AGENCI 4Y00 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 TOTAL#OF OBJECT 1 28
TRIBAL UNITS 02 STRUCK' FENCE
RESERVATION
z
3❑ DATE of M M D D Y Y Y Y TIME(2400) COUNTY# MILES N E IN CITY# ❑
CowsloN 07 - 1-- 2023 0813 17 ❑.= S 8 IN e 1070 3
4❑ oN (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓
SE CARR RD BLOCK NO. e✓ 10300
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ ❑ FEET ❑ S ❑ W❑ 0 1 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
,/No D:2536328234 30
6 LAST NAME RIVERA LOPEZ FIRST NAME RAUL MIDDLE J 9 2 31
INITIAL
STREET ❑ 21926 84TH AVE S APT 27 CITY KENT ST WA 2jp, 980322475 z=
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
INTERLOCK YES[:]NO INTERLOCKYEs NO YES R No�/
8❑ LRIIVER #
ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 HELMET
2 CLASS 1 NATURE OF INJURIES z❑
❑LICENSE CCM0629 sTArI WWAVIN# 2B3KA43G06H311746 3
10❑ PI ATE#
F_ TRAILER STATE TRAILER STATE
11 3 5 PLATE# PLATE# FROM To
TRLR. TRLR 7 3 33
12❑ VIN#' VIN#..
Ro❑34
13� VEH.YEAR 2006 MAKE DODG MODEL CHARG STYLE IV
AMAGE TOWED NOO pLSABLIN TSIYYEp9vMEYERS VEHICLE�
DAMAGE IILLJJII (S�IV6
REGISTERED OWNER INFO WILBERTO NIURILLO SOLTERO 1040665THAVEE PUYALLUP WA 98373 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
2 3 4
14 LIABILITY INSURANCE❑ INSURANCE CO
IN EFFECT &POLICY# 9TOP
VEwcLE CHARGE BOTTOM 5 36
-ALLv YES No CITATION# 3A0492512,3A0492512, NEGLIGENT DRIVING 2ND DEGREE,
15❑ STANDING 8 6
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT 02 VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES 1/ No D:4254307500
16❑
LAST NAME CITY OF RENTON FIRST NAME MIDDLE
INITIAL
17❑ STREET ❑', 1055 S GRADY WAY CITY' RENTON ST WA ZIP 98057 37
NEW ADDRESS ❑
18� CDL IGNITION REQUIRED IGNITION PRESENT MEDICALTRANSPORTED 38
INTERLOCKYES�NOF INTERLOCK YEs❑NOF YEs❑NO❑
19 LLIICENS # STATE SEX U MMDDYY 39
HELMET INJURY NATURE OF INJURIES 40
20❑ ON DUTY STATUS' AIRBAG RESTR EJECT USE CLASS ❑
❑21❑ LICENSE TArE VIN# 41
PLATE#
42
22❑ PR TRAILER LATE# STATE PLATE# STATE
23❑ 43
TRLR RLR
VIN#. IN#.
VEH YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN
TOWED BY GOV HI 44
L4❑ DAMAGE YES NO YES NO
REGISTERED OWNER INFO VEHICLE NO.2
SHADE IN DAMAGED AREA
2 3 4
LIABILITY
INSURANCE❑ INSURANCE
#E CO
IN EFFECT &PO IGQVE"lLE :
,J� CITATION# CHARGE
LEGALLY YES N`L J
25 s � e
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# JAGENCY
26
K.LANE 10008 WA0171300
PART A PAGE 01 OF C7
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. ED76158
COLLISION REPORT III III III III III 111
1591972 CASE# 23-7541
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'
Unit 1 was traveling eastbound on SE Carr RD approaching the 10300 blk in the right lane. Driver 1
said that he was traveling at such a speed that when he entered a sweeping left hand curve and
needed to brake, his front tires broke traction causing him to drift straight ahead as the road curved to
the left. Unit 1 front passenger tire struck the curb which sent the vehicle out of control into a hard left
turn. Unit 1 crossed over the center line, across oncoming lanes of traffic, and up onto the north side
sidewalk. Unit 1 continued forward through a chain link fence (Unit 2) and down into a thicket of
sticker bushes approximately 10 feet below the roadway surface. This collision caused significant
damage to the front end and underside of Unit 1 but Driver 1 was uninjured. Unit 1 towed out by Gene
Meyers tow.
Driver 1 was identified via WA ST ID card and DOL records check showed he was not licensed but
eligible. Driver 1 also advised the vehicle was uninsured.
Driver 1 was cited for Negligent Driving in the 2nd degree. This is based on the fact that Driver 1 was
driving in a negligent manner at such a speed with the roadway conditions that the front-end lost
traction causing it to lose control and strike a curb. This resulted in the vehicle crossing over all lanes
of traffic, out of control, up onto a sidewalk, through a fence, and down an embankment. This action
potentially endangered any motor traffic on the roadway or pedestrian traffic on the sidewalk.
Driver 1 was also cited for operating a motor vehicle without a valid license (NVOL 2nd) and
operating a motor vehicle without insurance.
I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT.
K.LANE 07-03-23 11:59 AM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY E
DAT
C.JACOBS 1953 7/3/2023 3:21:56 PM
BADGE OR ID# 10008 ORI# WA0171300 TIME POLICE DISPATCHED; 8:27 AM TIME POLICE ARRIVED 8:31 AM
PART I PAGE IT]OF 3�
REPORT NO. ED7]5 RASE# 2y7 4] AT m°M\ O»0/230 d3
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