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HomeMy WebLinkAbout23-7131 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 0 27c COLLISION REP FIT 1591971 CASE 23-7131 z INTERSTATE ❑ CITY STREET FIRE ❑RESULTED 1 STOLEN STATE ROUTE ❑ OTHER ❑ VFHIr.I 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 06 - 1-- 2023 1510 17 ❑-= S 8 IN e 1070 3 4❑ oN (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑ SE CARR RD BLOCK NO. e ❑ 4a❑ MILEPOST DISTANCE OF(REFERENCE OR CROSS STREET) 5❑ ❑ FEET e S ❑ W e 108THAVESE 0 1 29 MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE UNIT 01 VEHICLE ❑ CYCLE El ,/NO D:2067870816 0 6 30 6� LAST NAME SQUIRES FIRSTNAME RICHARD MIDDLE P 1 1 2 31 INITIAL STREET ❑ 3117 MAIN AVE S CITY RENTON ST WA ZIP 980555792 z NEW ADDRESS 7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3 1/ I iNTERLOCKYEs NO NTERLOCKYEs NO Z/ YES R No�/ 8❑ LRIIVER # ON DUTY❑ STATUS AIRBAG 3 RESTR 4 EJECT 1 H USEET ICNLJAURY 1 NATURE OF INJURIES z❑ 3 10❑ Pi aTES� AF05048 sTArI WAVIN# 5TFJX4GN9CX008991 TRAILER STATE TRAILER STATE 11 0 0 PLATE# PLATE# FROM TO TRLR. TRLR 7 3 33 12 0 0 VIN#' VIN# >; FROM TO ❑ VEH.YEAR 2012 MAKE MODEL STYLE VEHICLE TOWED TO BLIN T k GOVT.VEHICLE 34 13 4 TOYT TACOM PK DAMAGE YES NOBS 7 3 YES❑ No✓ REGISTERED OWNER INFO RICHARD SQUIRES 3117 MAINAVE S RENTON WA 98055 VEHICLE NO. 1 ❑ SHADE IN DAMAGED AREA 35 14LIABILI INSURANCE INSURANCE CO USAA 01461 2441U 3 4 IN EFFECT &POLICY# 9TOP VEHCLE CHARGE 5 36 LEGALLY YES❑NO❑ CITATION# 1 o BOTTOM 15❑ STANDING 7 6 MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE UNIT 02 VEHICLE ❑ CYCLE ❑ ❑ OWNER [:]EA. YES 1/ No D:2536529498 16 a LAST NAME MBALA FIRST NAME PASCAL MIDDLE N INITIAL 17 NEW ADDRE_ 15300 3STREET 3RD AVE S APT N326 CITY' SEATAC ST WA ZIP 98188 4❑ 37 18� CDL IGNITION REQUIRED IGNITION PtR—E—S1ENT MEDICAL TRANSPORTED 38 INTERLOCK YEs❑NO� INTERLOCK YEs I I NOF YEs t l NOF,/ 19 LDIIVERS STATE WA SEX M M .C... 10 _ 17 1988 0 39 WELMET INJURY1 NATURE OF INJURIES 40 20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 USE CLASS ❑ ❑21❑ PLATE# CGS5530 TAre 41 WA VIN# 3G18E6SM8HS552503 1 42 22❑ PLATE# STATE PLATE# STATE 23❑ VIN#. 43 TRLR RLR 'IN#. TOWED BV Gov HI 44 VEH YEAR 2017 MAKE CHEV MODEL CRUZE STYLE 4H —FEHICLE TOWED✓ NOO BLIN BANKERS YES No�/ 24❑ REGISTERED OWNER INFO OWNED SY DRIVER VEHICLE N0.2 SHADE IN DAMAGEbAREA 2 3 Cd LIABILITY INSURANCE INSU&POLICY#E CO UNKNOWNIN 1U 9TOP VE""LE ❑ ,J� CITATION# CHARGE o BOTTOMLEGALLYYES N`L J25 ' OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# JAGENCY 26 M.MAZURE 11700 WA0171300 PART A PAGE 01 OF C7 3000-345-159 OR 11/181 STATE OF POLICETRAFFICN CORRECTION REPORT NO. ED73795 COLLISION REPORT III III III III III 111 1591972 CASE# 23-7131 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' On 6/23/23 at approximately 1514 hours I was dispatched to a blocking collision. I arrived at the intersection od 108th Ave SE and S Carr Rd at approximately 1525 hours. Both vehicles were unable to move from the scene. The first vehicle was a Red Toyota Tacoma bearing WALP AF05048 and I contacted the driver, who was later ositively identified by his picture matching WADL as Richard P. Squires. Richard told me he was driving in the righ lane, going east on SE Carr Rd. He said the light at 108th Ave SE was yellow but he thought the driver would still go through. The driver of the car in front of him stopped quick and Richard did not have time to stop. Richard hit the back of the car in front of him causing his airbags to deploy. I then talked to the driver of the other car, a gray 2017 Chevrolet Cruize bearing WALP CGS5530. The driver who was later positively identified by his picture matching WADL as Pascal N. Mbala told me the following. He was going east on SE Carr Rd and stopped for the traffic light at 108th Ave SE and that is when the truck hit him from behind. Pascal did see Renton Fire onscene but did not go to the hospital. I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT. M.MAZURE 06-26-23 09:26 AM INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED APPROVED BY DATE DESIRES SCOTT 10272 1 6/26/2023 9:57:08 AM BADGE OR ID# 11700 ORI# WA0171300 TIME POLICE DISPATCHED', 3:14 PM TIME POLICE ARRIVED 3:25 PM PART I PAGE IT]OF REPORT NO. ED73795 CASE# ' 23-7131 DATE AND TIME 06/23/23 15:10 OF COLLISION 108th Ave. SE. N©t fo Scaie.. SE Carr Rd PAGE 3 OF 3