HomeMy WebLinkAbout23-8982 POLICETRAFF'c" III !�� I IIIllI111IN II II I REPORT NO. ED88765 170
27
COLLISION REP FIT 1591971
❑ ❑ FIRE ❑ CASE# 23-8982 2 0 6
INTERSTATE CITY STREET RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHICI 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
2
3❑ DATE OF M M D D Y Y Y Y TIME(2400) COUNTY# MILES N E IN CITY# ❑
cowsloN 08 - 1-- 2023 1640 17 ❑.= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓
SUNSET BLVD N BLOCK NO. e
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ 100 00 FEET e S MILES N B W e N 3RD ST
0 2 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
,/No D:4253219998 0 11
30
LAST NAME RODRIC�UEZAREVALOS FIRSTNAME CHRISTIAN MIDDLE' N
6 INITIAL 1 2 31
STREET El 12033 WOODINVILLE DR TRLR 32 CITy BOTHELL ST WA 2jp, 980115438 2
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
1/INTERLOCK YES[:]NO INTERLOCKYEs Z/NO YES �No /
LRIIVER # STATE WA SEX'M MI MIT Y
8❑ ' 05 — 01 — 1990 1 2 32
9 ON DUTY❑ STATUS AIRBAG 4 RESTR 4 EJECT 1 H U EET ICNLJAURY 1 NATURE OF INJURIES 2❑
3
10❑ P1 aTES� BTJ9110 sTArr WAurN# 5FNYF6H93L6018974
TRAILER STATE TRAILER STATE
11 0 0 PLATE# PLATE# FROM TO
TRLR. TPILF1 1 5 33
12 0 0 VIN#' VIN#
FROM TO
VEH.YEAR 2020 MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE 1 5 34
13 HOND PILOT UT DAMAGE YES NO YES[:] No✓
REGISTERED OWNER INFO INDUSTRIAL CREDIT UNIONPO BOX 1767 BELLINGHAM WA 98227 D:4253219998 VEHICLE NO. 1
SHADE IN DAMAGED AREA 35
4 INSURANCE CO 3 4
14 LIABILITY INSURANCE SAFECO H2498778
IN EFFECT &POLICY# 9TOP
VEH'CLE CHARGE to BOTTOM 5 36
LEGALLv YES❑NO❑ CITATION# 5
15❑ STANDING 8 6
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT VEHICLE ❑ CYCLE ❑ ❑
16 : OWNER ❑ YES 1/ NO D:2065107296
a
LAST NAME JEFFRIES FIRST NAME JOEL MIDDLE P
INITIAL
17 STREET NEW ADOREs7 922 GLENNWOOD AVE NE APT 1 CITY RENTON ST WA ZIP 980563061 4❑ 37
18� CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 38
INTERLOCK YES❑NO INTERLOCK YEs I I NOF YEs t l NOF,/
19 DRIVER'S STATE WA SEX M D.Q.B. 03 _ 17 1982 39
LICENSE# MMDDYY
20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 HEJ EET NJAURSY 1 NATURE OF INJURIES 40
❑21❑ PLATE# CFX4612 TArE WA VIN 1 KMHJG25F51 U253006 41
1
42
22❑ PLATE# STATE PLATE# STATE
23❑ UIN#. 43
TRLR RLR
'IN#.
TOWED BY Gov HI 44
VEH YEAR 2001 MAKE yyUN MODEL TIBURON STYLE CP DAMAGE TOWED NOO✓ BLIN YES NO
24❑ REGISTERED OWNER INFO OWNED SY DRIVER VEHICLE N0.2
SHADE IN DAMAGED AREA
2 3 4
INAEFFITY ECTNSURANCE INSU&POLICY#E CO USER I 9TOP 5
VE"LE ❑ ,J� CITATION# CHARGE i o BOTTOM
LEGALLY YES N J
25 a
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
26
RYAN KARLO RIVERA 12649 WA0171300
PART A PAGE 01 OF
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. ED88765
COLLISION REPORT III III III III III 111
1591972 CASE# 23-8982
ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY)
NAME MIDDLE INITIAL) ROMERO PEREZ KENIA 1
(LAST FIRST,
ADDRESS&PHONE#
12033 WOODINVILLE DR TRLR 32 BOTHELL WA 98011 SEXi F MMDOYyvv 04 - 17 - 1993
PASSENGER WITNESS ,UNIT# 1 PpS. 3 AIRBAG q RESTR. q EJECT ? 1 HELMET INJURY NATURE OF INJURIES
USE CLASS 1
NAME
(LAST,FIRST,MIDDLE INITIAL) RODRIGUEZ CHRISTIAN
ADDRESS&PHONE# D O B
12033 WOODINVILLE DR TRLR 32 BOTHELL WA 98011 SEX M MMDD'Y 05
SEAT HELMET I INJURY NATURE of INJURIES
PASSENGER Z WITNESS UNIT# 1 POS. 10 AIRBAG 4 RESTR. 4 EJECT 1 USE CLASS 1
NAME
LAST FRST MIDDLE INITIAL) RODRIGUEZ CHRISTOPHER
AooREss&PHONE# 12033 WOODINVILLE DR TRLR 32 BOTHELL WA 98011 SEX M D•O
MMDD•B• 02 _ 05 _ 2019
YYYY
PASSENGER WITNESS UNIT# ! 1 SEAT 10 AIRBAG 4 RESTR. 4 EJECT 1 HELMET NJURY 1 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.
RYAN KARLO RIVERA 08-06-23 06:43 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
DESIREE SCOTT 10272 8/13/2023 12:44:08 PM
BADGE OR ID# 12649 ORI# WA0171300 TIME POLICE DISPATCHED! 4:46 PM TIME POLICE ARRIVED',4:50 PM
PART Ei PAGE IT]OF
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. ED88765
COLLISION REPORT III III III III III 111
1591972 CASE# 23-8982
ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY)
NAME MIDDLE INITIAL) RODRIGUEZ LEAH
(LAST FIRST,
ADDRESS&PHONE# D O.B.
12033 WOODINVILLE DR TRLR 32 BOTHELL WA 98011 SEXi F MMDOYyry 07 - 03 - 2020
PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT ' HELMET INJURY NATURE OF INJURIES
❑✓ 1 POS. 10 4 4 1 USE CLASS 1
NAME
'(LAST,FIRST MIDDLE INITIAL)
ADDRESS&PHONE# DOB
SEX' MMDDYYYY
PASSENGER ❑WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET NJURY 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 GLASS ----�
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.
RYAN KARLO RIVERA 08-06-23 06:43 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
DESIRES SCOTT 10272 8/13/2023 12:44:08 PM
BADGE OR ID# 12649 ORI#' WA0171300 TIME POLICE DISPATCHED! 4:46 PM TIME POLICE ARRIVED',4:50 PM
PART Ei PAGE IT]OF
REPORT NO. ED88765 CASE# 23_8982 O OFF CbLL COLLOTINIEI510N 08/06/23 16:40
NARRATIVE
On 08/06/2023, 1 was working uniformed patrol in a marked police car as 3R25. At approximately
1646 hours, I was dispatched to a non-injury and non-blocking collision at the intersection of NE 3rd
St/Sunset Blvd N, which is within the city limits of Renton, county of King, Washington. Dispatch
advised that about 3 minutes ago, two vehicles were in a collision. Dispatch also advised that the
drivers had moved into the Burger King parking lot which is on the northwest corner of the
intersection.
When I arrived, I was able to speak to both involved parties.
I identified the driver of Unit 1 to be Christian Rodriguez Arevalos (DOB: 05/01/1990, verified via DOL
photo). He was the driver of the white 2020 Honda Pilot (WA/BTJ9110, VIN/5FNYF6H93LB018974).
Officer M. Long spoke with this driver and relayed the following information to me:
Unit 1 stated he thought he was in the number 1 right-hand turn lane in the southbound lanes of
Sunset Blvd N. He then began to turn right to head westbound on N 3rd St. He then remembers
colliding with Unit 2.
Unit 1's vehicle sustained damage to its front passenger side wheel well. There were obvious dents in
the area. His vehicle also had airbag deployments along the passenger side of the vehicle.
Unit 1 and its vehicle's occupants were not injured.
I then identified the driver of Unit 2 to be Joel P. Jeffries (DOB: 03/17/1982, verified via DOL photo).
He was the driver of the yellow Hyundai Tiburon (WA/CFX4612, VIN/KMHJG25F51 U253006). My
conversation with him is summarized as follows:
Unit 2 was in the number 2 lane headed southbound on Sunset Blvd N. He also said Unit 1 was in the
number 3 lane. He then remembers that he briefly saw Unit 1 erratically turn right towards N 3rd St.
Unit 2 was unable to react fast enough and collided with Unit 1 just before the intersection.
Unit 2's vehicle sustained damage to its driver's side area. There were obvious dents and a flat tire in
this area.
Unit 2's driver was not injured.
Based on the information provided by the driver I found that Unit 1 was the cause of the accident.
This concludes my report.
I certify (declare) under penalty of perjury under the laws of the State of Washington that the
foregoing is true and correct.
Signed:yan Rivera #12649 Date & Place:08/06/2023 @ Renton, Washington
**** AUTO-POPULATED SECTION ****
THE FOLLOWING ARE DESCRIPTIONS ENTERED FOR ITEMS SELECTED AS "OTHER":
Motor Vehicle Unit 1
Seat Position (Passenger CHRISTIAN RODRIGUEZ): BACK SEAT
PAGE 4 OF 6
REPORT NO. ED88765 CASE# 23_8982 O OFF CbLL COLLOTINIEI510N 08/06/23 16:40
NARRATIVE
Seat Position (Passenger CHRISTOPHER RODRIGUEZ): BACK SEAT
Seat Position (Passenger LEAH RODRIGUEZ): BACK SEAT
**** END OF AUTO-POPULATED SECTION ****
PAGE 5 OF 6
REPORT NO. ED88765 CASE# ' 23-8982 DATE AND TIME 08/06/23 16:40
OF COLLISION
RPo C.-#23 8982.:
,NOT DRAWN TO SCALE'
N 3rd St
NE:3rd 5t
raC:�f 6mpac€.
z
ti
Unit 2
PAGE 6 OF s