HomeMy WebLinkAbout23-9687 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 5 27c
COLLISION REP FIT 1591971
CASE 23-9687 z
INTERSTATE ❑ CITY STREET FIRE ❑RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHIC;I F ❑ LOCAL AOENC 4200 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 08 - 1-- 2023 1716 17 ❑-= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
TALBOT ROAD SOUTH BLOCK NO. e✓ 2600 ❑
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ ❑ FEET e S ❑ W e S 26TH STREET
0 1 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
,/NO D:2069904741 0 9 30
6 LAST NAME VARGAS BRACHO FIRST NAME WILFRIDO MIDDLE D 1 2 31
INITIAL
STREET ❑ 1190 UNION AVE NE APT F3 CITy RENTON ST WA 2jp, 980594437 z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
iNTERLOCKYEs 1/ I NO NTERLOCKYEs NO Z/ YES R No�/
8❑ L IIER # STATE yyq SEX'M I D-MM D Y' 12 - 05 - 1959 1 1 2 32
9 ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 HELMETU E 2 CLASS 1 NATURE OF INJURIES z❑
3
10[9 PI PI ATE 14 CBN5102 sTAr WAv N#' JN8DR09Y53W822881
0 TRAILER STATE TRAILER STATE
11 3 0 PLATE# PLATE# FROM TO
FT -R TPILF1 1 5 33
12 3 0 VIN#' VIN#
FROM TO
VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE J 9 34
13 2 2003 NISS PATHFIN SV DAMAGE YES NO YES[:] No✓
REGISTERED OWNER INFO WILFRIDO VARGAS 1110 UNIONAVE NEAPTF3 RENTON WA 98059 D:2069904741 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
2 3 4
14 2 LIABILI INSURANCE❑ INSURANCE CO
IN EFFECT &POLICY# 9TOP
vewcLE CHARGE 10 BOTTOM 5 36
EGHALLY YES❑NO CITATION# W23010283,W23010283 INATTENTIVE DRIVING,OP MOT VEH
15❑ STANDING 8 6
MOTOR PEDAL PROPERTY DAM THR OLD MET PHONE
UNIT 02 VEHICLE CYCLE ❑ PEDESTRIAN ❑ OWNER ❑ YES 1/
16 NO D:4254421852
a
LAST NAME BRAGER FIRST NAME JOSHUA MIDDLE N
INITIAL
17 STREET 14109 S
NEW ADDRESS❑' E 168TH ST CITY RENTON ST WA ZIP 980588515 4❑ 37
18� CDL IGNITION REQUIRED IGNITION PR-E-1SENT MEDICAL TRANSPORTED 38
INTERLOCK YEs❑No� INTERLOCK YEs It I NOF YES
t l NOF,/
19 DRIVER #
❑ ON DUTY STATUS I
AIRBAG 2 RESTR 4 EJECT 1 H U EET 2 NJAURSY 1 NATURE OF INJURIES ❑ 40
❑ILICENSE 21❑ PLA E# AEJ6399 TArE 41
WA VIN# JF1GH6B656H824517 1
42
22❑ PLATE# STATE PLATE# STATE
23❑ UIN#. 43
TRLR RLR
'IN#.
VEH YEAR 2011 MAKE SUBA MODEL ►MPREZA STYLE 4H VEHICLE TOWED TO BLIN TOWEDeY GOV HI 44
24❑ DAMAGE YES NO,/ YES NO
REGISTERED OWNER INFO JOSHUA SRAGER 14109 SE 168TH ST RENTON WA 98058 D:4254421852 VEHICLE NO.2
SHADE IN DAMAGED AREA
2 3 4
LIABILITY
INSURANCE INSU&PORGY#E CO USAA 010934233C71017IN 1 9TOP
VEwCLE CITATION# CHARGE
25 i o BOTTOM
LEGALLY YES NEB
❑ s e
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# 77P�
26MATTHEW NUGENT 11498 1300
PART A PAGE 01 OF C7
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. ED97761
COLLISION REPORT III III III III III 111
1591972 CASE# 23-9687
ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY)
NAME
(/AST FIRST,MIDDLE INITIAL)_
ADDRESS&PHONE#
SEX D.O.B. - -
MMDDYYYY.
PASSENGER❑WITNESS UNIT# SEAT AIRBAG RESTR. EJECT ' HELMET INJURY NATURE OF INJURIES
PM 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.
MATTHEW NUGENT 08-23-23 04:20 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY E
DAT
C.JACOBS 1953 911112023 7:39:02 AM
BADGE OR ID# 11498 ORI# WA0171300 TIME POLICE DISPATCHED 5:21 PM TIME POLICE ARRIVED 5:42 PM
PART I PAGE IT]OF 4�
REPORT NO. ED97761 CASE# 23-9687 OF COLLISION
08/22/23 17:16
OF CbLLI510N
NARRATIVE
23-9687
On 08/22/2023 at approximately 1721 hours, I was dispatched to a non-injury and non-blocking
vehicle collision at the intersection of Talbot Road South and South 26th Street, within the City Limits
of Renton, County of King, State of Washington.
Upon arrival, I confirmed there were no complaints of injury from either of the involved parties. There,
I collected each of the involved parties driving documents and their independent recollection of the
events leading up to the collision.
The driver of Unit#1 said he was the sole occupant of his vehicle and was traveling southbound in
about the 2600 block of Talbot Rd S approaching the intersection of S 26th ST. The driver of Unit#1
stated he was traveling directly behind Unit#2 and was not paying attention to traffic in front of him.
The driver of Unit#1 did not specify what was distracting him. When the driver of Unit#1 looked back
at traffic, he noticed Unit#2 had stopped for an upcoming turn. The driver of Unit#1 was unable to
stop in time subsequently colliding with the rear of Unit#2 causing minor damage to the front of Unit
#1.
The driver of Unit#2 said he was the sole occupant of his vehicle and was also traveling southbound
in about the 2600 block of Talbot Rd S approaching the intersection of S 26th ST. The driver of Unit
#2 stated he was intending to make a left turn to proceed eastbound onto S 26th ST. Due to traffic
approaching from the opposite direction, Unit#2 came to a stop to yield to opposing traffic. The driver
of Unit#2 stated that while stopped, Unit#1 collided with the rear of Unit#2 causing moderate
damage to the rear of Unit#2.
Based on the above statements, 1 determined that the Driver of Unit#1 (Vargas Bracho) was the
predominant factor for the cause of collision due to inattention causing a collision. I issued Vargas
Bracho a correction notice for Inattention and for Operating a Motor Vehicle without Insurance.
Vargas Bracho was given 14 days to comply with the correction notice.
All of the involved vehicles were able to be driven away without further incident. An exchange of
information was provided to all involved parties.
I certify (or declare) under penalty of perjury under the laws of the State of Washington that the
foregoing is true and correct.
Electronically signed by Officer M. Nugent#11498 4:13 PM 8/23/2023 Renton, King County, WA.
PAGE 3 OF 4
REPORT NO. ED97761 CASE# ' 23-9687 DATE AND TIME 08/22/23 17:16
OF COLLISION
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LC
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'Dogram nal tti scalp Unii#1
Ung#2 .
South 26th Sdroet
PAGE 4 OF 4