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Home My WebLink About23-10452 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 0 27c COLLISION REP FIT 1591971 CASE 23-10452 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 CITY# ❑ cowsloN 09 - 09 - 2023 1757 17 ❑.❑ N E IN S 8 W H OF e 1070 3 4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓ BLOCK NE SUNSET BLVD MILEPOST ST e✓ 1100 4a❑ DISTANCE OF(REFERENCE OR CROSS STREET) 5❑ 100 00 FMILES EET e S ❑ E e ABERDEEN AVE NE 0 1 29 MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE UNIT 01 VEHICLE ❑ CYCLE El �/No D:4255454008 0 7 30 6� LAST NAME ROCHA FIRSTNAME MIGUEL MIDDLE L 1 1 2 31 INITIAL STREET ❑ 1555 UNION AVE NE APT 7 CITy RENTON ST WA 2jp, 980593964 z= NEW ADDRESS 7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3 INTERLOCK YES[:]NO 1/ INTERLOCKYEs NO�/ YES R No�/ 8❑ LRIIVER # ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 H U SE ICNLJAUSSY 1 NATURE OF INJURIES z❑ 3 10 9❑ PI ATFBit CFY4188 sTATI WA urN#' JN16V7AR8EM692480 TRAILER STATE TRAILER STATE 11 3 5 PLATE# PLATE# ROM To TRLR. TRLR 3 7 33 12 3 5 VIN#' VIN#' ROM TO VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE 3 9 34 13 4 2014 INFI Q50 DAMAGE YES NO YES[:] No ✓ REGISTERED OWNER INFO MIGUEL ROCHA 3650 TRIBUTE AVE E FIFE WA 98424 D:4255454008 VEHICLE NO. 1 ❑ ❑ SHADE IN DAMAGED AREA 35 14 LIABILI INSURANCE INSURANCE CO TRAVELERS 611736050 203 1 3 4 IN EFFECT &POLICY# 9TOP VEHICLE 5 36 LEGALLv Yes❑NO❑ CITATION# CHARGE 10 BOTTOM 15❑ STANDING 8 7 6 MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE UNIT VEHICLE ❑ CYCLE ❑ ❑ 16 a OWNER ❑ YES 1/ NO D:4253898818 LAST NAME ADJEI FIRST NAME JABEZ MIDDLE N INITIAL 17 STREET I❑ s❑' 1215 FRANKLIN ST CITY' BELLINGHAM ST WA ZIP 982255208 4❑ 37 NEW ADOREs 18❑ CDL IGNITION REQUIRED IGNITION PtR—E—S1ENT MEDICAL—T�RANSPORTED � 38 INTERLOCKYES�NO INTERLOCK YEs I I NOF YEs t l NOF,/ 19 D IVE ❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 H U EET NJAURSY 1 NATURE OF INJURIES 40 ❑ILICENSE 21❑ PLA E# BVU7176 TATE 41 WA VIN# 3N1AB8CV2LY250051 1 42 22❑ PLATE# STATE PLATE# STATE 23❑ UIN#. 43 TRLR RLR 'IN#. VEH YEAR 2020 MAKE NISS MODEL SENTRA STYLE VEHICLETOWED TO BLIN TOWEDBY GOV HI 44 L4❑ DAMAGE YES NO YES NO REGISTERED OWNER INFO JABEZADJEI 1215 FRANKLIN ST BELLINGHAM WA 98225 D:4253898818 VEHICLE NO.2 SHADE IN DAMAGED AREA 2 3 4 LIABILITY INSURANCE❑ &POINSULICY#E CO STATE FARMIN 1 GD VEHICLE CITATION# CHARGE 25❑ LLY LEGA YES[Z NC[:] s e 7p-, S NAME(PRINT) OFFICER PHONE BADGE OR ID# TZ01Y71300 NC 26 TAGNE 12575 PART A PAGE 01 OF C7 3000-345-159 OR 11/181 STATE OF POLICETRAFFICN CORRECTION REPORT NO. EE05612 COLLISION REPORT III III III III III 111 1591972 CASE# 23-10452 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 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. P.LANTAGNE 09-10-23 07:22 PM INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED APPROVED BY DATE S.WOODWARD 11528 10/4/2023 1:52:22 PM BADGE OR ID# 12575 OR]4f WA0171300 TIME POLICE DISPATCHED; 6:01 PM TIME POLICE ARRIVED',6:03 PM PART I PAGE IT]OF 4� REPORT NO. EE05612 CASE# 23-10452 OF COLLISION 09/09/23 17:57 OF CbLLI510N NARRATIVE 23-10452 On 09/09/2023 at approximately 1757 hours, I, Officer Lantagne, responded to a non-blocking, non- injury collision which occurred on NE Sunset BLVD to the west of the Aberdeen AVE NE overpass, which is located in the City of Renton, County of King, and the State of Washington. I responded in my fully marked police vehicle, wearing my patrol uniform. The driver's advised they moved their vehicles to Gene Coulon Park. I arrived at the Gene Coulon parking lot and observed Unit#1, a 2014 Infiniti Q50 with license plates CFY4188 issued out of Washington State, and Unit#2, a 2020 Nissan Sentra with license plates BVU7176, parked in the lot. 1 was advised there were no injuries. I contacted the driver of Unit#1, Miguel L. Rocha (DOB 09/26/2003), who told me the following: Rocha was driving westbound on NE Sunset BLVD. After passing under the overpass of Aberdeen AVE NE, traffic stopped abruptly in front of him, and he was not able to stop his vehicle in time. The front of Rocha's vehicle struck the rear bumper of Unit#2. 1 contacted the driver of Unit#2, Jabez N. Adjei (DOB 04/09/1999), who told me the following: Adjei was driving westbound on NE Sunset Blvd. Traffic from the N-405 on ramp was backed up and Adjei had to stop his vehicle abruptly. After Adjei's vehicle came to a stop for the traffic, the rear bumper of his vehicle was struck by Unit#1. Adjei was not able to provide his insurance information at the time. I observed the damage to the vehicles and other physical evidence was consistent with the statements made by both drivers. Unit#1 had minor damage to the front bumper which was cracked and dented in several places. Unit#2 had minor damage to the rear bumper which had broken off on the driver's side. The collision diagram is an accurate illustration of the events leading up to the collision. I provided an exchange of information to Rocha and Adjei. I, Officer P. Lantagne #12575, certify (or declare) under penalty of perjury, under the laws of the State of Washington, the foregoing is true and correct. Electronically signed by Officer P. Lantagne #12575 at 0729 hours on 09/10/2023 at Renton, WA. PAGE 3 OF 4 REPORT NO. EE05612 CASE# ' 23-10452 DATE AND TIME 09/09/23 17:57 OF COLLISION Case#23-10452 N Unit#;1 IRJF Unit#2 Not to kale P. ILanta ne 12575 - . � BpE NHL t$ NE Sunset BLVD ,yy" 3C( Aberdeen AVE NE(Overpass) PAGE 4 OF 4