HomeMy WebLinkAbout23-10687 ITFF' "POLCERA II I !�� I III I III I IIII III II I . $ 27c
COLLISION REP FIT 1591971
CASE 23-10687 z
INTERSTATE ❑ CITY STREET FIRE ❑
RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHIC;I F ❑ LOCAL AGENCI 4100 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2� 1 1 8 28
TOTAL#OF OBJECT
TRIBAL UNITS 02 STRUCK' TRAFFIC SIGNAL POLE
RESERVATION
z
3❑ DATE OF M M D D Y Y Y Y TIME(2400) COUNTY# MILES N E IN CITY#
cawsloN 09 - 1-- 2023 1850 17 ❑-= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
HARDIE AVE SW BLOCK NO. e ❑
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5 .❑ FEET e S ❑ W e SW 7TH ST
❑ �
0 1 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
✓NO D:4707988078 0 11
30
6� LAST NAME SISTRUNK FIRSTNAME A-RON MIDDLE W 1 2 31
INITIAL
STREET ❑ 4605 S 164TH ST CITY TUKWILA ST WA 21p, 98188 z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
�Z iNTERLOCKYEs No INTERLOCKYEs NO YES R NO
❑ DRIVER'S' STATE GA SEX'M MELO B 11 1- 01 - 1987 2 32
8 LICENSE#
9 ON DUTY❑ STATUS AIRBAG 6 RESTR 4 EJECT 1 H U EET 2 INJURY CLASS 1 NATURE OF INJURIES z❑
3
10❑ P1 ATE 14 CES6873 STATE WA VIN# 3FMTK3RM1NMA34379
TRAILER STATE TRAILER STATE
11 1 5 PLATE# PLATE# FROM TO
TRLR. TRLR 7 3 33
12 1 5 VIN#' VIN#
>; FROM TO
❑ VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN T /g[ GOVT.VEHICLE 1 $ 34
13 2 2022 FORD MUSTAN SD DAMAGE YES NOBS YES[:] No✓
REGISTERED OWNER INFO S..JARATO 12731 SE 173RD PL RENTON WA 98058 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
14 LIABILI INSURANCE INSURANCE CO STATE FARM 524.1714-C12.47
IN EFFECT &POLICY# 9TOP
vECEHA"LE 5 36
LLLv res❑NO❑ CITATION# CHARGE 1 o BOTTOM
15❑ STANDING 8 6
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES 1/ NO D:5098291564
16 a
LAST NAME SILVA FIRST NAME EFRAIN MIDDLE M
INITIAL
17❑ STREET NEW ADOREss❑' 610 BOLIN DR CITY TOPPENISH ST WA ZIP 98948 37
18❑ CDL IGNITION REQUIRED IGNITION PR-E-1SENT MEDICAL-T�RANSPORTED � 38
INTERLOCKYES�NO INTERLOCK YEs It I NOF YES t l NO❑
19 D IVERI #
❑ ON DUTY STATUS AIRBAG,6 RESTR 4 EJECT 1 WEB SET 2 NJAURSY 7 COMPLAINED OF HEAD PAIN,FD EVALUATED ❑F—NATURE OF INJURIES 40
❑21❑ 41
LICENSE I PLA E# BZ41795 [TAT WA vIN# 2T3G1RFV8MC195903 1
42
22❑ PLATE# STATE PLATE# STATE
23❑ VIN#. 43
TRLR RLR
'IN#.
VEH YEAR 2021 MAKE TOYT MODEL RAV4 STYLE SD VEHICLETOWED TO BLIN TOWEDBY GOV HI 44
24❑ DAMAGE YES NO BANKERS YES NO
REGISTERED OWNER INFO EFRAIN SILVA 610 BOLIN DR TOPPENISH WA 98948 D:5098291564 VEHICLE NO.2
SHADE DA GEbAREA
LIABILITY
INSURANCE &POINSURGY#E CO PROGRESSIVE 961311641 Cdd
IN CTOP
VEHICLE ❑ ,.I—I CITATION# CHARGE to BOTTOM
LEGALLY YES N
25 7.FF1S NAME(PRINT) OFFICER PHONE BADGE OR ID# JAGENCY
26
EDIGER 12807 WA0171300
PART A PAGE 01 OF C7
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EE04685
COLLISION REPORT III III III III III 111
1591972 CASE# 23-10687
ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY)
NAME MIDDLE INITIAL) SILVA NORMA B
(LAST FIRST,
ADDRESS&PHONE# D O.B. '
200 SW 5TH PL,APT G303 RENTON WA 98057 5093674466 SEXi F MMDOYyry 10 - 10 - 1973
{� SEAT HELMET INJURY NATURE OF INJURIES
PASSENGER L�WITNESSR UNIT# 2 POS 3 AIRBAG 6 RESTR, q EJECT 1 USE 1 2 1 CLASS 6 RIB AND BACK SORENESS,
ABRASIONS ON ARMS
NAME
(LAST,FIRST,MIDDLE INITIAL)
ADDRESS&PHONE# D O E9
SEX MMDDVYYV
PASSENGER ❑WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET NJURY
POS. NATURE OF INJURIES
USE CLASS
NAME
(LAST FIR57 MIDDLE INITIAL)
AppRESS&PHONE#
SEX D.O.B.
MMDDYVYY. -
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.
TYLER EDIGER 09-16-23 09:14 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
S.WOODWARD 11528 1 101212023 3:46:13 PM
BADGE OR ID# 12807 OR]4f WA0171300 TIME POLICE DISPATCHED 6:55 PM TIME POLICE ARRIVED',6:57 PM
PART I PAGE IT]OF 4�
REPORT NO. EE04685 CASE# 23-10687 OF COLLISION
09/16/23 18:50
OF CbLLI510N
NARRATIVE
23-10687
On 09-16-2023 at approximately 1855 hours I was dispatched to a collision at the intersection of SW
7th St and Hardie Ave SW, in the City of Renton, King County, WA.
While en route dispatch advised that one vehicle had rolled over during the collision. Upon arrival
both parties had exited their vehicles and were in stable conditions.
Fire was started for the injuries and two tow trucks were started for the vehicles.
Unit 1 is a 2022 Ford Mustang Mach-E (WA/Lic: CES6873) Unit 1 was driven by A-Ron W Sistrunk
(11/01/1987).
Unit 2 is a 2021 Toyota Rav-4 (WA/Lic: BZA1795). Unit 2 was driven by Efrain M Silva (10/24/1972)
with Norma B Silva (10/10/1973) as a passenger in the front passenger seat.
Unit 2 was driving southbound on Hardie Ave SW straight through a green light at the intersection of
SW 7th St. Unit 1 was driving eastbound on SW 7th St and went through a red light at the intersection
causing this collision.
The driver of unit 1 stated that his light was red but as he went to hit his breaks his vehicle did not
stop. I pressed his brake pedal at the scene, and it still had compression and caused the brake lights
to activate.
This collision caused both cars to end up on the SE corner of the intersection, causing unit 2 to roll
over and end up on its top side.
The driver of unit 1 did not complain of injuries and did not have any apparent injuries.
The driver of unit 2 stated that his head was hurting, and he was evaluated by fire, and his son was
going to drive him to the hospital after he was able to retrieve items from his car. The passenger of
unit 2 had multiple abrasions causing minor bleeding on each arm and complained of rib and back
pain. She was evaluated by fire and transported to Valley Medical Center.
This collision caused substantial damage to the front and passenger side of unit 1, and substantial
damage to the entirety of unit 2.
Pictures were taken of this collision and uploaded through Axon.
Based on the statements from both parties there is proximate cause to believe Unit 1 caused this
collision.
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 T. Ediger 12807 9/16/2023 Renton, King County, WA.
PAGE 3 OF 4
REPORT NO. EE04685 CASE# ' 23-10687 DATE AND TIME 09/16/23 18:50
OF COLLISION
1(n
iv
S
-0
SW''7th St _ UM2
M14ot araim to S-k,
PAGE 4 OF 4