HomeMy WebLinkAbout23-14310 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 5 27c
COLLISION REP FIT 1591971
CASE 23-14310 z
INTERSTATE ❑ CITY STREET FIRE ❑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
z
3❑ DATE OF M M D D Y Y Y Y TIME(2400) COUNTY# MILES N E IN CITY# ❑
cowsloN 12 - 1-- 2023 1400 17 ❑.= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
AIRPORT WAYS BLOCK NO. e✓ 200 ❑
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ ❑ FEET ❑ S ❑ W e SHATTUCKAVES
0 4 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
No ,/ I D:2064788464 0 11
30
6 LAST NAME SOLIS FUENTES FIRST NAME MARIA MIDDLE D 1 2 31
INITIAL
STREET ❑ 4455 NE 12TH ST APT 24-7 CITY RENTON ST WA 71p 98058 z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
iNTERLOCKYEs NO INTERLOCK YES NO YES No
$F-I LRIIVERCENS # STATE SEX'F MDMDD� 04 - 22 - 1991 1 2 32
9 ON DUTY❑ STATUS I
AIRBAG 2 RESTR 9 EJECT 1 H USEET CLAY 0 NATURE OF INJURIES z❑
❑10[1 PI ATNE 14 CGY9688 sTAr WWAuN# 1GNDT13S722146552 3
5 TRAILER STATE TRAILER STATE
11 3 5 PLATE# PLATE# FROM TO
TRLR. TRLR. 3 5 33
12 3 5 VIN#' VIN#
>; FROM TO
VEH.YEAR 2002 MAKE CHEV MODEL TRAIL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE 7 3 34
DAMAGE YES NO YES[:] NO✓
13❑ REGISTERED OWNER INFO MARIASOLISFUENTES4155NE12THSTAPT24-7RENTONWA98058 D:2064788464 VEHICLE NO. 1
SHADE IN DAMAGED AREA ❑ 35
2 3 4
14 LIABILI INSURANCE❑ INSURANCE CO
IN EFFECT &POLICY# 9TOP
VEHlcl.e CHARGE 10BOTTOM 5 36
LEGALLY YES❑NO❑ CITATION# 3A0387761,3A0387761 FAIL TO YIELD MOTOR VEHICLE,NO
15❑ NDING 6
MOTOR PEDAL- PROPERTY DAM THR OLD MET PHONE
UNIT 02 ❑✓ ❑ PEDESTRIAN ❑ ❑ D:2065519811
VEHICLE CYCLE OWNER YES,/ NO
16 a
LAST NAME 1 777771BONDS FIRST NAME JUSTICE MIDDLE /
INITIAL
17❑ STREET ❑', 6940 S 123RD ST APT L240 CITY' SEATTLE ST WA ZIP 981784184 37
NEW ADDRESS ❑
18� CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED ❑ 38
INTERLOCKYES�NOR INTERLOCK YEs❑NOF YEs❑NO❑
19 DRIVER #
INJURY1 NATURE OF INJURIES 40
20❑ ON DUTY STATUS' AIRBAG,4 RESTR 9 EJECT ''1 USE CLASS ❑
21❑ LICENSE I CFU7070 TAre WA VIN# 5NPET46C68H319004
❑ 41
PLATE#
42
22❑ PLATE# STATE PLATE# STATE
23❑ UIN#. 43
TRLR RLR
'IN#.
VEH YEAR 2008 MAKE HYUN MODEL SONATA STYLE VEHICLE TOWED TO BLIN TOWEDBY GOV HI 44
24❑ DAMAGE YES,� NO GENE MEYERS YES NO
REGISTERED OWNER INFO JUSTICE BONDS 6940 S 123RD ST APT L240 SEATTLE WA 981784184 D:2065519811 VEHICLE NO.2
SHADE IN DAMAGED AREA
2 3 4
INAEFFITY ECTNSURANCE❑ &POINSULICY#E CO I 9TOP 5
'E""LE ❑ ,J� CITATION# CHARGE i o BOTTOM
LEGALLY YES N J
25 OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
26
J.M/TCHELL 10377 WA0171300
PAGE 01 OF
PART A
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT No. EE33296
COLLISION REPORT III III III III III 111
1591972 CASE# 23-14310
ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY)
NAME MIDDLE INITIAL) PRESTON ASHLEYB
(LAST FIRST,
ADDRESS&PHONE# D O.B. '
3220 81ST PL SE UNIT 210 MERCER ISLAND WA 980402995 SEXi F MMDDYyry 04 - 13 - 1990
PASSENGER WITNESS UNIT# SEAT ! AIRBAG RESTR. EJECT ' HELMET INJURY NATURE OF INJURIES
❑✓ � 2 POS. 3 2 4 1 USE CLASS 1
NAME
(LAST,FIRST,MIDDLE INITIAL)
ADDRESS&PHONE# D O 8
SEX MMDDVYYY
PASSENGER ❑WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET NJURY NATURE OF INJURIES
POS. USE GLASS
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'
On 12/13/23 1 responded to a 2-vehicle non-injury/blocking collision at Airport Way and Shattuck Ave
S.
I contacted the driver of unit 2 who told me they were traveling in the #2 lane of eastbound Airport
Way, entering the intersection (Shattuck Ave S) on a green light when they were involved in a
collision with unit 1. The driver and passenger did not complain of injury. The vehicle sustained
heavy driver side damage.
I contacted the driver of unit 1, identified as Maria Solis Fuentes (dob 04-22-91) via her Mexican ID.
Solis Fuentes says she was making a left turn from westbound Airport Way to southbound Shattuck
Ave S (with a green light) when she was involved in a collision with unit 2. Solis Fuentes did not
complain of injury due to the collision but was seen by Renton Fire at her request. The vehicle
sustained front driver side bumper damage.
But not for the action of UNIT 1 DRIVER the result would not have happened.
I cited Solis Fuentes via SECTOR under RCW 46.61.180.1 -Failure to Yield and RCW 46.20.015- No
Valid Operator's License.
I declare under penalty of perjury under the laws of the State of Washington that the foregoing is true
and correct.
I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT.
J.MITCHELL 12-19-23 09:01 AM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST.DET DATED PLACE SIGNED
APPROVED BY DATE
CO.JOHNSON 0505 1 12/22/2023 8:03:46 AM
BADGE OR ID# 10377 ORI# WA0171300 TIME POLICE DISPATCHED; Y:00 PM TIME POLICE ARRIVED 2:10 PM
PART I PAGE IT]OF
REPORT NO. EE33296 CASE# ' 23-14310 DATE AND TIME 12/13/23 14:00
OF COLLISION
_,. .<
fi s.
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