HomeMy WebLinkAbout23-14468 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 5 27c
COLLISION REP FIT 1591971
CASE 23-14468 z
INTERSTATE ❑ CITY STREET FIRE ❑RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHICI F ❑ LOCAL AOENC WA0171.300 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 2 TRIBAL 02
TOTAL#OF OBJECT 1 1 8 28
UNITS ❑
RESERVATION I I
STRUCK z
3 M M D D Y Y Y Y TIME(2400) COUNTY# MILES CITY#
c usoN 12 - 17 - 2023 1100 17 ❑.= E IN e 1070 3
S 8
4❑ oN (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓
108TH AVE S BLOCK NO. e✓ 19044
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ 25 1. 00 FEET MILES e S B W e S 192ND ST
0 1 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
,/No D:2532892947 0 11
30
6 LAST NAME FLORES CORTES FIRST NAME JESUS MIDDLE 1 2 31
INITIAL
STREET El 22823 92ND AVE S APT N306 CITY KENT ST WA ZIP 98031 z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
iNTERLOCKYEs NO 1/ I INTERLOCKYEs Z NO I YES R No�/
8❑ LRIIVER #
ON DUTY❑ STATUS AIRBAG 3 RESTR 4 EJECT 1 HELMET 2 INJURY 6 NATURE OF INJURIES z❑
USE CLASS j I PAIN AND ABRASION TO LEFT HAND
LIC3
ENS BZR6713 STATE WA VIN#' YV1TS94D8Y1089194
10[1 PI
F_ TRAILER STATE TRAILER STATE
11 0 0 PLATE# I PLATE# I I FROM TO
FT -R TPILF1 1 5 33
12 0 0 VIN#' VIN#
FROM TO
VEH.YEAR ZOOO MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE 1 5 34
13 VOLV SSO $D DAMAGE YES NO YES[:] No
✓
REGISTERED OWNER INFO SEROIO FLORESALVAREZ 2282392NDAVE S APTN306 KENT WA 98031 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
14 LIABILITY INSURANCE❑ INSURANCE CO 3 4
IN EFFECT &POLICY# 9TOP
VEHICLE CHARGE 5 36
LEGALLY YEs❑No CITATION# 3A0847226 NOVAUNO INSURANCE o BOTTom
15❑ STANDING <1 7 6
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES 1/ No D:2535611343
16 a
LAST NAME 1 77771RETOLONG FIRST NAME PERLEEN MIDDLE
INITIAL
17 NEW STREETREs7' 10922 SE 254TH PL APT E03 CITY KENT ST WA ZIP 98030 37
18� CDL IGNITION REQUIRED IGNITION PRESENT MEDICALTRANSPORTED 38
INTERLOCK YEs❑No� INTERLOCK yEs❑NOF YEs❑NOF,/
19 DRIVER'S STATE I WA ]SEX IF D.Q.B. 07 14 1987 39
LICENSE# MMDDYY
20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 HELMET 2 INJURY 6 NATURE OF INJURIES 40
USE CLASS PAIN IN BACK
❑ 41
21❑ LICENSE I PLA E# CGH2494 TATE WA VIN# 2G1125S36F9206417 1
42
22❑ PLATE# STATE PLATE# STATE
r
23❑ 43
IN# IN RLR
#.UIN#. '
I
VEH YEAR 2015 MAKE CHEV MODEL IMPALASTYLE $D DAMAGE TO WED NOO✓ BLIN TOWED BY 44
Yr
GOV H YES
NO 1/
24❑ REGISTERED OWNER INFO OWNED SY DRIVER VEHICLE N0.2
SHADE IN DAMAGEbAREA
2 3 Cd
LIABILITY INSURANCE❑ INSURANCE CO
IN EFFECT &POLICY# 970E
"E""LE Yes Nc❑ cIrATION# 3AO847227 CHARGE NO INSURANCE oaoTroM
LE...LY
25 $
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# 7AGENCY
26
ROSEANNE HYNES 12612 WA0171300
PAGE 01 OF
PART A
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EE32900
COLLISION REPORT III III III III III 111
1591972 CASE# 23-14468
ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY)
NAME MIDDLE INITIAL) FLORES CORTES SERGIO
(LAST FIRST,
ADDRESS&PHONE# D O.B.
22823 92ND AVE S APT N306 KENT WA 98031 2532177261 SEX M MMDOYyry 06 - 28 - 2003
SEAT HELMET INJURY NATURE OF INJURIES
PASSENGER�WITNESS� UNIT# 1 POS. 3 AIRBAG!3 RESTR. 4 EJECT 1 USE 2 CLASS i6 PAlNTOLEFTKNEE
NAME
(LAST,FIRST,MIDDLE INITIAL) BILLY BARAK M
ADDRESS&PHONE# D O B
10922 SE 254TH PL APT E03 KENT WA 98030 SEX M MMDDYvvv 11 _ 01 _ 2012
SEAT HELMET INJURY NATURE OF INJURIES
PASSENGER WITNESS UNIT# 2 POS 3 AIRBAG 2 RESTR. 4 EJECT 1 USE 1 2 CLASS 1
NAME
(LAST FIR57 MIDDLE INITIAL)
AppRESS&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.
ROSEANNE HYNES 12-17-23 05:06 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
QUINT TIBEAU 07691 1 12/21/2023 8:53:18 AM
BADGE OR ID# ( 12612 OR]# WA0171300 TIME POLICE DISPATCHED; 11:03 AM TIME POLICE ARRIVED',11:08 AM
FART I PAGE IT]OF 4�
REPORT NO. EE32900 CASE# 23-14468 OF COLLISION
12/17/23 11:00
OF CbLLI510N
NARRATIVE
On 12/17/2023 at 1103 hours, I was in full patrol uniform and driving a marked Renton Police patrol
vehicle when I was dispatched to 19044 108th Ave SE in the city of Renton, County of King, State of
Washington regarding a traffic collision.
Upon arrival, I saw V1-gray Volvo (WA LIC# BZR6713) resting on all four tires in the roadway on
108th Ave S, just north of SE 192nd St. V1 had severe damage to it's front end. The front driver and
front passenger airbag had been deployed. V1 was in the southbound left lane. I saw V2 -red Chevy
Impala (WA LIC# CGH2494) parked in the parking lot of the 76 Gas station at 19044 108th Ave SE. I
saw damage to the rear of the vehicle.
I spoke with D1-Jesus Flores-Cortes and he told me in summary: He was driving south on 108th Ave
S approaching the intersection at SE 192nd St. V2 was driving in front of him. He saw the traffic
signal light turn yellow. V2 braked and he, D1, applied the brakes on his vehicle but could not stop in
time. His vehicle skidded and collided into the rearend of V2. I asked D1 if he knew about how far
away from V2 he was when V2 applied the breaks. He pointed to the approximate area of the
distance between his vehicle and V2. I estimated it was about two car lengths away. I saw redness to
the back of D1's hand. He complained of pain to his left hand. He declined medical treatment and
transport on scene. D1 said his brother, passenger Sergio Florez-Cortes was sitting in the front
passenger seat at the time of the accident. Sergio complained of pain to his left leg. Sergio left the
scene before I could speak with him. I asked D1 for his driver license and insurance information. D1
said he did not have a driver license and had a Washington ID only. He also said he didn't have proof
of insurance with him. He believed his father had insurance for the vehicle, but was not certain.
I spoke with D2-Perleen Retolong and she told me in summary: She was driving south on 108th Ave
S in the left lane and approaching the light at SE 192st St. The light turned yellow so she braked and
stopped her vehicle. Immediately afterward, she was hit from behind by V1. D2 complained of pain to
her back. She declined medical assistance and transport. I did not observe visible injury upon her. D2
said her juvenile son, Barak M. Billy, was sitting in the front passenger seat at the time of the collision.
She said he appeared uninjured and did not complain of injury to her. I did not observe injury upon
Barak. I asked D2 for her license and insurance information. D2 said she did not have insurance for
her vehicle.
Because D1-Cortes was driving a motor vehicle on the city street without a driver's license but had
valid identification, I determined he was in violation of RCW 46.20.015 -No Valid Operators License
with Valid ID. Because D1 did not have proof of insurance, I also cited him for being in violation of
RCW 46.30.020-Operating a Motor Vehicle without Insurance. Reference citation #3A08472256.
Because D2-Retolong did not have insurance, I cited her for RCW 46.30.020 -Operating a Motor
Vehicle without Insurance. Reference citation #3A0847227.
V1 was privately towed from the scene. V2 was driven from the scene. I have nothing further.
This incident was captured on my body worn video camera. This report is a summary of events that
occurred and is not an exact sequencing of events. Statements have been paraphrased and
summarized.
I certify (declare) under penalty of perjury under the laws of the State of Washington that the
foregoing is true and correct.
Electronically signed: R. Hynes #12612 Date & Place: 12/17/2023 @ 1700 hrs Renton, WA
PAGE 3 OF 4
REPORT NO. EE32900 CASE# ' 23-14468 DATE AND TIME 12/17/23 11:00
OF COLLISION
i
Not
Drawn to Scale
1Se, 192nd St
q
b
3
i iI
PAGE 4 OF 4