HomeMy WebLinkAbout23-14759 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 1 27c
COLLISION REP FIT 1591971
CASE 23-14759 z
INTERSTATE ❑ CITY STREET FIRE ❑
RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHICI F ❑ LOCAL AGENCI 4Y00 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 TOTAL#OF OBJECT 1 28
TRIBAL UNITS 01 STRUCK EARTH BANK OR LEDGE
RESERVATION
z
3❑ DATE OF M M D D Y Y Y Y TIME(2400) COUNTY# MILES N E IN CITY# ❑
cawsloN 12 - 1-- 2023 1816 17 ❑.= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓
BLOCK
NE SUNSET BLVD MILEPOST ST e✓ Y800
4a❑
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ ❑ FEET e S ❑ W e 0 1 29
MOTUNIT U1 VEHIOR Z PEDAL-CLE CYCLE ElYESA,G/E NHORESHOLD MET PHONE 30
6� LAST NAME SOTO-BARAJAS FIRSTNAME ANGEL MIDDLE U 1 1 2 31
INITIAL
STREET ❑ 1418 INDEX AVE NE CITY RENTON ST WA 2jp, 98056 z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED I IGNITION PRESENT MEDICAL TRANSPORTED 3
iNTERLOCKYEs �/ I NO NTERLOCKYEs NO Z YEs No�/
8❑ LICIENSE#VERS STATE SEX M MMDDBI Y 06 - 15 - 1993 32
9 ON DUTY❑ STATUS AIRBAG 3 RESTR 4 EJECT 1 HELMET USE 2 1 CLAY NATURE OF INJURIES z❑
3
10❑ Pi aT�S� CHX6931 sTArI WAvrN# 1HGCG5544WA195686
0 TRAILER STATE TRAILER STATE
11 0 0 PLATE# PLATE# FROM TO
TRLR. TRLR 3 7 33
12❑ vIN#' VIN#
1998 HOND CIVIC SD pL FROM 34
❑ VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO u BLIN TOWED BY GOVT.VEHICLE
13 4 DAMAGE YES NO �I YES[:] NO
REGISTERED OWNER INFO LUIS GUTLERRIZ-MONROY 1418/NDEXAVE NE RENTON WA 98056 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
14❑ LIABILITY INSURANCE❑ INSURANCE CO 3 4
IN EFFECT &POLICY# 9TOP
vwcLE YES CHARGE 5 36
❑NO❑ CITATION# BOTTOM
15❑ LEeCALLv STAIN,'" 8 6
UNIT U2 MOTOVEHIR
❑ CYCLE ❑ PEDESTRIAN ❑ OWNFRRTY ❑ DYES H OLD MET PHONE
16❑
LAST NAME FIRST NAME MIDDLE
INITIAL
STREET
CITY' ST ZIP 4❑ 37
17❑ NEW ADDRESS❑'
18❑ CDL IGNITION REQUIRED IGNITION PtR-E-S1ENT MEDICAL-T�RANSPORTED ❑ 38
INTERLOCK YEs❑NOR INTERLOCK YEs I I NOF YEs t l NO❑
19 LLIRIVEWSTICENS # STATE SEX MMDDYY -�_ 39
HELMET INJURY NATURE OF INJURIES 40
20❑ ON DUTY STATUS' AIRBAG RESTR EJECT USE CLASS ❑
❑21❑ TArE 41
IN#LICENSE V 1
PLATE#
42
22❑ PLATE# STATE PLATE# STATE
23❑ 43
TRLR RLR
VIN#. IN#.
VEH YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN
TOWEDBY Gov HI 44
L4❑ DAMAGE YES NO YES NO
REGISTERED OWNER INFO VEHICLE NO.2
SHADE IN DAMAGED AREA
2 3 4
LIABILITY
INSURANCE❑ INSURANCE
#E CO
IN EFFECT &PO IGQVE""LE
❑ ,J� CITATION# CHARGE
LEGALLY YES N`L J
25
7CA
NAME(PRINT) OFFICER PHONE BADGE OR ID# 777T�NCY
26LAN 12007 0171300
PART A PAGE 01 OF
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EE37458
COLLISION REPORT III III III III III 111
1591972 CASE# 23-14759
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
POS. 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'
On December 24, 2023, at 1816 hours dispatch requested that I respond to a collision that occurred
at the Shell Gas station, 2800 NE Sunset Blvd, in the City of Renton, County of King, and the State of
Washington. The reporting party stated that someone driving an older Honda Accord had just driven
into one of the gas station pillars.
Upon arrival officers were already on scene. The driver, identified by his Honduran passport as Angel
U. Soto-Barajas (06/15/1993), stated he was operating the vehicle and driving westbound on NE
Sunset Blvd when his vehicle sustained a flat tire, made vehicle pull right, losing control of it and
causing it to drive over the sidewalk along the gas station. The vehicle sustained 2 more flat tires and
triggered the airbags to deploy. The vehicle did not damage anything else, but itself. Angel refused
any medical attention because he said he was fine.
I confirmed that the gas station did not have anything that was damaged, so I provided Angel with my
case number and contact information.
This concludes my investigation.
I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT.
C.CATALAN 12-28-23 11:11 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY E
DAT
CO.JOHNSON 0505 11512024 9:52:58 AM
BADGE OR ID# 12007 ORI# WA0171300 TIME POLICE DISPATCHED! 6:19 PM TIME POLICE ARRIVED',6:22 PM
PART I PAGE IT]OF
REPORT NO. EE37458 CASE# ' 23-14759 DATE AND TIME 12/24/23 18:16
OF COLLISION
NE T'
NE SUNSET BLVD
SHELL GAS
., vw a �uV��muaraar v
SIDEWALK
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