HomeMy WebLinkAbout23-11280 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 5 27c
COLLISION REP FIT 1591971
CASE 23-11280 z
INTERSTATE ❑ CITY STREET FIRE ❑RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHIC;I F ❑ LOCAL AOENC 4Y00 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 3 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# ❑
COLLISION.. 10 - 1-— 2023 1612 17 ❑.= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓
HARRINGTON AVE NE BLOCK NO. e✓ 1300
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ 100 00 FEET MILES e S B W e NE 13TH ST
0 1 29
MOTOR PEDAL- DAM THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El YEs NO ,/ D:2066366569 1 3 30
6 LAST NAME GONZALEZ OROSCO FIRST NAME ERENDIDA MIDDLE N 1 2 31
INITIAL
STREET ❑ 1524 KENNEWICK AVE NE CITY RENTON ST WA ZIP 980562811 z
NEW ADDRESS
7 CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
❑
iNTERLOCKYEs NO 1/ INTERLOCKYEs NO Z YEs No�/
8❑ LRIIVER #
ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 H U SE
ICNLJAUSSY 1 NATURE OF INJURIES z❑
3
,OF]
0❑ PI ATES 4 BRW2631 STATE WA VIN# 4JGBF86E98A317463
IT STATE TRAILER STATE
11 2 5 PLATE# PLATE# ROM To
TRLR. YRLR 1 5 33
12 0 0 vIN#' YIN#
FROM TO
VEH.YEAR 2008 MAKE MERZ MODEL GL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE 1 5 34
13 4 DAMAGE YES NO YES[:] ✓
REGISTERED OWNER INFO RAFAEL PEREZQUINTERO 1524 KENNEWICKAVENE RENTON WA 98056 VEHICLE NO. 1
❑ ❑
SHADE IN DAMAGED AREA 35
14❑ LIABILI INSURANCE❑ INSURANCE CO 3
IN EFFECT &POLICY# 9TOP
vE—LE CHARGE 5 36
LEGALLY
Yes❑NO❑ CITATION# 10 BOTTOM
15❑ STANDING 8 7 6
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES NO ,/ D:2068325690
16❑
LAST NAME NARIO JIMENEZ FIRST NAME LUIS MIDDLE I E
INITIAL
17 STREET I❑ 1140 GLENNWOOD AVE NE APT A CITY RENTON ST WA ZIP 980563014 37
NEW ADOREss❑'
18❑ CDL IGNITION REQUIRED IGNITION PtR—E—S1ENT MEDICAL—T�RANSPORTED � 38
INTERLOCK YEs❑No� INTERLOCK YEs I I NOF YES
t l NO
�
19 DRIVER'S STATE WA SEX M D. 08 _ 13 _ 1970 39
LICENSE# MMDC7YY
HELMET INJURY NATURE OF INJURIES 40
20❑ ON DUTY STATUS AIRBAG 2 RESTR 1 EJECT 1 USE 9 1
CLASS ❑
❑ILICENSE 21❑ PLA E# BLR0016 TATe 41
WA vIN# 1NXBR30E27Z864364 1
42
22❑ PLATE# STATE PLATE# STATE
TRLR
23❑ VIN#. IN#. 43
RLR
'
VEH YEAR 2007 MAKE TOYT MODEL COROLL STYLE VEHICLETOWED TO BLIN TOWEDBY GOV HI 44
24❑ DAMAGE YES NO,/ YES NO
REGISTERED OWNER INFO LUIS NARIO JIMENEZ 1140 GLENNWOOD AVE NEAPTA RENTON WA 98056 VEHICLE NO.2
SHADE IN DAMAGED AREA
2 3 4
LIABILITY
INSURANCE &POINSURGY#E CO FIRST NATIONAL H2525058IN I STOP 5
VEHICLE ❑ ,.I—I CITATION# CHARGE i o BOTTOM
LEGALLY YES N
25 —TA
s 6
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
26
P.LANTAGNE 12575 WA0171300
PAGE 01 OF
PART A
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EE05613
COLLISION REPORT III III III III III 111
1591972 CASE# 23-11280
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'
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 10-03-23 09:59 AM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
S.WOODWARD 11528 101412023 1:49:55 PM
BADGE OR ID# 12575 OR]4f WA0171300 TIME POLICE DISPATCHED; 4:36 PM TIME POLICE ARRIVED]4:57 PM
PART I PAGE IT]OF 4�
REPORT NO. EE05613 CASE# 23-11280 OF COLLISION
10/02/23 16:12
OF CbLLI510N
NARRATIVE
23-11280
On 10/03/2023 at approximately 1612 hours, I, Officer Lantagne, responded to a non-blocking, non-
injury collision which occurred on Harrington AVE NE to the north of NE 13th ST, 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.
I arrived on scene and observed Unit#1, a 2008 Mercedes-Benz with license plates BRW2631
issued out of Washington State, and Unit#2, a 2007 Toyota Corolla with license plates BLRO016,
parked near the intersection. I was advised there were no injuries.
I contacted the driver of Unit#1, Erendida Gonzalez-Orasco (DOB 12/24/1981), who told me the
following: Gonzalez-Orasco was driving southbound on Harrington AVE NE. Harrington was
distracted by children and her vehicle drifted to the right. As Gonzalez-Orasco was correcting the
vehicle, the right rear corner of the vehicle scraped the left rear passenger door of Unit#2 which was
parked on the side of the road. Gonzalez-Orasco was driving a friend's vehicle and did not have proof
of insurance.
I contacted the driver of Unit#2, Luis Nario-Jimenez (DOB 08/13/1970), who told me the following:
Nario-Jimenez was waiting in his vehicle for his child's soccer game to end. As Nario-Jimenez was
sitting in his vehicle, the left side of the vehicle was struck by Unit#1.
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 rear bumper and taillight which
was cracked. Unit#2 had minor damage to the driver's side doors which were scraped.
The collision diagram is an accurate illustration of the events leading up to the collision.
I provided an exchange of information to Gonzalez-Orasco and Nario-Jimenez.
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 0948 hours on 10/03/2023 at Renton, WA.
PAGE 3 OF 4
REPORT NO. EE05613 CASE# ' 23-11280 DATE AND TIME 10/02/23 16:12
OF COLLISION
Case #23-1120
Q
9
Not to Scale
Unit#1 P. Lantagne #1257
Unit#2
Harrington AVE NE
s.
vi
r
NE 13th ST
PAGE 4 OF 4