HomeMy WebLinkAbout23-11289 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 0 27c
COLLISION REP FIT 1591971
CASE 23-11289 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 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 1810 17 ❑.= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓
NE 3RD ST BLOCK NO. e✓ 2300
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5 100 00 FEET e S ❑ W e EDMONDS AVE NE❑
0 1 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
No ,/ I D:4253516731 0 11
30
6� LAST NAME LOPEZ-CAMPOS FIRSTNAME PEDRO MIDDLE N 1 1 2 31
INITIAL
STREET El 212 GLENNWOOD PL SE CITY RENTON ST WA 2jp, 980568889 z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
,/ I INTERLOCK YES[:]NO NTERLOCKYEs Z/NO YES R NoF,/
LRIIVER # STATE WA SEX'M MI MIT Y
8❑ ' 04 — 13 — 1960 1 2 32
9 ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 H USE 2 1 CLASS NATURE OF INJURIES 2❑
3
10 9� PiATE14 D02219A STATE WA VIN# 1C6RR"G1FS668363
11[-j- TRAILER STATE TRAILER STATE
11 3 5 PLATE# PLATE# IR.. ro
TRLR. TRLR 7 3 33
12 3 5 VIN#j VIN#
:: FROM TO
VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE 7 3 34
13 2 2015 RAM 1500 PK DAMAGE YES NO YES[:] No
✓
REGISTERED OWNER INFO OWNEDBYDRIVER VEHICLE NO. 1
SHADE IN DAMAGED AREA ❑ 35
14 LIABILITY INSURANCE INSURANCE CO ALLSTATE 917987453 3 4
IN EFFECT &POLICY# 9TOP
VEHICLE CHARGE 1 5 36
F�A�LY YES❑NO❑ CITATION# 3A0318974 IMPROPER LANE USAGE o Borrom
15❑ STANDING 8 7
1.' MOTOR PEDAL- : PROPERTY DAM THR OLD MET PHONE
UNIT a2 VEHICLE CYCLE ❑ PEDESTRIAN ❑ OWNER ❑ YES,/ NO DD 2062500148
16 a
LAST NAME CUMMINGS FIRST NAME SPECIAL M{DDLE I L
INITIAL
17❑ STREET ❑', 21636 29TH AVE S APT 2 CITY DES MOINES ST WA ZIP 981987778 37
NEW ADDRESS ❑
18� CDL IGNITION REQUIRED IGNITION PR—E-1SENT MEDICAL TRANSPORTED 38
INTERLOCKYES�NO� INTERLOCK YEs It I NOF YES
t l NOF,/
19 DRIVER'S STATE WA ]SEX IF D.C... 05 _ 17 1996 39
LICENSE# MMDDYY
HELMET {NJURY 1 NATURE OF INJURIES 40
20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 USE 2 CLASS ❑
21❑ LICENSE I CCX5617 TATe WA vIN# 2HKYF18463H558358
❑ 41
PLATE#
42
22❑ PLATE# STATE PLATE# STATE
TRLR
23❑ VIN#. IN#. 43
RLR
'
VEH YEAR 2003 MAKE HOND MODEL PILOT STYLE UT VEHICLE TOWED TO BLIN TOWEDBY GOV HI �44
L4❑ DAMAGE YES NO,� YES NO
REGISTERED OWNER INFO YONAS GEBREGIORGIS 808 FIRST UNIT 640 SEATTLEWA98104 D:2065134258 VEHICLE NO.2
SHADEDAMAGEDAREA
3 4
LIABILITY INSURANCE❑ INSURANCE CO
IN EFFECT &POLICY# 1
25 5YES NuCITATION# 3A0318972,3A0318973 CHARGE DWLS 3RD DEGREE,OP MOT VEH GQ
LEGALLY
s � a
=WARD
AME(PRINT) OFFICER PHONE BADGE OR ID# 77]�NCY
26 11528 0171300
PART A PAGE 01 OF C7
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EE05609
COLLISION REPORT III III III III III 111
1591972 CASE# 23-11289
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
PM 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.
S.WOODWARD 10-03-23 10:33 AM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
S.WOODWARD 11528 101412023 1:50:13 PM
BADGE OR ID# 11528 OR]4f WA0171300 TIME POLICE DISPATCHED 6:15 PM TIME POLICE ARRIVED',6:15 PM
PART I PAGE IT]OF
REPORT NO. EE05609 CASE# 23-11289 OF COLLISION
10/02/23 18:10
OF CbLLI510N
NARRATIVE
All addresses listed herein, unless otherwise noted, are within the limits of the city of Renton King
County WA. This report is a summation of events that occurred and is not an exact sequence of
events.
On 10-02-23, at approx. 1802 hrs, I was dispatched to a blocking disabled vehicle near the
intersection of NE 3rd St/Edmonds Ave NE, involving a broken down U-Haul truck that was blocking a
lane of eastbound traffic. While enroute, an additional call was received about a collision at that
location involving a truck that was reported to have hit the U-Haul.
On arrival, I found the U-Haul as described. I spoke to a male on scene who told me the truck was
just out of gas. He said the truck had not been hit.
I then saw a maroon truck with its flashers on, stopped on NE 3rd St, to the west of the U-Haul.
contacted the driver, later photo identified with his WADL as Pedro Lopez-Campos (04-13-60), who
said his truck had been hit by another vehicle. A female walked up then and said she was the other
driver. She was later photo identified through her WADL as Special L Cummings (05-17-96).
The truck was identified as a maroon 2015 Dodge Ram, WALP D02219A. The second vehicle was
identified as a light blue Honda Pilot, WALP CCX5617.
Cummings said the Pilot belonged to her boyfriend. She provided her DL and the registration but said
there was no insurance on the vehicle. Campos provided all necessary paperwork.
Cummings conveyed she was eastbound on NE 3rd St in the #2 lane. As she was driving east, the
maroon truck suddenly moved over into her lane. She was unable to stop in time and the right
passenger corner of her car hit the back end of the truck.
Campos conveyed he was driving east in the #1 lane. He saw the stopped truck in his lane in front of
him and wanted to move over to go around. He looked and saw the other car coming but thought
there was room so merged over into the other lane. There was not enough space/time however and
his rear driver's corner was hit by the other car.
I looked at both cars and the damage to both of them corresponded to their accounts. There was
minor damage to the truck and moderate damage to the SUV. When asked, both drivers declined
medical attention. They were the sole occupants of their vehicles.
When checked, Cummings' license status showed as suspended/revoked in the 3rd degree. She
exclaimed that she didn't know why this was.
For moving over into the other lane when there was oncoming traffic that had the right of way, I
determined Campos was the proximate cause of the collision. I advised him he would be getting a
citation in the mail for the violation. He protested that she was coming too fast and that she had been
on her phone but I advised him that even if this were true, he still needed to give right of way to her.
I advised Cummings she would be receiving a citation for driving with a suspended license and for
driving a vehicle without any insurance and that it would be mailed to her.
I completed citation 3AO318974 on Campos and citation 3AO318972 and 973 on Cummings, then
sent them to the prosecutor to be mailed to them.
PAGE 3 OF 5
REPORT NO. EE05609 CASE# 23-11289 OF COLLISION
10/02/23 18:10
OF CbLLI510N
NARRATIVE
This concluded my involvement in this incident.
PAGE 4 OF 5
REPORT NO. EE05609 CASE# ' 23-11289 DATE AND TIME 10/02/23 18:10
OF COLLISION
AIN
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PAGE 5 OF 5