HomeMy WebLinkAbout23-12682 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 1 27c
COLLISION REP FIT 1591971
CASE 23-12682 z
INTERSTATE ❑ CITY STREET FIRE ❑RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHIC;I F ❑ LOCAL AOENC 4900 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 2 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 11 - 1-- 2023 1525 17 ❑-= S 8 IN e 1070 3
4❑ oN (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
MONROEAVENE BLOCK NO. M600 ❑
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ �,❑ FEET e S ❑ W e NE 6TH PL
0 1 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
,/No D:4256526616 0 9 30
6� LAST NAME DEARAUJO FIRSTNAME ADRIANO MIDDLE R 1 1 2 31
INITIAL
STREET ❑✓ 2408 SE 2ND CT CITY RENTON ST WA ZIP 98056 z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION : PRESENT MEDICAL TRANSPORTED 3
iNTERLOCKYEs NO 1/ INTERLOCKYEs NO YEs No�/
8❑ DRIVERS
# STATE WA SEX'M I ELMIDI Y' 05 — 15 — 1977 1 2 32
9 ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 HELMETU SE CLASS 1 NATURE OF INJURIES z❑
3
10 9❑ Pi ATNES# D83390A sTAr WAu N# 1 FDAF56P66ED28812
0 TRAILER STATE TRAILER STATE
11 3 0 PLATE# PLATE# FROM TO
TRLR. TPILF1 1 5 33
12 3 0 VIN#' VIN#
FROM TO
VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE 1 9 34
13 2 2006 FORD F550 TT DAMAGE YES NO YES[:] No
✓
REGISTERED OWNER INFO ADRIANO DEARAUJO 17071 WOODSIDEDR SE RENTON WA 98058 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
14 LIABILITY INSURANCE❑ INSURANCE CO 3 4
IN EFFECT &POLICY# 9TOP
VEIF" CHARGE 5 36
LEGALLv Yes❑NO❑ CITATION# 1 o BOTTOM
15❑ STANDING 7 6
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT U2 VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES 1/ No D:4252879575
16 a
LAST NAME ALMEJO DE LA CRUZ FIRST NAME ELI MIDDLE
INITIAL
17❑ STREET ❑', 3307 NE 6TH PL CITY RENTON ST WA ZIP 980563936 37
NEW ADDRESS ❑
18� CDL IGNITION REQUIRED IGNITION PR—E-1SENT MEDICAL—T�RANSPORTED ❑ 38
INTERLOCK YEs❑No� INTERLOCK YEs It I NOF YES
t l NOF,/
19 DRIVER'S STATE I WA SEX M D.C.B. 05 _ 12 _ 1979 39
LICENSE# MMDDYY
WELMET INJURY 7 NATURE OF INJURIES 40
20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 USE CLASS PAIN IN NECK AND BACK ❑
21❑ LICENSE I C94708J TAre WA vIN1t 1FTEW1EF9GKE97524
❑ 41
PLATE#
42
22❑ PILER LATE# STATE PLATE# STATE
TRLR
23❑ VIN#. IN#. 43
RLR
'
VEH YEAR 2016 MAKE FORD MODEL F150 STYLE PK VEHICLETOWED TO BLIN TOWEDBY GOV HI 44
L4❑ DAMAGE YES NO YES NO
REGISTERED OWNER INFO JOSE ALMEJO DELA CRUZ 11414 AVONDALE RD NE TRLR 84 REDMOND WA 98052 VEHICLE NO.2
SHADE IN DAMAGEbAREA
2 3 Cd
LIABILITY
INSURANCE Z &POINSURGY#E CO STATE FARM 4653062-1310-47BIN 1 STOP
VEHICLE CITATION# CHARGE i o BOTTOM
LEGALLY YES NC[:]
25❑ s
7.FF1CJEO-S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
26
HNSON 0505 WA0171300
PART A PAGE 01 OF
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EE18229
COLLISION REPORT III III III III III 111
1591972 CASE# 23-12682
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.
CO.JOHNSON 11-03-23 04:31 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
CO.JOHNSON 0505 1 111912023 4:11:54 PM
BADGE OR ID# 0505 OR]# WA0171300 TIME POLICE DISPATCHED 3:34 PM TIME POLICE ARRIVED',3:36 PM
PART I PAGE IT]OF 4�
REPORT NO. EE18229 CASE# 23-12682 OF COLLISION
11/03/23 15:25
OF CbLLI510N
NARRATIVE
U2 SIB 600 block Monroe Ave SE stopped for left turn onto NE 6th PI; U1 behind U2 applied brakes
unable to stop to avoid collision, U1 flatbead towtruck with 4 dr crossover car on deck
On 11-03-2023 at about 1534 hours I self dispatched to a collision in the vicinity of Monroe Ave NE
and NE 6th PI in the City of Renton, County of King, Washington State. Dispatch received a crash
notification from a Ford vehicle and there was limited information available. Another officer located
the involved vehicles on NE 6th PI to the east of Monroe Ave NE. I arrived in the area at about 1536
hours.
The driver of Unit 02 was identified by WA DL. The driver said he was wearing a seatbelt at the time
of the collision and complained of pain in his neck and back as a result of the collision. The driver
declined to be seen by fire department personnel. Unit 02 was south bound in the 600 block of
Monroe Ave NE and stopped in the lane of travel to make a left turn onto NE 6th Pl. While waiting for
north bound traffic to clear, Unit 02 was hit from behind by Unit 01.
The driver of Unit 01 was identified by WA DL. The driver said he was wearing a seatbelt at the time
of the collision and was not injured during the collision. Unit 01 was south bound on Monroe Ave NE
when he noticed Unit 02 ahead, stopped in the roadway. Unit 01 applied his brakes but was unable
to fully stop and avoid colliding with Unit 02. The driver of Unit 01 said his vehicle was heavy and he
could not stop in time. The driver of Unit 01 was unable to provide proof of insurance.
The damage to the vehicles was consistent with the information provided by both drivers. There was
moderate damage to the front of Unit 01 to include the bumper and radiator. The rear bumper and
tailgate of Unit 02 sustained moderate damage. There was a large amount of fluid on Monroe Ave
NE in the vicinity of the collision. A trail of the fluid led to Unit 01 on NE 6th PI. Unit 01 was a Ford
F550 flat bed tow truck transporting a mid-sized 4-door crossover SUV.
The proximate cause of the collision was Inattention on the part of the driver of Unit 01 who was
unable to bring his vehicle to a complete stop without colliding with Unit 01 (legally standing on the
roadway). Were it not for the actions of the driver of Unit 01 the collision would not have occurred.
No citations or infractions issued. Report for information and insurance purposes.
PAGE 3 OF 4
REPORT NO.! EE18229 CASE# ' 23-12682 DATE AND TIME 11/03/23 15:25
OF COLLISION
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