HomeMy WebLinkAbout24-5116 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 1 27c
COLLISION REP FIT 1591971
CASE 24-5116 z
INTERSTATE ❑ CITY STREET FIRE ❑
RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHIC;I F ❑ LOCAL AGENCI 4900 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 TOTAL#OF OBJECT 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#
cawsloN 05 - 1-- 2024 0615 17 ❑-= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
BLOCK
EASTVALLEYRD ST e✓
MILEPOST 4100 ❑
4a❑
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ ❑ FEET e S ❑ W e SW41ST ST
0 1 29
MOTU '�01 VEHtOCLEZ PEAL-CYMLE. El �ESAGE NHORE✓LD MET PHONE 0 $ 30
6� LAST NAME UNKNOWN FIRSTNAME MIDDLE 1 1 2 31
INITIAL
STREET ❑ CITY ST zIP z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNIT{ON PRESENT MEDICAL TRANSPORTED 3
iNTERLOCKYEs NO INTERLOCK YES NO YES No
8❑ LIRCIENSRE#
STATE I
SEX u MMDDYY '❑- 1 1 2 32
9 ON DUTY❑ STATUS I
AIRBAG 9 RESTR 9 EJECT 1 H U EEr 9 CLAY 0 NATURE OF INJURIES z❑
3
10[1 PI ATNE 14 CKB2677 sTAT WAuN# KMHE24L11HA045865
5 TRAILER STATE TRAILER STATE
11 3 5 PLATE# PLATE# Rom To
TRLR. YRLR. 5 1 33
12 3 5 VIN#' VIN#
>; FROM TO
VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED By GOVT.VEHICLE 5 9 34
13 2 2017 HYUN SONATA 4D DAMAGE YES NO YES❑ NO
REGISTERED OWNER INFO AHMED AHMED 1582540TH PL S APT 104 TUKWILA WA 98188 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
14 LIABILITY INSURANCE INSURANCE CO PATRIOT GENERAL 11400133747 3 4
IN EFFECT &POLICY# 9TOP
VEHICLE CHARGE 5 36
LEGALLv res❑NO❑ CITATION# 10 BOTTOM
❑ STANDING
15 8 6
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT 02 VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES NO 1/ D:2536524010
16 a
LAST NAME BETANCOURT VILLAMIL FIRST NAME RICHARD MIDDLE
INITIAL
17❑ NEW STREETREs7 3001 S 288TH ST TRLR 81 CITY FEDERAL WAY ST WA ZIP 98003 37
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 WA SEX M D.C.B. 04 10 _ 1975 El 39
LICENSE# MMDDYY
HELMET {NJURY 6 NATURE OF INJURIES 40
20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 USE 2 CLASS RIGHT LEG PAIN ❑
41
❑
21❑ LICENSE PLA E# CHZ5872 TATe WA VIN# USE
4
42
22❑ PLATE# STATE PLATE# STATE
23❑ UIN#. 43
TRLR RLR
'IN#.
GoI
VEH YEAR 2013 MAKE 7'Oy7' MODEL pRIUS C STYLE 5D —FEHICLE
TOWED NOO✓ BLIN TOWED BY v HyES NO 44
24❑ fj
REGISTERED OWNER INFO OWNED SY DRIVER VEHICLE N0.2
SHADE IN DAMAGED AREA
2 3 4
LIABILITY
INSURANCE INSU&PORGY#E CO PROGRESSIVE 979470147IN 1 GD
LEG25
ALLY YES Nu
❑ s a
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# JAGENCY
26
C.STEED 8770 WA0171300
PART A PAGE 01 OF C7
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EE77728
COLLISION REPORT III III III III III 111
1591972 CASE# 24-5116
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.
C.STEED 05-14-24 08:27 AM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY E
DAT
D.SKELTON 9139 511712024 8:48:19 AM
BADGE OR ID# 8770 OR]# ! WA0171300 TIME POLICE DISPATCHED; 6:32 AM TIME POLICE ARRIVED i 6:41 AM
PART I PAGE IT]OF 4�
REPORT NO. EE77728 CASE# 24-5116 OF COLLISION
05/14/24 06:15
OF CbLLI510N
NARRATIVE
On 05/14/24 at about 0641 hrs I arrived at East Valley Rd and SW 41st St for a Hit and Run Collision,
in the City of Renton, County of King, and State of Washington. Using language line for Spanish
Richard Bentancourt Villamil explained he was northbound on East Valley Rd and stopped for a red
light at SW 41st St. Richard said unit#1 ran into the back of his vehicle causing minor damage and
causing pain in his right leg. He was treated by Renton Fire for the leg pain. Richard said the vehicle
tried to back up and drive away and he blocked him from leaving. The driver of unit#1 initially pulled
into the parking lot at 101 SW 41 st St and provided insurance information for the vehicle.
When Richard asked for his driver's license he refused. Richard took a photograph of Unit#1 and the
insurance card. The driver would not allow him to take a picture of him. When Richard said he was
calling the police the driver fled in the vehicle NB on East Valley Hwy. Richard described the driver of
unit#1 as a black male, 25 years old, 5'6", medium build, wearing a blue t-shirt and dark pants. WA
DOS checks on the suspect vehicle plate of CKB2677 showed it was owned by Ahmed M. Ahmed
who matched the description provided by Richard for the driver. The photographs and video taken by
Richard were uploaded to evidence.com
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. The video was uploaded to evidence.com.
I certify (declare) under penalty of perjury under the laws of the State of Washington that the
foregoing is true and correct.
Electronically Signed by Officer Steed on 05/14/24 0807 hrs, Renton Washington
Cassidy Steed/8770
PAGE 3 OF 4
REPORT NO. EE77728 CASE# 24-5116 DATE AND TIME 05/14/24 06:15
OF COLLISION
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PAGE 4 OF 4