HomeMy WebLinkAbout24-4736 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 0 27c
COLLISION REP FIT 1591971
CASE 24-4736 z
INTERSTATE ❑ CITY STREET FIRE ❑
RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHICI F ❑ LOCAL AGENCI 4900 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 TOTAL#OF OBJECT 2$
TRIBAL UNITS 01 STRUCK' TREE OR STUMP
RESERVATION
z
3❑ DATE OF M M D D Y Y Y Y TIME(2400) COUNTY# MILES N E IN CITY# ❑
COLLISION'. 05 — 02 — 2024 1446 17 ❑.= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓
LINCOLN DR NE BLOCK NO. e✓ 3400
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5 10 00 FEET e S B W e SE MAY CREEK PARK DR❑
0 1 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
,/NO D:2066556665 30
6� LAST NAME DIAZ FIRSTNAME JENNIFER MIDDLE S 1 1 2 31
INITIAL
STREET ❑1 1400 LAKE WASHINGTON BLVD N APT B403 CITY RENTON ST I WA 2jp, 98056 z
NEW ADDRESS
7❑ ODL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
iNTERLOCKYEs NO 1/ INTERLOCKYEs NO�/ YEs No�/
8❑ LICENSE# STATE yyq SEX'F MMDDYY 06 — 20 — 1998 32
9 ON DUTY❑ STATUS' AIRBAG 6 RESTR 4 EJECT 1 HE U EET 2 1 INJURY CLASS 5 UNKNOWN[NATURE OF NJURIEs z❑
3
10❑ Pi ATE 14 BVM9906 STATE WA VIN# 5J8YD4H39Ll039560
TRAILER STATE TRAILER STATE
11 0 0 PLATE# PLATE# FROM ro
TRLR. TplLR. 1 3 33
12❑ vIN#' VIN#
FROM
34
VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN T /g[ GOVT.VEHICLE
13 2020 ACUR MDX DAMAGE YES NO � '` RS TOWING YES[:] No✓
REGISTERED OWNER INFO JENNIFER DIAZ 1400 LAKE WASHINGTON BLVD N APT B403 RENTON WA 98056 D:2066556665 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
14❑ LIABILITY INSURANCE INSURANCE CO PROGRESSIVE 960280498
IN EFFECT &POLICY# �1'OP
CHA
ve'CLE RGE ❑ 36
LECALLv res❑NO❑ CITATION# BOTTOM
15❑ STAIN,DIING
UNIT U2 VEHICCLE ❑ CYCLE ❑ PEDESTRIAN ❑ oWNFRRTY ❑ DYESMOTO NO OLD MET PHONE
16❑
LAST NAME FIRST NAME MIDDLE
INITIAL
STREET
CITY' ST ZIP 4❑ 37
17❑ NEW ADDRESS❑'
18❑ IGNITION REQUIRED IGNITION PRESENT
RESENT MEDICAL TRANSPORTED ❑ 38
YECDL ERLOCKYES�NORINTERLOCKYEs --1NOF S ]
NO❑
19 LLIICENS # STATE SEX MMDDYY —�_ 39
HELMET INJURY NATURE OF INJURIES 40
20❑ ON DUTY STATUS' AIRBAG RESTR EJECT USE CLASS ❑
❑21❑ TATE 41
IN#LICENSE V 1
PLATE#
42
22❑ PLATE# STATE PLATE# STATE
23❑ 43
TRLR RLR
UIN#. 'IN#.
VEH YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN
TOWED BY 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 1 VE—LE ❑ ,J� CITATION# CHARGE
25 GQ
LEGALLY YES N`L J
s � e
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
J
26
E.S/MS 12225 WA0171300
PART A PAGE 01 OF C7
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EE75203
COLLISION REPORT III III III III III 111
1591972 CASE# 24-4736
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.
E.SIMS 05-02-24 05:30 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
DESIRES SCOTT 10272 51812024 10:47:45 AM
BADGE OR ID# 12225 ORI#' WA0171300 TIME POLICE DISPATCHED! 2:50 PM TIME POLICE ARRIVED:2:57 PM
PART Ei PAGE IT]OF 4�
REPORT NO. EE75203 CASE# 24-4736 OF COLLISION
05/02/24 14:46
OF CbLLI510N
NARRATIVE
Renton Case #24-4736
On 05/02/2024 at approximately 1450 hours, I was dispatched to 3437 Lincoln DR NE, in the City of
Renton, King County, Washington, for an unknown injury accident.
While driving to the location dispatch advised they were receiving reports of a vehicle that had driven
into a tree and advised the driver was trapped inside.
Upon arrival I observed a white 2020 Acura MDX, bearing WA license plate #BVM9906 On a grassy
area of Lincoln DR NE. The vehicle had sustained severe damage to the front and side of the vehicle.
The vehicles passenger side was up against a large tree and from the tire tread marks on both the
street and dirt area along the road, it appeared the vehicle was driving southbound on SE May Creek
Park DR and began to enter the curve that led eastbound. It appeared the vehicle was driving at a
high rate of speed when it entered the turn and lost control. From the tire marks it looked as though
the vehicle turned sideways and the passenger side of the vehicle hit the tree.
The driver was identified via her WADL as Jennifer S Diaz (DOB 06/20/1998). Diaz was trapped in
the vehicle and Renton Fire extracted her. Due to Diaz injuries and being taken to Harbor View
Medical Center I was unable to interview her. I was advised by Renton Fire that Diaz was stable, but
her injuries were unknown.
Diaz mother, who I identified via her WADL as Gladys Ramirez (DOB 03/12/1980), arrived at the
location and I advised her of what happened and provided her with a business card with the case
number on it.
I took photos of the vehicle and later uploaded them onto AXON.
Banker's towing was called to the location and towed the vehicle. I then cleared the scene. This ends
my report.
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 E. Sims on 05/02/2024 at 1728 hours, In the City of Renton, WA.
PAGE 3 OF 4
REPORT NO. EE75203 CASE# ' 24-4736 DATE AND TIME 05/02/24 14:46
OF COLLISION
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