HomeMy WebLinkAbout24-00024 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 0 27c
COLLISION REP FIT 1591971
CASE 24-00024 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 1 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'. 01 — 01 — 2024 2005 17 �. S 8 W H OF e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
NE 4TH ST BLOCK NO. e✓ 3300 ❑
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ 1.❑ FEET e S ❑ W e MONROE AVE NE
2 0 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
✓NO D:2066374785 0 11
30
6 LAST NAME OSMAN IDOW FIRST NAME MEYMONA MIDDLE 1 2 31
INITIAL
STREET ❑✓ 11801 78TH AVE S CITy SEATTLE ST WA ZIP 98178 z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
iNTERLOCKYEs NO 1/ INTERLOCKYEs NO�/ YEs No�/
8❑ LICENSE WA STATE Wq SEX'F MM DAY' 01 - 01 - 1999 1 2 32
9 ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 H USEET 2 CLASS 1 NATURE OF INJURIES z❑
3
10 9❑ P1 ATES# CHA2375 sTAr WAv N# 4T18E32K66U722449
TRAILER STATE PLATE
STATE
11 3 5 PLATE# PLATET## ROM To
TRLR. TRLR 7 3 33
12 3 5 VIN#' VIN#
>;. FROM TO
VEH.YEAR 2006 MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED By GOVT.VEHICLE 7 3 34
13 4 TOYT CAMRY SD DAMAGE YES NO YES[:] No
✓
REGISTERED OWNER INFO ALIALI 6940 MLKJR WAYS APTE501 SEATTLE WA 98118 VEHICLE NO. 1
❑ ❑
SHADE IN DAMAGED AREA 35
4
14 4 LIABILITY INSURANCE❑ INSURANCE CO NONE NONE
IN EFFECT &POLICY# 9TOP 5
VEwcLE CHARGE I o BOTTOM 36
LEGALLY YES❑NO CITATION# 4A0014428,4AO014428 FLD SIGNAL STOPS/TURNS-UNSAFE
15❑ STANDING 8 7 6
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT 02 VEHICLE ❑ CYCLE ❑ OWNER ❑ YES 1/ NO D:2066683200
16 a
LAST NAME BRAVO PETIT FIRST NAME OTTO MIDDLE JE
INITIAL
17❑ NEW ADDRE— 454 MO STREET NROE AVE NE APT.204 CITY RENTON ST WA ZIP 98056 4❑ 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 DRIVERS
# STATE WA SEX M M .C.B. 05 _ 09 _ 1990 39
20❑ ON DUTY STATUS I
AIRBAG 2 RESTR 4 EJECT 1 H U EET 2 NJAURSY 1 NATURE OF INJURIES ❑ 40
❑21❑ PLATE# 41
BYR5209 TArE WA VIN# 3C4PDDEG9FT676023 1
42
22❑ PLATE# STATE PLATE# STATE
TRLR
23❑ UIN#. IN#.
43
RLR
'
I
VEH YEAR 2015 MAKE DODG MODEL JOURNEYSTYLE UT DAMAGE TO WED NOO✓ BLIN TOWED BY Gov 44
Yr
H YES
NO
24❑ REGISTERED OWNER INFO OWNED SY DRIVER VEHICLE N0.2
SHADE IN DAMAGED AREA
2 3 4
LIABILITY
INSURANCE 8 POINSURGY#E CO pROGRESSIVE 948368506
IN 9TOP
VEHICLE YES N(� CITATION# NIA CHARGE NONE t o BOTTOM
LEGALLY `LJ 6
25 OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# JAGENCY
26
J.CHRISTIANSEN 10437 WA0171300
PART A PAGE 01 OF
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EE37380
COLLISION REPORT III III III III III 111
1591972 CASE# 24-00024
ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY)
NAME MIDDLE INITIAL) ARTIGASRODRIGUEZ BREIDYM
(LAST FIRST,
ADDRESS&PHONE#
11819 SE 171 ST LN,APT R103 RENTON WA 98058 2064602228 SEXi F MMDOYyvv 07 - 09 - 1989
PASSENGER WITNESS UNIT# SEAT ' AIRBAG RESTR. EJECT ' HELMET INJURY NATURE OF INJURIES
❑✓ E] 2 POS. 3 2 4 1 USE 2 CLASS 1
NAME
(LAST,FIRST,MIDDLE INITIAL) : BRAVO PETIT JOSE E
ADDRESS&PHONE# D O 8
454 MONROE AVE NE,APT 204 RENTON WA 98056 2062801987 SEX' U MMDDYvvv 11 f 4 _ 1993
SEAT HELMET NJURY NATURE OF INJURIES
PASSENGER Z WITNESS UNIT# 2 PGS 6 AIRBAG 1 RESTR. 4 EJECT 1 USE 2 CLASS 1
NAME
(LAST FIRST,MIDDLE INITIAL) VELEN ENVO
AppRESS&PHONE# RENTON SEX V 03 U1 _ 2008
D.O.B.M -
MDDYYYY
PASSENGER WITNESS UNIT# ! 2 SEAT 4 AIRBAG 1 RESTR. 4 EJECT 1 HELMET 2 INJURY 1 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.
J.CHRISTIANSEN 01-01-24 09:25 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST.DET DATED PLACE SIGNED
APPROVED BY DATE
J.TRADER 4553 1 11512024 12:19:16 AM
BADGE OR ID# 10437 OR]# WA0171300 TIME POLICE DISPATCHED 8:09 PM TIME POLICE ARRIVED:8:09 Pry]
PART I PAGE IT]OF 6�
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EE37380
COLLISION REPORT III III III III III 111
1591972 CASE# 24-00024
ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY)
NAME MIDDLE INITIAL) VERCKEN ENEVO
(LAST FIRST,
ADDRESS&PHONE#
RENTON SEX U MMDDYYYY 10 - 20 - 2020
-------------------------
PASSENGER Z WITNESS UNIT# SEAT AIRBAG' RESTR. EJECT ' HELMET U 2 CCLASS 1 NATURE OF INJURIES
Lr 1 � 2 POS. 7 1 10 1
NAME
(LAST,FIRST,MIDDLE INITIAL) ERAVO BIANCA
ADDRESS&PHONE# D O B
RENTON SEX' U MMnDYvvv26 _ 2013
SEAT HELMET INJURY NATURE OF INJURIES
PASSENGER Z WITNESS UNIT# 2 PCS 9 AIRBAG 2 RESTR. 4 EJECT 1 USE 2 CLASS 1
NAME
(LAST FIR57 MIDDLE INITIAL)
AppRESS&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.
J.CHRISTIANSEN 01-01-24 09:25 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
J.TRADER 4553 1 11512024 12:19:16 AM
BADGE OR ID# 10437 OR]# WA0171300 TIME POLICE DISPATCHED 8:09 PSI TIME POLICE ARRIVED:8:09 Pm
PART I PAGE 3�OF 6�
DATE AND
REPORT NO. EE37380 CASE# 24-00024 OFCOLISION 01101/2420:05
OF COLLISION
NARRATIVE
RPD CASE#: 24-00024
RECORDED ON AXON
*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. *
On 01.01.2024, at approximately 2009 hours, I was driving to the Renton City Shops, located at 3555
NE 2nd ST, in the City of Renton, WA, the County of King.
I was assigned to uniformed marked patrol in the City of Renton, WA, the County of King. I was
operating a fully marked Renton Police Tahoe #304, equipped with "POLICE" markings, overhead
exterior lights, and audible siren. I was wearing my department-issued uniform, including a fully
equipped duty belt, exterior ballistic vest with "POLICE" stenciled on the front and back and Renton
Police badge affixed to the left breast. I was also wearing my department-issued jumpsuit with
"POLICE" patches on both shoulders and across the rear shoulders. It would be immediately obvious
to any reasonable person I was a police officer. I was assigned as 3r23.
At the time of this incident, it was clear, approximately 37 degrees and the roadway was clean and
dry. It was dark and streetlights were illuminated.
I was traveling southbound on Monroe Ave NE, when I was flagged down for two vehicles that had
been in a collision in the area of NE 4th ST and Monroe Ave NE.
Unit 01 was identified as a beige in color Toyota Camry bearing WA/CHA2375. Unit 01 had damage
to the front passenger side bumper, '/ panel and passenger side body of the vehicle but it was
operable.
Unit 01's driver was identified by her WADL as OSMAN IDOW, MEYMONA (DOB: 01.01.1999).
OSMAN IDOW matched the photo on her WADL she advised she did not have the vehicle
registration and did not have insurance on the vehicle. OSMAN IDOW did not speak fluent English
and she contacted the registered owner, listed, who arrived on scene and confirmed he did not have
insurance on the vehicle.
A WACIC/NCIC/DOL query on OSMAN IDOW was clear and valid.
Unit 02 was identified as a white in color Dodge Journey bearing WA/BYR5209. Unit 02 had damage
to the front driver's side bumper and 1/4 panel with damage to the front driver's side door. Unit 02 was
operable.
Unit 02's driver was identified by his WADL as BRAVO PETIT, OTTO ENRIQUE (DOB: 05.09.1990).
BRAVO PETIT matched the photo shown on his WADL and stated he was traveling eastbound on NE
4th ST, approaching the intersection with Monroe Ave NE, occupying the right/curb lane of travel.
BRAVO PETIT was traveling straight ahead when he states Unit 01, who was in the left lane,
changed lanes into the right lane, striking his vehicle and causing damage. Unit 01's driver confirmed
this version of events and stated Unit 02 was `in her blind spot' and did not see him.
A WACIC/NCIC/DOL query BRAVO PETIT revealed he was clear and valid.
Unit 01's OSMAN IDOW, MEYMONA (DOB: 01.01.1999) is the causing party in this collision.
advised OSMAN IDOW she would be receiving a citation via the mail for violation of RCW 46.61.305:
Unsafe Lane change/fail to signal; and violation of RCW 46.30.020: Operating a vehicle with no proof
of insurance. OSMAN IDOW was issued citation 4A0014428, which will be mailed via the courts.
No injuries were recorded and both parties were given my business card with the case number listed.
I certify (or declare) under penalty of perjury under the laws of the State of Washington that the
foregoing is true and correct.
Electronically signed by Officer J. Christiansen #10437, on January 1, 2024, at approximately 2124
hours, in Renton, WA.
**** AUTO-POPULATED SECTION ****
THE FOLLOWING ARE DESCRIPTIONS ENTERED FOR ITEMS SELECTED AS "OTHER":
PAGE 4 OF 6
DATE AND
REPORT NO. EE37380 CASE# 24-00024 OFCOLISION 01101/2420:05
OF COLLISION
NARRATIVE
Location Character: CITY STREET
**** END OF AUTO-POPULATED SECTION ****
PAGE 5 OF 6
REPORT NO. EE37380 CASE# ' 24-00024 DATE AND TIME 01/01/24 20:05
OF COLLISION
*NOT TO a
,*
h
1-21
PAGE 6 OF 6