HomeMy WebLinkAbout24-7696 ITFF' "POLCERA II I !�� I III I III I IIII III II I . S 27c
COLLISION REP FIT 1591971
SASE 24asss 2
INTERSTATE ❑ CITY STREET FIRE ❑
RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHICI F ❑ LOCAL AGENCI 4250 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2❑ TOTAL#OF OBJECT ❑2$
TRIBAL UNITS 01 STRUCK' FENCE
RESERVATION
z
3❑ DATE of M M D D Y Y Y Y TIME(2400) COUNTY# MILES N E IN CITY#
GowsloN 07 - 1-- 2024 2043 17 ❑-= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
NE 12TH BLOCK NO. e✓ 4018 ❑
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ ❑ FEET e S ❑ W e UN/ON AV NE
0 4 29
MOTUNIT U1 VEHIOR Z PEDAL-CLE CYCLE ElDESA✓NHORESHOLDMET PHONE 30
6� LAST NAME UNKNOWN FIRSTNAME MIDDLE 1 1 2 31
INITIAL
STREET ❑ CITY RENTON ST ZIP 2
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
iNTERLOCKYEs NO 1/ INTERLOCKYEs NO�/ YEs No�/
DRIVERS
STATE SEX D '❑— 328 LICENSE MDYY❑ M
9 ON DUTY❑ STATUS I
AIRBAG 2 RESTR 4 EJECT 1 H USEEr 9 CLAY 0 NATURE OF INJURIES z❑
3
10❑ P1 ATE 14 BFP6520 STATE WA VIN# 1J4Gt48K95W600548
TRAILER STATE TRAILER STATE
11 2 5 PLATE# PLATE# FR.. ro
TRLR. TRLR. 5 7 33
12❑ VIN#' VIN#'
Rom 34
13 4 VEH.YEAR ZOOS MAKE JEEP MODEL LIBERT STYLE 4T VEHICLE TOWED TO pLSSBLIN TQ yE kkRS YOS❑ENO
❑ DAMAGE ILJI tSA1Wl6
REGISTERED OWNER INFO JOSE RAMIREZESPINOZA 14244124THAVENE KIRKLAND WA 98034 VEHICLE NO. 1 ❑
❑ SHADE IN DAMAGED AREA 35
14 LIABILITY INSURANCE❑ INSURANCE CO NONE IN EFFECT &POLICY#VEHICLE CHARGE 36
LEGALLY YES❑NO❑ CITATION# <14,
15❑ STAIN.F-
UNIT 02 VE IOCLE ❑ CYCLE ❑ PEDESTRIAN ❑ OWNER
❑ DYES NO OLD MET PHONE
16❑
LAST NAME FIRST NAME MIDDLE
INITIAL
STREET
CITY' Sr ZIP 37
17❑ NEW ADDRESS❑'
18❑ CDL IGNITION REQUIRED IGNITION PRES
ENT MEDICAL t—T�RANSPORTED ❑ 38
INTERLOCK YEs❑NoR INTERLOCK YES I I NOF YES t l NO❑
19 LLIICENS RIVEWS# STATE SEX MMDDYY —❑_ 39
-----WELMET NATURE OF INJURIES 4O
20❑ ON DUTY STATUS' AIRBAG RESTR EJECT USE CLASS ❑
❑21❑ LICENSE TATE 41
VIN# `1
PLATE#
42
22 [TRAILER T
❑ PLATE# STATE pLATE#ILER STATE
23❑ 43
TRLR RLR
UIN#. 'IN#.
VEH YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN
TOWED BY Gov HI 44
24❑ 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 IGQVE"LE
❑ ,J� CITATION# CHARGE
LEGALLY YES N`L J
25
=HSU
AME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
J
26 12551 WA0171300
PART A PAGE 01 OF C7
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EF06202
COLLISION REPORT III III III III III 111
1591972 CASE# 24-7696
ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY)
NAME MIDDLE INITIAL) PEDROZA TORRES ARMANDO
(LAST FIRST,
ADDRESS&PHONE#
3815 NE 4TH ST 839 RENTON WA 98056 SEX i U MMDDYyry 08 - 27 - 1992
SEAT HELMET INJURY NATURE OF INJURIES
PASSENGER WITNESS❑j UNIT# POS 3 AIRBAG 9 RESTR. 9 EJECT 9 USE 9 CLASS 0 NONE
NAME
(LAST,FIRST,MIDDLE INITIAL) DELA CRUZ LEO
ADDRESS&PHONE# D O B
364 FIELD PL NE RENTON WA 98059 SEX M MMDDVYYu 12 _ 21 _ 1998
PASSENGER UNIT# SEAT AIRBAG RESTR. EJECT HELMET INJURY NATURE OF INJURIES
[:]WITNESS POS. USE CLASS
NAME
(LAST FIR57 MIDDLE INITIAL)
AppRESS&PHONE#
SEX D.O.B.MMDD -❑
YYYY.
PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET NJURY NATURE OF INJURIES
❑ ❑ POS. USE CLASS ----�
NARRATIVE'
Unit 1 traveling north on Union Av NE approaching NE 12th St. Unit 1 driver loses control of vehicle
and veers in a left turn from the intersection into the fence and side yard of 4018 NE 12th St, crashing
through fence and coming to rest atop a children's playhouse. Passerby's reported driver running
away from the vehicle westbound after crashing. No witnesses were able to readily identify the driver.
A Hispanic male, later identified through his WA DOL photo as Armando Pedroza Torres, whose
wallet and phone were located inside the crashed Jeep, later came to the scene and claimed that he
had been driving said vehicle. However, witnesses on scene could not confirm that Pedroza Torres
was the driver. Unit 1 vehicle sustained reportable disabling front end damage. No injuries reported.
I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT.
HANSEN HSU 07-21-24 10:20 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
P.SUMMERS 8887 8/18/2024 9:53:04 PM
BADGE OR ID# ! 12651 ORI# WA0171300 TIME POLICE DISPATCHED; 8:43 PM TIME POLICE ARRIVED 8:46 PM
PART I PAGE IT]OF 3�
REPORT NO. EF06202 CASE# 24-7696 DATE AND TIME 07/21/24 20:43
OF COLLISION
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