HomeMy WebLinkAbout24-645 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 1 27c
COLLISION REP FIT 1591971
❑ ❑ RESULTED ❑ CASE 24-645 2
INTERSTATE CITY STREET FIRE
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHICI F ❑ LOCAL AGENCI 4900 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 TOTAL#OF OBJECT 1 28
TRIBAL UNITS 02 STRUCK' MAILBOX
RESERVATION
2
3❑ DATE of M M D D Y Y Y Y TIME(2400) COUNTY# MILES CITY# ❑
cowsloN 01 - 18 - 2024 2222 17 ❑.❑ N E IN S 8 W H OF e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓
NE 10TH ST BLOCK NO. e✓ 4000
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ ❑ FEET e S ❑ W e 1 9 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
✓NO D:2065389129 30
6 LAST NAME AGUILAR DIAZ FIRST NAME PABLO MIDDLE A 1 1 2 31
INITIAL
STREET 01 1420 HARRINGTON AVE NE APT 1931 CITY RENTON ST WA ZIP 98056 2
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
iNTERLOCKYEs NO 1/ INTERLOCKYEs NO�/ YES R No�/
8❑ LRIIVER #
ON DUTY❑ STATUS' AIRBAG 2 RESTR 9 EJECT 1 I I [NATURE OF INJURIES
H U EET 2 1 INJURY CLASS ju GLASS IN LEFT HAND 2❑
3
10❑ Pi ATNES# CBA3116 sTAr WAv N# JTKDE177950017696
IT STATE TRAILER STATE
11 2 5 PLATE# I PLATE# I I FROM TO
TRLR. TRLR 7 3 33
12❑ VIN#j VIN#
2005 TOYT SCION SD pL FROM 34
❑ VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO u BLIN TOWED BY GOVT.VEHICLE
13 4 DAMAGE YES NO �/ YES[:] NO
REGISTERED OWNER INFO LUISAGUILAR DIAZ650 DUVALL AVENEAPT1931 RENTON WA 98059 VEHICLE NO. 1
SHADE IN DAMAGED AREA 35
14❑ LIABILITY INSURANCE❑ INSURANCE CO
IN EFFECT &POLICY# OTOP
vewcLE CHARGE BOTTOM ❑ 36
15❑ STANofNG YEs No CITATION# gg0022149,4A0022149, OP MOT VEH W/OUT INSURANCE,NO
MOTOR PEDAL PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES NO ,/ D:2067348529
16❑
LAST NAME AUGER FIRST NAME DEEANN MIDDLE C
INITIAL
17 STREET I❑ s❑' 3919 NE 10TH ST CITY' RENTON ST WA ZIP 98056 4❑ 37
NEW ADOREs
18❑ CDL IGNITION REQUIRED IGNITION PtR-E-S1ENT MEDICALt-T�RANSPORTED ❑ 38
INTERLOCKYES�NOR INTERLOCK YEs I I NoF YES t l No❑
19 DRIVE # STATE SEX F M .O.B. 02 _ 16 _ 195 8 39
CEN -----WELMET NATURE OF INJURIES 4O
20❑ ON DUTY STATUS' AIRBAG RESTR EJECT USE CLASS ❑
❑21❑ TArE LICENSE vIN# 41
1
PLATE#
42
22❑ PR TRAILER LATE# 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 I 970E 5
vE""LE ❑ ,J� CITATION# CHARGE i o BOTTOM
LEGALLY YES N J
25 s e
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
26
C.ARNOLD 12509 WA0171300
PAGE 01 OF
PART A
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EE48842
COLLISION REPORT III III III III III 111
1591972 CASE# 24-645
ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY)
NAME MIDDLE INITIAL) AGUILAR AGUILAR BRANDON S
(LAST FIRST,
ADDRESS&PHONE# D O.B.
650 DUVALL AVE NE RENTON WA 98056 SEX M MMDDYyYv 09 - 15 - 2006
SEAT HELMET INJURY NATURE OF INJURIES
PASSENGER WITNESS❑,UNIT# POS. 3 AIRBAG'2 RESTR. 4 EJECT 1 USE 2 CLASS 6 CUTS TO LEFT HAND
NAME
'(LAST,FIRST MIDDLE INITIAL)
ADDRESS&PHONE# D O E4
SEX' MMDDVYYV
PASSENGER []WITNESSO UNIT# SEAT AIRBAG RESTR. EJECT HELMET NJURY NATURE OF INJURIES
POS. USE CLASS
NAME
(LAST FIR57 MIDDLE INITIAL)
AppRESS&PHONE#
SEX D.O.B.
MMDDYVYY.
PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET NJURY NATURE OF INJURIES
❑ ❑ POS. USE CLASS ----�
NARRATIVE'
On 01/18/2024 1 was dispatched to an injury collision at the 4000 block of NE 10th St. I arrived on
scene to find Vehicle 1 overturned and both occupants outside of the vehicle. Driver 1 sustained
minor injuries to his left hand from broken glass and Passenger 1 sustained minor injuries to his left
hand. Driver 1 said that he was traveling East on NE 10th St at around the 4000 block when he felt
one of his rear tires not working properly. Driver 1 said that he was traveling at around 30-35 mph
when he lost control and struck a large metal mailbox belonging to 3919 NE 10th St. Vehicle 1 then
somehow overturned and ended up back in the roadway. It should be noted that at the time of the
collision it was wet and rainy. Driver 1 stated that he did not have a drivers license and provided me
with his name. Upon a check of DOL, it showed that Driver 1 was not licensed but was eligible.
Neither Driver 1 nor the owner of Vehicle 1 had insurance for Vehicle 1. Driver 1 did not have any
insurance at all. I located gouge marks in the roadway where the vehicle overturned as well as tire
marks in the mud leading towards the mailbox. Based on my training and experience, Vehicle 1
would have to have been traveling at a higher rate of speed that 35 mph in order to overturn. Driver 1
and Passenger 1 were both evaluated by Renton Fire Authority at the scene and refused transport to
the hospital.
I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT.
C.ARNOLD 01-19-24 12:00 AM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
D.MOYNIHAN 11288 1 2/9/2024 9:10:04 PM
BADGE OR ID# 112509 ORI#' WA0171300 TIME POLICE DISPATCHED 10:25 PM TIME POLICE ARRIVED 10:34 PM
PART I PAGE IT]OF 3�
REPORT NO. EE48842 CASE# ' 24-645 DATE AND TIME 01/18/24 22:22
OF COLLISION
' `+ -.
s
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