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HomeMy WebLinkAbout24-10713 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 0 27c
COLLISION REP FIT 1591971
CASE 24-10713 z
INTERSTATE ❑ CITY STREET FIRE ❑RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHIC;I F ❑ LOCAL AGENC 4100 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#
cawsloN 10 - 1-- 2024 0940 17 ❑-= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
116TH AVE SE BLOCK NO. e✓ 16300 ❑
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ ❑ FEET e S ❑ VV a SE 163RD STREET
0 1 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
✓NO D:2063215528 0 6 30
6 LAST NAME LLANEZ URBINA FIRST NAME ROGER MIDDLE S 1 1 2 31
INITIAL
STREET ❑ 11038 LAKE CITY WAY NE#409 CITY SEATTLE ST WA ZIP 98125 z
'NEWADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
INTERLOCK YES NO INTERLOCK YES NO YES NO
8❑ LRIIVER #
ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 HELMETU SE CLASS 1 NATURE OF INJURIES z❑
3
10 9❑ P1 aT�S� CER5484 sTATI WAvIN# 1NXBR32E94Z311333
TRAILER STATE TRAILER STATE
11 2 5 PLATE# PLATE# FROM TO
TRLR. YRLR. 5 1 33
12 2 5 VIN#' VIN#
FROM TO
❑ VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE 5 1 34
13 2 2004 TOYT COROL 4D DAMAGE YES NO YES[:] NO✓
REGISTERED OWNER INFO RAFAEL GARCIA BRIC.0 8558 NESBITAVEN SEATTLE WA 98103 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
<53 4
14 2 LIABILITY INSURANCE INSURANCE COIN EFFECT &POLICY# TOPVEwcLE CHARGE TTOM 5 36
ALLY YES NO CITATION# 4A0612142,4A0612142, NO VALID OPER LICENSE WITH
15❑ STANDING 7 6
MOTOR PEDAL-: ❑ PEDESTRIAN PROPERTY DAM THR PHONE
UNIT 02 V� IEHIC OLD MET LE ❑ CYCLE ❑ OWNER ❑ YES 1/ NO D:2062809277
16 a
LAST NAME LUNA MUNOZ FIRST NAME ANA MIDDLE L
INITIAL
17❑ STREET ❑', 19619 116TH AVE SE CITY KENT ST WA ZIP 980310439 37
NEW ADDRESS ❑
18� CDL IGNITION REQUIRED IGNITION PR-E-1SENT MEDICAL TRANSPORTED ❑ 38
INTERLOCKYES�NOR INTERLOCK YEs It I NOF YES t t- l NO❑
19 LICENSE# STATE WA SEX F M .C.B. 10 _ 19 _ 1989 39
20❑ ON DUTY STATUS AIRBAG,2 RESTR 4 EJECT 1 H U NEET LASSY 6 [-�A—TUREOF INJURIES
C/O BACK PAIN.DECLINED RRFA RESPONSE ❑ 40
21❑ LICENSE I BXJ6061 TATE WA vIN# 5TDJZRBH7MS083270
❑ 41
PLATE#
42
22❑ PLATE# STATE PLATE# STATE
23❑ 43
TRLR RLR
VIN#. IN#.
VEH YEAR 2021 MAKE TOYT MODEL HIGHLAN STYLE SI/ VEHICLETOWED TO BLIN TOWEDBY GOV HI 44
24❑ DAMAGE YES NO YES NO
REGISTERED OWNER INFO MOISES OS.GAR.19619116TH AVE SE KENT WA 98031 D:2062809277 VEHICLE NO.2
SHADE IN DAMAGEbAREA
2 3 Cd
LIABILITY
INSURANCE INSU POLICY#E CO SAFECO Y9014314IN 1 9TOP
VE""LE ❑ N J
,J� CITATION# CHARGE
LEG
25 i o BOTTOM
ALLY YES $
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
26
MATTHEW NUGENT 11498 WA0171300
PART A PAGE 01 OF C7
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EF26729
COLLISION REPORT III III III III III 111
1591972 CASE# 24-10713
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
POS. 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.
MATTHEW NUGENT 10-15-24 03:09 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY E
DAT
K.LANE 10008 1012112024 9:34:37 AM
BADGE OR ID# 11498 OR]# WA0171300 TIME POLICE DISPATCHED' 9:41 AM TIME POLICE ARRIVED',9:43 AM
PART I PAGE IT]OF
REPORT NO. EF26729 CASE# 24-10713 OF COLLISION
10/14/24 09:40
OF CbLLI510N
NARRATIVE
24-10713
On 10/14/2024 at approximately 0942 hours, I was dispatched to an unknown-if-injury vehicle
collision at the intersection of 116th Ave SE and SE 163rd Street, within the City Limits of Renton,
County of King, State of Washington.
Officers J. Kaupila and E. Chang arrived on scene prior to me and determined there were no injuries
requiring immediate medical response at the time of report. Upon my arrival, I collected the involved
parties driving documents and their independent recollection of events leading up to the collision.
Officer Chang and his Student Officer determined the following information via Language Line
Solutions for Spanish. The driver of Unit#1 said he was the sole occupant of his vehicle and was
traveling northbound in about the 16300 block of 116th Ave SE just south of the intersection of SE
163rd ST. The driver of Unit#1 stated he was traveling directly behind Unit#2 and saw as Unit#2
suddenly slowed for an uninvolved vehicle turning at the uncontrolled intersection. The driver of Unit
#1 stated that he simply was unable to stop in time and subsequently collided with the rear of Unit#2
causing significant damage to the front of Unit#1.
The driver of Unit#2 said she was the sole occupant of her vehicle and was also traveling northbound
in about the 16300 block of 116th Ave SE just south of the intersection of SE 163rd ST. While Unit
#2 was slowing for a turning vehicle ahead, Unit#1 collided with the rear of Unit#2 causing moderate
damage to the rear of Unit#2.
A DOL records check revealed that the driver of Unit#1 (Llanez Urbina) was listed as "Not Licensed -
Eligible". Officer Chang and his Student Officer were able to identify Llanez Urbina via a pictured
Venezuelan Passport. Llanez Urbina did however violate RCW 46.20.015 by Driving without a Valid
Operator's License with valid Identification.
Llanez Urbina was also unable to produce proof of motor vehicle insurance upon request therefore I
cited him for violation of RCW 46.30.020 -Liability Insurance. RCW 46.30.020 says that no person
may operate a motor vehicle subject to registration under chapter 46.16A RCW in this state unless
the person is insured under a motor vehicle liability policy with liability limits of at least the amounts
provided in RCW 46.29.090, is self-insured as provided in RCW 46.29.630, is covered by a certificate
of deposit in conformance with RCW 46.29.550, or is covered by a liability bond of at least the
amounts provided in RCW 46.29.090. Proof of financial responsibility for motor vehicle operation
must be provided on the request of a law enforcement officer in the format specified under RCW
46.30.030.
The driver of Unit#1 (Llanez Urbina) was also following the vehicle in front of him too closely violating
RCW 46.61.145. RCW 46.61.145 states that the driver of a motor vehicle shall not follow another
vehicle more closely than is reasonable and prudent, having due regard for the speed of such
vehicles and the traffic upon and the condition of the highway.
Based on the above statements, I determined that the Driver of Unit#1 (Llanez Urbina) is the
proximate cause for the collision due to following too closely causing a collision.
I cited Llanez Urbina in-person for NVOL with ID, No Insurance, and Following too closely. Unit#1
had to be towed away due to extensive damage. Unit#2 was able to be driven away without further
incident. An exchange of information was provided to all involved parties.
I certify (or declare) under penalty of perjury under the laws of the State of Washington that the
PAGE 3 OF 5
REPORT NO. EF26729 CASE# 24-10713 OF COLLISION
10/14/24 09:40
OF CbLLI510N
NARRATIVE
foregoing is true and correct.
Electronically signed by Officer M. Nugent#11498 2:51 PM 10/15/2024 Renton, King County, WA.
PAGE 4 OF 5
REPORT NO. EF26729 CASE# 24-10713 DATE AND TIME 10/14/24 09:40
OF COLLISION
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