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HomeMy WebLinkAbout24-11917 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 0 27c COLLISION REP FIT 1591971 CASE 24-11917 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$ i TRIBAL UNITS 01 STRUCK UT/tITYPOLE RESERVATION z 3❑ DATE of M M D D Y Y Y Y TIME(2400) COUNTY# MILES N E IN CITY# ❑ COLLISION.. 11 — 1] — 2024 1422 17 ❑.= S 8 IN e 1070 3 4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓ NE 3RD ST BLOCK NO. e✓ 2000 4a❑ MILEPOST DISTANCE OF(REFERENCE OR CROSS STREET) 5❑ 300 00 FMILES EET e S ❑ W e MONTEREYAVE NE 0 1 29 MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE UNIT 01 VEHICLE ❑ CYCLE El ✓NO D:2065038470 30 6 LAST NAME PAEZ MIRANDA FIRST NAME JESUS MIDDLE 1 1 2 31 INITIAL STREET ❑ 2221 NE 6TH PL CITY RENTON ST WA ZIP 98056 z NEW ADDRESS 7❑ ODL 1/ I IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3 iNTERLOCKYEs NO NTERLOCKYEs NO�/ YES 1/ NO 8❑ LRIIVER # � ON DUTY❑ STATUS' AIRBAG 2 RESTR 1 . EJECT 1 HELMETU E 2 CLASS 6 [NATURE OF INJURIES LARGE LUMP ON FOREHEAD z❑ 3 10❑ PI ATNE 14 AOG3931 sTAr WAvN# 1FMPU18L8XtC42112 TRAILER STATE TRAILER STATE 11 3 5 PLATE# PLATE# FROM ro TRLR. TRLR 7 3 33 12❑ VIN#j VIN# FROM 34 13� VEH.YEAR 1999 MAKE FORD MODEL EXPEDI STYLE UT DAMCLETOWED NOOpLSABLIN TOyED.BLRS YES[:] No DAMAGE IILLJJII ttSSAA1IVV/it�66 REGISTERED OWNER INFO PASCUAL PAEZ 221 NE 6TH PL RENTON WA 98056 VEHICLE NO. 1 ❑ ❑ SHADE IN DAMAGED AREA 35 14 LIABILITY INSURANCE❑ N CO UNKNOWN IN EFFECT &POLICY## �1'OP vewcLE CHARGE BOTTOM ❑ 36 15❑ VEIF"LL YES No CITATION# 4A0148252 SPEED TOO FAST FOR CONDITIONS UNIT 02 VE IOOR El CYCLEEl PEDESTRIAN ❑ OWNERPROPE ❑ D YES NO ME PEDAL- OLD T PHONE 16❑ LAST NAME FIRST NAME MIDDLE INITIAL STREET CITY' ST ZIP 4❑ 37 17❑ NEW ADDRESS❑' 18❑ GNITION 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❑ TArE LICENSE vIN# 41 1 PLATE# 42 22❑ PR TRAILER LATE# STATE PLATE# STATE 23❑ 43 TRLR RLR UIN It '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 INAEFFITY ECTNSURANCE❑ &POINSULICY#E CO 1 9TOP 5 VEHICLE ❑ C[:] CITATION# CHARGE i o BOTTOM LEGALLY YES N 25 s e OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY 26 J.CARSTENSEN 11648 WA0171300 PART A PAGE 01 OF 3000-345-159 OR 11/181 STATE OF POLICETRAFFICN CORRECTION REPORT NO. EF38799 COLLISION REPORT III III III III III 111 1591972 CASE# 24-11917 ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY) NAME MIDDLE INITIAL) LELL SHANNON (LAST FIRST, ADDRESS&PHONE# D.O.B. 4259564510 SEX' U MMDDYYYY -❑ ---------------------------- PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT ' HELMET INJURY NATURE OF INJURIES ❑ ❑✓ PM USE CLASS NAME '(LAST,FIRST MIDDLE INITIAL) ADDRESS&PHONE# D O B SEX MMDDYYYY PASSENGER ❑WITNESS❑ UNIT# SEAT AIRBAG RESTR. EJECT HELMET INJURY NATURE OF INJURIES 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' 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.CARSTENSEN 11-17-24 05:15 PM INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED APPROVED BY DATE DESIRES SCOTT 10272 1112312024 9:52:56 AM BADGE OR ID# 11648 OR]# WA0171300 TIME POLICE DISPATCHED 2:22 Pry TIME POLICE ARRIVED',2:25 PM PART Ei PAGE IT]OF 4] REPORT NO. EF38799 CASE# 24-11917 OF COLLISION 11/17/24 14:22 OF CbLLI510N NARRATIVE On 11/17/24 at about 1425 hours I was working uniformed patrol in my unmarked patrol vehicle when I was dispatched to a collision at 2000 NE 3rd ST in the City of Renton, King County, WA. I arrived and contacted a witness, Shannon Lell, who told me that Unit 1 was traveling eastbound up the hill when they collided with a utility pole and spun around into the bushes on the south side of the road. Shannon was traveling westbound, so she turned her car around. When she pulled up, the driver was already out of the truck and talking with Shannon. I contacted the driver of Unit 1, who was identified by his WA DOL photo. Driver of Unit 1 had a very large lump on his forehead. He could not remember the accident and anything before it. Renton Fire arrived and determined Unit 1 driver should go to the hospital. He was later transported via TriMed to VMC. It appears that Unit 1 was travelling eastbound on NE 3rd ST up the hill in about the 2000 block when it lost control and travelled off the road slightly on the south side. The left-rear quarter panel collided with the utility pole, which likely caused Unit 1 to then spin counter-clockwise and into the bushes further on the south side. Bankers Towing arrived and towed the vehicle away. By operating a motor vehicle in a manner too fast for the road conditions, Jesus Paez-Miranda (DOB: 12/23/05) committed the crime of Too Fast For Conditions. Infraction #4A0148252 was sent via Court Mail. I certify (declare) under penalty of perjury under the laws of the State of Washington that the foregoing information provided by me is true and correct. Electronically signed: J. Carstensen #11648 PAGE 3 OF 4 REPORT NO. EF38799 CASE# ' 24-11917 DATE AND TIME 11/17/24 14:22 OF COLLISION 0 2000 NE 3rd SIM Q., PAGE 4 OF 4