HomeMy WebLinkAbout24-11842 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 1 27c
COLLISION REP FIT 1591971
CASE 24-11842 z
INTERSTATE ❑ CITY STREET FIRE ❑
RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHIC;I F ❑ LOCAL AGENCI 4250 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 TOTAL#OF OBJECT 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 11 - 1-- 2024 2257 17 ❑-= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
108 AVE SE BLOCK NO. e✓ 17941 ❑
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5 .❑ FEET e S ❑ W e SE 180TH ST
❑ �
0 2 29
UNIT MOTOR
VEHICL Z CYDALCLE ElDDAMYESA✓NOESHOLDMET PHONE O 11
30
6� LAST NAME UNKNOWN FIRSTNAME MIDDLE 1 2 31
INITIAL
STREET ❑ CITY MARYSVILLE ST ZIP 2=
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION : PRESENT MEDICAL TRANSPORTED 3
iNTERLOCKYEs NO 1/ INTERLOCKYEs NO�/ YEs No�/
8❑ LICIENSE#
STA fE I
SEX u MMDOBYY '❑- 1 1 2 32
9 ON DUTY❑ STATUS I
AIRBAG 9 RESTR 9 EJECT 1 H USEEr 9 CLAY 0 NATURE OF INJURIES z❑
3
10 9❑ LICENS P1 ATE 14 581766 STATE WA VIN# JS1VP55AX92101431
TRAILER STATE TRAILER STATE
11 0 0 PLATE# PLATE# FR.. ro
TRLR. A'RLR. 1 5 33
12 0 0 VIN#' VIN#
>; FROM TO
VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE 1 $ 34
13 3 2009 SUMC SFV650 MT DAMAGE YES NO YES❑ NO✓
REGISTERED OWNER INFO DANA GROULX 471580TH DR NE MARYSVILLE WA 98270 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
❑ ❑ INSURANCE CO �:w
14 IN EF ITV INSURANCE N/A N/A
IN EFFECTPOLICV#VE— CHARGE 36
LECALLvYes❑NO CITATION#
15❑ STANDING
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT 02 VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES 1/ NO D:4256260601
16 a
LAST NAME LEE FIRST NAME DANIEL MIDDLE D
INITIAL
17 STREET NEW ADDRESS❑' 720 S 55TH ST CITY' RENTON ST WA ZIP 98055 37
18� CDL IGNITION REQUIRED IGNITION PtR-E-S1ENT MEDICAL-T�RANSPORTED 38
INTERLOCK YEs❑No� INTERLOCK YEs I I NOF YEs t l NOF,/
19 LDIIVEW # STATE WA SEX M M .C.B. 01 20 _ 1951 39
20❑ ON DUTY STATUS AIRBAG 2 RESTR 9 EJECT 1 H U EET NJAURSY 1 NATURE OF INJURIES ❑ 40
❑21❑ PLATE# BPV6505 TATE WA VIN# 41
STDDGRFHSKS060395 4
42
22❑ PLATE# STATE PLATE# STATE
23❑ UIN#. 43
TRLR RLR
'IN#.
VEH YEAR 2019 MAKE TOYT MODEL HIGHLAN STYLE 4D VEHICLETOWED TO BLIN TOWEDBY GOV HI 44
L4❑ DAMAGE YES NO YES NO
REGISTERED OWNER INFO DANIEL LEE 720 S 55THST RENTON WA 98055 D:4256260601 VEHICLE NO.2
SHADEDAMAGEDAREA
3 4
LIABILITY
INSURANCE &POINSURGY#E CO ALLSTATE 817890697IN 9TOP 5
VE""LE ❑ ,J� CITATION# CHARGE to BOTTOM
LEGALLY YES N`L J
25 ' e
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# JAGENCY
26
J RAYGOZA 12503 WA0171300
PART A PAGE 01 OF C7
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EF36940
COLLISION REPORT III III III III III 111
1591972 CASE# 24-11842
ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY)
NAME MIDDLE INITIAL) STEWART PALANI J
(LAST FIRST,
ADDRESS&PHONE#
18617 112TH AVE SE RENTON WA 98055 2064599955 SEX M MMDOYyry 01 - 17 - 1977
PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT ' HELMET INJURY NATURE OF INJURIES
POS. USE CLASS +
NAME
(LAST,FIRST,MIDDLE INITIAL)
ADDRESS&PHONE# DOB
SEX' MMDDYVYV
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.
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 RAYGOZA 11-15-24 12:52 AM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
J.THIELMAN 11462 1 1111812024 8:00:04 PM
BADGE OR ID# 12503 OR]# WA0171300 TIME POLICE DISPATCHED! 10:59 PM TIME POLICE ARRIVED',11:08 PM
PART I PAGE IT]OF 4�
REPORT NO. EF36940 CASE# 24-11842 OF COLLISION
11/14/24 22:57
OF CbLLI510N
NARRATIVE
Case Number 24-11842
On 11/14/2024 at approximately 2259 hours, I was dispatched to 108th Ave SE and SE 180th ST
within the City of Renton, King County, Washington to a hit and run collision. Dispatch relayed over
the radio that a white SUV and a motorcycle collided at the location. The driver of the motorcycle was
walking away from the location and the driver of the SUV parked his vehicle at the Shell parking lot
located at 17941 108th Ave SE.
On arrival I saw unit 1 a black and red motorcycle parked on the sidewalk north of the Shell gas
station. The motorcycle had major damage to the rights side, and it had no license plates on it and
was identified by its VIN number as a 2009 Suzuki SFV650 WA/LIC 5131766
VIN#JS1VP55AX92101431. The motorcycle was registered to Groulx, Dana Ellen DOB (12/01/1956)
but no one was around it when I arrived. I contacted the reporting party who was identified by his
WADOL as Stewart, Palani Jay DOB (01/17/1977) who was standing next to the other involved driver
identified by his WADOL as Lee, Daniel Daikyu DOB (01/20/1951).
1 spoke with Palani, and he stated that he was inside the Shell gas station when he heard a loud
crash outside. Palani walked outside and saw unit 2 identified as a white 2019 Toyota Highlander
WA/LIC BPV6505 VIN#5TDDGRFH8KS060395 parked on the road with Daniel outside of it trying to
talk to the driver of the Suzuki. The driver of the Suzuki picked up his motorcycle that was on the
ground and started pushing their motorcycle north bound on the sidewalk and ignored Daniel who
was telling them to come back. The driver of the Suzuki was then picked up by someone in another
motorcycle and left the location leaving unit 1 behind. Palani was unable to tell if the driver of unit 1
was a male or female due to their helmet. The description Palani gave was an unknown race male or
female, thin, wearing a black motorcycle helmet and black clothing.
I spoke with Daniel the driver of unit 2 and he said he was driving southbound on 108th Ave SE on
the lane closest to the curb and that unit 1 was driving behind him. As Daniel was driving south, unit 1
drove near the curb and on the right side of Daniel and attempted to pass him but collided with the
front right side of Daniel's vehicle. The driver of unit 1 fell off the bike and unit 1 fell to the ground and
slid a few feet away in front of unit 2. Daniel then parked his vehicle on 108th Ave SE and checked on
the driver of unit 1 but the drive of unit 1 ignored Daniel and picked up his vehicle from the ground
and continued walking north on 108th Ave SE. Daniel moved his car off the road and parked it at the
Shell parking lot and continued to call out to the driver of unit 1 but they were soon picked up by
another subject in a motorcycle and left the location last seen driving southbound on 108th Ave SE.
Daniel was unable to identify the driver of unit 1 either and said they were very slim and were wearing
all black clothing with a black helmet. Daneil was not hurt and provided me with a valid driver's
license, proof of insurance and registration.
I took pictures of Daneil's vehicle and of the Suzuki motorcycle and submitted them into evidence. I
provided Daniel with my business card and the case number, and he drove his vehicle back home.
Unit 1 was not on the road, so I decided to leave it at the location, it had major damage to it and the
chain to the bike was heavily damaged. If the driver of unit 1 is located and identified there is
probable cause to arrest them for hit and run.
This concludes my involvement with this case.
I certify (declare) under the penalty of perjury under the laws of the State of Washington that the
foregoing is true and correct.
Electronically signed J.Raygoza/12503
11/15/2024 0030 Hours Renton, WA.
PAGE 3 OF 4
REPORT NO. EF36940 CASE# ' 24-11842 DATE AND TIME 11/14/24 22:57
OF COLLISION
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