HomeMy WebLinkAbout24-12977 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 5 27c
COLLISION REP FIT 1591971
CASE 24-12977 z
INTERSTATE ❑ CITY STREET FIRE ❑RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHICI F ❑ LOCAL AGENCI 4150 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 CITY#
COLLISION.. 12 — 19 — 2024 1630 17 . N E IN� S 8 W H OF e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
SE 168TH STREET BLOCK NO. e✓ 12100 ❑
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ �,❑ FEET e S ❑ W e 121STAVESE
0 1 29
MOTUNIT U1 VEHIOR Z PEDAL-CLE CYCLE ElDESA✓NHORESHOLD MET PHONE 30
6� LAST NAME UNKNOWN FIRSTNAME MIDDLE 1 1 2 31
INITIAL
STREET ❑ CITY ST ZIP z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
iNTERLOCKYEs NO INTERLOCK YES NO YES No
DRIVERS
STATE SEX D '❑- 328 LICENSE MMDYY❑
9 ON DUTY❑ STATUS I
AIRBAG 9 RESTR 9 EJECT 1 H USEEr 9 CLAY 0 NATURE OF INJURIES z❑
3
LICENSE sTATI urN#'
10[ PI ATE#
C7
TRAILER STATE TRAILER STATE
11 3 0 PLATE# PLATE# IR.. ro
TRLR. TRLR 3 7 33
12❑ VIN# VIN#
FROM TO
❑ VEH.YEAR MAKE MODEL STYLE SV VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE 5 1 34
13 4 DAMAGE YES NO YES❑ NO✓
REGISTERED OWNER INFO UNKNOWN VEHICLE NO. 1
SHADE IN DAMAGED AREA ❑ 35
14 ABILI INSURANCE❑ INSURANCE CO 3 4
IN EFFECT &POLICV# 9TOP
vENICLE CHARGE 5 36
LEGALLY YES❑NO❑ CITATION# 1 o BOTTOM
15❑ STANDING 8 6
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT VEHICLE ❑ CYCLE ❑ ❑ : OWNER ❑ YES 1/ NO D:2069476120
16 a
LAST NAME JAKARTA FIRST NAME KEIKO MIDDLE S
INITIAL
17 STREET I 20TH AVE SE CITY RENTON ST WA ZIP 98058 37
ADOREs�' 16504 1
18� CDL IGNITION REQUIRED IGNITION PtR-E-S1ENT MEDICAL t—T�RANSPORTED 38
INTERLOCK YEs❑NO� INTERLOCK YEs I I No� YES t l NO❑
19 DRIVE # STATE SEX F M .C.B. O6 _ 19 _ 2007 39
ON DUTY STATUS 3 AIRBAG RESTR EJECT H EET 2 NJAURSY 5 FX.PELVIS,SYNCOPE,FACIAL LACERATION ❑ 40
❑21❑ TATE 41
IN#LICENSE V `1
PLATE#
42
22 [TRAILER TILER
❑ PLATE# STATE PLATE# STATE
23❑ 43
TRLR RLR
VIN#. IN#.
VEH YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN
TOWED BY Gov HI 44
L4 0 3 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
=UGENT
(PRINT) OFFICER PHONE BADGE OR ID# 771�NCY
26 11498 0171300
PART A PAGE 01 OF C7
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EF48216
COLLISION REPORT III III III III III 111
1591972 CASE# 24-12977
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
PM 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 12-19-24 07:20 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY E
DAT
G.BARFIELD 6476 12/20/2024 8:20:48 AM
BADGE OR ID# 11498 OR]# WA0171300 TIME POLICE DISPATCHED' 4:31 PM TIME POLICE ARRIVED',4:34 PM
PART I PAGE IT]OF 4�
REPORT NO. EF48216 CASE# 24-12977 OF COLLISION
12/19/24 16:30
OF CbLLI510N
NARRATIVE
24-12977
On 12/19/2024 at approximately 1631 hours, I was dispatched to a hit-and-run motor vehicle versus
pedestrian injury collision at the intersection of SE 168th Street and 121 st Ave SE, within the city
limits of Renton, County of King, State of Washington.
While en route, dispatch advised that one pedestrian was struck by a single vehicle and that only the
pedestrian remained on scene on SE 168th Street. The reporting party requested immediate medical
attention for the downed pedestrian and described the fleeing vehicle as a black or dark-colored SUV
that was last seen traveling westbound towards the 7-11 store which is located at SE 168th ST/116th
Ave SE). Dispatch informed responding Officers that King County Medic One would also be
responding due to a report that the pedestrian losing consciousness and being unable to sstand up.
Upon arrival, the Renton Regional Fire Authority (RRFA) was already on scene and treating the
injured pedestrian, later identified by pictured Indonesia Driver's License as JAKARTA, KEIKO S
(DOB 06/19/2007). According to RRFA on scene, Jakarta's primary complaint of pain was her
pelvis/hip and a facial laceration.
Officers C. Catalan and M. Mollenberg began speaking to witnesses on scene. According to
witnesses, the causing vehicle had been traveling westbound on SE 168th Street and approaching
the uncontrolled intersection of 121 st Ave SE. Per the witnesses, the causing vehicle made no
attempt to stop and struck the pedestrian in the crosswalk. Witnesses described that the witness was
nearly across the intersection prior to being struck. Witnesses described the pedestrian as being
"spun" after being struck. Witnesses confirmed that Unit#1 then fled westbound on SE 168th Street.
It is believed that there would be damage to the front bumper/quarter panel of the fleeing vehicle,
likely on the passenger side. See Officer Catalan/Mollenberg's supplemental report for further details.
Jakarta was in the ambulance and being prepared for transport to Harborview Medical Center
hospital as a result of the collision. Based on witness account and surveillance footage reviewed by
Officer Catalan, it is believed Jakarta conducted the following;
Jakarta was walking eastbound on SE 168th Street along the south sidewalk and had reached the
intersection of 121 st Ave SE. Jakarta crossed from west to east before reaching the southeast corner
of the intersection before stopping. Jakarta prepared to cross from south to north at the marked
crosswalk. Jakarta is seen on camera waiting for an opening in traffic. Eventually, Jakarta began to
cross SE 168th from south to north. Upon Jakarta almost being completely across the crosswalk,
witnesses say Jakarta was struck by Unit#1 in the crosswalk.
On-duty Renton Police Traffic Unit representatives were called to the scene conducted an
investigation. The pedestrian location was marked with paint for follow-up investigation. Photographs
were captured and have since been uploaded to this case.
This collision remains under investigation and should be forwarded to Renton Police Traffic
Detectives for Felony Hit-and-Run Investigation.
I certify (or declare) under penalty of perjury under the laws of the State of Washington that the
foregoing is true and correct.
Electronically signed by Officer M. Nugent#11498 7:07 PM 12/19/2024 Renton, King County, WA.
PAGE 3 OF 4
REPORT NO. EF48216 CASE# ' 24-12977 DATE AND TIME 12/19/24 16:30
OF COLLISION
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PAGE 4 OF 4