Loading...
HomeMy WebLinkAbout25-804 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 6 27c COLLISION REP FIT 1591971 ❑ ❑ RESULTED ❑ CASE# zs-so4 2 INTERSTATE CITY STREET FIRE 1 STOLEN STATE ROUTE ❑ OTHER ❑ VFHICI F ❑ LOCAL AOENC 4Y00 3 HIT&RUN CODING COUNTY RD PRIVATE WAY INVOLVED 2❑ TOTAL#TRIBAL OF 02 OBJECT 1 1 8 28 UNITS RESERVATION I STRUCK 2 3 DATE OF M M D D Y Y Y Y TIME(2400) COUNTY# MILES N E IN CITY# CowsloN 01 - 1-- 2025 0406 17 ❑.= S IN 1070 3 4❑ oN (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑ 108TH AVE SE BLOCK NO. e✓ 17600 ❑ 4a❑ MILEPOST DISTANCE OF(REFERENCE OR CROSS STREET) 5❑ MILES❑ FEET e S ❑ E e SEPETROVITSKYRD 0 4 29 MOTOR PEDAL- DAMETHRESHOLD MET PHONE UNIT 01 VEHICLE ❑ CYCLE ElYES AG�/No D:4253898048 0 1 30 6 LAST NAME PINEDA ROMERO FIRST NAME GABRIEL MIDDLE F 1 1 2 31 INITIAL STREET ❑, 17116 125TH PL SE CITY RENTON ST WA ZIP 98058 2 NEW ADDRESS 7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3 1/ I iNTERLOCKYEs NO NTERLOCKYEs No�/ YES R No�/ 8❑ LDRIVER # STATE WA SEX'M MID LOB 12 — 09 — 2008 1 2 32 9❑ ON DUTY❑ STATUS' AIRBAG 2 RESTR I [NATURE OF 4 EJECT 1 H U EET 2 1 INJURY CLASS ju CUT ON HAND INJURIES 2❑ 3 10❑ P1 ATNFS# C19370T sTAT WA V N# 1FTEX1E67AFC53058 ----� TRAILER STATE PLATE# STATE 11 0 0 PILER LATE# PLATE# FROM TO TRL . TRLR. 1 3 33 12 0 0 R TIN VIN# FROM TO VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN T /g[ GOVT.VEHICLE 5 1 34 13 3 2010 FORD F150 PK DAMAGE YES NOBS YES[:] No ✓ REGISTERED OWNER INFO ELIZABETH ROMERO OIAZ 17116125TH PL SE RENTON WA 98058 D:4259193124 N:4259293124 VEHICLE NO. 1 SHADE IN DAMAGED AREA ❑ 35 3 INSURANCE CO <1�3 4 14 IN EF E INSURANCE STATE FARM 5017268-D20.47 IN EFFECT &POLICV# TOPOTTOM VEHICLE YES❑NO❑ CITATION# CHARGE 5 36 LEGALLY 5A0064647 NO VALID OPER LICENSE WITH 15 2 STANDING 7 6 MOTOR PEDAL- PROPERTY DAM THR OLD MET PHONE UNIT 02 VEHICLE CYCLE ❑ PEDESTRIAN ❑ OWNFR ❑ YES 1/ No D:4255259779 16 a LAST NAME BUI FIRST NAME NHAN MIDDLE INITIAL 17 STREET I❑ 17739 110TH PL SE CITY RENTON ST WA ZIP 98055 37 NEW ADDRESS❑' 18❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL—T�RANSPORTED � 38 INTERLOCK YEs❑No� INTERLOCK YEs I I NOF YES t l NOF,/ 19 DRIVER'S STATE WA SEX M D.O.B. 07 23 _ 1966 39 LICENSE# MMDDYY 20❑ ON DUTY STATUS AIRBAG 6 RESTR 1 EJECT 1 H U EET 2 NJAU EY 1 NATURE OF INJURIES ❑ 40 LICENSE I ❑21❑ PLA E# CKG6495 TATE WA uIN# 41 JTMABACA3PA015217 1 42 22❑ PLATE# STATE TILER PLATE# STATE TRLR 23❑ UIN#. N#. 43 RLR 'I GI VEH YEAR 2023 MAKE 7'Dy7- MODEL BZ4X STYLE $V DAMAGE TO ✓WED NOO BLIN TOWED BY 44 Yr OV H BANKERS YES No 24❑ REGISTERED OWNER INFO OWNED SY DRIVER VEHICLE N0.2 SHADE IN DAMAGED AREA 2 3 4 LIABILITY INSURANCE INSU&PORGY#E CO AMERICAN FAMILY 41023-83590-72 9TOP 5 IN EFFECT VE."LE ❑ ,J� CITATION# CHARGE i o BOTTOM LEGALLY YES N`LJ 6 25 7JUS NAME(PRINT) OFFICER PHONE BADGE OR ID# JAGENCY 26KAUPPILA 12883 WA0171300 PART A PAGE 01 OF C7 3000-345-159 OR 11/181 STATE OF POLICETRAFFICN CORRECTION REPORT NO. EF60968 COLLISION REPORT III III III III III 111 1591972 CASE# 25-804 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,FIRS 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. JUSTIN KAUPPILA 01-26-25 07:29 PM NVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED APPROVED BY DATE J.CHRISTIANSEN 10437 113012025 5:53:37 PM BADGE OR ID# 12883 OR]#' WA0171300 TIME POLICE DISPATCHED; 4:09 AM TIME POLICE ARRIVED 4:15 AM PART PAGE IT]OF 4� REPORT NO. EF60968 CASE# 25-804 OF LNa 01/25/25 04:06 F coy�isI©�ON u NARRATIVE 25-00804 Unless otherwise noted, the following occurred within the city limits of Renton, county of King, state of Washington. On 01/25/2025, 1 was working as a uniformed police officer for the city of Renton. At approximately 0409 hours, I was dispatched to a blocking accident at the intersection of 108th Ave SE and SE Petrovitsky Rd. Portions of my involvement in the incident were captured on my department-issued Axon body-worn camera. While enroute, dispatch relayed two vehicles were blocking the intersection. The two vehicles involved and their drivers were as follows: Unit 1 -a white 2010 Ford F150 (WA lic/C19370T, VIN/1 FTEX1 E67AFC53058) being driven by Gabriel F Pineda Romero (12/09/2008 -WA ID card photo). Unit 2 -a white 2023 Toyota BZ4X (WA lic/CKG6495, VIN/JTMABACA3PA015217) being driven by its registered owner, Nhan Bui (07/23/1966 -WA Driver's License photo). When I arrived on scene, I first spoke with Nhan, who gave me the following account of the collision: He was traveling northbound in lane 1 of 2 on 108th Ave SE. As he approached the intersection at SE Petrovitsky Rd, he claims to have observed a green stoplight signaling that he had the right-of-way to continue through the intersection. As he was proceeding through, he was struck by unit 1, which prior to the collision, was in the southbound lanes on the north side of the intersection. I spoke with Gabriel who gave the following recap: He was just north of the dispatched intersection in lane 4 of 4, preparing to turn eastbound onto SE Petrovitsky Rd. He claims to have observed a green left turn light, signaling that he had the right-of- way to complete his turn. As he was doing so, he struck unit 2 as it was passing through that same intersection. Both vehicles sustained heavy damage as a result of the collision. Bankers Tow arrived on scene and towed both from the roadway. Renton Regional Fire Authority also responded to the scene to evaluate both involved parties. Gabriel informed me that he does not have a valid driver's license, but rather, only a state-issued ID card. His father later arrived on scene and transported him home. Due to not possessing a valid driver's license, but only a state ID card, while driving a motor vehicle upon a highway in Washington State, I Gabriel a citation for driving without a license -traffic infraction (RCW 46.20.015). PAGE 3 OF 4 REPORT NO. EF60968 CASE# 25-804 DATE AND TIME 01/25/25 04:06 OF COLLISION r c x, } r 5 i � Y r 3.� t t k 1s z��ty l r' It 2 }} i tt H t , 4`a e t 4i t , r PAGE 4 OF 4