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HomeMy WebLinkAbout24-5364 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 5 27c COLLISION REP FIT 1591971 CASE 24-5364 z INTERSTATE ❑ CITY STREET FIRE ❑ RESULTED 1 STOLEN STATE ROUTE ❑ OTHER ❑ VFHICI F ❑ LOCAL AGENCI 4Y00 3 HIT&RUN CODING COUNTY RD PRIVATE WAY INVOLVED 2 TOTAL#OF OBJECT 1 8 28 TRIBAL UNITS OS STRUCK RESERVATION z 3❑ DATE OF M M D D Y Y Y Y TIME(2400) COUNTY# MILES N E IN CITY# COLLISION.. 05 — 21 — 2024 0801 17 ❑-= S 8 IN e 1070 3 4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑ S 2ND ST BLOCK e✓ 000 ❑ 4a❑ MILEPOST DISTANCE OF(REFERENCE OR CROSS STREET) 5❑ ❑ FEET e S ❑ W e RAINIER AVE S 0 3 29 MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE UNIT 01 VEHICLE ❑ CYCLE El �/No D:3238429580 0 3 30 6 LAST NAME DE LEON VICENTE FIRST NAME ERICK MIDDLE A 1 2 31 INITIAL STREET ❑ 3025 NE 7TH ST CITy RENTON ST WA Zjp, 980563753 z NEW ADDRESS 7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3 :NTERLOCKYEs NO INTERLOCK YES NO YES No 8❑ LICIENSE# STATE WA SEX'M MM DAY' 06 - 17 - 1991 1 2 32 9 ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 H USEET 2 CLASS 1 NATURE OF INJURIES z❑ 3 10❑ Pi aT�S� D90655D sTAr� WAurN# JALC4W16687002344 TRAILER STATE TRAILER STATE 11 3 5 PLATE# PLATE# FROM TO TRLR. TRLR. 3 1 33 12 0 0 VIN#' VIN# >; FROM TO VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE 3 1 34 13 4 2008 !SU NPR TR DAMAGE YES NO YES[:] NO✓ ❑ REGISTERED OWNER INFO DELEON GENERAL CONTRACTOR LL 950 EDMONDS AVENE RENTON WA 98056 VEHICLE NO. 1 ❑ SHADE IN DAMAGED AREA 35 4 LIABILITY INSURANCE INSURANCE CO 2 3 4 14 ❑ PENDING PENDING IN EFFECT &POLICY# 9TOP ❑ LEGALLY LE CHARGE 1 5 36 15 2 re5 No clTAnoN# 4A0196793 INATTENTIVE DRIVING o eorrob MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE UNIT 02 VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES V NO D:2066962287 16 a LAST NAME BROWN FIRST NAME CHRISTINE MIDDLE I D INITIAL 17 STREET I❑ s❑' 17735 1 4❑05TH PL SE APT H2O5 R WA 98055 CITY RENTON ST WA ZIP 980550000 37 NEW ADOREs 18❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL t-T�RANSPORTED � 38 INTERLOCKYES�NOR INTERLOCK YEs I I No� YES t l No❑ 19 LICENSE# STATE WA ]SEX IF M .C... 10 _ 08 _ 1959 39 20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 H EET 2 NJAURSY 1 NATURE OF INJURIES ❑ 40 ❑ILICENSE 21❑ PLATE# 847MSC TArE OR VIN# JA4ARUAU9MU024003 41 1 42 22❑ PILER LATE# STATE PLATE# STATE 23❑ 43 TRLR RLR VIN#. IN#. VEH YEAR 2021 MAKE MITS MODEL MIRAGE STYLE UT VEHICLE TOWED TO BLIN TOWEDeY GOB HI �44 24❑ DAMAGE YES NO YES NO REGISTERED OWNER INFO CHRISTINE BROWN 17735105TH PL SE APT H2O5 R WA 98055 RENTON WA 980550000 D:2066962287 VEHICLE NO.2 SHADE DAGED AREA 4 LIABILITY INSURANCE INSU&PORGY#E CO SELF INSURED EAN HOLDINGS IUR 5 IN EFFECT 'E""LE ❑ ,J� CITATION# CHARGE LEGALYYES N`L J25 OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY J 26 C.JACOBS 1953 WA0171300 PART A PAGE 01 OF C7 3000-345-159 OR 11/181 STATE OF POLICETRAFFICN CORRECTION REPORT NO. EE85816 COLLISION REPORT III III III III III 111 1591972 CASE# 24-5364 ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY) NAME MIDDLE INITIAL) RAMIREZ CRUZ OSVALDO N (I.P.ST FIRST, ADDRESS&PHONE# D O.B. ' 2307 NE 4TH ST APT C205 RENTON WA 980564094 SEX M MMDOYyry 09 - 03 - 1989 PASSENGER WITNESS UNIT# SEAT ' AIRBAG RESTR. EJECT ' HELMET INJURY NATURE OF INJURIES ❑✓ �, 1 POS. 3 2 4 1 USE 2 CLASS 1 NAME (LAST,FIRST,MIDDLE INITIAL) ADDRESS&PHONE# DOB SEX MMDDYYYY PASSENGER ❑WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET NJURY 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. C.JACOBS 06-03-24 09:33 AM NVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED APPROVED BY DATE C.JACOBS 1953 1 6/12/2024 7:26:16 AM BADGE OR ID# 1953 ORI# WA0171300 TIME POLICE DISPATCHED 8:05 AM TIME POLICE ARRIVED:8:20 AM PART I PAGE IT]OF 5� DATE AND TIME REPORT NO. EE85816 CASE# 24-5364 OF COLLISION05/21/2408:01 NARRATIVE On 5-21-24 at about 0815 1 arrived in the 100 block of Rainier Ave S for a 3 vehicle collision. I contacted the drivers of units 1 and 2 in or near their vehicles. Both drivers were identified via WADL. Driver 1 did not speak much english so we spoke in spanish. Driver 1 told me; -He was making a right turn from s 2nd street to Rainier ave S. when units 1 and 2 collided. He nor his passenger were injured. Driver 2 told me; -She was making a right turn from S 2nd Street to Rainier Ave S when unit 1 failed to maintain its lane and came into her lane, striking her vehicle on the passenger side. She was not injured. I was able to locate a video fo the initial collision via a camera at Gene Meyers Towing. The video showed, unit 1 failled to maintain its lane and crossed over into lane 2, striking unit 2. Both vehicles pulled to the curb lane and partially up onto the sidewalk. While stopped and waiting for police to arrive, unit 3 drove by and hit the mirror of unit 2 and kept driving without stopping. Driver 2 only knows it was a truck that damaged her mirror. No injuries reported. I cited Driver 1, Erick DeLeon Vicente for inattention via complaint. This collision occurred in the city of Renton, County of King. I declare under penalty of perjury under the laws of the state of Washington laws that the foregoing is true and correct. C. Jacobs/1953 PAGE 3 OF 5 SUPPLEMENTAL REPORT NO. EE85816 r`) POLICE TRAFFIC 1 1 7 27 COLLISION REPORT CASE# 24-5364 1 COMMERCIAL MOTOR CARRIER INTERSTATE INTRASTATE G UNIT'# USDOT ICC# VEHICLE TYPE CARGO BODY ;TYPE 2 ❑ 1 28 CARRIER NAME 3 CARRIER ADDRESS ` CITY ST ZIP—1 I ' 4 ❑ NAME # PLACARD: :❑ GI PLACARD IF NO NUMBER SOURCE AXLES + 4a ❑ ADDITIONAL UNITS MOTOR PEDAL- PROPERTY DAMAGETHRESHOLD MET PHONE 5 ❑ UNIT# 3 VEHICLE t_"J � PEDESTRIAN YES NO 0 1 29 LAST NAME : UNKNOWN FIRST NAME , MIDDLE INITIAL STREET 30 NEW AnDRFS CITY RENTON ST ZIP 6 CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TANSPORTED 1 1 2 31 INTERLOCK YES[:]NO NTERLOCK YES E]Na� YEs N DRIVER'S STATE I SEX U M��OVSYv' -� 2 LICENSE 7F-ION DUTY STATUS AIRBAG 9 RESTR. 9 EJECT 1 HELMET 9 INJURY 0 NATURE OF INJURIES F� USE CLASS 8 ❑ ' 1 32 LICENSE+ rar V1N.# PLATE# 9 TRAILER TRAILER PLATE# STATE PLATE# STATE 10 ❑ TRLR TRLR VIN.#. VIN.#. 11 0 0 VEH.YEAR MAKE UNKN MODEL STYLE TR VEHICLE TOWS E T SABLIN TOWED BY anvi vEH1C P FROM TO DAMAGE YES 'E YES NO REGISTERED OWNER INFO.UNKNOWN RENTON m 33 12 � SHADE IN DAMAGED AREA j 4 FROM TO ((ABILITY INSURANCE[] INSURANCE CO IN EFFECT &POLICY# t 9 1"01? VEHICLE 1l1 BorruM 34 13 ❑ Lecnuv YES❑ NO❑ CITATION# CHARGE STANDING S} 8 7 6 14 ❑ UNIT Tr Vd 1RE O CYDCLE OWNER YES AGE NOHRESHOLD MET PHONE El 35 PEDESTRIAN 15 LAST NAME FIRST NAME MIDDLE INITIAL TIAL ❑ STREET 16 STREETAnnR"[-] CITY ST Z!P CDL IGNITION REdUiRED IGNITtGN PRESENT MEDICALTANSPORTED NTERLOCK YES NO NTERLOCK YES NO 'YES NO ❑ 17 5 37 LICENSE# STATE SEX MMDDDYBYY 18 ❑ ON DUTY� STATUS AIRBAG RESTR. ; EJECT HELMET INJURY NATURE of INJURIES 38 USE (CLASS 19 ❑ vIN# 39 LICENSE PLATE# rnr 20 ❑ TRAILER' TRAILER ❑ 40 PLATE# STATE PLATE# STATE 21 ❑ [441 TRLR TRLR VIN# YIN#i 42 22 VEH.YEAR MAKE I MODEL STYLE I VEHICLE TO DUET SABLIN TOWED BY GOVT.VEHICLE DAMAGE YES NO YES NO 23 REGISTERED OWNER INFO_ SHADE IN DAMAGED AREA 43 3 4 71 LIABILITY INSURANCE INSURANCE CO ' VINE EFFECT &POLICY# i 970P - 4 E:l 44 24 LEHIcLE YES❑ NO❑ CITATION# CHARGE iq 60TiOM LeGALLv STANDING S 7 6 1 CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT. C.JACOBS 06-03-24 09:33 AM 25 INVESTIGATING OFFICER'S SIGNATURE OFFICER'S PHONE UNIT OR DIST DET DATED: PLACE SIGNED APPROVED BY DATE 26 OR ID 1953 O#I',WA0171300 JACOBS 6112/2024 PAGE�OF F 3000-345-013(R 11118) REPORT NO. EE85816 CASE# 24-5364 DATE AND TIME 05/21/24 08:01 OF COLLISION 0n.. 1 Al Drawn to scate r PAGE 5 OF 5