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HomeMy WebLinkAbout24-5839 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 1 27c
COLLISION REP FIT 1591971
❑ ❑ FIRE ❑ CASE$# 24-5839 2 0 4
INTERSTATE CITY STREET RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHIl.I F ❑ LOCAL AOENC 4100 3 6 0
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 3 TOTAL#OF OBJECT 1 1 8 28
TRIBAL UNITS OZ RESERVATION STRUCK
2
3❑ DATE of M M D D Y Y Y Y TIME(2400) COUNTY# MILES N E IN CITY# ❑
cowsloN 06 - 1-- 2024 2101 17 ❑.❑ S 8 W e IN e 1070 3
4❑ oN (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
TALBOT ROADS BLOCK NO. e✓ 1500
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ �,❑ FEET e S ❑ W e S.15TH ST/S.PUGET
1 9 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
✓NO D:2068996052 0 4 30
6� LAST NAME SALEM FIRSTNAME AOSAMMAR MIDDLE 0 11 31
INITIAL
STREET ❑, 813 S SOUTHERN ST CITY SEATTLE ST WA ZIP 98108 2
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
1/ I iNTERLOCKYEs NO NTERLOCKYEs NO�/ YES R No�/
8❑ LRIIVER #
ON DUTY❑ STATUS' AIRBAG 3 RESTR 4 EJECT 1 HELMETU E 2 CLASS 7 [NATURE OF INJURIES
COMPLAINED OFARM PAIN 2❑
3
10 1❑ LICENS P1 ATE 14 CKT2627 sTAr WAv N# 5NPET4AC2AH640194
TRAILER STATE TRAILER STATE
11 4 0 PLATE# PLATE# Rom ro
TRLR. YRLR. 5 1 33
12 3 5 VIN#' VIN#
>; FROM TO
❑ VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TAW/[g GOVT.VEHICLE 34
13 4 2010 HYUN SONATA SD DAMAG 1 3 E YES NO TOWING YES❑ No✓
REGISTERED OWNER INFO OWNEDBYDRIVER VEHICLE NO. 1
SHADE IN DAMAGED AREA ❑ 35
4 INSURANCE CO <�g3 4
14 IN EF IT INSURANCE NO INSURANCE NO INSURANCE IN EFFECT &POLICV# OPVE"'C' CHARGE TTOM 5 ❑ 36
LEGALLY YES❑NO❑ CITATION# 4AO505791,4AO505791, SPEED TOO FAST FOR CONDITIONS,
15❑ STANDING 7 6
MOTOR PEDAL-: PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
16
UNIT U2 VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES 1/ No D:7278341302
a
LAST NAME DELGARDO FIRST NAME AMBER MIDDLE IL
INITIAL
17 STREET NEW ADDRESS❑' 3126 74TH DR NE CITY MARYSVILLE ST WA ZIP 98270 37
18� CDL IGNITION REQUIRED IGNITION PRESENT MEDICALTRANSPORTED 38
INTERLOCKYES�NO� INTERLOCK YEs❑NOF YEs❑NOF,/
19[—] DRIVER # STATE WA SEX F M D.O.B. 09 _ 27 1995 39
20 ON DUTY STATUS AIRBAG,3 RESTR 4 EJECT 1 H EET 2 NJAU SY 7 STOMACH PAIN BRUISING TO THIGH URE OF INJURIES 40
❑21❑ PLATE# CFV2496 TArE WA VIN# 41
KM8K33A35NU805093 1
42
22❑ PLATE# STATE PLATE# STATE
TRLR
23❑ VIN#. N#. 43
RLR
'I
VEH YEAR 2022 MAKE HYUN MODEL KONA STYLE UT I VEHICLE TOWED TO BLIN TOWED BY GOV HI 44
24 DAMAGE YES NO BANKERS TOWING YES No
REGISTERED OWNER INFO AMBER DELGARDO 312674TH DR NE MARYSVILLE WA 98270 D:7278341302 VEHICLE NO.2
SHADEDAMAGEDAREA
3 4
LIABILITY
INSURANCE &POINSURGY#E CO GEIC04518307691
IN ®TOP
LVEHICLEEGA— Yes N� CITATION# NONE CHARGE NIA GD BOTTOM
LEGALLY `LJ 6
25 OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# JAGENCY
26
J.CHRISTIANSEN 10437 WA0171300
PART A PAGE 01 OF
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EE82908
COLLISION REPORT III III III III III 111
1591972 CASE# 24-5839
ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY)
NAME MIDDLE INITIAL) GARMAN ANN M
(IAST FIRST,
ADDRESS&PHONE# D O.B.
1816 EDMONDS WAY SE RENTON WA 98058 2067144841 SEXi F MMDOYyry 03 - 28 - 1965
PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT ' HELMET INJURY NATURE OF INJURIES
�✓ POS. USE CLASS
NAME
'(LASTr FIRS' MIDDLE INITIAL)
ADDRESS&PHONE# DOB
sE MMDDYYYV
PASSENGER ❑WITNESS UNIT# SEAT I AIRBAG RESTR. EJECT HELMET NJURY NATURE OF INJURIES
POS. USE CLASS
NAME
(LAST FIR57 MIDDLE INITIAL)
AppRESS R PHONE#
SEX D.O.B.
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.CHRISTIANSEN 06-02-24 10:57 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
E.EDMUNDS 12576 1 6/3/2024 2:08:53 AM
BADGE OR ID# 10437 OR]# WA0171300 TIME POLICE DISPATCHED; 9:09 PSI TIME POLICE ARRIVED',9:04 PM
PART I PAGE IT]OF 5�
REPORT NO. EE82908 CASE# 24-5839 OF COLLISION
06/02/24 21:01
OF CbLLI510N
NARRATIVE
RPD CASE#: 24-5839
RECORDED ON AXON
Unit 01: white in color Hyundai Sonata bearing WA/CKT2627
Unit 01's driver: SALEM, AOS AMMAR (DOB: 12.09.2001) -driving status: clear; ISSUED SECTOR
citations: 4AO505791
Unit 02: white in color Hyundai Kona bearing WA/CFV2496
Unit 02's driver: :DELGARDO, AMBER LYNN (DOB: 09.27.1995) driving status: clear
*This incident was captured on my body worn video camera. This report is a summary of events that
occurred and is not an exact sequencing of events. Statements have been paraphrased and
summarized. *
On 06.02.2024, at approximately 2101 hours, I was dispatched to a two-vehicle, injury, blocking
collision in the intersection of Talbot Road S. (Benson Drive S.) and S. Puget Drive (S. 15th ST), in
the City of Renton, WA, the County of King.
I was assigned to uniformed marked patrol in the City of Renton, WA, the County of King. I was
operating a fully marked Renton Police Tahoe #304, equipped with "POLICE" markings, overhead
exterior lights, and audible siren. I was wearing my department-issued uniform, including a fully
equipped duty belt, exterior ballistic vest with "POLICE" stenciled on the front and back and Renton
Police badge affixed to the left breast. I was also wearing my department-issued jumpsuit with
"POLICE" patches on both shoulders and across the rear shoulders. It would be immediately obvious
to any reasonable person I was a police officer. I was assigned as 3r16.
At the time of this incident, it had been raining steadily, the roadway was wet with standing water, and
it was dark, streetlights were illuminated.
Prior to my arrival, dispatch advised Renton Fire Authority had been dispatched and injuries were
reported. Further, witness/reporting parties stated the vehicles were blocking and there was debris
strewn across the roadway.
I arrived on scene at approximately 2014 hours and met with an independent witness, later identified
as Garman, Ann M. (DOB: 03.28.1965; 206/714-4841). Garman stated she was westbound on S.
Puget Drive, in the far right turn lane, stopped for a solid red signal light at the intersection with Talbot
Road S/Benson Drive S. Garman observed Unit 02, later identified, in the left turn lane facing
southbound on Talbot Road S. Garman stated the left turn signal light changed to green, and as Unit
02 proceeded with her turn left onto S. Puget Drive, the driver of Unit 01, who was traveling
northbound on Benson Drive. S., failed to stop for the solid red traffic signal light, went through the
intersection and struck Unit 02.
Unit 01 was identified as white in color Hyundai Sonata bearing WA/CKT2627. Unit 01 had extensive
front end damage and airbag deployment and was inoperable. Dispatch was updated and Bankers
towing responded.
Unit 01's driver was identified as SALEM, AOS AMMAR (DOB: 12.09.2001) SALEM spoke
exclusively to Officer Petty and informed him he was traveling northbound on Benson Drive S., and
as he approached the intersection with S. Puget Drive/S. 15th ST, he states the brakes `went out' in
his vehicle, and he was unable to stop. Further, SALEM told Officer Petty the brakes `went out' in his
vehicle earlier today, but at that time they were just `mushy' and he continued to drive the vehicle.
SALEM complained of arm pain and was medically evaluated and cleared on scene by Renton Fire
Authority (RFA).
A WACIC/NCIC/DOL query on SALEM was clear and valid.
Unit 02 was identified as a white in color Hyundai Kona bearing WA/CFV2496. Unit 02 had extensive
front end damage and airbag deployment and was inoperable. Dispatch was updated and Bankers
towing started a second tow for impound.
Unit 02's driver was identified by her WADL as DELGARDO, AMBER LYNN (DOB: 09.27.1995).
DELGARDO stated she was facing southbound on Talbot Road S., in the left turn lane waiting to
make a left turn, eastbound, onto S. Puget Drive. When the left turn signal changed to green, so
started to make her left turn when Unit 01, who was driving northbound on Benson Drive S., failed to
PAGE 3 OF 5
REPORT NO. EE82908 CASE# 24-5839 OF COLLISION
06/02/24 21:01
OF CbLLI510N
NARRATIVE
stop for the stop light, and struck her vehicle. DELGARDO was physically shaken up, crying and had
an obvious bruise to her right thigh. DELGARDO stated she didn't think she struck her head, but she
complained of stomach pain and said her glasses flew off her face at the time of impact. Renton Fire
Authority checked DELGARDO, and per her parents who were on the telephone, I transported
DELGARDO to Valley Medical Center's Emergency Room and she was checked in for medical
evaluation and clearance.
A WACIC/NCIC/DOL query on DELGARDO revealed she was clear and valid.
Unit 01's driver, SALEM, AOS AMMAR (DOB: 12.09.2001) was in violation of RCW 46.61.400.1:
Speed Too Fast for Conditions. Further, he was in violation of RCW 46.37.020: Operating a motor
vehicle without proof of insurance, violation of RCW 46.37.360: Operating a motor vehicle with
defective brakes and violation of RCW 46.61.050: Fail to Obey Traffic Control Device.
SALEM was issued the following citations: ISSUED SECTOR citations: 4A0505791, for the above
listed violations. The infraction will be mailed via the courts.
Both vehicles were towed privately.
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 J. Christiansen #10437, on June 2, 2024, at approximately 2231
hours, in Renton, WA.
**** AUTO-POPULATED SECTION ****
THE FOLLOWING ARE DESCRIPTIONS ENTERED FOR ITEMS SELECTED AS "OTHER":
Location Character: CITY STREET
Motor Vehicle Unit 1
Action Code: DISREGARDING SOLID RED TRAFFIC SIGNAL
**** END OF AUTO-POPULATED SECTION ****
PAGE 4 OF 5
REPORT NO. EE82908 CASE# 24-5839 DATE AND TIME 06/02/24 21:01
OF COLLISION
RentQu lice * . 24-5839,-2-.2,o,:14, (:?t )
Officer J. Christiansan #10437
*NOT TO SC.AILE*
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4
PAGE 5 OF 5