Press Alt + R to read the document text or Alt + P to download or print.
This document contains no pages.
HomeMy WebLinkAbout24-7716 POLICETRAFF'c" III !�� I IIIllI111IN II II I REPORT NO. EE99549 170
27
COLLISION REP FIT 1591971
CASE 24-7716 z
INTERSTATE ❑ CITY STREET FIRE ❑RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHIr.I F ❑ LOCAL AOENC 4Y00 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 1 TOTAL#OF OBJECT 1 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 07 - 1-- 2024 1214 17 ❑-= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
S 3RD ST BLOCK NO. e✓ 1000 ❑
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ ❑ FEET e S ❑ W e HOUSER WAYS
2 0 29
MOTOR PEDAL- DAM THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El YES NO �/ D:2065861881 0 11
30
6� LAST NAME QUEZADA FIRSTNAME MIGUEL MIDDLE
INITIAL 1 2 31
STREET ❑ 3723 S 180TH ST B23 CITY SEATAC ST WA 2jp, 98188 z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
iNTERLOCKYEs NO 1/ INTERLOCKYEs NO�/ YES R No�/
8❑ LRIIVER #
ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 HELMETU E 2 CLASS 1 NATURE OF INJURIES z❑
3
10 9❑ Pi aT�S� CHU6326 sTArI WAVIN# 2D8HN44E19R532394
IT STATE TRAILER STATE
11 0 0 PLATE# I PLATE# FROM ro
TRLR. TRLR 7 3 33
12 2 5 VIN#' VIN#
FROM TO
VEH.YEAR 2009 MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE 7 3 34
13 4 DODO CARAVA VN DAMAGE YES NO YES[:] NO✓
REGISTERED OWNER INFO MIGUEL QUEZADA 3723 S 180TH ST B23 SEA TAC WA 98188 D:2065861881 VEHICLE NO. 1
❑ ❑
SHADE IN DAMAGED AREA 35
14 LIABILITY INSURANCE INSURANCE CO PROGRESSIVE 950146934
IN EFFECT &POLICY# 9TOP
VEHICL'
15❑ EC 1 5 36
LALLv YES❑NO❑ CITATION# CHARGE 1 o BOTTOM
STANDING 8 7 6
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT 02 VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES NO 1/ D:4255771173
16 2
LAST NAME MANAEA FIRST NAME TATIANA MIDDLE M
INITIAL
17❑ STREET I47TH PL SE CITY' RENTON ST WA ZIP 98059 4❑ 37
NEW ADOREs�' 14224 1
18� CDL IGNITION REQUIRED IGNITION PRESENT MEDICALTRANSPORTED 38
INERLOCKYEs❑No� INTERLOCK ves No� YEs NDF
19 DRIVERS#
{NJURY 6 NATURE OF INJURIES 40
20❑ ON DUTY STATUS AIRBAG,2 RESTR 4 EJECT 1 USE 2 CLASS SORE HIP AND NECK
❑ILICENSE 21❑ PLA E# BTF4635 TAre 41
WA VIN1 WDDHF8J87G6189332 1
42
22❑ PILER LATE# STATE PLATE# STATE
23❑ UIN#. 43
TRLR RLR
'IN#.
VEH YEAR 2016 MAKE MERZ MODEL E CLASS STYLE SO VEHICLE TOWED TO BLIN TOWED BY GOV HI 44
L4❑ DAMAGE YES NO YES NO
REGISTERED OWNER INFO TATIANA MANAEA 14224147THPL SE RENTON WA 98059 D:4255771173 VEHICLE NO.2
SHADE DA GEbAREA
LIABILITY
INSURANCE INSU&PORGY#E CO ALL STATE 807 609 554IN I 5
VE LEGwcLE ❑ ,J� CITATION# CHARGE
25 GQ
ALLY YES N`L J
s � e
=RSE
PRINT) OFFICER PHONE BADGE OR ID# 771�NCY
26 12994 0171300
PART A PAGE 01 OF C7
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT No. EE99549
COLLISION REPORT III III III III III 111
1591972 CASE# 24-7716
ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY)
NAME MIDDLE INITIAL) SERRATO MARIELA
(LAST FIRST,
ADDRESS&PHONE# D O.B. '
3723 S 180TH ST B23 SEATAC WA 98188 2065861881 SEXi F MMDDYyry 09 - 03 - 1993
PASSENGER Z WITNESS UNIT# j 1 SEA 3 AIRBAG 12 RESTR. 4 EJECT ? 1 HELMET LASS NATURE OF INJURIES
USE 2 CLASS 1
NAME
(LAST,FIRST,MIDDLE INITIAL) :: SERRATO MARCELA
ADDRESS&PHONE# DOB
3723 S 180TH ST B23 SEATAC WA 98188 SEX: F MM 0-:vB v 11 _ 02 _ 2021
SEAT HELMET INJURY NATURE OF INJURIES
PASSENGER WITNESS UNIT# 1 POS 9 AIRBAG 2 RESTR. 10 EJECT 1 USE 2 CLASS 1
NAME
(LAST FIRST,MIDDLE INITIAL) SERRATO ISAIAS
ADDREss PHONE# 3723 S 180TH ST B23 SEATAC WA 98188 SEX M 11 02 _ 2021
. D.O.B.M _
MDDYYYY
PASSENGER WITNESS UNIT# ! 1 SEAT 7 AIRBAG 2 RESTR. 10 EJECT 1 HELMET 2 INJURY 1 NATURE OF INJURIES
❑ POS. USE GLASS
NARRATIVE'
On 07-22-2024 at 1215 hours I was dispatched to a collision at S 3rd St and Houser Way S in the city
of Renton, King County WA. I arrived on scene and spoke with the driver of unit 1, Miguel Quezada
who told me the following:
Quezada was driving eastbound when he changed lanes. One of his kids in the back seat threw
something up front which distracted him. As Quezada changed lanes he collided with unit 2. Nobody
in his vehicle was injured.
I spoke with the driver of unit 2, Tatiana Manaea who stated she was also traveling eastbound. She
was driving straight ahead when unit 1 changed lanes into her causing the collision.
Based on the statements from both parties Quezada caused the collision by changing lanes when it
was not safe to do so causing the vehicles to collide.
My Axon camera was on for this call. Both parties were given the case number.
I certify (declare) under penalty of perjury under the laws of the State of Washington that the
foregoing is true and correct. This report was electronically signed by Officer Phillips 11649, July
22nd, 2024, Renton, WA.
I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT.
JAMAAL KEARSE 07-22-24 06:03 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
TIM GUMMING 11488 1 7/26/2024 3:26:40 PM
BADGE OR ID# 12994 OR]#' I WA0171300 TIME POLICE DISPATCHED 12:15 PM TIME POLICE ARRIVED]12:22 PM
PART I PAGE IT]OF 3�
REPORT NO. EE99549 CASE# ' 24-7716 DATE AND TIME 07/22/24 12:14
OF COLLISION
}r
Y
r �
r �
I
1k
r
K tiy�
x
i - 11 t it q 11
PAGE 3 OF 3