HomeMy WebLinkAbout24-7722 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 5 27c
COLLISION REP FIT 1591971
CASE 24-7722 z
INTERSTATE ❑ CITY STREET FIRE ❑RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHIC;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 1631 17 ❑.= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓
SW 41ST STREET BLOCK MILEPOST ST e✓ 100
4a❑
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ 345 00 FMILES EET e S ❑ E e EAST VALLEYHWY
0 1 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
✓NO D:2068868150 0 7 30
6 LAST NAME CAIRO PUPO FIRST NAME CRISTIAN MIDDLE J 1 1 2 31
INITIAL
STREET ❑✓ 17303 120TH LN SE#L203 CITY RENTON ST WA ZIP' 98058 z
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 2 RESTR 4 EJECT 1 HELMETU E 2 CLASS 1 NATURE OF INJURIES z❑
3
10 9❑ PI ATE CLX5205 sTArI WAvIN#' JT8BF28G1X0227968
TRAILER STATE TRAILER STATE
11 3 5 PLATE# PLATE# ROM TO
TREK TREK 7 3 33
12 3 5 VIN#' VIN#
;. FROM TO
VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE g 9 34
13 2 1999 LEXS ES300 4D DAMAGE YES NO YES[:] No✓
REGISTERED OWNER INFO OWNEDBYDRIVER VEHICLE NO. 1
SHADE IN DAMAGED AREA ❑ 35
<53
4
14 2 LIABILITY INSURANCE INSURANCE COIN EFFECT &POLICY# TOPVE— CHARGE OTTOM 5 36
LEGAY YEs NO CITATION# 4A0612097,4A0612097, NO VALID OPER LICENSE WITH
15❑ LL
STANDING 6
MOTOR PEDAL-: PEDESTRIAN PROPERTY DAM THR PHONE
UNIT 02 V� IEHIC OLD MET LE ❑ CYCLE' ❑ ❑ OWNER ❑ YES 1/ NO D:5097607309
16 a
LAST NAME PARA FIRST NAME CHELSEA MIDDLE R
INITIAL
17 STREET❑ NEW ADDRESS❑' 11126 SE 290TH ST CITY AUBURN ST WA ZIP 980921910 37
18❑ CDL IGNITION REQUIRED IGNITION PtR—E—S1ENT MEDICAL—T�RANSPORTED ❑ 38
INTERLOCK YEs❑No� INTERLOCK YEs I I NOF YEs t l NOF,/
19 LDI IVER # STATE WA ]SEX IF M D.C.B. 09 _ 25 _ 1988 39
HELMET {NJURY 1 NATURE OF INJURIES 40
20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 USE 2 CLASS ❑
❑21❑ PLATE# CBA0729 TAre 41
WA VIN# 2T3A1RFV1MC239021 1
42
22❑ PLATE# STATE PLATE# STATE
23❑ VIN#. 43
TRLR RLR
'IN#.
VEH YEAR 2021 MAKE TOYT MODEL RAV4 STYLE SV VEHICLETOWED TO BLIN TOWEDBY GOV HI 44
24❑ DAMAGE YES NO YES NO
REGISTERED OWNER INFO CHELSEA PARA 606 WHITWORTH LN S RENTON WA 98057 VEHICLE NO.2
SHADE IN DAMAGEbAREA
2 3 Cd
LIABILITY
INSURANCE I PORGY#E CO PROGRESSIVE 953327926IN 1 9TOP
'E""LE CITATION# CHARGE
YES
25 i o BOTTOM
LEGALLY Nu
❑ s
7mHE
NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY26W NUGENT 11498 WA0171300
PART A PAGE 01 OF
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EF03710
COLLISION REPORT III III III III III 111
1591972 CASE# 24-7722
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 07-29-24 04:36 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
CO.JOHNSON 0505 1 8/9/2024 9:58:21 AM
BADGE OR ID# 11498 ORI# WA0171300 TIME POLICE DISPATCHED; 4:35 PM TIME POLICE ARRIVED',4:52 PM
PART I PAGE IT]OF 4�
E AND
REPORT NO. EF03710 CASE# 24_7722 OF COLLISION 07/22/24 16:31
OF COLLISION
NARRATIVE
24-7722
On 07/22/2024 at approximately 1635 hours, I was dispatched to a blocking vehicle collision in the
100 block of SW 41 st Street (JWO East Valley Road) within the City Limits of Renton, County of King,
State of Washington.
Upon arrival, I confirmed there were no complaints of injury requiring immediate medical response at
the time of report. I collected the driving documents and independent recollection from each of the
involved parties leading up to the incident.
The driver of Unit#1 said he was the sole occupant of his vehicle and was traveling eastbound in the
100 block of SW 41 st ST in lane 2 of 2. The driver of Unit#1 stated he noticed Unit#2 had stopped
directly in front of him in queued traffic. The driver of Unit#1 said that he was unable to stop his
vehicle in time and subsequently collided with the rear of Unit#2 causing moderate damage to the
front of Unit#1.
The driver of Unit#2 said she and her infant passenger were also traveling eastbound in the 100
block of SW 41 st ST in lane 2 of 2. The driver of Unit#2 stated she had come to a stop for queued
traffic ahead, and that while stopped, Unit#1 collided with the rear of Unit#2 causing moderate
damage to the rear of Unit#2.
Upon a DOL records check, it was determined that the driver of Unit#1 (Cairo Pupo) was listed as
Not Licensed - Eligible. Cairo Pupo violated RCW 46.20.015 by Driving without a Valid Operators
License with valid Identification. Cairo Pupo also admitted to not having vehicle insurance.
Based on the above statements, 1 determined that the Driver of Unit#1 (Cairo Pupo) was the
predominant factor for the collision due to Inattentive Driving causing a collision.
I cited the driver of Unit#1 (Cairo Pupo) via mail for NVOL-with ID, Inattentive Driving, and operating
a motor vehicle without insurance.
The driver of Unit#1 had made private arrangements for a tow due to extensive damage. Unit#2 was
able to be driven away without further incident. An exchange of information was provided to all
involved parties.
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 7/29/2024 4:32 PM Renton, King County, WA.
PAGE 3 OF 4
REPORT NO.! EF03710 CASE# ' 24-7722 DATE AND TIME 07/22/24 16:31
OF COLLISION
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PAGE 4 OF 4
