HomeMy WebLinkAbout24-10186 iiTFiNII IIIII III IIIII II IIII IIIII I . 27c REPORT NO EF22173oc� RA
COLLISION REPORT 1591971
CASE# 24-10186 2
INTERSTATE CITY STREET FIRE I
RESULTEDSTOLENSTATE ROUTE OTHER VEHICLE LOCALANG 4200 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 TOTAL#OF OBJECT 1 s 28
TRIBAL UNITS 02 STRUCK
RESERVATION : 1 1
2
3� M M D D Y Y Y Y TIME(2400) COUNTY# MILES CITY#
eaCL s on' 09 - 29 - 2024 1356 17 =.= S 8 W e OF IN e 1070 s
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓
BLOSERENTON-ISSAQUAH MILE POT e 14600 .�
4a❑ MILE POST
❑ DISTANCE OF(REFERENCE OR CROSS STREET)
5 400 00 FEET e✓ S 8 W e 148TH AVE SE
0 1 29
MOTOR ✓ PEDAL- DAM AG THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE ❑ YEs Vl No D:2532633373 0 8 30
5 LAST NAME EMGE FIRST NAME HANNAH MIDDLE L 1 1 2 31
INITIAL
STREET ❑ 317 E TITUS ST CITY; KENT I ST WA ZIP; 98030 2
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
INTERLOCKYEs NO✓ INTERLOCKYEs ND✓ YES No�/
8❑ DRIVER # STATE WA SEXI F MMDDYY' 10 - 18 - 1997 1 2 32
-NJUR
9 ON DUTY STATUS' AIRBAG 2 RESTR 4 EJECT 1 HELMET
2 CLASSY 1 [NATURE of INJURIES 2
LICENSE, CKA2785 STATE WA VIN# JF2SJAAC5FH800180 3
10 Fl I as ATP tt
TRAILER STATE TRAILER STATE
11 0 0 PLATE# PLATE# ROM To
TRLR rRLR. 7 1 3 33
12 0 0 VIN#' VIN#
FROM TO
13 2 VEH.YEAR2015 MAKE SUBA MODEL FOREST STYLE SV VEHICLETOWED2TOIyS46LIN ajWgYMEYERS VEHICLE✓ 9 9 34
DAMAGE IIII._IIII
REGISTERED OWNER INFO OWNEDBYDRIVER VEHICLE NO. 1
SHADE IN DAMAGED AREA 35
2 LIABILITY INSURANCE INSURANCE CO 4
14 NATIONAL GENERAL 2023724056
IN EFFECT &POLICY# 9TOP
VEn" CHARGE 5 36
Lec Ly YES❑NO❑ CITATION# t a 80TTOM
15❑ STANDING 7 e
MOTOR ✓ PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT 02 VEHICLE CYCLE nWNFR D:2065513920
16�
LAST NAME SERENA MARTINEZ FIRST NAME RUTH MIDDLE ,/
INITIAL
17 F1 STREET ❑ 4308 NE 24TH ST CITY RENTON ST, yyq ZIP 98059 4 37
NEW ADDRESS ❑
18 IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 38
CDL INTERLOCKYES No✓ INTERLOCK YEs NO✓ ves No✓
19 DRIVER'S
MMDDYY I I —
20❑ ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 H ET 2 INJURY 1 NATURE OF INJURIES 40
21 LICENSE BAH8811 TATE WA VIN# JTLKT334854017181 41
22❑ PLATE# STATE PLATE# STATE 42
23 TRLR r RLR 43
UIN#. 'IN#
VEH.YEAR 2005 MAKE TOYT MODEL $(,/Qi1J STYLE $�/ VEHICLE TOWED TO BLIN TOWED BY GOV HI 44
24 DAMAGE YES �/ No GENE MEYERS ves No✓
REGISTERED OWNER INFO OWNED BY DRIVER VEHICLE NO.2
SHADE IN DAMAGEAREA
2 3
LIABILITY INSURANCE INSURANCE CO NATIONAL GENERAL 2021529720
IN EFFECT &POLICY# 9TOP
V—L ,J—I CITATION# CHARGE to BOTTOM
LEGA�Y YES N`[
25 a s
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
26
WILLIAM RIDGEWAY 12500 WA0171300
PAGE 01 OF
PART A 3000-345-189(R 11/18)
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EF22173
COLLISION REPORT III III III III III 111
1591972 CASE# 24-10186
E NA ADDITIONAL PERSONS INVOLVED(PASSENGERS AND/OR WITNESSES ONLY)
M
(LAST,FIRST,MIDDLE INITIAL) EMGE SMITH JAMARI D
ADDRESS&PHONE#
317 E TITUS ST KENT WA 98030 SEX i U MMDDDYBYYY
PASSENGER WITNESS UNIT SEAT AIRBAG RESTR. EJECT HELMET INJURY NATURE OF INJURIES
z � 1 POS. 9 6 11 1 USE 1 2 CLASS i 1 ----�
:NAME
Lnsr EIRST,MIDDLE INITIAL) i BERANZA ROSAS ISRAEL
ADDRESS R PHONE# D�B
4308 NE 24TH ST RENTON WA 98059 2069318404 SEX'' M MMDavvvr 08 _ 24 _ 1980
SEAT HELMET INJURY NATURE OF INJURIES
PASSENGER a WITNESS UNIT# 2 POS. ' 3 AIRBAG 2 RESTR. 4 EJECT 1 USE 2 CLASS 1 ----�
NAME MIDDLE INITIAL) MARTINEZ ROSAS NICOLASA
(LAST,FIRST,
AQQREss a PHONE# 4308 NE 24TH ST RENTON WA 98059 2065513920 SEX} F D,O.B. 11 1_M_ 1949
MMDDYYYY
PASSENGER WITNESS UNIT# 2 SEAT 7 AIRBAG 2 RESTR. 4 EJECT 1 HELMET 2 INJURY' 1 NATURE OF INJURIES
a 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.
WILLIAM RIDGEWAY 09-29-24 04:58 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST.DET DATED PLACE SIGNED
APPROVED BY DATE
DESIRES SCOTT 10272 10/7/2024 11:32:50 AM
BADGE OR ID# 12500 ORI# WA0171300 TIME POLICE DISPATCHED 1 2:06 PM TIME POLICE ARRIVED i 2:15 PM
PART B a Do-3m5-attar(t 1Mff) PAGE F2 --]OF 4
REPORT NO. EF22173 CASE# 24-10186 OF DATE AND r�N + 09/29/24 13:56
O�COLLISION
NARRATIVE
24-10186
At about 1406 hours on 09/29/2024, 1 was dispatched to an accident with injuries that occurred at NE
Sunset Blvd and 145th PL SE in the City of Renton, King County, Washington.
Upon arrival, FIRE was on scene and stated all parties involved did not require medical transport. All
parties were told they would be recorded.
Unit 1 was a green 2015 Subaru Forester (CKA2785/WA). Unit 1 was driven by the registered owner:
Hannah L. Emge (DOB:10/18/1997-verified by WADL photo). Hannah had her child: Jamari D. Emge
-Smith (DOB:06/04/2023) in the rear pass seat (car seat). No injuries were reported. Both had
seatbelts.
Hannah said it was her fault and that she thought traffic was still going and did not realize Unit 2 was
still stopped, when she rear ended them. Hannah said she was traveling eastbound on Sunset about
35mph, when she tried to hit the brakes, but they locked up, so she veered to the right, to minimize
the impact. When asked if there were any other contributing factors, she said no.
I observed heavy damage to the front end of Unit 1. Photos were taken and uploaded. Unit 1 was not
drivable, and Gene Meyers Tow provided a private tow.
Unit 2 was a green 2005 Toyota Scion (BAH8811/WA). Unit 2 was driven by the registered owner:
Ruth J. Serena-artinez (DOB:02/10/1985-verified by WADL photo). Inside Unit 2 was her husband:
Israel Beranza-Rosas (DOB:08/24/1980) who was in the front passenger's seat and her mother:
Nicolasa Martinez-Rosas (DOB:11/26/1949) who was in the rear driver's side seat. All parties
complained of neck and back pain. All parties were wearing their seatbelts.
According to Ruth, she was stopped behind traffic at a red light on Sunset and 148th Ave SE. The
cars in front of her were starting to go, when she was still stopped, and rear ended by Unit 1. Israel
said he saw Hannah with a cell phone in her hand when Unit 1 passed by them and veered to the
right off the roadway.
I observed heavy damage to the rear passenger's side corner of the vehicle, which bent metal into
the rear tire, making the vehicle unable to drive. Gene Meyers Tow provided a private tow.
Both parties had valid insurance information. 1 provided both parties with an exchange of information
form and business cards. Both had people on scene to take them home.
This concludes my involvement in this case.
I declare under penalty of perjury under the laws of the State of Washington that the foregoing is true
and correct.
Electronically signed by W. Ridgeway#12500 on 09/29/2024 at 1653 hours in Renton, Washington.
PAGE 3 OF 4
REPORT NO. EF22173 CASE# 24-10186 DATE AND TIME 09/29/24 13:56
OF COLLISION
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