HomeMy WebLinkAbout24-7955 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 2 27c
COLLISION REP FIT 1591971
CASE 24-7955 z
INTERSTATE ❑ CITY STREET FIRE ❑
RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHICI F E: LOCAL AGENCI 4300 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 3 1 1 8 28
TOTAL#OF OBJECT
i TRIBAL UNITS 03 STRUCK' UTILITY
RESERVATION
z
3❑ DATE OF M M D D Y Y Y Y TIME(2400) COUNTY# MILES N E IN CITY# ❑
CowsloN 07 - 29 - 2024 0820 17 ❑.❑ S 8 W e IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓
NE 7TH ST BLOCK NO. e✓ 2600
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ 100 00 FMILES EET e S ❑ E e FERNDALEAVENE
0 5 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
,/No D:4254295517 0 11
30
6� LAST NAME DELAROSA FIRSTNAME RAMONA MIDDLE 1 1 2 31
INITIAL
STREET ❑ 2612 NE 7TH ST CITY RENTON ST WA ZIP 98056 z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
iNTERLOCKYEs NO 1/ INTERLOCKYEs NO�/ YEs No�/
8❑ DRIVERS
# STATE WA SEX'F MIDI Y' 08 — 28 — 1993 1 2 32
9 ON DUTY❑ STATUS' AIRBAG 6 RESTR 9 EJECT 1 H USE CLASS 2 CUSS 6 [NATURE OF INJURIES 2❑
3
10 9❑ PI ATE 14 CAB3245 sTAr WA u N#' JTHR9JBH9M2052242
TRAILER STATE TRAILER STATE
11 2 5 PLATE# PLATE# FROM TO
TRLR. TRLR. 3 3 33
12 2 5 VIN#' VIN#
>; FROM TO
VEH.YEAR 2021 MAKE LEXS MODEL uX STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE 3 7 34
13 4 DAMAGE YES NO YES[:] ✓
REGISTERED OWNER INFO OTTUM LEE 2612 NE 7TH ST RENTON WA 98056 VEHICLE NO. 1
❑ ❑
SHADE IN DAMAGED AREA 35
14 LIABILITY INSURANCE❑ INSURANCE CO
IN EFFECT &POLICY# OTOP
❑ VE— CHARGEBOTTOM ❑ 36
15 2 srnNoiNG YES❑NO CITATION# 4AO541199 FAIL YIELD LEFT TURN MOTOR
MOTOR PEDAL- PROPERTY DAM THR OLD MET PHONE
UNIT 02 ❑✓ ❑ PEDESTRIAN ❑ ❑ YES�/ NO D:2066980880
VEHICLE CYCLE OWNER
16 a
LAST NAME HERRERA-RAMIREZ FIRST NAME JORGE MIDDLE A
INITIAL
17 STREET❑ NEW ADOREss❑' 454 MONROE AVE NE#207 CITY RENTON ST Zip 4❑ 37
18❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL—T�RANSPORTED � 38
INTERLOCK YEs❑No� INTERLOCK YEs It I NOF YES
t l NOF,/
19 DRIVEW # STATE MX SEX M MMDDYY 07 08 _ 1994 39
20 ON DUTY STATUS AIRBAG,6 RESTR 4 EJECT 1 WEB C SET 2 NJAURSY 6 PAIN IN CHEST AND BACK 3�F—NATURE OF INJURIES 40
❑21❑ PLATE# A7319568 TArE 41
WA VIN# 1HGEM22594L049704 1
42
22❑ PLATE# STATE PLATE# STATE
T
23❑ 43
IN# N RLR
#.UIN#. 'I
VEH YEAR 2004 MAKE HOND MODEL CIVIC STYLE VEHICLETOWED TO BLIN TOWEDBY GOV HI 44
L4❑ DAMAGE YES NO YES NO
REGISTERED OWNER INFO CINTHIA PORTILLO CORDERO 454 MONROE AVE NE 207 RENTON WA 98056 D:2066980880 VEHICLE NO.2
SHADEDAMAGEDAREA
3 4
INAEFFITY ECTNSURANCE❑ &POINSULICY#E CO 9TOP 5
"""LE ❑ ,.I— CITATION# CHARGE io BOTTOM
LEGALLY YES N
25 e
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
26
R.PHILLIPS 11649 WA0171300
PART A PAGE 01 OF C7
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EF00940
COLLISION REPORT III III III III III 111
1591972 CASE# 24-7955
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.
R.PHILLIPS 07-29-24 03:44 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
P.KORDEL 9676 713112024 2:48:10 PM
BADGE OR ID# 11649 OR]# WA0171300 TIME POLICE DISPATCHED', 8:24 AM TIME POLICE ARRIVED 8:26 AM
PART I PAGE IT]OF 5�
REPORT NO. EF00940 CASE# 24-7955 OF COLLISION
07/29/24 08:20
OF CbLLI510N
NARRATIVE
At 0824 hours I was dispatched to a traffic accident near NE 7th ST and Edmonds Ave NE in the city
of Renton, King County WA.
I arrived on scene and located the crashed vehicles in the 2600 block of NE 7th ST. There was a
2000s era Honda coupe with heavy front end damage and a newer Lexus SUV with driver's side
damage. The Lexus was sitting on top of some sort of an electrical box.
The Honda had temp plate, A7319568 and was unit 2. Unit 2 was driven by Jorge Herrera-Ramirez.
Herrera-Ramirez was identified using his Mexico driver's license. Herrera-Ramirez stated he was
west bound on NE 7th ST. He observed unit 1 on the side of the road with the brake lights on then all
the sudden and without a blinker unit 1 made a u-turn. Herrera-Ramirez was not able to stop in time
and the vehicles crashed. Unit 1 was spun around and came to rest on the opposite sidewalk.
Herrera-Ramirez stated his chest and back hurt from the accident. Renton Fire was dispatched for aid
to both driver's.
The Lexus was unit 1 and had license plate CAB3245. The driver was identified as Ramona Delarosa
by her WA driver's license. Delarosa informed me she was parked next to the curb and made a u-
turn. She stated she didn't see unit 2.
Neither unit had car insurance. Delarosa was cited for failing to yield to unit 2 which caused the
accident. Both parties were given an exchange of information. I was not able to locate the owner of
the power box that was hit.
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 R. PHILLIPS #11649, July 29th, 2024 Renton, WA.
PAGE 3 OF 5
SUPPLEMENTAL REPORT NO. EF00940
r`I POLICE TRAFFIC 1 27
COLLISION REPORT CASE# 24-7955
1 COMMERCIAL MOTOR CARRIER INTERSTATE INTRASTATE G
UNIT'# USL70r ICC# VEHICLE TYPE CARGO BODY
TYPE
2 ❑ 1 28
CARRIER
NAME
3 CARRIER
ADDRESS `
CITY ST' ZIP'
4 ❑ NAME # PLACARD: :❑
GI NAME IF NO NUMBER
SOURCE AXLES +
4a ❑ ADDITIONAL UNITS
MOTOR PEDAL- PROPERTY DAMAGE THRESHOLD MET PHONE
5 ❑ UNIT# 3 VEHICLE I_J CYCLE u PEDESTRIAN � OWNER � YEs� IN
MIDDLE' 29
LAST NAME : UNK FIRST NAME INITIAL
STREET 30
NFW AnDRFSP. 2611 NE 7TH ST CITY RENTON ST WA ZIP 1
98055
6
CDL GNITIttN REQUIRED GNiTION PRESENT MEDICAL TANSPORTED 1 31
INTERLOCK YEs NO 3NTERLOCK YEs�NO� YES[:]N
DRIVER'S STATE I SEX U M��DYSYv' —� 2
LICENSE
7
ON DUTY STATUS AIRBAG RESTR. EJECT HELMET INJURY 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 VEH.YEAR MAKE I MODEL STYLE I VEHICLE TOWS E T SABLIN TOWED BY anvi vEHII' P FROM TO
DAMAGE YES NO YES NO
REGISTERED OWNER INFO. m 33
12 SHADE IN DAMAGED AREA
FROM TO
LIABILITY INSURANCE❑ INSURANCE CO
IN EFFECT &POLICY# tGQ
VEHICLE 34
13 ❑ LEGALLY YES[:] NO❑ CITATION# CHARGE
STANDING } 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': INITIAL36
STREET"[—]
❑
16 NFn+AnnRFs.�' CITY'. ST ZIP
CDL IGNITION REdUiRED IGNITION PRESENT MEDICALTANSPORTED
INTERLOCK YES NO INTERLOCK YEs NO YEs Nb E17 37
LICENSE# STATE SEX MMDDDYBYY
18 ❑ ON DUTY� STATUS AIRBAG RESTR. ; EJECT HELMET INJURY NATURE of INJURIES 38
USE ICLASS
19 ❑ vIN# 39
LICENSE
PLATE# rnr
20 ❑ TRAILER TRAILER ❑ 40
PLATE# STATE PLATE# STATE
21 ❑ TRLR TRLR 41
ViN# YIN#i
42
22 VEH.YEAR MAKE I MODEL STYLE I VEHICLE TOWED DUE TfABLINJ TOWED BY GOVT.VEHICLE
DAMAGE YES NO YES NO
23 REGISTERED OWNER INFO_ SHADE IN DAMAGED AREA 43
3 a 71
LIABILITY INSURANCE INSURANCE CO '
VEHICLE
EFFECT &POLICY# i 970P _ 4 44
24 LEwcLE YES❑ NO❑ CITATION# CHARGE iq 60TiOM
LeGALLv
F-1
STANDING 8 7 6
1 CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT.
R.PHILLIPS 07-29-24 03:44 PM
25 INVESTIGATING OFFICER'S SIGNATURE OFFICER'S PHONE UNIT OR DIST DET DATED: PLACE SIGNED
26 OI BADGE 11649 O#II,WA0171300 APPROVED BY
7/331/2024 PAGE 4 OF F
3000-345-013 IR 11t18)
REPORT NO. EF00940 CASE# 24-7955 DATE AND TIME 07/29/24 08:20
OF COLLISION
----------------------------
PAGE 5 OF 5
