HomeMy WebLinkAbout24-10378 POLICETRAFF'c" III !�� I IIIllI111IN II II I REPORT NO. EF22841 170
27
COLLISION REP FIT 1591971
CASE 24-10378 z
INTERSTATE ❑ CITY STREET FIRE ❑RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHIC;I F ❑ LOCAL AOENC 4900 3
HIT 8 RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 3 TOTAL#OF OBJECT 1 1 8 28
TRIBAL UNITS OZ STRUCK
RESERVATION
z
3❑ BATE OF M M D D Y Y Y Y TIME(2400) COUNTY# MILES N E IN CITY#
COLLISION.. 10 - 1-— 2024 0853 17 ❑-= S 8 IN e 1070 3
4 4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
RAINER AVE S BLOCK NO.
1❑ e✓ ❑
MILEPOST
4a
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ ❑ FEET e S ❑ W e AIRPORT WAY S
0 4 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
,/No D:4258301829 0 11
30
6� LAST NAME HUESCA-FLORES FIRSTNAME JOSE MIDDLE J 1 2 31
INITIAL
STREET ❑ 3811 NE 3RD CT APT 1101 CITY RENTON ST WA Zjp, 98056 z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
iNTERLOCKYEs NO INTERLOCK YES NO YES No
$ D
RI
VER # STATE SEX'U MDMDD 05 - 07 - 2001 1 1 2 32
9 ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 H USEET ICNIJAU RY 1 NATURE OF INJURIES z❑
3
LICENSE CLG7854 sTArI WAurN# 1HGCP26308A147321
10 PI ATE#
TRAILER STATE TRAILER STATE
11 3 0 PLATE# PLATE# FROM ro
TRLR. YRLR. 3 5 33
12 3 5 VIN#' VIN#
>; FROM TO
❑ VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TR Y GOVT.VEHICLE 7 $ 34
13 2 2008 HOND ACCOR DAMAGE YES NO MEYER YES[:] NO✓
REGISTERED OWNER INFO LUIS FLORES MARCIAL 3811 NE 3RD CT APT 1101 RENTONWA 98056 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
3 4
14 2 LIABILITY INSURANCE❑ INSURANCE CO
IN EFFECT &POLICY# 9TOP
VE— CHARGE to BOTTOM 5 36
LEGALLY YEs NO CITATION# 4A0765706,4A0765707, NO VALID OPER LICENSE W/OUT
15❑ STANDING 6
�IJNIT
MOTOR PEDAL-: PEdESTRIAN ❑ PROPERTY ❑ DAM THR OLDMET PHONE
02 VEHICLE CYCLE OWNER YES�/ NO
16 a
LAST NAME LEAL LEPE FIRST NAME ARMANDO MIDDLE N
INITIAL
17❑ STREET ❑', 7403 S 126TH ST CITY SEATTLE ST WA ZIP 981784340 37
NEW ADDRESS ❑
18� CDL IGNITION REQUIRED IGNITION PR-E-1SENT MEDICAL-T�RANSPORTED ❑ 38
INTERLOCKYES�NOR INTERLOCK YEs It I NOF YES
t l NO❑
19 DRIVER'S STATE WA SEX M D.C.B. 08 _ 30 _ 1988 39
LICENSE# MMDDYY
20❑ ON DUTY STATUS AIRBAG 3 RESTR 4 EJECT 1 HELMET INJURY 7 NATURE OF INJURIES ❑ 40
USE CLASS NECK
21❑ LICENSE I C70107U TArE WA vIN# 5FPYK3F87J6010790
❑ 41
PLATE#
42
22❑ PLATE# STATE PLATE# STATE
TRLR
23❑ UIN#. IN#.
43
RLR
'
VEH YEAR 201E MAKE HOND MODEL RIDGELIN STYLE VEHICLE TOWED TO BLIN TOWEDBY GOV HI 44
24❑ DAMAGE YES NO GENE MEYER YES NO
REGISTERED OWNER INFO ARMANDO LEAL LEPE7403 S 126TH ST SEATTLE WA 981784340 VEHICLE NO.2
SHADEDAMAGEDAREA
3 4
LIABILITY
INSURANCE I PORGY#ECO AMFAM41062-08317-66IN 9TOP 5
VE""LE ❑ Nu,J CITATION# CHARGE to BOTTOM
LEGALLY YES
25 ' e
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
J
26
M.LEVERTON 2517 WA0171300
PART A PAGE 01 OF C7
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EF22841
COLLISION REPORT III III III III III 111
1591972 CASE# 24-10378
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
POS. 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.
M.LEVERTON 10-04-24 10:56 AM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
CO.JOHNSON 0505 1 101912024 10:06:10 AM
BADGE OR ID# 2517 ORI# WA0171300 TIME POLICE DISPATCHED 8:54 AM TIME POLICE ARRIVED',8:59 AM
PART I PAGE IT]OF 4�
REPORT NO. EF22841 CASE# 24-10378 OF COLLISION
10/04/24 08:53
OF CbLLI510N
NARRATIVE
slv/1 It on reg no lic no in ftyrow blk/1 straight green In 1
CC
On 10/04/2024 at about 0851 hours within the city limits of Renton/King/WA I responded to a 2
vehicle head on crash at the intersection of Rainier Ave S at Airport Way S.
I contacted the driver of unit 2 who told me he was headed east on Airport through the intersection on
his green light when unit 1 entered the intersection and crashed into his truck. He complained of a
neck injury. He was treated on scene and transported to VMC-ED for further treatment. His vehicle
was tow for damages.
I contacted the driver of unit 1. He was not able to provide any form of picture ID but gave me a
invoice with what he said was his name and verbally provided his date of birth, Huesca-Flores, Jose
Juan 05072001. A WACIC/DOL check via Dispatch revealed no record found. His cousin showed up
at the crash and told me Jose did not have any form of ID or a drivers license. Unit 2 did not provide
additional information about the crash. He was unable to provide valid proof of insurance. He did not
complain of injury and damages required a tow truck.
I cited unit 1/Jose ref RCW 46.61.055 FTCWTCD-Red light two vehicle injury crash, ref RCW
46.30.020 no valid proof of insurance via complaint and ref RCW 46.20.005 Driving with no valid
operators license with no ID (NVOL 1st) via the Renton Prosecutors Office.
I certify (declare) under penalty of perjury under the laws of the State of Washington that the
foregoing is true and correct.
M.Leverton/2517 City of Renton/King/Wa 10/04/2024
PAGE 3 OF 4
REPORT NO. EF22841 CASE# ' 24-10378 DATE AND TIME 10/04/24 08:53
OF COLLISION
�s
x
tlt I
I tt
y �QY.iKA
�r l�ldl
r
A ,
nk1�
�c
l a
\ is3 1
S
�}I
Ysz.
i
U
t "r
Y
PAGE 4 OF 4
