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Home My WebLink About24-13234 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 5 27c COLLISION REP FIT 1591971 CASE 24-13234 z INTERSTATE ❑ CITY STREET FIRE ❑RESULTED 1 STOLEN STATE ROUTE ❑ OTHER ❑ VFHICI F ❑ LOCAL AOENC 4900 3 HIT&RUN CODING COUNTY RD PRIVATE WAY INVOLVED 2 3 TOTAL#OF OBJECT 1 1 8 28 TRIBAL UNITS 03 STRUCK RESERVATION z 3❑ DATE of M M D D Y Y Y Y TIME(2400) COUNTY# MILES N E IN CITY# COLLISION 12 - 1-- 2024 2107 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 ❑ VV a MAIN AVE S 0 3 29 MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE UNIT 01 VEHICLE ❑ CYCLE El NO F,/ I D:2062502985 30 6� LAST NAME HOLLIS FIRSTNAME ISAIAH MIDDLE A 1 1 2 31 INITIAL STREET ❑ 1660 KIRKLAND CT SE CITY RENTON ST WA ZIP' 980583818 z 'NEW ADDRESS 7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3 1/iNTERLOCKYEs NO INTERLOCKYEs Z/NO YES �No / LRIIVER # STATE WA SEX'M MMDDYY 8❑ ' 08 — 26 — 2007 32 9 ON DUTY❑ STATUS AIRBAG 1 RESTR 4 EJECT 1 HELMET USE 2 CLASS 1 NATURE OF INJURIES z❑ 3 10 1❑ P1 ATNES# 14680E sTATe WA vN# 1HGFA15546L080087 -- TRAILER STATE TRAILER STATE 11 2 5 PLATE# PLATE# FROM To TRLR. TRLR 7 5 33 12❑ VIN#' VIN#. :: FROM TO ❑ VEH.YEAR 2006 MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE 7 3 34 13 4 HOND CIVIC SD DAMAGE YES NO YES[:] No✓ REGISTERED OWNER INFO BLACKOUT MOTORS 1505 S 356TH ST STE 114K1 FEDERAL WAY WA 98003 VEHICLE NO. 1 SHADE IN DAMAGED AREA 35 14 LIABILI INSURANCE INSURANCE CO ACORD 29100044162 3 4 IN EFFECT &POLICY# 9TOP 15❑ LE vEGALLr HIa.E 5 36 res�No D CITATION# 4g0890410 CHARGE FAIL YIELD TO PEDESTRIAN io eorrom STANDING 8 7 6 MOTOR PEDAL-UNI ❑ PROPERTY PHONE T VEHICLE ❑ PEDESTRIAN ❑ ❑ HR 16 a CYCLE OWNER YES TNO D:25 33266719 LAST NAME GAMBOA FIRST NAME SARA MIDDLE R INITIAL 17 STREET I❑ s❑' 12313 129TH ST CT E CITY' PUYALLUP ST' WA ZIP 98374 4❑ 37 NEW ADOREs 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 IF D.C... 05 _ 25 _ 1990 39 LICENSE# MMDDYY 20 ON DUTY STATUS 3 AIRBAG RESTR EJECT I HELMET 2 INJURY 7 NATURE OF INJURIES ❑ 40 USE CLASS FOOT PAIN ❑21❑ TATE LICENSE vIN1 41 1 PLATE# 42 22❑ PR TRAILER LATE# STATE PLATE# STATE TRLR 23❑ VIN#. IN#. 43 RLR ' VEH YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOV HI 44 L4 Q 1 DAMAGE YES NO YES NO REGISTERED OWNER INFO VEHICLE NO.2 SHADE IN DAMAGED AREA 2 3 4 LIABILITY INSURANCE❑ INSURANCE #E CO IN EFFECT &PO I 9TOP 5 vE""LE ❑ ,J� CITATION# CHARGE i o BOTTOM LEGALLY YES N J 25 s e =RSE PRINT) OFFICER PHONE BADGE OR ID# AGENCY 26 12994 WA0171300 PAGE 01 OF PART A 3000-345-159 OR 11/181 STATE OF POLICETRAFFICN CORRECTION REPORT NO. EF63213 COLLISION REPORT III III III III III 111 1591972 CASE# 24-13234 ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY) NAME (/AST 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. JAMAAL KEARSE 12-27-24 11:41 PM INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED APPROVED BY DATE QUINT TIBEAU 07691 1 2/6/2025 11:05:56 PM BADGE OR ID# ( 12994 OR]#' I WA0171300 TIME POLICE DISPATCHED 9:08 Pry TIME POLICE ARRIVED]9:09 PM FART I PAGE IT]OF 5� REPORT NO. EF63213 CASE# 24-13234 OF COLLISION 12/27/24 21:07 OF CbLLI510N NARRATIVE This incident was captured on my body worn video camera and in-car cameras. This report is a summary of events that occurred and is not an exact sequencing of events. On 12/27/2024, at approximately 2108 hours I was dispatched to a report of a vehicle versus pedestrian collision at Main Ave S and S 3rd St. Dispatch advised pedestrian is still on the ground but is conscious. The pedestrian has complaints of pain on the left side of his body, specifically his left arm. Dispatch later advised the pedestrian is up and walking. At approximately 2109 hours I arrived on scene. I contacted the pedestrian who was later identified as Tommy D Gamboa DOB 06/25/1985 via DOL. Tommy was in a squatting position leaning up against the wall. Tommy stated he was in pain and could move his left arm. Renton Fire arrived to evaluate Tommy. I contacted the Driver of Unit 1 who was identified as Isaiah A. Hollis DOB 8/26/2007 via WADL. asked for Isaiah's license, registration, and proof of insurance ad he provided all three documents. Isaiah advised that he was traveling eastbound on S 3rd St in lane 2 of 2 approaching the intersection of Main Ave S. He had a green light and started to turn southbound on Main Ave S. As he was turning, he saw a male in the crosswalk and attempted to stop but was not able to in time and struck Tommy with the front passenger side bumper of Unit 1. He stated when Tommy was struck by the vehicle Tommy fell on to the hood of Unit 1 landing on his back. He then stopped the car and got out to check on Tommy. Sgt Christiansen spoke with another involved party identified as Sara R.0 Gamboa DOB 5/25/1990 via DOL. Sarah provided the following information. She and Tommy were on the sidewalk on the south side of S 3rd St. They were walking eastbound towards the intersection of Main Ave S and hit the crosswalk button. The walk sign illuminated, and they began to cross the intersection. Unit one turned southbound on Main and struck Tommy on the left side. Unit 1 also ran over her foot causing her pain. Tommy and Sara were both transported to Valley Medical via Tri-med. I Issued a Citation for failure to yield to pedestrian in crosswalk RCW 46.61.261. Isaiah committed this offense by turning into the intersection striking a pedestrian in a crosswalk with his vehicle while despite having a green light, the walk sign was illuminated giving pedestrians the right of way. I certify (declare) under penalty of perjury under the laws of the State of Washington that the foregoing is true and correct. Electronically signed by Officer J. Kearse #12994 12/27/2024 2259 Hours Renton, King County, Washington PAGE 3 OF 5 SUPPLEMENTAL REPORT No. EF63213 r`) POLICE TRAFFIC 1 1 8 27 COLLISION REPORT CASE# 24-13234 1 COMMERCIAL MOTOR CARRIER INTERSTATE INTRASTATE G UNIT'# USDOT ICC# VEHICLE TYPE CARGO BODY ;TYPE 2 ❑ 1 28 CARRIER NAME 3 CARRIER L ADDRESS ` CITY ST ZIP—1 I ' 4 ❑ NAME # PLACARD: :❑ GI PLACARD IF NO NUMBER SOURCE AXLES + 4a ❑ ADDITIONAL UNITS MOTOR PEDAL- PEDESTRIAN PROPERTY DAMAGETHRESHOLD MET PHONE 5 ❑ UNIT# 3 VEHICLE I_J CYCLE OWNER � YEs� NO D:2533288719 MIDDLE.. 29 LAST NAME : GAMBOA FIRST NAME TOMMY INITIAL D STREET _—] H 30 NEW AnDRFSP 1 12313 129TH ST CT E CITY PUYALLUP ST WA ZIP 98374 6 CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TAN5PORTED 1 31 INTERLOCK YEs No zERLOCK YES[:]NO[:] YEs N DRIVER'S D.O.B LICENSE STATE WA SEX M MMDDYYv', 06 - 25 - 1985 7 HELMET INJURY NATURE OF INJURIES ON DUTY STATUS 3 AIRBAG RESTR. EJECT USE 2 CLASS 6 LEFT ARM PAIN.COULDNT MOVE LEFT ARM 8 ❑ 1 32 LICENSE+ raT VIN.# PLATE# 9 TRAILER TRAILER PLATE# STATE PLATE# STATE 10 ❑ TRLR TRLR VIN.#. VIN.#. 11 VEH.YEAR MAKE MODEL STYLE VEHICLE TOWS T SABLIN TOWED BY anvi vEHIC P FROM TO DAMAGE Y E ES NO YES NO REGISTERED OWNER INFO. ] 3 33 12 SHADE IN DAMAGED AREA FROM TO ((ABILITY INSURANCE❑ INSURANCE CO IN EFFECT &POLICY# tGQ EwcLE 34 13LEGALLY YES❑ NO❑ CITATION# CHARGE STANDING } 8 7 6 14 ❑ UNIT Tr Vd 1RE O CYDCLE OWNERRTY YES AGE NOHRESHOLD MET PHONE ❑ 35 PEDESTRIAN 15 LAST NAME FIRST NAME MIDDLE 36 ❑ STREET 16 TEETFs.�' CITY ST ZIP CDL IGNITION REdUiRED IGNITtGN PRESENT MEDICALTANSPORTED INTERLOCK YES No INTERLOCK YEs NO YEs NO ❑ 17 4 37 1 ❑ LICENSE# STATE SEX MMDDDYBYY 8 ON DUTY� STATUS AIRBAG RESTR. ; EJECT HELMET INJURY' NATURE OF INJURIES 38 USE CLASS 19 LICENSE rnr vIN# ❑ 39 PLATE# 20 ❑ TRAILER' STATE TRAILER STATE ❑ 40 PLATE#< PLATE# 21 ❑ ❑ 41 TRLR TRLR VIN# YIN#i 42 22 VEH.YEAR MAKE I MODEL STYLE I VEHICLE TO DUET SABLIN TOWED BY GOVT.VEHICLE DAMAGE YES NO YES NO 23 1 REGISTERED OWNER INFO_ SHADE IN DAMAGED AREA 43 3 4 LIABILITY INSURANCE INSURANCE CO ' VINE EFFECT &POLICY# i 970P - 4 E:l 44 24 LEwcLE YES❑ NO❑ CITATION# CHARGE iq 60TiOM LEGALLv 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. JAMAAL KEARSE 12-27-24 11:41 PM 25 INVESTIGATING OFFICER'S SIGNATURE OFFICER'S PHONE UNIT OR DIST DET DATED: PLACE SIGNED 26 � OR ID# 12994 O#I',WA0171300 APPROVED BY 2/6/2025 PAGE F OF 3000-345-013(R 11118) REPORT NO. EF63213 CASE# 24-13234 DATE AND TIME 12/27/24 21:07 OF COLLISION ask } ca k k k � k P k w, gk r s k, l k k 1�sx r k t 1�+ t' ql i SY j x r. ar fix, 1 i� �kY5 k Y { PAGE 5 OF 5