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HomeMy WebLinkAbout24-11206 a ITFFi "POLCERA II IfI) 1 IlfII ('II (Illf If( fI I . 0 27c COLLISION REP FIT 1591971 SASE 24-11206 2 INTERSTATE ❑ CITY STREET FIRE ❑RESULTED 1 STOLEN STATE ROUTE ❑ OTHER ❑ VFHIC;I F ❑ LOCAL AOENC 4900 3 HIT&RUN CODING COUNTY RD PRIVATE WAY INVOLVED 2 2 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# ❑ COLLISION 10 - 1-- 2024 0709 17 ❑.❑ S 8 W e IN e 1070 3 4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓ SUNSET BLVD N BLOCK NO. e✓ 330 4a❑ MILEPOST DISTANCE OF(REFERENCE OR CROSS STREET) 5❑ 2501. 00 FEET e S MILES N B W e N 3RD ST 0 1 29 MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE UNIT 01 VEHICLE ❑ CYCLE El ✓NO D:4259004776 0 7 30 LAST NAME RIVERA-URIZAR FIRSTNAME BEDER MIDDLE N 6 INITIAL 1 2 31 STREET ❑ 9003 W SHOREWOOD DR#AP699 CITY MERCER ISLAND ST I WA 2jp, 98040 z NEW ADDRESS 7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3 iNTERLOCKYEs NO INTERLOCKYEs NO _YES R NO LRIIVERS STATE WA SEX'U MM DAY' 03 - 29 - 1999 1 1 2 32 8❑ 9 ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 HELM USEET I ICNLJA 1 URY NATURE OF INJURIES z❑ 3 10 9❑ P1ATE14 CCX5235 STATE WA VIN# 1NX6602E1T2444315 TRAILER STATE TRAILER STATE 11 3 0 PLATE# PLATE# FROM TO FT -R TPILF1 1 5 33 12 0 0 VIN#' VIN# FROM TO ❑ VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN T GOVT.VEHICLE J 9 34 13 2 1996 TOYT COROL DAMAGE vE5 0NO f �AWkkRS vEs❑ No REGISTERED OWNER INFO DA.PAL.GARCIA 365134THAVES APTB502 SEATTLE WA 98144 VEHICLE NO. 1 ❑ SHADE IN DAMAGED AREA 35 3 4 14 2 LIABILITY INSURANCE❑ INSURANCE CO IN EFFECT &POLICY# 9TOP VE— CHARGE 10 BOTTOM 5 36 LEGALLY YEs❑NO CITATION# 4A0765711,4A0765711, SPEED TOO FAST FOR CONDITIONS, 15❑ NDING 7 6 UN�T MOTOR PEDAL-: ❑ PEDESTRIAN ❑ PROPERTY ❑ DAM THR OLDMET PHONE VEHICLE CYCLE : OWNER YES�/ NO 16 a LAST NAME NGUYEN FIRST NAME CALVIN MIDDLE N INITIAL 17❑ STREET ❑', 834 LYNNWOOD AVE NE CITY' RENTON ST WA ZIP 980563805 37 NEW ADDRESS ❑ 18� CDL IGNITION REQUIRED IGNITION PtR-E-S1ENT MEDICALt-T�RANSPORTED 38 INTERLOCKYES�NOR INTERLOCK YEs I I NoF YES t l NO❑ 19 LDIIVEW # STATE WA SEX M M .C.B. O6 _ 24 1961 39 20� ON DUTY STATUS AIRBAG,2 RESTR 4 EJECT 1 HELMET INJURY 7 NATURE OF INJURIEs 40 USE CLASS L ARM 21❑ LICENSE I CNJ5145 TATE WA VIN# KNDAFFS53R6050643 ❑ 41 PLATE# 42 22❑ PLATE# STATE PLATE# STATE 23❑ VIN#. 43 TRLR RLR 'IN#. VEH YEAR 2024 MAKE KIA MODEL EV9 STYLE VEHICLETOWED TO BLIN TOWEDBY GOV HI 44 L4❑ DAMAGE YES NO YES NO REGISTERED OWNER INFO CALVIN NGUYEN 834 LYNNWOOD AVE NE RENTON WA 980563805 D:2068329579 VEHICLE NO.2 SHADE IN DAMAGEbAREA 2 3 Cd LIABILITY INSURANCE INSU PORGY#E CO NAT WIDE 7246J 059993IN 1 9TOP 'E""LE CITATION# CHARGE LEG 25 i o BOTTOM ALLY YES N� ❑ s OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY J 26 M.LEVERTON 2517 WA0171300 PAGE 01 OF PART A 3000-345-159 OR 11/181 STATE OF POLICETRAFFICN CORRECTION REPORT NO. EF31936 COLLISION REPORT III III III III III 111 1591972 CASE# 24-11206 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 10-29-24 08:29 AM INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED APPROVED BY E DAT C.JACOBS 1953 111412024 1:38:43 PM BADGE OR ID# 2517 OR]#' WA0171300 TIME POLICE DISPATCHED 7:09 AM TIME POLICE ARRIVED]7:15 AM PART I PAGE IT]0F 4� REPORT NO. EF31936 CASE# 24-11206 OF COLLISION 10/29/24 07:09 OF CbLLI510N NARRATIVE BLUE SUV/2 LANE 2 STOPPED BIEGE SEDAN 1 REAR CC Within the city limits of Renton/King/WA I responded to a 2 vehicle blocking crash at about the 330 block of Sunset Blvd N southbound lane 2. 1 arrived and found two vehicle blocking. Unit 2 was able to move his vehicle to the Burger King parking lot and unit 1 required a tow truck to move with heavy front end damage. I contacted the driver of unit 2 who told me he was stopped when he heard unit 1 skidding then felt the impact of being hit from behind. Unit 2 told me the skidding sound seemed to last for a long time and wasnt a sudden impact. He complained of injury. He was treated and released on scene by Renton Fire. His vehicle was not towed for damages. I contacted the driver of unit 1 ID'd by a picture Guatemalan ID card. He tried to say his brakes did not work but a preliminary check of the brake pedal seemed it was in working order. He could not provide a valid proof of insurance. A WACIC/DOL check via MDC revealed he had an assigned OLN number but no other information or valid drivers license. He did not complain of injury and damages required a tow truck. The tabs on his vehicle showed May of 2023. A WACIC/DOL check revealed they were expired 05-26-2023. 1 cited unit 1 ref RCW 46.61.400 Speeds too fast for conditions, RCW 46.20.015 NVOL 2nd With ID, RCW 46.30.020 No Insurance, and RCW 46.16A.020 Expired tabs more than 2 months via complaint. 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 10/29/2024 PAGE 3 OF 4 REPORT NO. EF31936 CASE# 24-11206 DATE AND TIME 10/29/24 07:09 OF COLLISION i riruStl�t �y n t�. i PAGE 4 OF 4