HomeMy WebLinkAbout24-11529 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 6 27c
COLLISION REP FIT 1591971
CASE 24-11529 z
INTERSTATE ❑ CITY STREET FIRE ❑RESULTED
1 STATE ROUTE OTHER STOLEN
❑ ❑ HFHIC;I F ❑ LOCAL AOENC 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 1 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: 11 — 1—— 2024 1510 17 ❑. S 8 W Li OF e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
LIND AVE SW BLOCK NO. e✓ 1600
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ ❑ FEET e S ❑ W e SW 16TH ST
0 4 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
✓NO D:2065499729 0 11
30
6 LAST NAME VICTO CASTILLO FIRST NAME DIEGO MIDDLE J 1 2 31
INITIAL
STREET ❑1 23401 104TH AVE SE APT 87 CITY KENT ST WA 2jp, 98031 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 I EL MI MIT Y
8❑ ' 08 — 16 — 2003 1 2 32
9 ON DUTY❑ STATUS AIRBAG 2 RESTR 9 EJECT 1 H U EET ICNLJAURY 1 NATURE OF INJURIES z❑
3
LICENSE CFG8459 sTArI WAvIN# JM3TB3CV6C0359574
10❑ PI ATE 14
TRAILER STATE TRAILER STATE
11 3 5 PLATE# PLATE# FROM TO
TRLR. YRLR. 3 5 33
12 3 5 VIN#' VIN#
>; FROM TO
VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE 1 $ 34
13 2 ZO12 MAID CX-9 UT DAMAGE YES NO YES[:] No
✓
REGISTERED OWNER INFO PAVILLE CASTILLO 23401104TH AVE SE APT 87 KENTWA 98031 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
14 LIABILI INSURANCE INSURANCE CO ALLSTATE INSURANCE 970786950 3 4
IN EFFECT &POLICY# 9TOP
15❑ VEHICLE 1 5 36
LEGALLY YES�No D CITATION# 4A0598502 CHARGE NO VALID OPER LICENSE WITH )o Borrow
STANDING 8 7 6
MOTOR PEDAL- .PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT 02 VEHICLE ❑ CYCLE' ❑ ❑ OWNER ❑ YES 1/ NO D:6692945959
16 a
LAST NAME RAMIREZ FIRST NAME RAIZA MIDDLE G
INITIAL
17❑ NEW ADDRESSSTREET ❑' 1205 N 10TH PL APT 2420 CITY RENTON ST WA ZIP 98057 4❑ 37
18❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED � 38
INTERLOCK YEs❑NO� INTERLOCK vEs❑NOF YEs❑NOF,/
19 D IVERI # STATE WA SEX F MMor w 10 _ 03 _ 1993 39
WELMET INJURY1 NATURE OF INJURIES 40
20❑ ON DUTY STATUS AIRBAG 2 RESTR 9 EJECT 1 USE CLASS ❑
LICENSE I ❑21❑ PLA E# CLD6631 TAre WA VIN# 41
JTMABACA4PA029482 1
42
22❑ PLATE# STATE TILER PLATE# STATE
23❑ UIN#. 43
TRLR RLR
'IN#.
VEH YEAR 2023 MAKE TOYT MODEL BZ4X STYLE UT VEHICLE TOWED TO BLIN TOWEDBY GOV HI 44
L4❑ DAMAGE YES NO YES NO
REGISTERED OWNER INFO GABRIEL GUERRERO AYALA 412740TH AVE SW UNIT B SEATTLEWA98116 VEHICLE NO.2
SHADE DAGELLAREA
LIABILITY INSURANCE INSU&PORGY#E CO GEICO INSURANCE 6117-66-88-60 IGQ,
IN EFFECTVEHICLE ❑ ,.I—I CITATION# CHARGE
LEGALLY YES N`E]
25 s � e
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# JAGENCY
26
JESSE VANDERHOEK 11631 WA0171300
PART A PAGE 01 OF C7
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EF32880
COLLISION REPORT III III III III III 111
1591972 CASE# 24-11529
ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY)
NAME MIDDLE INITIAL) YEATES FRED
(LAST FIRST,
ADDRESS&PHONE# D.O.B.
5097874385 SEX' U MMDDYYYY -❑
--------------------------------
PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT ' HELMET INJURY NATURE OF INJURIES
❑ ❑✓ POS. USE CLASS
NAME
(LAST,FIRST,MIDDLE INITIAL)
ADDRESS&PHONE# DOB
SEX MMDDYYYY
PASSENGER ❑WITNESS❑ UNIT# SEAT AIRBAG RESTR. EJECT HELMET INJURY NATURE OF INJURIES
POS. USE CLASS
NAME
(LAST FIR57 MIDDLE INITIAL)
AppRESS&PHONE#
SEX D.O.B.MMDD -❑
YYYY.
PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET NJURY NATURE OF INJURIES
❑ ❑ POS. USE CLASS ----�
NARRATIVE'
Vehicle #1 was traveling westbound on SW 16th St approaching Lind Ave SW, preparing to turn left
at this intersection. Vehicle #2 was traveling southbound on Lind Ave SW approaching SW 16th St.
The front right corner of vehicle #1 collided with the left side of vehicle #2 as both vehicles proceeded
through this intersection at the same time. The driver of vehicle #2 stated she had a green light to
proceed south through this intersection. Driver#2's story was corroborated by an uninvolved witness
who was driving directly behind vehicle #2 and saw the collision occur. The driver of vehicle #1
stated he had a yellow left turn arrow to turn left onto Lind Ave SW. Based on the totality of the
circumstances, it appeared vehicle #1 caused this collision.
RTF
I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT.
JESSE VANDERHOEK 11-06-24 05:18 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
D.SKELTON 9139 1 111712024 3:51:24 AM
BADGE OR ID# 11631 OR]#' WA0171300 TIME POLICE DISPATCHED 3:34 PM TIME POLICE ARRIVED 3:43 PM
PART B PAGE IT]OF 3�
REPORT NO. EF32880 CASE# ' 24-11529 DATE AND TIME 11/06/24 15:10
OF COLLISION
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