HomeMy WebLinkAbout24-8995 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 0 27c
COLLISION REP FIT 1591971
CASE 24-8995 z
INTERSTATE ❑ CITY STREET FIRE ❑RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHICI F ❑ LOCAL AGENCI 4Y00 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 TOTAL#OF OBJECT 2$
TRIBAL UNITS 02 STRUCK' FIRE HYDRANT
RESERVATION
z
3❑ DATE of M M D D Y Y Y Y TIME(2400) COUNTY# MILES N E IN CITY# ❑
CowsloN 08 - 27 - 2024 0106 17 ❑.❑ S 8 W e IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓
LOGAN AVE N BLOCK NO. e✓ 700
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ ❑ FEET e S ❑ W e 0 1 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
,/No D:4254965398 30
6❑ LAST NAME CARBALLO ORTIZ FIRST NAME JOSUE MIDDLE 1 2 31
INITIAL
STREET ❑ 1311 139TH AVE NE APT 4 CITy BELLEVUE ST WA 2jp, 98005 z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
1/ I INTERLOCK YES[:]NO NTERLOCKYEs NO�/ YES R No�/
8❑ LDRIVER # STATE WA SEX'M MID
-O B 10 — 20 — 1997 32
9 ON DUTY❑ STATUS AIRBAG 6 RESTR 4 EJECT 1 H USE 2 1 CLASS NATURE OF INJURIES z❑
3
10❑ P1 ATE 14 CKW1308 STATE WA u N# 3FADP4BJ2BM135755
TRAILER STATE TRAILER STATE
11 0 0 PLATE# PLATE# Rom ro
TRLR. TRLR 5 1 33
12❑ VIN#' VIN#.
Rom 34
13� VEH.YEAR2O11 MAKE FORD MODEL FIESTA STYLE SD VEHICLE TOWEDNOOpLSABLIN TSIYYEp9vMEYER vOs❑ENo�
HICLE
DAMAGE IILLJJII (��IV6
REGISTERED OWNER INFO OWNEDBYDRIVER VEHICLE NO. 1
SHADE IN DAMAGED AREA ❑ 35
14❑ LIABILI INSURANCE INSURANCE CO NATIONAL GENERAL 29742 3 4
IN EFFECT &POLICY# 9TOP
VEHICLE CHARGE 5 36
LEGALLY YES❑NO❑ CITATION# 1 o BOTTOM
15❑ STANDING
MOTOR PEDAL- PEDESTRIAN PROPERTY ✓ DAM THR OLD MET PHONE
UNIT U2 VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES 1/ NO D:4254307500
16❑
LAST NAME CITY OF FIRST NAME RENTON MIDDLE
INITIAL
17 STREET NEW ADOREs7 1055 SOUTH GRADY WAY CITY RENTON ST WA ZIP 98057 37
18� CDL IGNITION REQUIRED IGNITION PtR—E—S1ENT MEDICAL TRANSPORTED 38
INTERLOCKYES�NOR INTERLOCK YEs I I NOF YEs t l NO❑
19 LLIICENS # STATE SEX U MMDDYY —�_ 39
HELMET INJURY NATURE OF INJURIES 40
20❑ ON DUTY STATUS' AIRBAG RESTR EJECT USE CLASS ❑
❑21❑ TATE 41
IN#LICENSE V 1
PLATE#
42
22❑ PLATE# STATE PLATE# STATE
23❑ 43
TRLR RLR
VIN#. IN#.
VEH YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN
TOWED BY Gov HI 44
L4❑ DAMAGE YES NO YES NO
REGISTERED OWNER INFO VEHICLE NO.2
SHADE IN DAMAGED AREA
2 3 4
INAEFFITY ECTNSURANCE❑ &POINSULICY#E CO I 9TOP 5
VE."Le YES❑ N J
,J� CITATION# CHARGE i o BOTTOM
LEGALLY
25 s � e
7BRYAN
NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
J
26GROZAV 1 12489 WA0171300
PAGE 01 OF
PART A
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EF10490
COLLISION REPORT III III III III III 111
1591972 CASE# 24-8995
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'
On Tuesday August 27th, 2024, 1 responded to a single vehicle collision in the 700 block of Logan
Ave North. Upon arriving on scene, I noticed the vehicle involved a 2011 Ford Fiesta resting on its
side on the sidewalk against a light pole. There was a large crowd near the vehicle who indicated the
driver was out of the vehicle and pointed to Josue Carballo Ortiz (DOB: 10.20.1997). 1 quickly learned
Josue was deaf, unable to speak, couldn't read, and did not know sign language. Josue did not
appear injured but was screened by Renton Fire on scene and released. It is unknown how the crash
occurred since I was unable to communicate with Josue. Based on the circumstances, it appeared
Josue was traveling north on Logan Ave North, lost control due to the heavy rain, struck a fire
hydrant, the vehicle flipped onto its side at some point and came to a rest on its side against the light
pole. The light did not appear to have any significant damage. Josue handed me an ID and did not
have a valid driver's license.
I issued Josue a traffic citation for the following traffic violations:
46.61.400.1 SPEED TOO FAST FOR CONDITIONS
46.20.015- NO VALID OPER LICENSE WITH VALID ID
Josue's vehicle was towed from the scene.
I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT.
BRYAN GROZAV 08-27-24 06:14 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
P.SUMMERS 888 1 91112024 12:36:32 AM
BADGE OR ID# ! 1Y489 OR]# WA0171300 TIME POLICE DISPATCHED'; 4:08 AM TIME POLICE ARRIVED f 1:12 AM
PART I PAGE IT]OF 3�
REPORT NO.! EF10490 CASE# ' 24-8995 DATE AND TIME 08/27/24 01:06
OF COLLISION
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