Press Alt + R to read the document text or Alt + P to download or print.
This document contains no pages.
HomeMy WebLinkAbout24-11438 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 6 27c
COLLISION REP FIT 1591971
CASE 24-11438 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 1 ❑2$
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#
cawsloN 11 - 1-- 2024 1118 17 ❑-= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
LOGAN AVENUE SOUTH BLOCK e✓ 100 ❑
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ �,❑ FEET e S ❑ W e AIRPORT WAY
0 4 29
MOTUNIT U1 VEHIOR PI PEDAL-CLE CYCLE ElYESA,G/E NHORESHOLD MET PHONE =30
6 LAST NAME BUSTOS GONZALES FIRST NAME GILBERTO MIDDLE D 1 1 2 31
INITIAL
STREET ❑ 838 HARR/NGTON AVE NE APT 13 CITy RENTON ST WA 2jp, 98056 z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION : PRESENT MEDICAL TRANSPORTED 3
iNTERLOCKYEs NO INTERLOCKYEs NO YES NO
$❑ LICENS
DRIVER # STATE WA SEX'M MMDDYY 01 - 30 - 2010 32
9 ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 H USEET ICNLJAURY 1 NATURE OF INJURIES z❑
3
10❑ Pi aT�S� CCW4320 sTATe WAvrN# 3VWC576U6KM105419
TRAILER STATE TRAILER STATE
11 3 0 PLATE# PLATE# FROM TO
TRLR. TRLR 7 1 33
12❑ vIN#' VIN#
FROM
34
VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TR Y GOVT.VEHICLE
13 2019 VOLK JETTA 4D DAMAGE YES NO �MEYERS YES❑ NO✓
REGISTERED OWNER INFO GIL.ERTO BUSTOS BENITEZ 838 HARRINGTON AVENEAPT 13 RENTON WA 98056 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
14❑ LIABILITY INSURANCE❑ INSURANCE CO <��34
IN EFFECT &SUR N#VEHICLE CHARGE 5 36
LECALLvYes❑NO CITATION#
15❑ STANDING 7 6
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
16
UNIT 02 VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES�/ NO D:4252265238
❑
LAST NAME TO GO FIRST NAME SUBS MIDDLE
INITIAL
17❑ STREET ❑', 30 LOGAN AVE SOUTH CITY RENTON ST WA ZIP 98057 37
NEW ADDRESS ❑
18� CDL IGNITION REQUIRED IGNITION PtR-E-S1ENT MEDICAL t-T�RANSPORTED ❑ 38
INTERLOCKYES�NOR INTERLOCK YEs I I No� YES t l NO❑
19 LLIICENS RIVERS# STATE SEX U MMDDYY -❑_ 39
HELMET INJURY NATURE OF INJURIES 40
20❑ ON DUTY STATUS' AIRBAG RESTR EJECT USE CLASS ❑
❑21❑ LICENSE TATE VIN# 41
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
24❑ 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 IGQVE""LE
❑ ,J� CITATION# CHARGE
LEGALLY YES N`L J
25
=UGENT
(PRINT) OFFICER PHONE BADGE OR ID# 771�NCY
26 11498 0171300
PART A PAGE 01 OF C7
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EF37922
COLLISION REPORT III III III III III 111
1591972 CASE# 24-11438
ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY)
NAME MIDDLE INITIAL) TELLEZ GOMEZ KENNY
(LAST FIRST,
ADDRESS&PHONE#
662 DAYTON AVE NE RENTON WA 98056 4259028620 SEX M MMDDvyry 01 - 12 - 2010
PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT ' HELMET INJURY NATURE OF INJURIES
❑✓ ❑ 1 POS. ' 9 2 4 1 USE CLASS +1
NAME
(LAST,FIRST,MIDDLE INITIAL) BERNAL PEDROZA ERICA B
ADDRESS&PHONE# DOB
3518 NE 4TH STREET RENTON WA 98056 4255246398 SEX F MMDDvvvv 11 _ 07 _ 2009
SEAT HELMET I INJURY NATURE of INJURIES
PASSENGER P]WITNESS❑ UNIT# 1 POS 3 AIRBAG 2 RESTR. 4 EJECT 1 USE CLASS 1
NAME
(LAST FIRST,MIDDLE INITIAL) RIVERA LUIS
ADDREss&PHONE# 662 DAYTON AVE NE RENTON WA 98056 2065664629 SEX M I. _ 11 - 2009
MDDYYYY
PASSENGER WITNESS UNIT# ! 1 SEAT 7 AIRBAG 2 RESTR. 4 EJECT 1 HELMET NJURY 1 NATURE OF INJURIES
❑ POS. USE CLASS �N----�
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.
MATTHEW NUGENT 11-06-24 02:10 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY E
DAT
C.JACOBS 1953 1112112024 7:09:46 AM
BADGE OR ID# 11498 ORI# WA0171300 TIME POLICE DISPATCHED' 11:19 AM TIME POLICE ARRIVED',11:20 AM
PART I PAGE IT]OF 4�
REPORT NO. EF37922 CASE# 24-11438 OF COLLISION
11/04/24 11:18
OF CbLLI510N
NARRATIVE
24-11438
On 11/04/2024 at 1119 hours, I was dispatched to the `Subs To Go' restaurant located at 30 Logan
Avenue South, within the City Limits of Renton, County of King, State of Washington regarding a
single vehicle collision report.
Officer G. Ridgeway arrived on scene prior to me and confirmed there were no injuries requiring
immediate medical response at the time of report.
Upon my arrival, I contacted the driver of Unit#1 (U1), who had later been verified as the driver via
surveillance footage from the Subs to Go restaurant. The driver of Unit#1 stated that he did not have
any form of identification on him and that he took the vehicle from his parent's house, and they were
unaware. U1 stated that he was traveling northbound on Logan Ave South when he lost control and
unintentionally drove up and onto the curbed sidewalk and into the north curbing that lines the
parking lot of the Subs to Go location. No injuries were reported. U1 caused moderate damage to
U2's curbing.
The male driver was subsequently detained into handcuffs until his identity could be verified per
violation of RCW 46.61.020, and until I could verify the vehicle's stolen status. I read the male his
Miranda Rights from my Department Issued Code Book with the juvenile addendum which he stated
he understood. I identified the male via DOL photo as BUSTOS GONZALES, GILBERTO D (DOB
01/30/2010).
A parent/guardian of one of the involved passengers arrived on scene. The parent/guardian was
identified via pictured WADL as Pedroza Perez, Maria D (01/25/1986). Pedroza Perez was able to
contact Bustos Gonzales' parents by phone. Due to Bustos Gonzales' parents both being out of the
area for work, Bustos Gonzales was released to Pedroza Perez at their request. Pedroza Perez was
the mother of Bustos Gonzales' girlfriend and stated she would get Bustos Gonzales back to school
and coordinate the towing of the vehicle due to disabling damage.
A DOL records check revealed that Bustos Gonzales was listed as "Not Licensed -Eligible". Bustos
Gonzales did not have any form of pictured or non-pictured identification on him and therefore
violated RCW 46.20.005 by Driving without a Valid Operator's License without valid Identification.
Bustos Gonzales had to be identified by DOL Photo for positive identification.
Bustos Gonzales also violated RCW 9A.56.075 - Taking motor vehicle without permission in the
second degree. Bustos Gonzales took a vehicle without the permission of the owner or person
entitled to possession, and intentionally drove the vehicle away, that is the property of another.
An exchange of information was provided to the Subs to Go restaurant employee, Bustos Gonzales,
as well as a business card and case number were provided to Pedroza Perez.
Please forward this report to the King County Juvenile Court for impending charges of NVOL without
Identification and Taking a Motor Vehicle Without Permission -2nd degree.
I certify (or declare) under penalty of perjury under the laws of the State of Washington that the
foregoing is true and correct.
Electronically signed by Officer M. Nugent#11498 2:08 PM 11/6/2024 Renton, King County, WA.
PAGE 3 OF 4
REPORT NO. EF37922 CASE# ' 24-11438 DATE AND TIME 11/04/24 11:18
OF COLLISION
I
a
to
s
,,,�.:.,..,
PAGE 4 OF 4