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HomeMy WebLinkAbout24-12086 IT si " II IIIII III IIIII II IIII IIIII I . 27c REPORT NO EF3880OLCERA COLLISION REPORT 1591971 CASE# 24-12086 2 INTERSTATE CITY STREET FIRE ❑ RESULTED 1 STATE ROUTE OTHER STOLEN ❑ ❑ VEHICLE ❑ LOCALANG 3 HIT&RUN C©DIN6 COUNTY RD PRIVATE WAY INVOLVED 2 TOTAL#OF OBJECT 1 s 28 TRIBAL UNITS 02 STRUCK RESERVATION : 1 1 2 3� M M D D Y Y Y Y TIME(2400) COUNTY# MILES CITY# DATE OF N E eDL�ISION' 11 - 21 - 2024 2314 17 =.�� S W OF 1070 3 4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑ BLOCK NO. e .� 4a S 2ND ST MILE POST ❑ ❑ DISTANCE OF(REFERENCE OR CROSS STREET) 5 �. FEET e S 8 W e WILLIAMS AVE S 0 1 29 MOTOR ✓ PEDAL- DAM AG THRESHOLD MET PHONE UNIT 01 VEHICLE ❑ CYCLE ❑ YES ✓NO 0 1 30 6❑ LAST NAME FLORES ORE FIRST NAME MARIA DEL MIDDLE C 1 2 31 INITIAL STREET ] 2101 SW SUNSET BLVD APT G105 CITY; RENTON ST WA ZIP; 98057 2 NEW ADDRESS 7 CDL IGN(TIUN REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED' 3 INTERLOCKYEs NO✓ INTERLOCKYEs NO✓ YES F NO F✓ DRIVER # STATE WA SEX I U MMDDYY' 07 — 03 — 1999 t 1 2 32 8� 9 ON DUTY STATUS' AIRBAG 2 RESTR 13 EJECT 1 HELM USEET 2 CLASSY 1 NATURE of INJURES 2 LICENSE, CMU0358 STATE WA VIN# JTDBR32E560081174 3 10 Fl I as ATP tt TRAILER 11 0 0 STATE TRAILER STATE PLATE# PLATE# ROM To TRLR TRLR 3 1 7 33 12 0 0 VIN#' vIN# FROM TO VEH.YEAR 2006 MAKE To�. MODEL COROL STYLE SD VEHICLE TOWED[n TO ZBLIN TOWEDBY GOVT VEHICLE 1 $ 34 13� DAMAGE YES II_II NO YESII_I) NO✓ REGISTERED OWNER INFO CR1ST/AN SANCHEZ 110 SW SUNSET BLVD APT G105 RENTON WA 98057 D:5613370553 VEHICLE NO. 1 SHADE IN DAMAGED AREA 35 3 4 14❑ LIABILITY INSURANCE❑ NSURANCE CO IN EFFECT &POLICY# 9TOP 5 VE" ta BOTTOM 36 L STM INcYES❑ ❑ CITATION CHARGE 15❑ 7 6 UN# MOTOR PEDAL- ❑ PEDESTRIAN PROPERTY DAM THR OLD MET PHONE 1 VEHICLE CYCLE nWNFR 16F] LAST NAME GADIAGA FIRST NAME PAPA MIDDLE' A INITIAL 17 F1 STREET ❑ ❑ 611 SW 5TH ST A201 CITY RENTON ST, WA ZIP 98057 4 37 NEW ADDRESS 18❑ CDL IGNITION REQUIRED (GNITION PRESENT MEDICALTRANSPORTED. 38 INTERLOCKYES ND✓ INTERLOCK YES N ✓ YEs NO'✓ 19 DRIVER'S ' STATE WA SEXI M D.O.B. 04 09 1993 � 39 LICENSE# MMDDYY I I — 20❑ ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 H ET 2 INJURY 1 NATURE OF INJURIES 40 21 LICENSE I PLATE# CMA1499 TATE I WA VIN# KMHDH4AE6DU947677 � 41 22❑ [TILER TAILER PLATE# STATE PLATE# STATE 42 23 TRLR RLR 43 UIN#. 'IN# VEH.YEAR 201$ MAKE HYUN MODEL ELANTRA STYLE SD VEHICLE TOWED TO BLIN TOWED BY GOV HI 44 24 DAMAGE YES NO✓ NO✓ REGISTERED OWNER INFO OWNED BY DRIVER VEHICLE N0.2 SHADE IN DAMAGED AREA 2 3 4 LIABILITY INSURANCE INSURANCE CO VERN FONK 21502342 IN EFFECT &POLICY# 9TOP vew1— ❑ ,.I—I CITATION# CHARGE to BOTTOM L','—LY YES No 25 a s OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY 26 E.EDMUNDS 12576 WA0171300 PAGE 01 OF PART A 3000-345-189(R 11/18) STATE OF POLICETRAFFICN CORRECTION REPORT NO. EF38805 COLLISION REPORT III III III III III 111 1591972 CASE# 24-12086 E NA ADDITIONAL PERSONS INVOLVED(PASSENGERS AND/OR WITNESSES ONLY) M (LAST,FIRST,MIDDLE INITIAL) GONZALEZ DONAIRE ZULEIKA N ADDRESS&PHONE# D� 2101 SW SUNSET BLVD APT G105 RENTON WA 98057 SEXi F MMDDYYYY 02 - 21 - 1991 PASSENGER Z WITNESS UNIT SEAT AIRBAG RESTR. EJECT HELMET INJURY NATURE OF INJURIES 1 POS. 3 2 4 1 USE 1 2 CLASS ;1 ----� :NAME Lnsr EIRST,MIDDLE INITIAL) MARTINEZ RUIZ WALEDKA C ADDRESS R PHONE# RENTON SEX' F D.O.B. 10 _ 20 _ 2003 MMDDYYYY SEAT HELMET INJURY NATURE OF INJURIEs PASSENGER a WITNESS UNIT# : 1 PEA 9 AIRBAG 2 RESTR. 4 EJECT 1 USE CLASS 1 ----� :NAME (LOST,FIRST,MIDDLE INITIAL) ADDRESS&PHONE# SEX/ D.O.B. - MMDDYYYY PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET NJURY NATURE OF INJURIES POS. I USE CLASS NARRATIVE Unit#2 was traveling south through the intersection of Williams Ave S and S 2nd ST on a green light. Unit#1 was traveling westbound on S 2nd St, entering the intersection. Unit#1 collided with Unit#2 in the intersection, causing significant damage to both vehicles. Driver#2 provided a WA driver's license, Registration Certificate, and proof of insurance. Driver#1 provided a WA ID card, but could not provide registration certificate or proof of insurance. Driver#1 was cited for no valid operator's license and operating a motor vehicle without insurance. 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 E. Edmunds/#12576 at 1715 hours on 11/16/2024, in the City of Renton, WA. I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT. E.EDMUNDS 11-22-24 12:34 AM INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST.DET DATED PLACE SIGNED APPROVED BY DATE DESIRES SCOTT 10272 1112312024 9:52:29 AM BADGE OR ID# 12576 ORI# WA0171300 TIME POLICE DISPATCHED 11:14 PM TIME POLICE ARRIVED 11:14 PM PAST B 3 Da-3mx-attar(t 1Mff) PAGE 2�OF F3 REPORT NO. E F38805 CASE# 24-12086 DATE AND TIME 11/21/24 23:14 OF COLLISION 11 4 I�i^ r; t h k ib t b,. f Y 1 afP 4 x t�Yt�1'bxm"bYL'x36'}bG}Ya6F'w� ., SxyY? s,�f Y ei y Y x { ,Y hm +� PAGE 3 OF 3