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HomeMy WebLinkAbout24-12167 a ITFFi "POLCERA II IfI) 1 IlfII ('II (Illf If( fI I . 6 27c COLLISION REP FIT 1591971 CASE 24-12167 z INTERSTATE ❑ CITY STREET FIRE ❑RESULTED 1 STOLEN STATE ROUTE ❑ OTHER ❑ VFHIr.I F ❑ LOCAL AOENC 4900 3 HIT&RUN CODING COUNTY RD PRIVATE WAY INVOLVED 2 3 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# cowsloN 11 - 1-- 2024 1925 17 ❑-= S 8 IN e 1070 3 4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑ NE 4TH ST BLOCK NO. e✓ 3200 ❑ 4a❑ MILEPOST DISTANCE OF(REFERENCE OR CROSS STREET) 5❑ ❑ FEET e S ❑ VV a MONROE AVE NE 0 1 29 MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE UNIT 01 VEHICLE ❑ CYCLE El ,/No D:2068300304 0 11 30 6 LAST NAME RIOS ANDRADE FIRST NAME ERNESTO MIDDLE J 1 2 31 INITIAL STREET ❑ 23020 25TH AVE S APT A301 CITY DES MOINES ST WA 2jp, 98198 z NEW ADDRESS 7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3 INTERLOCK YES[:]NO 1/ INTERLOCKYEs NO�/ YES R No�/ 8❑ LRIIVER # ON DUTY❑ STATUS AIRBAG 3 RESTR 4 EJECT 1 HELMET USE 2 1 CLASS NATURE OF INJURIES z❑ 3 10❑ PIATE14 CLJ2875 sTAr WAuN# 1N4At3AP1JC293230 5 TRAILER STATE TRAILER STATE 11 3 5 PLATE# PLATE# FROM TO TRLR. TRLR 3 7 33 12 2 5 VIN#' VIN# >; FROM TO ❑ VEH.YEAR 2018 NISS ALTIMA P4 MAKE MODEL STYLE VEHICLE TOWED TO BLIN T Y VT.VEHICLE 5 1 DAMAGE GO 34 13 4 YES NO �MEYERS TOWING O No REGISTERED OWNER INFO HORACIO RIOS 21.025THAVE S,APTA301 DES MOINES WA 98198 VEHICLE NO. 1 ❑ SHADE IN DAMAGED AREA 35 14LIABILI INSURANCE INSURANCE CO ALLSTATE 807989704 3 4 IN EFFECT &POLICY# 9TOP VEHCLE CHARGE 5 36 LEGALLY YES❑NO❑ CITATION# 4A0579057 FAIL STOP AT STOP )o BOTTOM 15❑ STANDING 7 6 MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE UNIT VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES 1/ NO D:4 16 a 255298596 LAST NAME HERNANDEZ PAEZ FIRST NAME MATILDE MIDDLE INITIAL 17 STREET❑ NEW ADOREss❑' 1455 S PUGET DR J204 CITY RENTON ST WA ZIP 98055 4❑ 37 18❑ CDL IGNITION REQUIRED IGNITION PR-E-1SENT MEDICAL-T�RANSPORTED � 38 INTERLOCKYES�NO� INTERLOCK YEs It I NOF YES t l NOF,/ 19 DRIVER'S STATE WA SEX F D.C.B. 03 _ 14 1973 39 LICENSE# MMDDYY 20❑ ON DUTY STATUS AIRBAG 3 RESTR 4 EJECT 1 H EET 2 NJAU EY 6 COMPLAINT OF CHEST PAIN ❑F—NATURE OF INJURIES 40 ❑21❑ PLATE# CKS7164 TArE 41 WA vIN# 2T3A1RFV2KW055654 1 42 22❑ PLATE# STATE PLATE# STATE 23❑ VIN#. 43 TRLR RLR 'IN#. GI VEH YEAR 2019 MAKE 7'Oy7' MODEL RAV4 STYLE P4 DAMAGE TOWED✓ NOO BLIN TOWED B GENEMEYERS V ov 44 H TOWING YES Noy/ 24❑ REGISTERED OWNER INFO OWNED SY DRIVER VEHICLE N0.2 SHADEDAMAGEDAREA 3 4 LIABILITY INSURANCE❑ &POINSURGY#E CO STATE FARM 513482OD2347DIN STOP 5 'E""LE ❑ ,J CITATION# CHARGE to BOTTOM LEGALLY YES Nu 25 ' e OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY J 26 D.NELSON 12421 WA0171300 PART A PAGE 01 OF 3000-345-159 OR 11/181 STATE OF POLICETRAFFICN CORRECTION REPORT NO. EF41406 COLLISION REPORT III III III III III 111 1591972 CASE# 24-12167 ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY) NAME MIDDLE INITIAL) GUTIERREZ SANCHEZ JORGE (LAST FIRST, ADDRESS&PHONE# D O.B. ' 15 146TH AVE SE BELLEVUE WA 98007 4254964774 SEX M MMDOYyry 01 - 18 - 1986 PASSENGER WITNESS UNIT# SEAT AIRBAG' RESTR. EJECT ' HELMET INJURY NATURE OF INJURIES ❑✓ SOS. USE CLASS + NAME '(LAST,FIRST MIDDLE INITIAL) ADDRESS&PHONE# DOB SEX' MMDDYYYY PASSENGER ❑WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET NJURY 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. D.NELSON 11-24-24 08:18 PM INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED APPROVED BY DATE P.SUMMERS 8887 1 121112024 7:00:20 PM BADGE OR ID# ! 12421 CRI#' WA0171300 TIME POLICE DISPATCHED' 7:27 PM TIME POLICE ARRIVED]7:Y7 Pm PART I PAGE IT]OF 4� REPORT NO. EF41406 CASE# 24-12167 OF COLLISION 11/24/24 19:25 OF CbLLI510N NARRATIVE 24-12167 COLL On 11/24/2024 1 was working as a uniformed patrol officer and driving a marked patrol vehicle for the City of Renton. I was dispatched to a two-vehicle collision with unknown injury in the intersection of NE 4th St and Monroe Ave NE Renton/King/WA. I arrived on scene and located both vehicles just west of the intersection. The driver of Unit 1, a gray 2018 Nissan Altima WA/CLJ2875, was identified by his WADL as Ernesto J Rios Andrade DOB: 4/18/1999. Ernesto advised he was driving east on NE 4th and was approaching the intersection when the light turned from yellow to red. Ernesto said that he attempted to make the light and once he entered the intersection, he struck Unit 2. The Nissan had damage to the front bumper and had to be removed from the scene by Gene Meyers Towing. Ernesto was evaluated by RRFA personnel at the scene and cleared. The driver of Unit 2, a blue 2019 Toyota Rav4 WACKS7164/, was identified by her WADL as Matilde Hernandez Paez DOB: 3/14/1973. Matilde said that she was driving north on Monroe Ave NE with a green light, she said as she entered the intersection, she was struck by Unit 1. The damage to Unit 2 was also on the front passenger quarter panel and front bumper. Matilde had a complaint of chest pain and was also evaluated and cleared by RRAF personnel. The Rav4 was removed from the scene by Gene Meyers Towing. Witness Jorge Gutierrez Sanchez DOB: 1/18/1986, advised he saw the collision. He confirmed that The Rav 4 had the green light and was in the intersection when the Nissan collided with it. Based in Ernesto's admission and witness accounts I completed Sector Citation #4A0579057 for Failure to Stop/Yield at a Marked Intersection RCW 46.61.190. This citation should be mailed to Ernesto at his DOL address. Nothing further. I certify under penalty pf perjury under the laws of the State of Washington that the foregoing is true and correct. D. Nelson #191 11/24/2024 Renton WA PAGE 3 OF 4 REPORT NO. EF41406 CASE# ' 24-12167 DATE AND TIME 11/24/24 19:25 OF COLLISION s t srtt's � 4 y t< Y V t PAGE 4 OF 4