HomeMy WebLinkAbout24-12171 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 1 27c
COLLISION REP FIT 1591971
CASE 24-12171 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 01 STRUCK
RESERVATION
z
3❑ DATE OF M M D D Y Y Y Y TIME(2400) COUNTY# MILES N E IN CITY# ❑
GawsloN 11 - 1-- 2024 2320 17 ❑.= S 8 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❑ 200 00 FEET MILES e S B W e N 7TH ST
0 1 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
✓NO D:2064169577 30
6� LAST NAME GONZALEZ FIRSTNAME ERVIN MIDDLE A 1 1 2 31
INITIAL
STREET ❑✓ 7227 S 128TH ST TTLE WA
NEW ADDRESS S7 zIP', 96178 2
CITY SEA
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
iNTERLOCKYEs NO 1/ INTERLOCKYEs NO�/ YES R No�/
8❑ LRIIVER #
ON DUTY❑ STATUS AIRBAG 1 RESTR 4 EJECT 1 H USE 2 1 CLASS NATURE OF INJURIES z❑
3
10❑ P1 ATE 14 CKT8466 STATE WA v N# 1 C4NJPBA5ED893753
11[-jTRAILER STATE TRAILER STATE
11 0 0 PLATE# PLATE# IRM ro
TRLR. TRLR. 5 1 33
12❑ VIN#' VIN#.
Rom 34
13❑ VEH.YEARN MAKE JEEP MODEL PATRIO STYLE SD VEHICLE TOWED 0 TOO
ffBLIN TQVWkkRS yOS❑ENO
DAMAGE ILJI tSA1Vi�6
REGISTERED OWNER INFO ERVIN GONZALEZ 7227 S 128TH ST SEATTLE WA 98178 D:2064169577 VEHICLE NO. 1
SHADE IN DAMAGED AREA 35
2 3 4
14 IN EF ITCY INSURANCE❑
INSURANCE CO
IN EFFECT &POLICY# � 9TOP
VEHCLE CHARGE 36
LEGALLY YES❑NO❑ CITATION# 10 BOTTOM
15❑ STAINDIING 8
UNIT U2 vEHIMOTOCLE ❑ CYCLE ❑ PEDESTRIAN ❑ OWNFR PEDAL RTY ❑ DYES NO OLD MET PHONE
16❑
LAST NAME FIRST NAME MIDDLE
INITIAL
STREET
CITY' ST ZIP 4❑ 37
17❑ NEW ADDRESS❑'
18❑ CDL IGNITION REQUIRED IGNITION PtR—E—S1ENT MEDICAL—T�RANSPORTED ❑ 38
INTERLOCKYES�NOR INTERLOCK YEs I I NOF YEs t l NO❑
19 LLIICENS # STATE SEX 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
LIABILITY
INSURANCE❑ INSURANCE
#E CO
IN EFFECT &PO I VE—LE ❑ ,J� CITATION# CHARGE
25 GQ
LEGALLY YES N`L J
s � e
=AS
NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
26 GOODWIN 12884 WA0171300
PART A PAGE 01 OF C7
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EF41407
COLLISION REPORT III III III III III 111
1591972 CASE# 24-12171
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'
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.
NICHOLAS GOODWIN 11-25-24 12:51 AM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
P.SUMMERS 8887 121112024 7:00:13 PM
BADGE OR ID# ! 12884 (DR]# WA0171300 TIME POLICE DISPATCHED', 11:21 PM TIME POLICE ARRIVED',11:23 PM
PART I PAGE IT]OF 4�
REPORT NO. EF41407 CASE# 24-12171 OF COLLISION
11/24/24 23:20
OF CbLLI510N
NARRATIVE
24-12171
Unless otherwise noted, the following took place within the city limits of Renton, County of King, WA.
On 11/24/2024 at approximately 2321 hours, I was dispatched to an unknown accident in front of Top
Golf, located at 780 Logan Ave N. Dispatch advised "ON LOGAN...1 AGO...JEEP VS LAMP
POST...4 PEOPLE STANDING AROUND VEH, UNK INJS".
I arrived on scene from south of the collision and observed a single vehicle collision involving a Jeep
Patriot. The vehicle was in the northbound lanes, facing southbound, with the rear driver's side tire
over the curb on the east sidewalk.
I approached and observed heavy damage to the rear driver's side quart panel. The rear driver's tire
was flat, the wheel was bent inward, and parts of the bumper were hanging off. I did not see damage
anywhere else, no air bag deployment and no intrusion near the driver's compartment.
Further, the vehicle had knocked over a light pole (#945C95) on the east sidewalk in front of Top
Golf. The pole was broken at the base, fell to the north and was laying parallel to the sidewalk.
Standing on the sidewalk were three subjects who spoke Spanish. Through language line 1 identified
the driver as Ervin A. Gonzalez (09/17/1997) and verified via his passport.
Speaking with Ervin I gathered the following:
He was driving northbound on Logan Ave N, obeying the speed limit, when he was blinded by a
vehicle's headlights that was traveling southbound on Logan Ave N. Ervin was momentarily blinded
and then fainted. He woke up momentarily and realized he was spinning out of control and then
fainted again. When he woke up the second time, he realized he had collided with the light pole.
Ervin advised he was not speeding and was simply distracted and suffered a medical condition
immediately prior to the collision.
Speaking with Ervin, I did not observe him to be experiencing any medical issues. I asked Ervin if he
would like to be evaluated by RRFA and he expressed that he was now totally fine and suffered no
injuries.
I discovered the registered owner of the vehicle is a friend of Ervin's who is currently out of the
country, so I was unable to verify if Ervin had permission to take the vehicle. The vehicle is not
reported stolen. Ervin does not have insurance for the vehicle, and he was unsure if the registered
owner has insurance for the vehicle either.
I advised Ervin that he would be receiving citations in the mail for Driving Without A License
(46.20.015), and Driving Without Insurance (RCW 46.30.020).
1 am unable to prove whether Ervin's story of events was legitimate. There were witnesses that
observed the collision.
Ervin was provided a case number and the vehicle was towed by Bankers Towing to Ervin's
residence in Seattle.
Nothing further.
I certify under penalty of perjury under the laws of the State of Washington that the foregoing is true
and correct.
Electronically signed by Officer N. Goodwin 12884 at 0029 hours on 11/25/2024 in Renton, WA.
PAGE 3 OF 4
REPORT NO. EF41407 CASE# ' 24-12171 DATE AND TIME 11/24/24 23:20
OF COLLISION
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