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HomeMy WebLinkAbout24-11672 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 5 27c COLLISION REP FIT 1591971 CASE 24-11672 z INTERSTATE ❑ CITY STREET FIRE ❑RESULTED 1 STOLEN STATE ROUTE ❑ OTHER ❑ VFHIC;I F ❑ LOCAL AOENC 4200 3 HIT&RUN CODING COUNTY RD PRIVATE WAY INVOLVED 2 1 TOTAL#OF OBJECT 1 1 8 28 TRIBAL UNITS 02 STRUCK RESERVATION z 3❑ DATE OF M M D D Y Y Y Y TIME(2400) COUNTY# MILES N E IN CITY# ❑ COLLISION'. 11 - 10 - 2024 1321 17 ❑.❑ S 8 W H OF e 1070 3 4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓ SUNSET BLVD N BLOCK NO. e✓ 200 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:2069543797 0 81 30 6❑ LAST NAME CUEVAS ORTIZ FIRST NAME BRENDA MIDDLE A 1 2 31 INITIAL STREET ❑✓ 2000 NE 16TH ST CITY RENTON ST WA ZIP 98056 z NEW ADDRESS 7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3 iNTERLOCKYEs NO 1/ INTERLOCKYEs NO�/ YES R No�/ 8❑ LDRIVER # STATE WA SEX'F MID .O B 02 1- 16 - 1985 2 32 9 ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 HELMETU E 2 CLASS 1 NATURE OF INJURIES z❑ 3 10❑ P1 aT�S� C17719L sTAr� WAvIN# 1C6JJFBG1ML526856 TRAILER STATE TRAILER STATE 11 3 5 PLATE# PLATE# FROM TO FT -R TPILF1 1 5 33 12 3 5 VIN#j VIN# FROM TO ❑ VEH.YEAR 2021 JEEP GLADIA PK MAKE MODEL STYLE VEHICLE TOWED fn TO VBLINJ TOWED BY I GOVT.VEHICLE J 9 34 DAMAGE YES NO 13 4 YES[:] No REGISTERED OWNER INFO LUISSANTANA 5210 E F ST TACOMA WA 98404 VEHICLE NO. 1 ❑ SHADE IN DAMAGEDAREA 35 14 LIABILITY INSURANCE❑ INSURANCE CO <53 4IN EFFECT &POLICV# Q vEHICL CHARGE 536 LEIF" YES❑NO CITATION# 4AO092401 OP MOT VEH W/OUT INSURANCE 15❑ STANDING 7 MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE 16 a UNIT 02 VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES 1/ NO D:2069144789 LAST NAME CONNOR FIRST NAME RECCO MIDDLE I D INITIAL 17 STREET❑ NEW ADDRESS❑' 257INDEX PL SE CITY RENTON ST WA ZIP 98056 4❑ 37 18❑ CDL IGNITION REQUIRED IGNITION PtR-E-S1ENT MEDICAL-T�RANSPORTED ❑ 38 INTERLOCKYES�NOR INTERLOCK YEs I I NOF YEs t l NO❑ 19 DRIVER # INJURY1 NATURE OF INJURIES 40 20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 USE CLASS ❑ LICENSE I ❑21❑ PLA E# BNW4066 TAre 41 WA VIN# STDYZ3DC4KS978869 1 42 22❑ PLATE# STATE PLATE# STATE TRLR 23❑ UIN#. IN#. 43 RLR ' VEH YEAR 2019 MAKE TOYT MODEL SIENNA STYLE VN VEHICLETOWED TO BLIN TOWEDBY GOV HI 44 L4❑ DAMAGE YES NO YES NO REGISTERED OWNER INFO RECCO CONNOR 257 INDEX PL SE RENTON WA 98056 D:2069144789 VEHICLE NO.2 SHADE IN DAMAGEbAREA 2 3 Cd LIABILITY INSURANCE INSU8 PORGY#E CO ALLSTATE 976501508IN I STOP VEHICLE CITATION# CHARGE 25❑ i o BOTTOM LEGALLY YES NC� s OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY 26 PHILIP DAVIS 12018 WA0171300 PAGE 01 OF PART A 3000-345-159 OR 11/181 STATE OF POLICETRAFFICN CORRECTION REPORT NO. EF42887 COLLISION REPORT III III III III III 111 1591972 CASE# 24-11672 ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY) NAME MIDDLE INITIAL) SICAN DAYRA (LAST FIRST, ADDRESS&PHONE# D O.B. ' TACOMq SEXi F MMDDYYYY 02 - 04 - 2016 PASSENGER WITNESS UNIT# SEAT AIRBAG' RESTR. EJECT ' HELMET INJURY NATURE OF INJURIES ❑✓ 1 POS. 3 2 4 1 USE CLASS 11 NAME (LAST,FIRST,MIDDLE INITIAL) PITERA SARAH D ADDRESS&PHONE# D O B RENTON SEX U M.:DO DDvvvy 08 _ 19 _ 1978 SEAT HELMET I INJURY NATURE of INJURIES PASSENGER Z WITNESS UNIT# 2 pOS 4 AIRBAG 2 RESTR. 4 EJECT 1 USE CLASS 1 NAME (LAST FIRST,MIDDLE INITIAL) CONNOR CAMERON D AppREss&PHONE# RENTON SEX U 07 14 _ 2016 . D.O.B.I. _ MDDYYYY PASSENGER WITNESS UNIT# ! 2 SEAT 3 AIRBAG 2 RESTR. 4 EJECT 1 HELMET NJURY 1 NATURE OF INJURIES ❑ SEAT USE CLASS NARRATIVE' 24-11672 On 11-10-24 around 1323hrs I dispatched to a collision in the 200 block of Sunset Blvd N, Renton, King Co, WA. Initial information was vehicles, C17719L/WA-unit 1, and BNW4066/WA-unit 2, were in a collision in the southbound lanes and pulled into the parking lot of 209 Sunset Blvd N. On arrival I observed moderate damage to the rearend of unit 2 and minor damage to the frontend of unit 1. I contacted both involved drivers, Brenda A Cuevas Ortiz 2-16-85 (unit 1) and Recco D Connor 11-11 -78 (unit 2), who advised the following. Unit was stopped behind several cars at a red light in lane 3 of southbound Sunset Blvd N. Then, unit 1 collided into unit 2 from behind. Brenda advised her foot slipped from the brake to the gas as she approached unit 2. All occupants of both vehicles were checked and cleared by RFA on scene, and both vehicles were drivable. Brenda was unable to provide valid proof of insurance and citation 4AO092401 was mailed to her provided address. I declare under penalty of perjury under the laws of the State of Washington that the foregoing is true and correct. Electronically signed by P Davis 12018 on November 10, 2024 at 14:26 hours in Renton, WA. I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT. PHILIP DAVIS 11-10-24 02:49 PM INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED APPROVED BY DATE S.WOODWARD 11528 1 12/6/2024 2:34:06 AM BADGE OR ID# 12018 ORI# WA0171300 TIME POLICE DISPATCHED; 1:23 PSI TIME POLICE ARRIVED 1:28 PM PART I PAGE IT]OF 4] STATE OF POLICETRAFFICN CORRECTION REPORT NO. EF42887 COLLISION REPORT III III III III III 111 1591972 CASE# 24-11672 ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY) NAME MIDDLE INITIAL) PITERA JOANN (LAST FIRST, ADDRESS&PHONE# D O.B. RENTON SEX U MMDDYYYY 06 - 26 - 1950 {� SEAT HELMET INJURY NATURE OF INJURIES PASSENGER ZWITNESS�'UNIT# 2 POS 6 AIRBAG 2 RESTR. 4 EJECT 1 USE CLASS 7 HEAD/NECK NAME (LAST,FIRST,MIDDLE INITIAL) ADDRESS&PHONE# DOB SEX MM o.YB., PASSENGER ❑WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET NJURY NATURE OF INJURIES POS. USE CLASS NAME (LAST FIR57 MIDDLE INITIAL) AppRESS&PHONE# SEX D.O.B. MMDDYYYY. PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET NJURY NATURE OF INJURIES ❑ ❑ POS. USE CLASS ----� NARRATIVE' 24-11672 On 11-10-24 around 1323hrs I dispatched to a collision in the 200 block of Sunset Blvd N, Renton, King Co, WA. Initial information was vehicles, C17719L/WA-unit 1, and BNW4066/WA-unit 2, were in a collision in the southbound lanes and pulled into the parking lot of 209 Sunset Blvd N. On arrival I observed moderate damage to the rearend of unit 2 and minor damage to the frontend of unit 1. I contacted both involved drivers, Brenda A Cuevas Ortiz 2-16-85 (unit 1) and Recco D Connor 11-11 -78 (unit 2), who advised the following. Unit was stopped behind several cars at a red light in lane 3 of southbound Sunset Blvd N. Then, unit 1 collided into unit 2 from behind. Brenda advised her foot slipped from the brake to the gas as she approached unit 2. All occupants of both vehicles were checked and cleared by RFA on scene, and both vehicles were drivable. Brenda was unable to provide valid proof of insurance and citation 4AO092401 was mailed to her provided address. I declare under penalty of perjury under the laws of the State of Washington that the foregoing is true and correct. Electronically signed by P Davis 12018 on November 10, 2024 at 14:26 hours in Renton, WA. I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT. PHILIP DAVIS 11-10-24 02:49 PM INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED APPROVED BY DATE S.WOODWARD 11528 1 12/6/2024 2:34:06 AM BADGE OR ID# 12018 ORI# WA0171300 TIME POLICE DISPATCHED; 1:23 PSI TIME POLICE ARRIVED 1:28 PM PART I PAGE IT]OF 4] REPORT NO. EF42887 CASE# ' 24-11672 DATE AND TIME 11/10/24 13:21 OF COLLISION k PAGE 4 OF 4