HomeMy WebLinkAbout24-12861 �oLce RaiTFFi " II (II IIII I III I I IIII III II I 5 3 27c REPORT NO. EF47141
"i ,one COLLISION REP F 1591971
CASE# 24-12861 2
INTERSTATE CITY STREET FIRE ❑
RESULTED
1 STOLEN
STATE ROUTE �✓ OTHERF-I VFHICI.F LOCAL AGENCY 4100 3[�
HIT 8 RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 TRIBAL TOTAL UN 75#OF OBJECT 1 STRUCK 1 8 28
02 METAL SIGN POST
RESERVATION 2
3 M M D D Y Y Y Y TIME I2400) COUNTY# MILES CITY#
coA spry 12 - 16 - 1 1922 17 �.� S e W 8 OF 8 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
MAPLE VALLEY HWY BLOCK NO.
8 1700 .�
4a❑ MILEPOST
❑ DISTANCE OF(REFERENCE OR CROSS STREET)
5 1.= FEET e S e W 8 ?405
0 1 29
MOTOR PEDAL- DAM ETHRESHOLD MET PHONE
UNIT 01 VEHICLE CYCLE YES ,/No D:4153193269 0 4 30
6 LAST NAME WHITE FIRST NAME RIKKI MIDDLE' R 1 2 31
INITIAL
STREET F-1' 306 VISTA AVE 5 CITY PASADENA 91107 z
NEW ADDRESS S7 CA 21p
7❑ COL IGNITION REQUIRED IGNITION PRESENT MEDICAL-1 NOFORTED 3
INTERLOCK YES No,/ INTERLOCKYES NO YES Na,/
DCENSE# STATE CA SEX' MMDD
F W 07 - 25 - 1996 1 1 2 32
8❑
9 ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 HELMET
L E7 SS 2 I A Y ? NATURE OF INJURIES 2
10 1❑ PiCn NSE 8ABX212 STATE CA WIN#' KNAFX4A6?G5603937 3
11 2 5 PLATE# STATE TRAIPLA7I# STATE ROMRAILER
To
TRLR TRLR. 3 7 33
12 2 5 VIN#' vIN#
FROM TO
13 3 VEH.YEAR2016 MAKE KIA MODEL FORTE STYLE P4 VEHICLETOWEED2NOn fBLIN 9NED.4LRS�OW/NG GOVT.VEHIICL✓ ] 1 34
❑ DAMAGE II1I�_IIII tlAlVt(t ccJllu—'II
REGISTERED OWNER INFO OWNED BY DRIVER VEHICLE NO. 1
SHADE 1N DAMAGED AREA ❑ 35
3 LIABILITY INSURANCE INSURANCE CO 2 3 4
14 CONNECT PROPERTY BX12112567
IN EFFECT &POLICY# 4TOP _
VEHICLE CHARGE 5 ❑ 36
EGALIrano v YES❑NO❑ CITATION# 10 ftOTTOM
15❑ s wc 6
MOTOR � PEDAL- I�I PROPERTY M THR OLD MET PHONE
UNIT QZ ICJ �( PEDESTRIAN ❑ OIL HO 4255432559
VEHICLE CYCLE OWNER S NO
16�
LAST NAME BOLANOS LINARES FIRST NAME LEONARDO MIDDLE
INITIAL
17� STREET El 3255 115TH AVE NE APT 154 CITY BELLEVUE ST, WA ZIP 98004 4
NEW ADDRESS ❑ 37
18❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDI.CALTRANSPORTED � 38
iNTERLOCKYEs NO INTERLOCK Es N YES No,�
19 DRIVER# STATE WA SEX M MMO"'L 09 19 2005 39
F—NATURE OF INJURIES
20 ON DUTY STATUS AIRBAG $ RESTR 4 EJECT 1 HELMET
2 CLASS 6 COMPLAINT OF PAIN TO LEFT EAR 40
❑21[ PLATE CRJ5053 TArE,WA vIN# KNAFK4A6XE5063869 41
1
42
22 PLATE#TRAILER STATE PLATE TRAILER STATE
23 43
TRLR RLR
VIN#. '[N#,
VEH.YEAR 2014 MAKE K/A MODEL FORTE STYLE p4 VEHICLE TOWED TO BLIN
TOWED BY GO HI 44
24= DAMAGE YES�/ NO BANKERS TOWING YEs No�/
REGISTERED OWNER INFO VICTOR BOLANOS MARTINEZ 3255115THAVE NE,APT 154 BELLEVUEWA98004 D:4255432559 VEHICLE NO.2
SHAD DAMAGED AREA
LIABILITY INSURANCE INSURANCE CO GEICO 6094-09-42-54 S 4
IN EFFECT &POLICY# 4TOP 5
Venice ❑ CL] CITATION# CHARGE
25 tO BOTTOM
LEGALLY YES N J
e
7DNE
'S NAME(PRINT) OFFICER PHONE BADGE OR ID# JAGENCY
26
SON 12421 WA0171300
PART A . PAGE 01 OF
9000-345-159(R 11(181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EF47141
COLLISION REPORT III III III III III 111
1591972 CASE# 24-12861
E NA ADDITIONAL PERSONS INVOLVED(PASSENGERS AND/OR WITNESSES ONLY)
M
(LAST,FIRST,MIDDLE INITIAL) BOLANOS LINARES AUBRICK
ADDRESS&PHONE# D�
3255 115TH AVE NE,APT 154 BELLEVUE WA 98004 4255432559 SEX' MMDDYYYY 07 - 12 - 2004
SEAT HELMET NJURY NATURE OF INJURIES
PASSENGER Z WITNESS[] UNIT# 2 POS 3 AIRBAG j 3 RESTR. 4 EJECT 1 USE 2 CLASS '6 COMPLAINT OF PAIN TO STOMACH
:NAME
(LAST FIRST MIDDLE INITIAL)
ADDRESS R PHONE#
SEX D.O.B. -
MMDDYYYY
PASSENGER❑WITNESS UNIT# : SEAT AIRBAG RESTR. EJECT HELMET INJURY: NATURE OF INJURIES
POS. USE CLASS ----�
:NAME
(LOST,FIRST,MIDDLE INITIAL)
ADDRESS&PHONE#
SEX MMDDYY D.O.B.
YY
PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET INJURY NATURE OF INJURIES
❑ ❑ POS. I 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 12-16-24 08:30 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST.DET DATED PLACE SIGNED
APPROVED BY DATE
P.SUMMERS 8887 1211712024 8:44:54 PM
BADGE OR ID# 12421 ORI#' i WA0171300 TIME POLICE DISPATCHED; 7:24 Pry/ TIME POLICE ARRIVED i 7:31 PM
PART B 3000-345.160(R1Vt8) PAGE F2 --]OF 47
REPORT NO. EF47141 CASE# 24-12861 OF COLLI ION 12/16/24 19:22
OF COLLISION
NARRATIVE
24-12861 COLL
On 12/16/2024 1 was working as a uniformed patrol officer and driving a marked patrol vehicle for the
City of Renton. 1 was dispatched to a report of a two-vehicle collision with no injury in the intersection
of Maple Valley Highway and the northbound 1405 on-ramp Renton/King/WA.
I arrived on scene and located a gray 2016 Kia Forte CA/8ABX212 with damage to the front bumper
and front driver side quarter panel. The driver, who was identified by her CA driver's license as Rikki
R White DOB7/25/1996. Rikki said that she was driving westbound on Maple Valley Highway in the
#2 lane. She said that she was not paying attention to the lights and ran a red light when she struck
Unit 2. Bankers Towing removed the Kia from the scene.
I then spoke with Leonardo Bolanos Linares DOB: 9/19/2005 who was the driver of Unit 2, the black
2014 Kia Forte WA/CRJ5053. Leonardo said that he was turning north onto the 1405 NB on-ramp
from the eastbound turn lane with a green light when he was struck by Unit 1. There was damage to
the entire front bumper of Unit 2 and both the driver and passenger front airbags had deployed. The
Kia had come to a rest against a metal street sign on Maple Valley Highway, there was no damage to
the sign. Leonardo said he had a complaint of pain to his left ear and his passenger, Audrik Bolanos
Linares DOB: 7/12/2024, had a complaint of paint to his abdomen. Both declined aid and Bankers
Towing removed the Kia from the scene.
Both parties were provided with an exchange of information and released from the scene.
Nothing further.
I certify under penalty of perjury under the laws of the State of Washington that the foregoing is true
and correct.
D. Nelson #191 12/16/2024 Renton WA
PAGE 3 OF 4
REPORT NO. EF47141 CASE# 24-12861 DATE AND TIME 12/16/2419:22
OF COLLISION
, c
It
i
1.
tt
I
a
L
Y v
PAGE 4 OF 4