The URL can be used to link to this page

Home My WebLink About24-13054 iiTFiNII IIIII III IIIII II IIII IIIII I . 27c REPORT NO EF48856oc� RA COLLISION REPORT 1591971 CASE# 24-13054 2 INTERSTATE CITY STREET FIRE I RESULTED STOLENSTATE ROUTE OTHER VEHICLE LOCCOAGENCY 4200 3 HIT&RUN CODING COUNTY RD PRIVATE WAY INVOLVED 2 TOTAL#OF OBJECT 1 s 28 TRIBAL UNITS 03 STRUCK RESERVATION : 1 1 2 3� M M D D Y Y Y Y TIME(2400) COUNTY# MILES CITY# eaCL s on' 12 - 21 - 2024 2334 17 =.= S 8 W e OF IN e 1070 s 4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑ S 43RD ST BLOCK NO. e 400 .� 4a❑ MILE POST ❑ DISTANCE OF(REFERENCE OR CROSS STREET) 5 C------ 1.1 FEET e S 8 W e TALBOT RD S 0 1 29 MOTOR PEDAL- DAMAG THRESHOLD MET PHONE UNIT 01 VEHICLE ❑ CYCLE ❑ YES No �/ D:2532506018 0 8 30 6 LAST NAME RIOS MENDOZA FIRST NAME ELMER MIDDLE E 1 1 2 31 INITIAL STREET ❑ 9415 S 213TH PL CITY; KENT I ST WA ZIP; 98031 2 NEW ADDRESS 7 CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3 INTERLOCKYES NO✓ INTERLOCKYES NO✓ YES NO✓ 8❑ DCIENSE# STATE WA SEXI M MMDDYY' 07 - 02 - 1977 1 2 32 9 ON DUTY STATUS' AIRBAG 2 RESTR 9 EJECT 1 N USEET INJUR CLASSY 14 1 NATURE of INJURIES 2 10 LI ENSE', BGN8454 STATE WA VIN# 1FMCU041X4KA63293 3 TRAILER STATE TRAILER STATE ROM TO 11 0 0 PLATE# PLATE# TRLR TRLR 3 1 7 33 12 0 0 VIN#' VIN# FROM TO VEH.YEAR 2004 MAKE FORD MODEL ESCAPE STYLE 4D VEHICLE TOWED TO BLIN TOWED By GES VEHICLE 9 9 34 13 DAMAGE YES ✓ YES NO✓ REGISTERED OWNER INFO ELMER RIOS MENDOZA 9415 S 213TH PL KENT WA 98031 D:2532506018 VEHICLE NO. 1 SHADE IN DAMAGED AREA 35 14 LIABILITY INSURANCE❑ NSURANCE CO NONE NONE 3 4 IN EFFECT &POLICY srgNOLNG ❑ ❑ 4A0911448 CHARGE OPERATING MOTOR VEHICLE s I000Tro6 36 ves NO CITATION# 15 MOTCYR ✓ PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE UNIT VEHICLE CYCLE nWNFR YES NO �/ D:2063905845 16� LAST NAME NGUYEN FIRST NAME HINH MIDDLE C INITIAL 17 F1 STREET ❑ 4623 S FONTANELLE ST CITY' SEATTLE ST, yyq ZIP 98118 4 37 NEW ADDRESS ❑ 1$❑ CDL IGNITION REQUIREfl IGNITION PRESENT MEDICAL TRANSPORTED' 38 INTERLOCKYES No✓ JNTERLOGKYES No✓ YEs NO✓ 19 DRIVER'S ' STATE WA SEXI U D.O.B. 1 07 04 1997 � 39 LICENSE# MMDDYY - 20❑ ON DUTY STATUS AIRBAG 2 RESTR 9 EJECT 1 R USE CLASSY 1 NATURE OF INJURIES 40 21 LICENSLATE# BWW6097 rarE WA vIN# 4T1BF1FK9HU764967 41 22❑ PLATE# STATE[TILER I PLATE# STATE 42 23 TRLR RLR 43 UIN#. 'IN# VEH.YEAR 2017 MAKE TpYT MODEL CAMRY STYLE 4p VEHICLE TOWED TO BLIN TOWED BY GOV HI 44 24 DAMAGE YES NO✓ VES NO✓ REGISTERED OWNER INFO HINHNGUYEN4623 SFONTANELLEST SEATTLE WA 98118 D:2063905845 VEHICLE NO.2 SHADE IN DAMAGED AREA 2 3 4 LIABILITY INSURANCE INSURANCE CO STATE FARM 47.2783-E66 IN EFFECT &POLICY# VEHICLEL'—LY YES❑ N,II CITATION11 CHARGE <E0Da 25 a s OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY 26 J RAYGOZA 12503 WA0171300 PAGE 01 OF PART A 3000-345-189(R 11/18) STATE OF POLICETRAFFICN CORRECTION REPORT NO. EF48856 COLLISION REPORT III III III III III 111 1591972 CASE# 24-13054 ADDITIONAL PERSONS INVOLVED(PASSENGERS AND/OR WITNESSES ONLY) '.NAME (LAST,FIRST,MIDDLE INITIAL) ADDRESS&PHONE SEXi D.O.B. — MMDDYYYY PASSENGERQ WITNESS� UNIT SEAT AIRBAG RESTR. EJECT ; HELMET INJURY NATURE OF INJURIES POS. ' USE GLASS 1 ----� :NAME (LAST FIRST MIDDLE INITIAL) ADDRESS&PHONE# SEX D.O.B. — MMDDYYYY PASSENGER❑WITNESS UNIT# : SEAT AIRBAG RESTR. EJECT HELMET INJURY: NATURECFINJURIES POS. USE CIASS ----� :NAME (LOST,FIRST,MIDDLE INITIAL) ADDRESS&PHONE# SEX MMDDYY D.O.B. YY PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET NJURY NATURE OF INJURIES POS. I USE GLASS 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. J RAYGOZA 12-22-24 03:31 AM INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST.DET DATED PLAGE SIGNED APPROVED BY DATE GREGORY BILLS 12495 12/22/2024 4:37:28 AM BADGE OR ID# 12503 ORI# WA0171300 TIME POLICE DISPATCHED 11:35 PM TIME POLICE ARRIVED i 11:35 PM PAST B 3 Do-3mx—attar(t 1Mff) PAGE 2�OF REPORT NO. EF48856 CASE# 24-13054 OATS OF COLLI r�510NN + 12/21/24 23:34 L1 NARRATIVE Case Number 24-13054 On 12/21/2024 at approximately 2335 hours, 1 responded to Talbot Rd S and S 43rd St within the City of Renton, King County, Washington to a collision with injury. Dispatch relayed over the radio that three vehicles were involved in a collision and all drivers moved their vehicles to the parking lot of Valley Medical Center located at 400 S 43rd St. Renton Fire was started due to one of the drivers complaining of head pain. On arrival 1 contacted Elmer Eulizar Rios Mendoza DOB (07/02/1977) who was the driver of unit 1 identified as a bronze 2004 Ford Escape WA/LIC BGN8454 VIN#1 FMCU041X4KA63293. Elmer provided me with his driver's license and vehicle registration but informed me that he didn't have insurance for his vehicle. Elmer was informed that he was being audio and video recorded and he said that he was driving westbound on SE Carr Rd behind a black sedan and that they were approaching the intersection of S 43rd St and Talbot Rd S. Elmer didn't remember how fast he was going but he said that the light turned red at the intersection and that he attempted to stop but that his vehicle skid and he ended up rear ending unit 2 that was later identified as a black 2017 Toyota Camry WA/LIC BWW6097 VIN#4T1 BF1 FK9HU764967. Both unit 1 and unit 2 sustained minor damage and both drivers appeared to be fine. Officers on scene spoke with the driver of unit 2 who was identified by his WADOL as Hinh Cong Nguyen DOB (07/04/1997) and he stated that he was driving westbound on SE Carr RD approaching the intersection of S 43rd St and Talbot Rd S. Hinh was behind and unit 3 which was identified as a white 2021 Subaru Crosstrek WA/LIC BUY4300 VIN#JF2GTHSC6MH2O1745. Hinh stated that the light at the intersection turned red, so he came to a complete stop but was then rear ended by unit 1 which caused his vehicle to move forward and collide with unit 3. Hinh was later examined by Renton Fire and was cleared medically. Hinh provided all necessary documents and was provided my business card with case number. Hinh's vehicle sustained minor damage to the front and back of the vehicle and unit 1's license plate was stuck in the rear bumper. Officers on scene also spoke with the driver of unit 3 who was identified by his WADOL as Mark Spencer S Sotelo DOB (06/21/1993). Mark stated that he was driving westbound on SE Carr RD approaching the intersection of S 43rd St and Talbot Rd S when the light turned red. Mark stopped his vehicle at the intersection but was then struck from behind by unit 2. Mark's vehicle sustained minor damage and Mark provided me with all the necessary documents. I Mark was not injured, and 1 provided him with my business card and the case number. I returned all documents to the drivers and informed Elmer that he was going to receive a citation in the mail for not having any insurance. I verified Emler's address and phone number and told him that he was free to leave. I asked Mark and Hinh if they had any questions for me before 1 left, and they both said "no". Once all drivers left the location I cleared the scene. This concludes my involvement with this case. I certify (declare) under the penalty of perjury under the laws of the State of Washington that the foregoing is true and correct. Electronically signed J.Raygoza/12503 12/22/2024 0300 Hours Renton, WA. PAGE 3 OF 5 SUPPLEMENTAL REPORT NO. EF48856 POLICE TRAFFIC 1 1 8 27 µ ^'� COLLISION REPORT CASE# 24-13054 t113197 1 COMMERCIAL MOTOR CARRIER INTERSTATE INTRASTATE UNIT# USDOT ICC# VEHICLE TYPE CARGO BODY 3 TYPE 2 ❑ 1 28 CARRIER NAME 3 CARRIER L ADDRESS CITY ST ZIP 4 ❑ NAME # PLACARD NAME IF NO NUMBER SOURCE AXLES + 4a ❑ ADDITIONAL UNITS MOTOR PEDAL- PROPERTY DAMAGE THRESHOLD MET PHONE 5 ❑ UNIT# 3 VEHICLE ( CYCLE ❑ PEDESTRIAN OWNER ❑'. YES NO D:2063533904 0 8 29 LAST NAME SOTELO FIRST NAME MARK MIDDLE. $ INITIAL STREET CITY 30 NFW ADOR#s . 20502 155TH LN E BONNEY LAKE ST WA ZiP gg391 6 ❑ 1 1 2 31 CDL IGNITION REQUIRED PRESENT MECiICALTANSPORTE6'. INTERLOCK YES NO ;INTERLOCK YESLl NO L DRIVER'S WA SEX M D.O.B 06 LICENSE MMDDVY - 21 - 1993 ON DUTY STATUS AIRBAG 2 RESTR. g EJECT 9 HELMET INJURY 1 NAruREofNJURIEs USE ;CLASS 8 ❑ 1 32 LICENSE BUY4300 TAT WA VN JF2GTHSC6MH2O1745 PLATE# 9 TRAILER I I TRAILER L PLATE# STATE PLATE# STATE 0 10 TRLR TRLR VIN.# VIN#. 11 0 0 VEIL YEAR2021 MAKE SUBA MODELCROSST STYLE 4D VEHICLE TOWE E T ABLIN TOWED BY GovT.vEHICI E FROM TO DAMAGE YES NO ✓ YES NO REGISTERED OWNER INFOMARKSOTELO 20502155THLNE BONNEY LAKE WA 98391 D:2063533904 SHADE IN DAMAGED AREA 9 9 33 12 z 3 4 FROM TO INSURANCE CO LIABILITY INSURANCE PROGRESS/VE 988694864 IN EFFECT � &POLICY# � _J7t1P_ m 34 13 YES NOZ CITATION# CHARGE 1080TTOM ecauv sTnNoiNc MOTOR PEDAL_ ' 1:1PROPERTYDAMAGE THRESHOLD MET PHONE 35 14 ❑ UNIT# VEHICLE CYCLE PEDESTRIAN OWNER YES NO 36 15 LAST NAME FIRST NAME NIT AL 16 ❑ STREET �' CITY ST ZIP NEW ADDRFSa CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TANSPGRTED INTERLOCK YES[]NO INTERLOCK YES NO 'YES NO 17 4 37 LICENSE#RIVER'SSTATE MMDD 1 18 ❑ ❑ HELMET 'INJURY NATURE OF INJURIES 38 ON DUTY STATUS AIRBAG RESTR. EJECT USE CLASS.: 19 ❑ LICENSE TAT AN# 39 PLATE# 20 TRAILER+ TRAILER 40 PLATE#.: STATE PLATE# - STATE ❑ 21 ❑ ❑ 41 TRLR TRLR VIN# VIN#Y 42 22 VEH.YEAR MAKE I MODEL I STYLE VEHICLE TOWED DUET ABLIN TOWED BY GOVT.VEHICLE DAMAGE YES NO YES NO 23 REGISTERED OWNER INFO. SHADE IN DAMAC ED AREA 43 2 3 4 LIABILITY INSURANCE INSURANCE CO IN EFFECT I &POLICY# 7c;Q 5. 44 vewc�e ❑ ❑ CITATION# CHARGE 24 I..TF_ YES NO STIWDING 8 3 G 1 CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT. J RAYGOZA 12-22-24 03:31 AM 25 INVESTIGATING OFFICER'S SIGNATURE OFFICER'S PHONE UNIT OR DIST DET DATED: PLACE SIGNED 26 BADGE 1 OR DD# 12503 O#RI WA0171300 APBILLS PROVED BY 12122/202 PAGE OFF 3000-345-013(R 11/18) REPORT NO. EF48856 CASE# 24-13054 DATE AND TIME 12/21/24 23:34 OF COLLISION �zs t Ilk i h )q m S t 4 F} x t� � t r 4 i t S s 1,. � t { w• rs v � t e l q a S} s m, 4 t PAGE 5 OF 5