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HomeMy WebLinkAbout24-12381 IT si " II IIIII III IIIII II IIII IIIII I . 27c REPORT NO EF49250OLCERA COLLISION REPORT 1591971 CASE# 24-12381 2 INTERSTATE CITY STREET FIRE ❑ RESULTED 1 STATE ROUTE OTHER STOLEN ❑ ❑ VEHICLE ❑ LOCALANG 3 HIT&RUN C©DIN6 COUNTY RD PRIVATE WAY INVOLVED 2 TOTAL#OF OBJECT 1 s 28 TRIBAL UNITS 02 STRUCK RESERVATION : 1 1 2 3I M M D D Y Y Y Y TIME(2400) COUNTY# MILES CITY# eaCLson' 12 - 01 - 2024 0946 17 =.= S 8 W e IN e 1070 s 4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓ RAINIER AVE N BLOCK NO. e 200 .� 4a❑ MILE POST ❑ DISTANCE OF(REFERENCE OR CROSS STREET) 5 2001.1 00 FEET e✓ S 8 W e AIRPORT WAY 0 1 29 MOTOR PEDAL- DAMAG THRESHOLD MET PHONE UNIT 01 VEHICLE ❑ CYCLE ❑ YES No �/ D:4255258566 0 9 30 5 LAST NAME GONZALEZ CAMPOS FIRST NAME JUAN MIDDLE P 1 1 2 31 INITIAL STREET ❑ 311 NW 6TH ST CITY; RENTON ST I WA ZIP, 98057 2 NEW ADDRESS 7 CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED' 3 INTERLOCKYEs NOR] INTERLOCKYEs No�/ YEs NO✓ 8❑ DCIENSE# STATE WA SEXI M MMDDYY' 03 — 11 — 2004 1 1 2 32 9 ON DUTY STATUS' AIRBAG 2 RESTR 4 EJECT 1 HELMET 2 CLASSY 1 [NATURE of INJURIES 2 LICENSE, CFE9224 STATE WA VIN# JH4CL96944C045928 3 10 Fq I as ATP rt TRAILER STATE TRAILER STATE 11 3 5 PLATE# PLATE# lE.M To TRLR zRLR. 1 5 33 12 3 5 VIN# vIN# FROM TO VEH.YEAR 2004 MAKE ACUR MODEL TSX STYLE SD VEHICLE TOWED TO BLIN TOWED By G VEHICLE 9 9 34 13 DAMAGE YES NO YESES) NO REGISTERED OWNER INFO OWNEDBYDRIVER VEHICLE NO. 1 SHADE IN DAMAGED AREA 35 14❑ LIABILITY INSURANCE❑ NSURANCE CO N/A 2 3 4 IN EFFECT &POLICY srgNOLNG ❑ ❑ 4AO043187 CHARGE OP MOT VEH W/OUT INSURANCE s ooTro6 36 Yes NO CITATION# 15 MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE UNIT O2 VEHICLE CYCLE nWNFR YES NO �/ D:2066969252 16� LAST NAME DO FIRST NAME QUAN MIDDLE' D INITIAL 17 F1 STREET ❑ 8319 WABASH AVE S STE F CITY SEATTLE ST, WA ZIP 98118 37 NEW ADDRESS I I I ❑ 18❑ CDL IGNITION REt]UIRED IGNITION PRESENT MEDICAL TRANSPORTED' 38 INTERLOCKYES ND INTERLOCK YES NO YES No 19 DRIVER'S ' MMDDYY — 20❑ ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 R U ET 2 INJURY 1 NATURE OF INJURIES 40 SS 21[ PLATE# CFU7444 rare WA vIN# 2T3A1RFV4KC014458 41 22❑ PLATE# STATE[TILER I PLATE# STATE 42 43 23 VfN RLR UIN#. 'IN# VEH.YEAR 2019 MAKE TOYT MODEL RAV4 STYLE UT VEHICLE TOWED TO BLIN TOWED BY GOV HI 44 24 DAMAGE YES NO NO REGISTERED OWNER INFO OWNED BY DRIVER VEHIC>'LE NQ.2 SHADE IN DAMAGED AREA 2 3 4 LIABILITY INSURANCE INSURANCE CO GEICO 6060-46.70.88 IN EFFECT &POLICY# STOP LVEHICLE '—LY YES N CL] CITATION# CHARGE CID BOTTOM LEGALL 25 s e OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY 26 JACOB WEBER 12532 WA0171300 PAGE 01 OF PART A 3000-345-189(R 11/18) STATE OF POLICETRAFFICN CORRECTION REPORT NO. EF49250 COLLISION REPORT III III III III III 111 1591972 CASE# 24-12381 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 CLASS 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 CLASS ----� :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 PC& 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. JACOB WEBER 12-01-24 11:32 AM INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST.DET DATED PLACE SIGNED APPROVED BY DATE P.KORDEL 9676 1212312024 9:03:48 AM BADGE OR ID# 12532 ORI# WA0171300 TIME POLICE DISPATCHED 1 9:54 AM TIME POLICE ARRIVED i 9:56 AM PAST B 3 Do-3m5—attar(t 1Mff) PAGE 2�OF 4 REPORT NO. EF49250 CASE# 24-12381 DATE OF COLLI r�510NN + 12/01/24 09:46 L1 NARRATIVE Unless otherwise noted, all events took place in the City of Renton, in the County of King, in the State of Washington. This incident was captured on my body worn video camera and in-car cameras. This report is a summary of events that occurred and is not an exact sequencing of events. On December 1 st, 2024, at approximately 0954 hours I was dispatched to a two-vehicle non-injury collision at Rainier Ave N and Airport Way. I arrived on scene, locating both vehicles in the 200 block of Rainier Ave N, in the southbound lanes. I contacted driver 1 (later identified as Juan P Gonzalez Campos DOB 03/11/2004, verified via WADL) and driver 2 (later identified as Quan D Do DOB 09/14/1966, verified via WADL). Driver 1 advised he had let his foot off the brake of his 2004 Acura TSX (WA LIC: CFE9924/ Unit 1) and rolled into the back of driver 2's 2019 Toyota Rav4 (WA LIC: CFU7444/ Unit 2) which was stopped for traffic. Driver 2 advised he was stopped for traffic when Unit 1 rolled into the back of his vehicle. There were no injuries, and the damage was extremely minimal. I collected the involved parties information and was advised by Driver 1 he did not have insurance. When asked why, he advised it was too expensive when he had last looked to get it. I helped facilitate an exchange of information. I cited the driver of Unit#1 in-person for violating RCW 46.30.020 -Liability Insurance as no person may operate a motor vehicle subject to registration under chapter 46.16A RCW in this state unless the person is insured under a motor vehicle liability policy with liability limits of at least the amounts provided in RCW 46.29.090, is self-insured as provided in RCW 46.29.630, is covered by a certificate of deposit in conformance with RCW 46.29.550, or is covered by a liability bond of at least the amounts provided in RCW 46.29.090. Proof of financial responsibility for motor vehicle operation must be provided on the request of a law enforcement officer in the format specified under RCW 46.30.030. 1 certify (declare) under penalty of perjury under the laws of the State of Washington that the foregoing is true and correct. Electronically signed by Officer J. Weber#12532 12/01/2024 1124 Hours Renton, King County, Washington PAGE 3 OF 4 REPORT NO. EF49250 CASE# 24-12381 DATE AND TIME 12/01/2409:46 OF COLLISION ks 'It err r �;1 PAGE 4 OF 4