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HomeMy WebLinkAbout25-2540 IT si " II IIIII III IIIII II IIII IIIII I . 27c REPORT NO EF75718OLCERA COLLISION REPORT 1591971 CASE# 25-2540 2 INTERSTATE CITY STREET FIRE I RESULTED STOLENSTATE ROUTE OTHER VEHICLE LOCAI-A`NG 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 3I M M D D Y Y Y Y TIME(2400) COUNTY# MILES CITY# eaCL s on' 03 - 20 - 2025 1419 17 =.= S 8 W e OF IN e 1070 s 4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑ NE SUNSET BL BLOCK NO. ❑ MILE POST e 4a ❑ DISTANCE OF(REFERENCE OR CROSS STREET) 5 1. FEET e S 8 W e HOQUJAM AVE NE 0 1 29 MOTOR ✓ PEDAL- DAM AG THRESHOLD MET PHONE UNIT 01 VEHICLE ❑ CYCLE ❑ YEs Vl No D:4252155894 0 7 30 6 LAST NAME MEXCANOS RIVERA FIRST NAME KEVIN MIDDLE D 1 1 2 31 INITIAL STREET ] 4300 NE SUNSET BL H5 CITY; RENTON ST WA ZIP; 98059 2 NEW ADDRESS 7� +CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3 INTERLOCK YES ✓NO INTERLOCKVEs Nb✓ YES NO✓ 8 DRIVERCENS # STATE WA SEXI M MMDDYY' 10 - 23 - 2006 1 2 32 9 ON DUTY STATUS' AIRBAG 2 RESTR 4 EJECT 1 N USEET 2 CLASSY 1 [NATURE of INJURIES 2 LICENSE, CHR4310 STATE WA VIN#; 1HGCR2F50FA259755 3 10 Fq I as ATP rt TRAILER STATE TRAILER STATE ROM To 11 3 5 PLATE# PLATE# TRLR TRLR 3 1 7 33 12 3 5 VIN# vIN# FROM TO VEH.YEAR 2015 MAKE HOND MODEL ACCOR STYLE 4D VEHICLE TOWED TO BLIN TOWED By GES VEHICLE 9 9 34 13 DAMAGE YES ✓ YES NO REGISTERED OWNER INFO ELVIS RIVERA RONQUILLO 4300 NE SUNSET BL H5 RENTON WA 98059 VEHICLE NO. 1 SHADE IN DAMAGED AREA 35 4 LIABILITY INSURANCE INSURANCE CO 4 14 FARMERS 2009365569 IN EFFECT &POLICY# 9TOP V""' CHARGE 5 I < 36 LEDgLLY YES❑NO❑ CITATION# t a 60TTOM 15❑ STANDING 7 e MOTOR ✓ PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE UNIT 02 VEHICLE CYCLE nWNFR D:2065136950 16� LAST NAME BALBJNO FIRST NAME LAYLA MIDDLE' $ INITIAL 17 F1 STREET ❑ 5210 NE 16TH ST CITY RENTON ST, WA ZIP 98059 37 NEW ADDRESS I I I I I I ❑ 18❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICALTRANSP©RTED. 38 INTERLOCKYES NO✓ (NTERLOCI£YES NO✓ YES NO✓ 19 DRIVER'S STATE WA SEXI F D.O.B. 07 13 2008 39 LICENSE# MMDDYY — 20❑ ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 H ET 2 INJ 6Y 1 NATURE OF INJURIES 40 21 LICENSECDW6688 TATE I WA VIN# 1N4AZOCP9FC304508 41 22❑ [TILER TAILER PLATE# STATE PLATE# STATE 42 23 TRLR RLR 43 UIN#. 'IN# VEH.YEAR 2015 MAKE pJJ$$ MODEL LEAF STYLE HB VEHICLE TOWED TO BLIN TOWED BY GOV HI 44 24 DAMAGE YES NO✓ VES NO✓ REGISTERED OWNER INFO MARCIO SANTOS 5210 NE 16TH ST RENTON WA 98059 VEHICLE NO.2 SHADE IN DAMAGEAREA 2 3 LIABILITY INSURANCE✓ INSURANCE CO PROGRESSIVE 952876411 IN EFFECT &POLICY# t STOP LVEHICLE '—LY YES� N.I,—I CITATION11 CHARGE to BOTTOM LEGALL 25 a OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY 26 J.TRADER 4553 WA0171300 PAGE 01 OF PART A 3000-345-189(R 11/18) STATE OF POLICETRAFFICN CORRECTION REPORT NO. EF75718 COLLISION REPORT III III III III III 111 1591972 CASE# 25-2540 E NA ADDITIONAL PERSONS INVOLVED(PASSENGERS AND/OR WITNESSES ONLY) M (LAST,FIRST,MIDDLE INITIAL) CALDERON MARTINEZ JESUS E ADDRESS&PHONE N, D� 3612 NE 4TH ST 11 RENTON WA 98059 4255918568 SEXi M M D.O E3.DD' Y 01 - 06 - 2010 PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET INJURY NATURE OF INJURIES Q 3 POS. 3 2 4 1 USE 2 CLASS 1 ---� :NAME Lnsr EIRST,MIDDLE INITIAL) BARRAZA RUIZ GERMAN J ADDRESS R PHONE* D O B 760 REDMOND AVE NE RENTON WA 98059 4259700446 SEX M MM DDYYvr 05 - 29 _ 2008 SEAT HELMET INJURY NATURE OF INJURIES PASSENGER a WITNESS UNIT# 3 POS. ' 9 AIRBAG 2 RESTR. 4 EJECT 1 USE 2 CLASS 1 ----� :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 CLASS NARRATIVE On 03-20-2024 at approximately 1419 hours, Unit Three was stopped for traffic WB on NE Sunset BL just west of Hoquiam AVE NE. Unit Two was stopped directly behind Unit Three and remained slightly in the intersection of Hoquiam AVE NE. Unit One was driving NB on Hoquiam AVE NE and turn left WB on NE Sunset BL. The driver who was identified with a WA State License as Mejicanos Rivera, Kevin D 10-23-2006, said he reached down to turn the volume down on his car and when he looked up traffic had stopped. Mejicanos Rivera was following too closely and collided with Unit Two forcing it into the back of Unit Three. There were no injuries. Unit One actions were the proximate cause of the collision. I did not issue any citations at the collision scene. I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT. J.TRADER 03-21-25 09:38 AM INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST.DET DATED PLACE SIGNED APPROVED BY DATE J.TRADER 4553 3/21/2025 9:39:39 AM BADGE OR ID# 4553 ORI# WA0171300 TIME POLICE DISPATCHED 1 2:19 PM TIME POLICE ARRIVED i 2:Y7 PM PAST B 3 Da-3mx-attar(txIMR) PAGE 2�OF 4 SUPPLEMENTAL REPORT No. EF75718 POLICE TRAFFIC 1 1 8 27 COLLISION REPORT CASE# 25-2540 t113197 1 COMMERCIAL MOTOR CARRIER INTERSTATE INTRASTATE UNIT# USDOT ICC# VEHICLE TYPE CARGO BODY: TYPE 2 ❑ 1 28 CARRIER NAME 3 CARRIER L ADDRESS CITY ST ZIP 4 ❑ NAME # PLACARD GWVR NAME IF NO NUMBER SOURCE AXLES + 4a ❑ ADDITIONAL UNITS MOTOR PEDAL- PROPERTY DAMAGE THRESHOLD MET PHONE UNIT# 3 PEDESTRIAN ❑', YE NO No D:4257611134 5 VEHICLE CYCLE OWNER H 29 LAST NAME CALDERON MARTINEZ FIRST NAME , BRINSON MIDDLE J INITIAL STREET 30 NEW ADDRFS 3612 NE 4TH ST 11 CITY RENTON ST WA ZiP gg059 6 ❑ 1 2 31 CDL IGNITION REQUIRED 1{iNiTiON PRESENT MECiICALTANSPORTEL7'. INTERLOCK YESO NO�/ INTERLOCK YES - DRIVER'S D.O.B L LICENSE' STATE wA SEX M MMDDYYv 09 - 07 - 2007 7 ON DUTY STATUS AIRBAG 2 RESTR. ¢ EJECT 9 HELMET 2 INJURY 1 NAruRE of INJURIES USE CLASS 8 ❑ 1 32 LICENSE.:BUY7808 TAT.WA uIN 1N4AL21E09C191227 PLATE# 9 9] TRAILER TRAILER L PLATE# STATE PLATE STATE 0 10 TRLR TRLR VIN.#. VIN#. 11 3 5 VEH.YEAR2009 MAKE NISS MODELALTIMA STYLE 4D VEHICLE TOWE E T ABLIN TOWED BY GovT.vFHICI E FROM TO DAMAGE YES NO ✓ YES NO GISELA MARTINEZ ROQUE 3612 NE 4TH ST RENTON WA 98059 g g 33 REGISTERED OWNER INFO. SHADE IN DAMAGED AREA 12 � ' FROM TO INSURANCE CO LIABILITY INSURANCE FARMERS 530158598 IN EFFECT &POLICY# 1 _JTt1P___. m 34 13 vewc�e YES NO[jj CITATION# CHARGE 1080TTOM ecauv sTANoiNc � 3 7 MOTOR PEDAL_ ' 1:1PROPERTY : DAMAGE 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 ADDRESS" CDL IGNI71t7N REQUIRED IGNITION PRESENT MEDICAL TANSPORTED. INTERLOCK YES NO INTERLOCK YES No IYES[-]NO' ❑ 17 4 37 LIRIVER'SICENSE# STATE SEX Moog L _ C-----� 18 ❑ HELMET NJURY NATURE OF INJURIES 38 ON DUTY STATUS AIRBAG RESTR. EJECT USE CLASS. 19 ❑ LICENSE TAT ViN# 39 PLATE# 20 TRAILER TRAILER 40 PLATE#. STATE PLATE# - STATE ❑ 21 ❑ ❑ 41 TRLR TRLR VIN# VIN#. 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 &POLICY# 7 _ » _.__ y. 44 24 ..ANDIGYES❑ O CITATION# CHARGE E:j STGN 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.TRADER 03-21-25 09:38 AM 25 INVESTIGATING OFFICER'S SIGNATURE OFFICER'S PHONE UNIT OR DIST DET DATED: PLACE SIGNED 26 OR Ib# 4553 O#RI WA0171300 APTRADER 3122112025 PAGE OF� 3000-345-013(R 11t18) REPORT NO. EF75718 CASE# 25-2540 DATE AND TIME 03/20/2514:19 OF COLLISION l�zv a2 rT, s 1 � La 1 a i �s s� { 4 PAGE 4 OF 4