HomeMy WebLinkAbout25-3143 )STATETFcN 0 4 27i t c� RA EF80960
COLLISION
RERT 1591971
❑ FIRE ❑ CASE 25-3143 z 6 0
INTERSTATE CITY STREET � RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VEHICLE ❑ LOCAL AGENCY 4100 3[--�
COUNTY RD NVOLVED CODING
PRIVATE WAY
2❑ TRIBAL UNITS 8
TOTAL S#OF 02 SO BJECT TRUCK 1 28
RESERVATION 2
3� M M D D Y Y Y Y TIME(2400) COUNTY# MILES CITY#
DATE OF'. N E
COLLISION'. 04 - 07 - 2025 2141 17 =.�� S W OF 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION �✓ NON INTERSECTION ❑
NE SUNSET BLVD BLOCK ST e Y800 .=
4a❑ MILE POST
❑ DISTANCE OF(REFERENCE OR CROSS STREET)
5 �. FEET S 8 W e NE 10TH ST
0 1 29
MOTtlR PEDAL- DAM AG THRESHOLD MET PHONE
UNIT 01 VEHiCLE ❑ CYCLE ❑ YEs Vl No D:4254730824 0 1 30
6 LAST NAME PORTILLO MOLINA FIRST NAME ARTS MIDDLE G 1 1 2 31
INITIAL
STREET ❑ 1151 OLYMPIA AVE NE 20 CITY RENTON ST WA ZIP 98056 2
NEW ADDRESS
7 CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
INTERLOCKYESDROP] INTERLOCKYEs No�/ YES No�/
8� LICIENS# STATE WA SEX M MMOCSYY' 11 1 2 32
9 ON DUTY STATUS AIRBAG 6 RESTR 4 EJECT 1 N USEET INJURY
CLASS 1 NAruRE of INJURIES 2
LICENSE, CNL1535 STATE WA VN# 19XFB2F8XDE278186 3
10 PI ATF#
TRAILER STATE TRAILER ,STATE
11 3 0 PLATE# PLATE# IRW TO
TRLR TRLR 5 1 33
1 3
IRW TO
2 Q VIN# VIN#
VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN GOVT VEHICLE 7 $ 34
13 4 2013 HOND CIVIC SO DAMAGE ves 2NO IMWI&RS YEs❑ No
REGISTERED OWNER INFO SAMUEL MONTOYA MOLINA 1151 OLYMPIA AVE NEAPT20 RENTON WA 98056 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
14 LIABILITY INSURANCE❑ NSURANCE CO NONE 3 4
IN EFFECT &POLICY# 4TOP
srgNOLNG [:]NO[:] 5AO115839 CHARGE OP MOT VEH W/OUT INSURANCE,NO o oorrob 36
Yes CITATION#
15
III MOTCSR � PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT VEHICLE CYCLE nWNFR YES 1/ NO D:4253060598
16�
LAST NAME BERG FIRST NAME GARETH MIDDLE' H
INITIAL
17 F1 STREET ❑❑ 975 ABERDEEN AVE NE APT 6201 CITY RENTON ST, yyq ZIP 37
980562880
NEW ADDRESS
18❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDIGALTRANSPORTED 38
INTERLOCKYEs No jNTERLOGKYES NO YEs No;�
19 DRIVER'S STATE WA SEXI M D O B 09 29 1950 39
LICENSE# MMDDYY —
20❑ ON DUTY❑ STATUS AIRBAG 6 RESTR 4 EJECT 1 HELMET I INJURY'. 7 NATURE OF INJURIES ❑ 40
USE CLASS LEG PAIN
21 LICENSLATE# B01751T rarE WA vIN# 1FMCU9EGXBKB25764 41
22❑ PLATE# STATE PATE# STATE ❑ 42
23 TRLR kRLR 43
UIN#. 'IN#.
TOWED BY GOV HI 44
VEH.YEAR 2Q11 MAKE FORD MODEL ESCAPE STYLE DAMIAGE TOWED No BLIN BANKERS YES NO�/
24
REGISTERED OWNER INFO GARETH BERG 975 ABERDEEN AVE NE APT 8201 RENTON WA 98056 VEHICLE NO.2
SHADEDAMAGEDAREA
3 4
LIABILITY INSURANCE INSURANCECO STATE FARM L024319EI447F
IN EFFECT &POLICY# 9TOP
vewaE ❑ CITATION11 CHARGE t080TTOM
A Y YES N J
25 N
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
26
HANSEN HSU 12651 WA0171300
PAGE 01 OF
PART A 3000-345-159(R 11/18)
POLIICFETRAFFICN CORRECTION REPORT NO. EF80960
COLLISION REPORT III III III III III 111
1591972 CASE# 25-3143
ADDITIONAL PERSONS INVOLVED(PASSENGERS AND/OR WITNESSES ONLY)
NAME MIDDLE INITIAL} MOLINA HERNANDEZ BRENDA Y
(LAST,FIRST
ADDRESS&PHONE#
1151 OLYMPIA AVE NE APT 20 RENTON WA 98056 SEX' F MMDDYYYv 09 — 20 — 1997
SEAT HELMET I INJURY NATURE OF INJURIES
PASSENGERP/l WITNESS El I UNIT# 1 1 1 POS. 1 3 AIRBAG 6 RESTR. 4 EJECT 1 USE CLASS 17 RIGHT LEG PAIN---�
'NAME
LAsr F RST,MIDDLE INITIAL) JOSE OROZCO
ADDRESS&PHONE# D(�B _F [------------�
2810 NE SUNSET BLVD RENTON WA 98056 4255241795 SEX' M MMDDYVYv
PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET INJURY NATURE OF INJURIES
❑ �✓ POS. USE CLASS ----�
'.NAME
(LAST,FIRST,MIDDLE INITIAL)
ADDRESS&PHONE#
SEX' D.O.B.M _T L----------�
MDDYYYY
PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET INJURY NATURE OF INJURIES
❑ Q POS. USE CLASS �____ ----�
NARRATIVE
Unit 1 traveling northbound along 2800 block of NE Sunset Blvd approaching the intersection at NE
10th St. Unit 2 traveling eastbound on NE 10th St approaching NE Sunset Blvd. Unit 1 driver reported
having yellow light and braking hard and reported sliding into intersection. Unit 2 driver reported
having the green light and believed that Unit 1 driver ran the red light. Unit 1 driver NVOL w/lD. Unit
1 sustained major disabling front end damage. Unit 2 also sustained major disabling front end
damage. Both Units privately impounded by Bankers tow. Unit 2 driver and Unit 1 front passenger
complaint of leg pain. Both assessed on scene by Renton Fire. Unit 1 driver appeared to be
proximate cause of collision. Given his account, his speed also played a factor in the inclement
weather. Unit 1 driver cited for NVOL w/ID, no vehicle insurance, and speeding too fast for conditions.
I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT.
HANSEN HSU 04-07-25 10:51 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST.DET DATED PLACE SIGNED
APPROVED BY E
DAT
P.SUMMERS 8887 41812025 10:25:36 PM
BADGE OR ID# 12651 ORI# ( WA0171300 TIME POLICE DISPATCHED; 9:42 PM TIME POLICE ARRIVED 9:47 PM
PART IS 3aaa-345-,aa(R11Y1s) PAGE 27OF 37
REPORT NO. EF80960 CASE# 213143 DATE AND TIME 04/07/25 21:41
OF COLLISION
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