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HomeMy WebLinkAbout25-5292 IT si " II IIIII III IIIII II IIII IIIII I . 27c REPORT NO EG04041OLCERA COLLISION REPORT 1591971 INTERSTATE CITY STREET FIRE I CASE# 25-5292 2 RESULTEDSTOLENSTATE ROUTE OTHER VEHICLE LOL`CODIOENC'Y 4100 3 HIT&RUN CODING COUNTY RD PRIVATE WAY INVOLVED 2 TOTAL#OF OBJECT 1 s 28 TRIBAL UNITS 02 STRUCK RESERVATION : 1 1 2 3� M M D D Y Y Y Y TIME(2400) COUNTY# MILES CITY# DATE OF N E IN eDL�ISION' 06 - 17 - 2025 1413 17 =.= S 8 W E OF M 1070 a 4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑ SE 168TH ST BLOCK NO. e 11323 .� 4a❑ MILE POST ❑ DISTANCE OF(REFERENCE OR CROSS STREET) 5 1. FEET e S 8 W e 113TH AVE SE 0 1 29 MOTOR ✓ PEDAL- DAM AG THRESHOLD MET PHONE UNIT 01 VEHICLE ❑ CYCLE ❑ YEs Vl No D:2068865906 0 1 30 5❑ LAST NAME ORTIZ FIRST NAME JEREMY MIDDLE D 1 2 31 INITIAL STREET ❑ 17418 127TH PL SE CITY; RENTON ST I WA ZIP, 98058 2 NEW ADDRESS 7 CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3 INTERLOCKYEs No✓ INTERLOCKYEs N©✓ YES No✓ 8 DCIENSE# STATE WA SEXI M MMDDYY' 12 - 02 - 1996 1 2 32 9 ON DUTY STATUS' AIRBAG 3 RESTR 4 EJECT 1 HELMET 2 CLASSY 1 [NATURE of INJURIES 2 10 LI ENSE' AIT2451 STATE WA VIN# 4F2YU08112KM48596 3 TRAILER STATE TRAILER STATE 11 0 0 PLATE# PLATE# ROM To TRLR TRLR 3 1 7 33 12 0 0 VIN#' VIN# ' FROM TO VEH.YEAR 2002 MAKE MAZD MODEL TRIBUT STYLE SV VEHICLE TOWED TO pLS�46LIN TDVyEp By GES VEHICLE 3 7 34 13� DAMAGE YES ✓ NO II_II AHA YESII_I) NO✓ REGISTERED OWNER INFO JEREMY ORTIZ 17418127TH PL SE RENTON WA 98053 D:2068865906 VEHICLE NO. 1 SHADE IN DAMAGED AREA 35 2 LIABILITY INSURANCE INSURANCE CO 4 14 GENERAL 53-WA 8462294 IN EFFECT &POLICY# 9TOP VEnicLE CHARGE t a 80TTOM I < 36 LEc Ly YES❑NO❑ CITATION# 5 15❑ STANDING 7 e MOTOR ✓ PEDAL- PEDESTRIAN1:1 PROPERTY DAM THR OLD MET PHONE UNIT 02 VEHICLE CYCLE nWNFR YES�/ NO D:4255451701 16� LAST NAME NELSON FIRST NAME TRINITY MIDDLE R INITIAL STREET ❑ 17 ❑ 16856 121 ST AVE SE CITY RENTON ST, WA ZIP 98058 37 NEW ADDRESS 18❑ IGNITION REQUIREfl IGNITION PRESENT MEDICAL TRANSPORTED ❑ 38 CDL INTERLOCKYES No✓ INTERLOCK YES 0No✓ YEs No✓ 19 DRIVER'S ' STATE WA SEX,F I D.O.B. 04 26 2001 � 39 LICENSE# MMDDYY — 20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 HELMET INJURY 7 NATURE A INJURIES ❑ 40 USE CLASS NECK PAIN 21 LICEN E CER1131 rarE WA vIN 1HGCP36828AO30020 41 22❑ [TILER TAILER PLATE# STATE PLATE# STATE 42 23 TRLR RLR 43 UIN#. 'IN# VEH.YEAR 200$ MAKE HOND MODEL ACCORD STYLE SD VEHICLE TOWED TO BLIN TOWED BY GOV HI 44 24 DAMAGE YES NO✓ NO✓ REGISTERED OWNER INFO OWNED BY DRIVER VEHICLE NO.2 SHADE IN DAMAGAREA 2 3 LIABILITY INSURANCE INSURANCE CO FARMERS INSURANCE 189312020 IN EFFECT 8.POLICY# t STOP V—L ❑ ,J—I CITATION# CHARGE to BOTTOM LEGALLY YES N`.LJ 25 s OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY J 26 ALEX IURCO 13169 WA0171300 PAGE 01 OF PART A 3000-345-189(R 11/18) STATE OF POLICETRAFFICN CORRECTION REPORT NO. EG04041 COLLISION REPORT III III III III III 111 1591972 CASE# 25-5292 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 0,SS ----� :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. ALEX lURCO 06-17-25 03:35 PM INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST.DET DATED PLAGE SIGNED APPROVED BY DATE P.SUMMERS 8887 612512025 5:49:42 PM BADGE OR ID# j 13169 ORI# WA0171300 TIME POLICE DISPATCHED 2:15 PM TIME POLICE ARRIVED i 2:Y0 Pm PAST B 3 Do-3mx—attar(t 1Mff) PAGE 2�OF 4 REPORT NO. EG04041 CASE# 25-5292 DATE OF COLLI r�510NN + 06/17/25 14:13 L1 NARRATIVE CC 25-5292 On 6/17/2025 at 1415 hours I was dispatched to a motor vehicle collision at 11312 SE 168th St in the City of Renton, King County, Washington. Pre-Collision Driver 2, Trinity R. Nelson (DOB 04/26/2001 via WADOL PHOTO) stated that she was traveling westbound on 168th St. and the vehicle behind her (Driver 1) was swerving through vehicles at a high rate of speed, and at one point went into the wrong lane of travel. Driver 1, Jeremy D. Ortiz (DOB12/02/1996 VIA WADOL PHOTO) stated that he was traveling westbound on 168th St. and the vehicle in front of him (Driver 2) slammed on the brakes, causing him to hit her vehicle. Collision Driver 2 stated that Jeremy rear ended her vehicle due to him traveling at a high rate of speed and not paying attention to the roadway. Driver 1 stated that he did hit Trinity's vehicle, but only because she slammed on her brakes, and he did not have any time to react. Jeremy's vehicle would not start after the collision. Injuries Trinity complained of neck pain due to the collision, the Fire Department was called to the scene as a precaution. She was cleared by Fire. Trinity told me she is going to the hospital for further checkups. Jeremy's front airbags deployed, I asked him if he was injured, and he stated he was not injured. I offered to have the Fire Department evaluate him, but he did not want to be checked out. Proximate Cause Due to Trinity's vehicle being rear ended by Jeremy, I find Jeremy (Driver 1) to be the proximate cause of the collision. Jeremy failed to maintain a safe distance of following the vehicle in front of him, and when Trinity (Driver 2) used her brakes, Jeremy was to close and had no time to react to her braking, which caused him to hit her vehicle. I 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 A. lurco #13169 at 15:29 on 6/17/2025 in the City of Renton, King County, Washington. PAGE 3 OF 4 REPORT NO. EG04041 CASE# 25-5292 DATE AND TIME 06/17/2514:13 OF COLLISION> ' s t r• 4f< i r G c ht �" wvv�t W tr r tiffs s. r 9 aw r °�tctiet. 3 �w PAGE 4 OF 4