HomeMy WebLinkAbout25-4528 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 1 27c
COLLISION REP FIT 1591971
CASE 25-4528 z
INTERSTATE ❑ CITY STREET ❑ FIRE ❑
RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ HIT F ❑ LOCAL AOENC 4'I00 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2� 1 1 8 28
TOTAL#OF OBJECT
TRIBAL UNITS OS STRUCK' BUILDING
RESERVATION
z
3❑ DATE OF M M D D Y Y Y Y TIME(2400) COUNTY# MILES N E IN CITY#
cawsloN 05 - 1-- 2025 1630 17 ❑-= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
EAST VALLEYROAD BLOCK NO. e✓ 3650 ❑
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ �,❑ FEET e S ❑ VV e SW 34TH STREET
Fill1 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
✓NO D:2532308692 30
6� LAST NAME ELSTAD FIRSTNAME DAVID MIDDLE B 1 1 2 31
INITIAL
STREET ❑ 1868 MCKINLEY STREET CITY ENUMCLAW ST WA ZIP 98022 z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
1/ I iNTERLOCKYES NO NTERLOCKYEs NO�/ YES R No�/
8❑ LRIIVER #
ON DUTY❑ STATUS AIRBAG 2 RESTR 9 EJECT 1 HELMET USE 2 1 CLASS NATURE OF INJURIES z❑
3
LICENSE CLH5873 STATE WAa VIN# 4T3ZF13C71U358694
10 9❑ Pr ATE�
TRAILER STATE TRAILER STATE
11 0 0 PLATE# PLATE# FROM ro
TRLR. TRLR 7 3 33
12❑ vIN#' VIN#
:: FROM TO
❑ VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN T Y GOVT.VEHICLE g 9 34
13 9 2001 TOYT SIENNA VN DAMAGE vEs 0NO agW�MEYERS ves❑ No
REGISTERED OWNER INFO OWNEDBYDRIVER VEHICLE NO. 1
SHADE IN DAMAGED AREA ❑ 35
14 ❑ INSURANCE CO 3 4
LIABILITY INSURANCE O�Tq�
IN EFFECT &POLICY# 6'eIOP
VE— CHARGE IOR TTOM 5 ❑ 36
LEGALLY YES NO CITATION# 5A0510376,5AO510376 NEGLIGENT DRIVING 2ND DEGREE,
15❑ NDING 7 6
UN�T MOTOR ❑ PEDAL-: ❑ PEDESTRIAN ❑✓ PROPERTY ❑ DAM THR OLDMET PHONE
VEHICLE CYCLE OWNER YES�/ NO
16 a
LAST NAME BARRUETA RAMOS FIRST NAME CHRISTIAN MIDDLE K
INITIAL
17 STREET❑ NEW ADOREss❑' 25003 16TH AVE S CITY DES MOINES ST WA ZIP 98198 4❑ 37
18❑ CDL IGNITION REQUIRED IGNITION PtR-E-S1ENT MEDICAL-T�RANSPORTED � 38
INTERLOCKYES�NOR INTERLOCK yEEsIII I I NOF YES t l NO❑
19 RIVELICENSE STATE SEX M MD.O.B. 11 23 _ 1979 39
20 ON DUTY STATUS 3 AIRBAG RESTR EJECT , HELMET 2 INJURY 5 NATURE OF INJURIES
❑ 40
USE CLASS FX HIP
❑21❑ TATE 41
LICENSE VIN# 1
PLATE#
42
22❑ PLATE# STATE PLATE# STATE
23❑ 43
TRLR RLR
VIN#. IN#.
VEH YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN
TOWED By Gov HI 44
L4 1 6 DAMAGE YES NO YES NO
REGISTERED OWNER INFO VEHICLE NO.2
SHADE IN DAMAGED AREA
2 3 4
LIABILITY
INSURANCE❑ INSURANCE
#E CO
IN EFFECT &PO I 970E 5
VE""LE ❑ ,J� CITATION# CHARGE i o BOTTOM
LEGALLY YES N J
25 s 6
=UGENT
PRINT) OFFICER PHONE BADGE OR ID# AGENCY
26 11498 WA0171300
PAGE 01 OF
PART A
3000-345-159 fR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EG07160
COLLISION REPORT III III III III III 111
1591972 CASE# 25-4528
ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY)
NAME MIDDLE INITIAL) RUBINO JOHN R
(LAST FIRST,
ADDRESS&PHONE# D O.B. '
2104 A ST SE AUBURN WA 98002 2065711147 SEX M MMDOYyry 05 - 30 - 1971
PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT ' HELMET INJURY NATURE OF INJURIES
❑ ❑✓ POS. USE CLASS
NAME
(LAST,FIRST,MIDDLE INITIAL) HARDCASTLE PHILIP D
ADDRESS&PHONE# D O B
16919 SE 149TH ST RENTON WA 98059 2062763090 SEX M MMDDYvvv O6 - 27 - 1968
PASSENGER []WITNESSZ UNIT# SEAT AIRBAG RESTR. EJECT HELMET NJURY
POS. NATURE OF INJURIES
USE CLASS
NAME
(LAST FIR57 MIDDLE INITIAL)
AppRESS&PHONE#
SEX D.O.B.MMDD -❑
YYYY.
PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET NJURY NATURE OF INJURIES
❑ ❑ POS. 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.
MATTHEW NUGENT 05-28-25 04:22 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
TIM GUMMING 11488 1 71612025 9:53:20 AM
BADGE OR ID# 11498 OR]#' I WA0171300 TIME POLICE DISPATCHED 4:30 PM TIME POLICE ARRIVED',4:30 PM
PART I PAGE IT]OF 7�
REPORT NO. EG07160 CASE# 25-4528 OF COLLISION
05/23/25 16:30
OF CbLLI510N
NARRATIVE
25-4528
On 05/23/2025 at approximately 1630 hours, I was on scene at the Clarion Hotel -3700 East Valley
Road, Renton, for an unrelated call for service. I was approached by a citizen to assist at a possible
unknown-if-injury vehicle into a building collision at Fortune Poker, located at 3650 East Valley Road
(one building north of my call location), within the City Limits of Renton, County of King, State of
Washington. I proceeded to the Fortune Poker location and notified Dispatch of my response.
Upon my arrival, 1 observed a vehicle had made extensive contact with the building and requested the
Renton Regional Fire Authority (RRFA) respond for mechanism of injury as well as a structural
integrity evaluation of the building. 1 approached the vehicle collision scene and contacted the driver
and sole occupant of Unit#1 -a tan 2001 Toyota Sienna (WA Plate # CLH5873). The driver of Unit#1
was the registered owner and later identified via pictured WADL as ELSTAD, DAVID B (DOB
10/06/1955). The driver of Unit#1 was entrapped inside of the vehicle and remained sitting in the
driver's seat. I was able to communicate with the driver of Unit#1 through the broken glass windows
on the sides of the vehicle that had been damaged because of the collision. The driver of Unit#1
seemed genuinely upset by the collision and was worried about unintentional injuries caused by the
collision. I asked that patrons of the business, who had now begun to surround the involved vehicle,
to begin checking on anyone inside that may be injured while I remained with the involved driver.
The driver of Unit#1 (ELSTAD) stated that prior to the collision, he was traveling eastbound through
the main parking lot of Fortune Poker and was attempting to locate a parking stall. The driver of Unit
#1 stated that he came to a stop near the main entrance when he "lost control" of his vehicle in the
moments prior to the collision. As a result, his vehicle proceeded forward uncontrollably into the west
side of the Fortune Poker building, just south of the main entry doors, penetrating the exterior wall.
Almost the entire length of the vehicle was now inside the building with only the trunk of the vehicle
remaining outside of the building.
Based on my initial interaction with the driver of Unit#1, he seemed disoriented and sluggish. I
requested that RRFA conduct an evaluation of the involved driver. RRFA later conducted a medical
evaluation and was able to extricate the driver by removing items from inside the van and having the
driver exit the rear of the vehicle. The driver of Unit#1 admitted to not having slept for a couple of
days. I did not detect any signs of impairment when interacting with the driver of Unit#1, however,
due to the nature of the circumstances involving a vehicle into the building and the male driver initially
identified as being a driver in a similar collision resulting in a DUI arrest, I asked if the driver would be
willing to perform voluntary Standardized Field Sobriety Tests (SFSTs). The male agreed. The male
was also later determined to not be the same male involved in a prior DUI collision which was initially
thought.
Officer J. Myers arrived on scene to assist me. I gathered my Department-issued Preliminary Breath
Test (PBT) instrument to detect the possibility of alcohol on the driver's breath. The driver of Unit#1
agreed to conduct a voluntary PBT. I coached the driver who performed the test without incident. The
PBT instrument indicated a result of .000. 1 conducted the remaining SFSTs but did not detect any
signs of impairment. I requested a Drug Recognition Expert (DRE) respond to the scene but was told
they would not respond unless the driver was in-custody.
According to the witnesses who remained at the scene and listed in this report, Unit#1 had been
driving through the parking lot and had made multiple laps around the lot itself, seemingly unable to
find a parking stall. One witness, identified as John Rubino, said that Unit#1 eventually came to a
stop near the entrance where he noticed the wheels starting to spin while the vehicle was stopped.
Rubino said Unit#1 then lurched forward as if the driver had lost control and collided into the building
PAGE 3 OF 7
REPORT NO. EG07160 CASE# 25-4528 OF COLLISION
05/23/25 16:30
OF CbLLI510N
NARRATIVE
where it came to a rest.
Officer Myers and RRFA identified three victims that were inside of the Fortune Poker building and
near the wall that was impacted by Unit#1. Officer Myers provided me with the names and contact
information for the victims who have been added to this report. The listed victims were all transported
to local hospitals for non-life-threatening injuries. It should also be noted that at the time of collision,
Fortune Poker was occupied by several patrons with a very active and full parking lot, several
pedestrians walking around both inside and outside of the business, as well as heavy vehicle traffic.
Based on the above statements and after examining the heavy mechanism of the involved vehicle, I
believe that the driver of Unit#1 is the proximate cause for the cause of collision due to traveling at
unsafe and uncontrolled speeds. I believe that the driver of Unit#1 violated RCW 46.61.525-
Negligent Driving in the second degree. This RCW is defined as a person being guilty of negligent
driving in the second degree if, under circumstances not constituting negligent driving in the first
degree, he or she operates a motor vehicle in a manner that is both negligent and endangers or is
likely to endanger any person or property.
"Negligent" means the failure to exercise ordinary care and is the doing of some act that a reasonably
careful person would not do under the same or similar circumstances or the failure to do something
that a reasonably careful person would do under the same or similar circumstances.
I believe that the drive of Unit#1 (Elstad) did not exercise ordinary care. Unit#1 had been seen
traveling through the parking lot during active business hours with heavy vehicle and pedestrian
traffic. The driver of Unit#1 (Elstad) admitted to having not slept in a couple of days which likely
contributed to him failing to operate his vehicle in a safe and controlled manner. I cited the driver of
Unit#1 (Elstad) via mail for Negligent Driving in the second degree and for Operating a Motor Vehicle
without Insurance.
Unit#1 had to be towed from the building due to extensive damage. I coordinated through Renton PD
Front Counter for a Building Inspector to be dispatched to the location due to the structural integrity of
the building likely having been compromised. I transported the driver of Unit#1 to a nearby bus
station. The driver of Unit#1 as well as the General Manager of Fortune Poker was provided a case
number and exchange of information.
I certify (or declare) under penalty of perjury under the laws of the State of Washington that the
foregoing is true and correct.
Electronically signed by Officer M. Nugent#11498 5/28/2025 3:54 PM Renton, King County, WA.
PAGE 4 OF 7
SUPPLEMENTAL REPORT NO. EG071 CO
r`) POLICE TRAFFIC 1 1 8 27
COLLISION REPORT CASE# 25-4528
1 COMMERCIAL MOTOR CARRIER INTERSTATE INTRASTATE G
UNIT'# USDOT ICC# VEHICLE TYPE CARGO BODY
;TYPE
2 ❑ 1 1 8 28
CARRIER
NAME
3 CARRIER
ADDRESS `❑
CITY ST ZIP—1 I '
4 ❑ NAME # PLACARD: :❑
GWVR NAME IF NO NUMBER
SOURCE AXLES +
4a ❑ ADDITIONAL UNITS
MOTOR PEDAL- PROPERTY DAMAGE THRESHOLD MET PHONE
5 ❑ UNIT# 3 VEHICLE I_J CYCLE u PEDESTRIAN � OWNER � YES� NO
D:2537540468 N:2537540468
29
MIDDLE'
LAST NAME MAGEO FIRST NAME IELOME INITIAL I P
STREET 30
NFW AnbRFSP 1300 SW CAMPUS DR,APT 47-2 CITY FEDERAL WAY ST WA ZIP 1 98023
6
CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TANSPORTED 1 31
INTERLOCK YEs No zERLOCK YES❑NO❑ YEs N
L
DRIVER'S STATE SEX M M�DDYBYv 07 - 22 - 1960
❑ LICENSE
7
HELMET INJURY NATURE OF INJURIES
ON DUTY STATUS 3 AIRBAG RESTR. EJECT USE 2 CLASS 6 TRANSPORTED TO VMC WITH MINOR INJURIES
8 ❑ 1 32
LICENSE+ raT VIN.#
PLATE#
9 [9] TRAILER TRAILER
PLATE# STATE PLATE# STATE
10 TRLR TRLR 91 VIN.#. VIN.#.
11 ❑ VEH.YEAR MAKE I MODEL STYLE I VEHICLE TOWS E T SABLIN TOWED BY anvi vEHIG P FROM TO
DAMAGE YES NO YES NO
REGISTERED OWNER INFO. g g 33
12 SHADE IN DAMAGED AREA
FROM TO
LIABILITY INSURANCE❑ INSURANCE CO
IN EFFECT &POLICY# 1 _R I"01?__ 9 9
VEHICLE 34
13 ❑ LEGALLY YES[:] NO❑ CITATION# CHARGE 10 BQTTUM
1a STANDING
# 4 MOTOR PEDAL-
❑ ❑ PROPERTY ❑ DAMAGETHRESHOLD MET PHONE ❑ 35
VEHICLE CYCLE PEDESTRIAN OWNER YES NO D:6087729882 N:6087729882
15 WANG ZHISHI MIDDLE ❑ 36
ME LAST NAME FIRST NA INITIAL
6 STREET
16 ❑ ❑ 2651 156TH AVE NE,UNIT 646 CITY REDMOND ST WA ZIP 98052
NFln+AnntxFSS
CDL IGNITION REOUIREE7 IGNITION PRESENT MEDICALTANSPORTEII
17 ❑ INTERLOCK YES NO INTERLOCK YEs NC7 YEs Nb ❑
DRIVER'S STATE SEX M D.O.B 4 37
18 ❑ LICENSE# MMDDYYY 07 - 04 - 1986
ON DUTY❑ STATUS 3 AIRBAG RESTR. EJECT HELMET 2 INJURY 6 NATURE OF INJURIES 38
USE CLASS TRANSPORTED TO VMC WITH MINOR INJURIES
19
LICENSE rnr vIN# ❑ 39
PLATE#
20 6 TRAILER' STATE TRAILER STATE 3❑ 40
PLATE#< PLATE#
21 ❑ ❑ 41
TRLR TRLR
VIN# YIN#i
22 ❑ 42
DAM ❑
VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED DUET SABLIN TOWED BY GOVT.VEHICLE
AGE YES NO YES NO
23 1 6 REGISTERED OWNER INFO_ SHADE IN DAMAGED AREA 43
3 4
LIABILITY INSURANCE INSURANCE CO '
IN EFFECT POLICY# i _9_rOP___ g 44
24 1 6 VEHICLE YES❑ N. CITATION# CHARGE 7960TiOM
EGALLY
E:l
STANDING 8 7 6
1 CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT.
MATTHEW NUGENT 05-28-25 04:22 PM
25 INVESTIGATING OFFICER'S SIGNATURE OFFICER'S PHONE UNIT OR DIST DET DATED: PLACE SIGNED
APPROVED BY DATE
26F7 OI BADGE 11498 O#I WA0171300 CUMMING 7/6/2025 PAGE❑OF❑
3000-345-013(R 11118)
SUPPLEMENTAL REPORT NO. EG071 CO
r` POLICE TRAFFIC 1 27
COLLISION REPORT CASE# 25-4528
1 COMMERCIAL MOTOR CARRIER INTERSTATE INTRASTATE G
UNIT'# USDOT ICC# VEHICLE TYPE CARGO BODY
;TYPE
2 ❑ 1 28
CARRIER
NAME
3 CARRIER
ADDRESS `
CITY ST' ZIP—1 I '
4 ❑ NAME # PLACARD: :❑
GWVR NAME IF NO NUMBER
SOURCE AXLES +
4a ❑ ADDITIONAL UNITS
MOTOR PEDAL- PROPERTY DAMAGETHRESHOLD MET PHONE
UNIT# 5 PEDESTRIAN � ✓�' YEs NO
5 VEHICLE CYCLE OWNER ✓ D:2068800265 N:4255726500
29
MIDDLE'
LAST NAME MESA FIRST NAME DAVID INITIAL A
STREET 30
NEW AnnRFSP 3650 EAST VALLEY ROAD CITY RENTON ST WA ZIP 1 98057
6
CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TANSPORTED 1 31
INTERLOCK YEs No zERLOCK YES E]Na� YEs N
L
DRIVER'S STATE I SEX M M�DDYBYv 04 - 25 - 1973
LICENSE
7 F-I ON DUTY STATUS AIRBAG RESTR. EJECT HELMET INJURY NATURE OF INJURIES
USE GLASS
8 ❑ ' 1 32
LICENSE+ rar VIN.#
PLATE#
9F-I TRAILER TRAILER
PLATE# STATE PLATE# STATE
10 ❑ TRLR TRLR
VIN.#. VIN.#.
11 VEH.YEAR MAKE MODEL STYLE VEHICLE TOWS T SABLIN TOWED BY anvi vEHIC E FROM TO
DAMAGE Y E ES NO YES NO
REGISTERED OWNER INFO. m 33
12 SHADE IN DAMAGED AREA
FROM TO
LIABILITY INSURANCE❑ INSURANCE CO
IN EFFECT &POLICY# tGQ
EHILLE 34
13 ❑ LEGALLY YES[:] NO❑ CITATION# CHARGE
STANDING } 8 7 6
14 ❑ UNIT Tr Vd IRE O CYDCLE OWNERRTY YES AGE NOHRESHOLD MET PHONE ❑ 35
PEDESTRIAN
15 LAST NAME FIRST NAME MIDDLE': INITIAL36
STREETIAL
❑
16 NEW AnnREs.� CITY'. ST ZIP
CDL IGNITION REdUiREE7 IGNITtGN PRESENT MEDICALTANSPORTED
INTERLOCK YES No INTERLOCK YEs NO YEs NO El
17 37
LICENSE# STATE SEX MMDDDYBYY
18 ❑ ON DUTY� STATUS AIRBAG RESTR. ; EJECT HELMET INJURY NATURE of INJURIES 38
USE (CLASS
19 ❑ vIN 39
LICENSE #
PLATE# rnr
20 ❑ TRAILER' TRAILER ❑ 40
PLATE# STATE PLATE# STATE
21 ❑ TRLR TRLR 41
VIN# YIN#i
42
22 VEH.YEAR MAKE I MODEL STYLE I VEHICLE TO DUET SABLIN TOWED BY GOVT.VEHICLE
DAMAGE YES NO YES NO
23 REGISTERED OWNER INFO_ SHADE IN DAMAGED AREA 43
3 4 71
LIABILITY INSURANCE INSURANCE CO '
VINE
EFFECT &POLICY# i 970P - 4 E:l
44
24 LEwGLE YES❑ NO❑ CITATION# CHARGE iq 60TiOM
C=DLv
STANDING 8 7 6
1 CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT.
MATTHEW NUGENT 05-28-25 04:22 PM
25 INVESTIGATING OFFICER'S SIGNATURE OFFICER'S PHONE UNIT OR DIST DET DATED: PLACE SIGNED
APPROVED BY DATE
26F7 OI BADGE 11498 O#I',WA0171300 CUMMING 7/6/2025 PAGE I OF F
3000-345-013(R 11118)
REPORT NO. EG07160 CASE# ' 25-4528 DATE AND TIME 05/23/25 16:30
OF COLLISION
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PAGE 7 OF 7