HomeMy WebLinkAbout25-7187 IT si " II IIIII III IIIII II IIII IIIII I . 27c REPORT NO EG21447OLCERA
COLLISION REPORT 1591971
INTERSTATE CITY STREET❑ FIRE ❑
CASE�# 25-7187 2
RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER VEHICLE LOCAL A`GENC'Y 4150 3
COUNTY RD NVOLVED CODING
PRIVATE WAY
2❑ TOTAL 1
TRIBAL UNITS#OF 03 SO BJECT TRUCK 1 8 28
RESERVATION 2
3� M M D D Y Y Y Y TIME(2400) COUNTY# MILES CITY#
DATE OF'. N E
GOLL.ISION'. 08 - 17 - 2025 1939 17 =.�� S WE IN
OF 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION
RAINIER AVE S BLOCK NO. e 520 .�
4a❑ MILE POST
❑ DISTANCE OF(REFERENCE OR CROSS STREET)
5 352 00 FEET e✓ S 8 W e S 4TH PL
0 1 29
MOTtlR PEDAL- DAM AG THRESHOLD MET PHONE
UNIT 01 VEHICLE CYCLE' YES ✓NO 1 4 30
6 LAST NAME UNKNOWN FIRST NAME MIDDLE 1 1 2 31
INITIAL
STREET
NEW ADDRESS CITY RENTON ST ZIP 2
7 CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
INTERLOCKYEs NO INTERLOCKYEs No YEs NO
LICIENSE# STATE SEX U MMDDYY'. —=— t 32
8❑ VERS
9 ON DUTY STATUS AIRBAG 9 RESTR 9 EJECT 1 HELM
USEET 9 CLASS 0 NATURE OF INJURIES 2
10❑ LI ENSrtEI D52482E STATE WA VIN# 1FTRF12545NBO2982 3
TRAILER STATE TRAILER ,STATE
11 3 5 PLATE# PLATE# FROM TO
TRLR rRLR 7 3 33
12 0 0 VIN# VIN#
( FROM TO
VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO
13 BLIN TOWED By GO VEHICLE
4 2005 FORD F150 PK DAMAGE YES ✓ YES No m 34
REGISTEREDOWNERINFO JDANP.R.D.,11.L4455.12TH,T,23-12 RENTON WA98059 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
14❑ LIABILITY INSURANCE❑ NSURANCE CO 4
IN EFFECT &POLICY# 9TOP
CHARGE 5 36
Lemur yes❑NO❑ CITATION# 7 o BOTTOM
15❑ sTnNowc B 7 e
UNIT OZ MOTOR PEDAL ❑ PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
VEHICLE CYCLE. nWNFR YES NO
16❑
LAST NAME UNKNOWN FIRST NAME MIDDLE'
INITIAL
17❑ STREET CITY RENTON ST ZIP 37
NEW ADDRESS
—
IGNITION CDL IGNITION REQUIRED (GNTION PRESENT MEDICAL TRANSPORTED 38
INTERLOCKYEs NO JNTERLOCKYES0-001 Es NO
19 LICIENSE# STATE SEX U MMDDYY —� 39
HELMET INJURY' NATURE OF INJURIES 40
20❑ ON DUTY� STATUS' AIRBAG g RESTR g EJECT 1 USE 9 CLASS 0 ❑
21 LICEN� BYHO472 rare WA vIN# USE
41
PLATE 22❑ [TILER AILER
PLATE# STATE PATE# STATE ❑ 42
23 TRLR kRLR 43
UIN#. 'IN#.
VEH.YEAR 2010 MAKE FORD MODEL ECONOLI STYLE VN VEHICLE TOWED TO BLIN
TOWED BY GOV HI 44
24 DAMAGE YES NO YES NO
REGISTERED OWNER INFO LETICIA VARGAS GARCIA 1781397THAVE S RENTON WA 98055 D:2535278628 VEHICLE NO.2
SHADE IN DAMAGAREA
2 3
LIABILITY INSURANCE INSURANCE CO ALLSTATE 807.337.863
IN EFFECT &POLICY# t 9TOP 5
vewae ❑ ,.I—I CITATION# CHARGE tO BOTTOM
EEGnEEv YES N`.LJ
25 a 7 a
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# JAGENCY
JAMAAL KEARSE
26 12994 WA0171300
PART A PAGE 01 OF
3000-345-159(R 11/181
POLIICFETRAFFICN CORRECTION REPORT NO. EG21447
COLLISION REPORT III III III III III 111
1591972 CASE# 25-7187
ADDITIONAL PERSONS INVOLVED(PASSENGERS AND/OR WITNESSES ONLY)
NAME PHAN PHUONG
(LAST,FIRST,MIDDLE INITIAL}
ADDRESS&PHONE# DOB
5165 S 160TH ST TUKWILA WA 98188 2067717216 SEX' F MMDDYYYY 12 — 31 1— 2001
PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET INJURY NATURE OF INJURIES
POS. USE CLASS
'NAME
(LAST FIRS,MIDDLE INITIAL)
ADDRESS&PHONE#
S ' D.O
EX .B.MMDD -F L----------�
YYYY
EAT HELMETNJURY URE OF
PASSENGER ❑WITNESS UNIT# S AIRBAG RESTR. EJECT NAT INJURIESPOS. : USE CLASS ----�
'.NAME
(LAST,FIRST,MIDDLE INITIAL)
ADDRESS&PHONE#
SEX D.O.B. - L----------�
MMDDYYYY
PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET INJURY NATURE OF INJURIES
❑ Q' POS USE CLASS r— ----�
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.
JAMAAL KEARSE 08-18-25 12:59 AM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST.DET DATED PLACE SIGNED
APPROVED BY DATE
QUINT TIBEAU 7691 1 8/22/2025 4:25:38 AM
BADGE OR ID# 12994 ORI# ( WA0171300 TIME POLICE DISPATCHED'; 7:40 PM TIME POLICE ARRIVED 7:41 Pm
PART B 3 Do-3mx-,aR(Burls) PAGE 27 OF 57
REPORT NO.` EG21447 CASE# 25-7187 O COLLI COLLISION TIME
OF 08/17/25 19:39
COLLI
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 8/17/2025, at approximately 1940 hours I was dispatched to a report of a vehicle vs pedestrian
collision at Baskin Robbins located at 520 Rainier Ave S. Dispatch advised it was a vehicle vs
pedestrian and the vehicle fled the scene.
At approximately 1941 hours I arrived on scene. I located the pedestrian identified as Roberto M.
Hernandez DOB 11/15/2011. Roberto advised the following. He had just arrived at Baskin Robbins
with his family. He was waiting in front of the store next to a white van when the back of the white van
swung into him causing him to fall to the ground scraping his left shoulder and left knee. He did not
see what happened as it all happened so fast.
I spoke with an employee at Baskin Robbins, identified as Phuong N. Phan DOB 12/31/2001 via
WADL, who had video footage of the incident. In the video a black 2005 Ford F150 (WA LIC
D52482E) exits the parking lot onto Rainier Ave S. The truck the turns right making a U-turn jumping
over the curb and accelerating into a white 2010 Ford Econoline (WA LIC BYH0472). The Ford
Econoline swings out hitting Roberto who was standing near the rear of the van. The truck then backs
up and takes off northbound on Rainier Ave S.
Officer Kauppila found the suspect vehicle utilizing Flock cameras which was last seen eastbound on
NE 4th St from Monroe Ave NE. Officer Kauppila took photos of the scene and the Ford Econoline.
See his report for more information.
According to DOL the registered owner of the vehicle is a Juan P. Pedroza Diaz Leal DOB 9/16/1994.
The address of the registered owner is: 4455 NE 12TH ST, APT 23-12, RENTON WA, 98059-4076.
Officer Smith went to the address and located the vehicle with heavy front-end damage. Officer Smith
attempted to contact the residents of the unit and got no answer at the door. Officer Smith took
pictures. See her report for more information.
The Ford Econoline belonged to the business next door, La Rancherita. Sgt. Tibeau spoke to an
employee from that business who also had video. In the video there were three occupants of the
suspect vehicle one male is seen getting into the driver seat.
The driver: Hispanic male, heavy build, medium length hair, black t-shirt sleeves cut off, logo on the
back of the shirt, black shoes, possible tattoos on left arm.
If the driver can be identified there is probable cause for the crime of Hit and Run.
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 J. Kearse #12994 8/17/2025 2356 Hours Renton, King County,
Washington
PAGE 3 OF 5
SUPPLEMENTAL REPORT NO. EG21 447
POLICE TRAFFIC
1 1 8 27
µ ^'� COLLISION REPORT CASE#+ 25-7187
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 NO NUMBER
SOURCE' AXLES ' + NAME IF
4a ❑ ADDITIONAL UNITS
'J ,µ MOTOR PEDAL- PROPERTY DAMAGE THRESHOLD MET PHONE
5 ❑ UNIT# 3 VEHICLE ❑ CYCLE ❑ PEDESTRIAN OWNER ❑' YES NO D:4259008117
MIDDLE 29
LAST NAME HERNANDEZ FIRST NAME ROBERTO INITIAL M
STREET 30
NFW ADnRFS.,P 2812 NE 12TH ST CITY RENTON ST WA ZJP 98056
6 ❑ PRESENT MEDICALTANSPORTED.. 1 31
CDL IGNITION REQUIRED .IGNITION
INTERLOCK YES[]NO[]...INTERLOCK YES Na YES N....
A
DRIVER'S STATE SEX M MD 'g 11 - 15 - 2011
LICENSE:
7
HELMET ,INJURY NATURE ODINJURIES
ON DUTY STATUS: 3 AIRBAG RESTR. EJECT USE 2 GLASS 6 PAIN AND SCRAPES ON LEFT SHOULDER/KNEE
8 ❑ 1 32
LICENSE rAr' VIN#
PLATE#
9 TRAILER TRAILER 2
PLATE#; STATE PLATE# STATE
10 ❑ TRLR TRLR
VIN.#. VIN.#.
11 VEH.YEAR MAKE MODEL I STYLE VEHICLE TOWE E T ABLIN TOWED BY GOVT.VFH'("E FROM TO
DAMAGE YES N01 I I YES nNO
9 9 33
REGISTERED OWNER INFO.� SHADE IN DAMAGED AREA
12
LIABILITY INSURANCE❑ INSURANCE CO 4 FROM TO
TO
IN EFFECT &POLICY# 34
13 ❑ vEnic�E YES NO CITATION CHARGE 108C)1`lOM
ecauv
sTnNoiNc
MOTOR PEDAL_ ' PROPERTY DAMAGE THRESHOLD MET PHONE ❑ 35
14 ❑ UNIT# VEHICLE CYCLE PEDESTRIAN OWNER YESF-1 NO
15 LAST NAME FIRST NAME INITIAL E
❑ 36
16 ❑ STREET CITY ST ZIP
NEW ADDRESS
GDL IGNITION REDD RED IGNITION PRESENT MEDICAL TANSPORTED
INTERLOCK YE5 No INTERLOCK YE
N(5
17 YES No ❑
'. 4 37
LLIRIVERS ICENSE# STATE SEX MDDowY' -� C---�
18 ❑
HELMET INJURY 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#: UIN#'.
42
22 VEH.YEAR MAKE I MODEL I STYLE VEHICLE TOWED DUE T SABLIN TOWED BY GOVT.VEHICLE
DAMAGE YES NO YES NO
23 G REGISTERED OWNER INFO. SHADE DAMAGED AREA 43
2 3 4
LIABILITY INSURANCE INSURANCE CO
IN EFFECT &POLICY# i
..IDIG
K-99
S 44
24 VES❑ O CITATION# CHARGE
STW�N 3
3 6
I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT.
JAMAAL KEARSE 08-18-25 12:59 AM
25 INVESTIGATING OFFICER'S SIGNATURE OFFICER'S PHONE UNIT OR DIST DET DATED: PLACE SIGNED
26 BADGE ORID# 12994 O#RI WA0171300 APTIBEAU 8122212025 PAGE F OF
3000-345-013(R 11l18)
REPORT NO. EG21447 CASE# 25-7187 DATE AND TIME i 08/17/25 19:39
OF COLLISION
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PAGE 5 OF 5