HomeMy WebLinkAbout25-7003 IT si " II IIIII III IIIII II IIII IIIII I . 27c REPORT NO EG22283OLCERA
COLLISION REPORT 1591971
CASE# 25-7003 2
INTERSTATE CITY STREET FIRE I
RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VEHICLE LOL`CODICENC'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#
eaCLson' 08 - 12 - 2025 0828 17 =.= S 8 W e IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION �✓
SE 8TH PL BLOCK NO. e 2160 .�
4a❑ MILE POST
❑ DISTANCE OF(REFERENCE OR CROSS STREET)
5 C------�.� FEET e S B W
2 3 29
MOTOR ✓ PEDAL- DAM AG THRESHOLD MET PHONE
UNIT 01 VEHICLE CYCLE YES ✓NO 1 4 30
6 LAST NAME JORGERICO FIRST NAME NEIDY MIDDLE J 1 1 2 31
INITIAL
STREET Q 2025 SE 8TH DR CITY; RENTON ST WA ZIP; 98055 2
NEW ADDRESS
7� +CDL IGN(TIUN REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
INTERLOCKYEs NO INTERLOCKVEs NO YES NO
8 DRIVE E# STATE SEX I F MMD4YY' O6 - 26 - 1995 t 32
9 ON DUTY STATUS' AIRBAG 3 RESTR 9 EJECT 1 HELMET INJURY 7 NATURE of INJURIES 2
USE CLASS CHEST PAIN
LICENSE, CPD1701 STATE WA VIN#, JTDBT923481218363 3
10 F1 as ATP tt
TRAILER STATE TRAILER STATE
11 2 5 PLATE# PLATE# ROM To
TRLR TRLR 7 3 33
12 0 0 VIN#' VIN#
FROM TO
VEH.YEAR 200E MAKE TOYT MODEL YARiS STYLE VEHICLE TOWED[n TO ZBLIN TOWEDBY GOVT VEHICLE m 34
13� DAMAGE YES II_II NO YESII_I) NO
REGISTERED OWNER INFO JOSE QUESADA URIBE 2025 SE 8TH DR RENTON WA 98055 VEHICLE NO. 1
SHADE IN DAMAGED AREA 35
2 3 4
14 LIABILITY INSURANCE❑ NSURANCE CO
IN EFFECT &POLICY# 4TOP
VEnicLE CHARGE 7080TTOM 5 36
15
Lrn Lyc YES❑NO❑ CITATION# 5A0625705,5AO625706, NO VALID OPER LICENSE W/OUT s 7 e
UNIT 02 MOTOR PEDAL- ❑ PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
VEHICLE CYCLE nWNRR
16❑
LAST NAME UNKNOWN FIRST NAME MIDDLE'
INITIAL
17❑ STREET F-1 CITY ST ZIP ❑ 37
NEW ADDRESS
1$� CDL IGNITION REQUIRED IGNITION PRESENT MED[CALTRANSPORTED 38
INTERLOCKYEs ND INTERLOCK YES R No vEs NQ
19 DRIVER'S
# STATE SEX U MMDDYY 39
HELMET INJURY: NATURE OF INJURIES 40
LICENSEI
20❑ ON DUTY STATUS AIRBAG 9 RESTR 9 EJECT 1 USE 9 CLASS 0 ❑
21 PLATE# BRK0782 rare WA vIN# 2FMPK4AP3GBC07644 41
22 [TILER TAILER
❑ PLATE# STATE PLATE# STATE 42
23 TRLR RLR 43
UIN#. 'IN#
VEH.YEAR 2016 MAKE FORD MODEL EDGE STYLE VEHICLE TOWED TO BLIN
TOWED BY GOV HI 44
24 DAMAGE YES NO VES NO
REGISTERED OWNER INFO BRIANNA MONTGOMERY 2160 SE 8TH DR RENTON WA 98055 D:2067907291 VEHICLE NO.2
SHADE IN DAMAGED AREA
2 3 4
LIABILITY INSURANCE INSURANCE CO USAA 0111319737101
IN EFFECT &POLICY# t STOP
L",vew1— ❑ ,.I—I CITATION# CHARGE to BOTTOM
—LY YES No
25 s e
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
26
C.ARNOLD 12509 WA0171300
PAGE 01 OF
PART A 3000-345-189(R 11/18)
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EG22283
COLLISION REPORT III III III III III 111
1591972 CASE# 25-7003
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 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.
C.ARNOLD 08-12-25 09:42 AM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST.DET DATED PLAGE SIGNED
APPROVED BY DATE
C.JACOBS 1953 8/25/2025 11:38:44 AM
BADGE OR ID# 12509 ORI# WA0171300 TIME POLICE DISPATCHED 8:30 AM TIME POLICE ARRIVED i 8:34 AM
PAST B 3 Do-3mx—attar(t 1Mff) PAGE 2�OF 4
REPORT NO.` EG22283 CASE# 25-7003 GATE OF COLLI r�510NN + 08/12/25 08:28
L1
NARRATIVE
CC 25-7003
On 8/12/2025 at 0835 hours I was dispatched to a motor vehicle collision at 2160 SE 8th PI in the City
of Renton, King County, Washington.
Pre-Collision
Unit 2 was unoccupied and parked legally within the driveway of the registered address and fully off
of the roadway.
Driver 1 was unable to provide comment as she was medically transported to Valley Medical Center.
Witness 1 was working outside in the house next door and had a clear view of the area where the
incident occurred.
Collision
Witness 1 stated that Unit 1 left the roadway in the front yard of 2148 SE 8th PI, then went through
the front yard of 2160 SE 8th Pl. Witness 1 stated that while the vehicle was off of the roadway, he
estimated that it was traveling at least 20 mph, however this is unverified. Witness 1 stated that the
front bumper of Unit 1 then collided with the drivers side doors of Unit 2, then pushing Unit 2
approximately 4 feet off of the driveway and into the side yard where it came to rest.
Injuries
Driver 1 was medically transported to VMC with a complaint of chest pain from airbag deployment.
Vehicle Disposition
Unit 1 was driven from the scene a short distance to the registered address. Unit 2 remained on
scene as it was already at the registered address. Unit 2 appears driveable.
Proximate Cause
I determined that Driver 1 is the proximate cause of this collision because it shall be unlawful to
operate or drive any vehicle or combination of vehicles over or along any pavement or gravel or
crushed rock surface on a public highway with one wheel or all of the wheels off the roadway thereof,
except as permitted by RCW 46.61.428 or for the purpose of stopping off such roadway, or having
stopped thereat, for proceeding back onto the pavement, gravel or crushed rock surface thereof.
Driver 1 also did not have insurance and did not have a valid license at the time of the collision. At the
time of this report, her identity is in doubt as she has no record per DOL. I had Driver 1 write her
name out for me to verify and I was still unable to get a return.
Driver 1 was cited per RCW 46.61.672, RCW 46.30.020, and 46.20.005.
1 spoke with the registered owner of Unit 1 and he advised that he knew that Driver 1 did not have a
license, and that he knew that she was driving Unit 1, and that he allowed her to driver Unit 1 upon a
public roadway.
The registered owner of Unit 1, Jose A. Quesada Uribe (DOB: 12/21/1993) was cited per RCW
46.16A.520.
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 C. Arnold #12509 at 09:28 on 8/12/2025 in the City of Renton, King
County, Washington.
PAGE 3 OF 4
REPORT NO. EG22283 CASE# 25-7003 DATE AND TIME 08/12/2508:28
OF COLLISION> '
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PAGE 4 OF 4