HomeMy WebLinkAbout25-80462 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 0 27c
COLLISION REP FIT 1591971
CASE 25-80462 z
INTERSTATE ❑ CITY STREET FIRE ❑RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHICI F ❑ LOCAL AOENC 4Y00 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 1 TOTAL#OF OBJECT 1 1 8 28
TRIBAL UNITS OZ STRUCK
RESERVATION
z
3❑ DATE OF M M D D Y Y Y Y TIME(2400) COUNTY# MILES N E IN CITY# ❑
COLLISION'. 12 - 1-- 2025 1854 17 ❑.= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓
SUNSET BLVD N BLOCK NO. e✓ 400
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ ❑ FEET e S ❑ W e 0 4 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
,/No D:5093048302 0 11
30
6❑ LAST NAME ORTIZ-HERNANDEZ FIRSTNAME BRIAN MIDDLE p
INITIAL 1 2 31
STREET El2301 E RAILROAD ST APT C5 CITy EASTON ST WA 2jp, 989255970 z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
INTERLOCK YES[:]NO 1/ INTERLOCKYEs NO Z/ YES R No�/
$❑ LICENS
DRIVER # STATE WA SEX'M MMDDYY 12 - 01 - 2004 1 2 32
9 ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 HELMET USE 2 CLASS 1 NATURE OF INJURIES z❑
3
LICENSE CRP8924 sTArI WAurN#' JFIVA1C64J9805169
10 F91 PI ATE#
TRAILER STATE TRAILER STATE
11 0 0 PLATE# PLATE# FROM ro
FT -R TPILF1 1 3 33
12 0 0 VIN#' VIN#
:: FROM TO
VEH.YEAR 2018 MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE 5 1 34
13 4 SUBA WRX SD DAMAGE YES NO YES[:] ✓
REGISTERED OWNER INFO OWNEDBYDRIVER VEHICLE NO. 1
❑
SHADE IN DAMAGED AREA ❑ 35
14� LIABILI VINSURANCE� INSURANCE CO STATE FARM 580 9775 D28 47 3 4
IN EFFECT &POLICY# 9TOP
vEGALLv Hla.e 5 36
YES No CITATION# 5A0128880 CHARGE FAIL YIELD LEFT TURN MOTOR o BorroM
15 LF❑ STANDING 8 7 6
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT VEHICLE ❑ CYCLE ❑ ❑ : OWNER ❑ YES 1/ NO D:2069603681
16 a
LAST NAME PINTO VELASQUEZ FIRST NAME REINALDO MIDDLE J
INITIAL
17❑ STREET ISET BLVD NE APT 205 CITY RENTON ST WA ZIP 980562991 37
NEW ADOREs�' 1100 SUN
18� CDL IGNITION REQUIRED IGNITION PtR-E-S1ENT MEDICAL TRANSPORTED 38
INTERLOCKYES�NO INTERLOCK YEs I I NOF YEs t l NoF,/
19 DRIVER'S STATE WA SEX M D.C... 11 � 1983 08 _ 39
LICENSE# MMDDYY
20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 H EET 2 NJAU EY 7 COMPLAINT OF PAIN TO NECK F—NATURE OF INJURIES 40
❑21❑ PLATE# CLS1504 TArE 41
WA VIN1 KMHCM3AC6AU170204 1
42
22❑ PILER LATE# STATE pLATE# STATE
23❑ VIN#. IN#. 43
rIN# RLR
'
VEH YEAR 2010 MAKE HYUN MODEL ACCENT STYLE HB VEHICLE TOWED TO BLIN TOWEDBY GOV HI 44
24❑ DAMAGE YES NO,/ YES NO
REGISTERED OWNER INFO EDIER MENDEZ VELASQUEZ 13445 MARTIN LUTHER KING JR W SEATTLEWA98178 VEHICLE NO.2
SHADE IN DAMAGED AREA
2 3 4
LIABILITY INSURANCE❑ INSURANCE CO
IN EFFECT &POLICY# I 9TOP 5
"F""LE Yes Nc❑ clrArloN# 5AO948575 CHARGE OP MOT VEH W/OUT INSURANCE o BOTTOM
LEGALLY1 ----j
25 $
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
26
BRYAN GROZAV 12489 WA0171300
PAGE 01 OF
PART A
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EG61070
COLLISION REPORT III III III III III 111
1591972 CASE# 25-80462
ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY)
NAME
(LAST FIRST,MIDDLE INITIAL)_
ADDRESS&PHONE#
SEX D.O.B. - -
MMDDYYYY.
PASSENGER❑WITNESS UNIT# SEAT AIRBAG RESTR. EJECT ' HELMET INJURY NATURE OF INJURIES
POS. USE CLASS
NAME
'(LAST,FIRST MIDDLE INITIAL)
ADDRESS&PHONE# D D B
SEX MMDDYYYY
PASSENGER ❑WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET INJURY NATURE OF INJURIES
POS. USE CLASS
NAME
(LAST FIRST MIDDLE INITIAL)
AppRESS R PHONE#
SEX D.O.B.
MMDDYYYY. -
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.
BRYAN GROZAV 12-07-25 12:55 AM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
M.BRAUN 2194 12/20/2025 5:47:49 PM
BADGE OR ID# ` 12489 OR]#' WA0171300 TIME POLICE DISPATCHED I` 6:54 PM TIME POLICE ARRIVED',6:57 PM
PART I PAGE IT]OF 4�
REPORT NO. EG61070 CASE# 25-80462 OF COLLISION
12/06/25 18:54
OF CbLLI510N
NARRATIVE
CASE 25-80462
SECTOR INFRACTION: 5A0128880/5A0948575
This incident was captured on my body worn video camera and/or in-car dash camera. This report is
a summary of events that occurred and is not an exact sequencing of events.
On Saturday December 6th, 2025, at approximately 18:54, 1 responded to a 911 call regarding a two-
vehicle collision at 7-11 located at 404 Sunset Blvd North within the City of Renton, King County,
Washington.
***CALL REMARKS: *OCC'D ON SUNSET BLVD N IFO LOC* SPANISH/16422, 2 MVA, RP CONS,
ADULT MALE, C/O PAIN TO ARM/SHOULDER, NB ...SEE RELATED EMS&Fire CALL RF25-80863.
I arrived on scene and noticed the involved vehicles stopped in the Enterprise vehicle rental parking
lot. The involved drivers were out of there vehicles and walking around.
I contacted the driver of unit one identified as Brian D. Ortiz-Hernandez (DOB:12.01.2004). Brian
indicated he was traveling south on Sunset Blvd North and wanted to make a left turn into the 7-11
parking lot and crashed into unit two. Brian was operating a White 2018 Subaru WRX with
Washington license CRP8924 which sustained damage to the front right but appeared drivable. Brian
had a valid driver's license and insurance. Brian was the sole occupant in the vehicle and did not
complain of injuries.
After speaking to Brian, I contacted the driver of unit two, identified as Reinaldo J. Pinto Velaaquez
(DOB: 11.08.1983) who was also outside of his vehicle. Reinaldo reported similar circumstances, he
was traveling north on Sunset Blvd North when he was struck by unit one. Reinaldo was operating an
orange 2010 Hyundai Accent with Washington license CLS1504 which sustained damage to along
the driver side of vehicle. The rear driver side tire was also damaged and flat. Reinaldo declined a
tow and indicated he was going to change out the tire. Reinaldo was the only occupant in the vehicle
but indicated the vehicle belonged to one of his friends. Reinaldo had a valid driver's license but
indicated he did not have valid vehicle insurance. Reinaldo was examined by aid on scene for pain to
his neck.
I issued Brian a traffic infraction for the following traffic violation:
RCW 46.61.185 Vehicle turning left: Brian failed to yield right of way to unit two who was approaching
from the opposite direction while he was attempting to turn left.
I issued Reinaldo a traffic infraction for the following traffic violation:
RCW 46.30.020 operating vehicle without valid insurance: Reinaldo said he did not have valid
insurance.
I provided Brian and Reinaldo their traffic infractions on scene as well as the SECTOR exchange of
information from.
This concludes my involvement in this case.
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 B. Grozav #12489 on 12.07.2025 at 00:49 hours in Renton, WA.
PAGE 3 OF 4
REPORT NO. EG61070 CASE# ' 25-80462 DATE AND TIME 12/06/25 18:54
OF COLLISION
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PAGE 4 OF 4