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HomeMy WebLinkAbout26-4667 IT �iNII I IIII �� I I III I I IIII IIIII I 27c REPORT NO.STATE OF COLLISION REPORT 1591971 CASE# 26-4667 2 INTERSTATE CITY STREET❑ FIRE ❑ RESULTED 1 STOLEN STATE ROUTE ❑ OTHER � VEHICLE ❑ LDCAI-ACENCY 4100 3 HIT&RUN CODING COUNTY RD PRIVATE WAY INVOLVED 2 TOTAL#OF OBJECT 1 s 28 TRIBAL UNITS 03 STRUCK BUILDING RESERVATION 2 3� M M D D Y Y Y Y TIME(2400) COUNTY# MILES CITY# DATE OF N E IN eDLLISION' 06 - 15 - 2026 1814 17 =.= S 8 W H OF M 1070 a 4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓ BLOCK NO. 3700 NE 4TH ST 4a❑ MILE POST ❑ DISTANCE OF(REFERENCE OR CROSS STREET) 5 1 MILES 1.1 FEET e S 8 W e 1 9 29 MOTOR PEDAL- DAM AG TSHOLD MET PHONE UNIT 01 VEHICLE ❑ CYCLE ❑ YES NHREO ✓ 30 6 LAST NAME RED-STEPHENS FIRST NAME SALEH MIDDLE F 1 1 2 31 INITIAL STREET ❑ 438 25TH AVE E '.NEW ADDRESS CITY I $EATTLE ST: WA ZIP: 98112 2 7 CDL IGN(TIUN REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3 INTERLOCKYES NL ✓ INTERLOCKYES NO✓ YEs NO✓ # STATE SEX F MMD4YY' 06 — 21 — 2014 t 32 $❑ 9 ON DUTY STATUS' AIRBAG 2 RESTR 1 EJECT 1 HELM USEET 2 CLASSY 1 NATURE OF INJURIES 2 10 LI ENSE', BZV2196 STATE WA VIN# 1N4AA5AP4BC859710 3 TRAILER STATE TRAILER STATE 11 0 0 PLATE# PLATE# 5 ROM TRLR zRLR 9 5 33 12 VIN#' VIN# FROM TO VEH.YEAR ZOII MAKE NiSS MODEL MAXIMA STYLE $D VEHICLE TOWED[n TO ZBUN TOWEDBY GOVT VEHICLE 1 $ 34 13� DAMAGE YES II_II NO YESII_I) NO✓ REGISTERED OWNER INFO RAY-CHELL GILBER143825THAVEE SEATTLE WA 981124718 D:2068861136 VEHICLE NO. 1 SHADE IN DAMAGED AREA 35 A LIABILITY INSURANCE INSURANCE CO 14 GE/CO 4359116482 IN EFFECT &POLICY#VEn" CHARGE 36 Lec Ly YES❑NO❑ CITATION# <14, 15 STANDING MOTOR PEDAL-:. PROPERTY DAM THR OLD MET PHONE UNIT 02 PEDESTRIAN Q✓ D:2064878521 VEHICLE CYCLE CfWNFR YES✓ NO 16� LAST NAME PEDROZA TORRES FIRST NAME ARMANDO MIDDLE N INITIAL 17 F1 STREET ❑❑ 3815 NE 4TH ST APT B39 CITY RENTON ST, WA ZIP 980564137 4 37 NEW ADDRESS 18❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED'. 38 INTERLOCKYEs No INTERLOCK YES xz YEs NO 19 DRIVER'S MMDDYY I - 6 INJURY 40 NATURE OF INJURIES 3 20❑ ON DUTY HELMET STATUS 3 AIRBAG' RESTR EJECT USE 2 CLASS 6 LEFT FORARM AND ELBOW SCRAPS AND PAIN ❑ 21 PLATE# TATE VIN# 41 22❑ PLATE# STATE PLATE# STATE 42 23 TRLR RLR 43 UIN#. 'IN# VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOV HI 44 24 1 6 DAMAGE YES NO YES NO REGISTERED OWNER INFO VEHICLE NO.2 SHADE IN DAMAGED AREA 2 3 4 LIABILITY INSURANCE❑ INSURANCE CO IN EFFECT &POLICY# 9TOP vewaE ❑ , CITATION# CHARGE to BOTTOM EEGnEEY YES N.I—I 25 a s OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY 26 KEVIN PETERSON 12808 WA0171300 PAGE 01 OF PART A 3000-345-189(R 11/18) STATE OF POLICETRAFFICN CORRECTION REPORT NO. COLLISION REPORT III III III III III 111 1591972 CASE# 26-4667 ADDITIONAL PERSONS INVOLVED(PASSENGERS AND/OR WITNESSES ONLY) '.NAME (LAST,FIRST,MIDDLE INITIAL) ADDRESS&PHONE SEXi D.O.B. — MMDDYYYY PASSENGERF�WITNESS[:] UNIT# SEAT AIRBAG RESTR. EJECT ; HELMET INJURY NATURE OF INJURIES POS. ' USE CLASS 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 CLASS ----� :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. KEVIN PETERSON 06-16-26 12:28 AM INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST.DET DATED PLAGE SIGNED APPROVED BY DATE M.BRAUN 2194 1 711512026 11:08:11 PM BADGE OR ID# 12808 ORI# WA0171300 TIME POLICE DISPATCHED; 7:15 Pry] TIME POLICE ARRIVED i 7:17 PM PAST B 3 Do-3mx—attar(t 1Mff) PAGE 2�OF F5 REPORT NO.` CASE# 26-4667 DATE OF COLLI r�510NN + 06/15/26 19:14 L1 NARRATIVE I was dispatched to a vehicle into a building collision on 06/15/26 at Los Jalapenos at 3700 NE 4th St, in city Renton, King County WA. Unit 1 BZV2196 Driver: Saleh F. Red-Stephens (DOB 06/21/2014) Unit 1 BZV2196 Owner: Ray'Chell A. Gilbert (DOB 01/28/1995) Unit 2 Pedestrian: Armando Pedroza-Torres (DOB 08/27/1992) Unit 3 Owner: Maria E. Gonzalez (DOB 10/06/1978) Upon arriving I saw the front of the store pushed in and the vehicle parked in the parking lot with minimal damage. The vehicle was not occupied at this time, and I checked on Unit 2 the individual that got hit by the door of the store. He stated that he only had pain in his left arm and elbow. I spoke with the store owner Unit 3 that took me upstairs where I contacted the vehicle owner who did not understand what was going on. After speaking to her she told me that her 11 year old daughter Unit 1 driver took the keys to go down to the car for something. I asked the child if she hit the building while the mother was present and she said no. I spoke to another person who stated they saw the daughter get out of the car after hitting the building and then she went upstairs to the barber shop. Unit 1 would not say any other information to her mom or grandmother of what happened. Do not have the information of the witness that saw the daughter getting out of the car. I spoke to the business owner who told me that no one else was hurt. Renton Fire came to the scene and evaluated all that were involved in the accident. Picture of the front of the business and the car as well as the victim were taken and submitted to evidence. An information exchange with the case number was given to all involved parties I certify (declare) under penalty of perjury under the laws of the State of Washington that the foregoing is true and correct. Electronically signed: Officer Kevin L. Peterson Date and Place: 06/16/2026, 0007 hours at Renton, WA **** AUTO-POPULATED SECTION **** THE FOLLOWING ARE DESCRIPTIONS ENTERED FOR ITEMS SELECTED AS "OTHER": Motor Vehicle Unit 1 Action Code: DROVE OVER CURB INTO BUILDING **** END OF AUTO-POPULATED SECTION **** PAGE 3 OF 5 SUPPLEMENTAL REPORT NO.POLICE TRAFFIC 1 27 ... ;'� COLLISION REPORT CASE# 26-4667 t113197 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 NAME IF NO NUMBER SOURCE AXLES + 4a ❑ ADDITIONAL UNITS MOTOR PEDAL- PROPERTY DAMAGE THRESHOLD MET PHONE UNIT# 3 PEDESTRIAN �' vps� No D:2537778065 5 VEHICLE CYCLE OWNER 29 LAST NAME GONZALEZ FIRST NAME MARIA MIDDLE. E INITIAL STREET CITY 30 NFW ADDRFs 22305 30TH AVE E SPANAWAY ST WA ZiP gg3877301 6 ❑ CDL GNITION REQUIRED PRESENT MEDICALTANSPORTED: 1 31 I IGNITION :: INTERLOCK YES.. NO '.INTERLOCK YES 0 NO vE5 N.. L LICENSE DRIVER'S STATE SEX F MD.D0.6 10 O6 - 1978 ; 7 ON DUTY STATUS AIRBAG RESTR. EJECT HELMET INJURY NATURE of INJURIES USE CLASS 8 ❑ 1 32 LICENSE TAT VIN. PLATE# 9 TRAILER TRAILER L PLATE# STATE PLATE# STATE 0 10 ❑ TRLR TRLR VIN.# VIN#. 11 VEIL YEAR MAKE MODEL STYLE VEHICLE TOWE E T ABLIN TOWED BY GovT.vEHICI E FROM TO DAMAGE YES NO YES NO m 33 REGISTERED OWNER INFO.� SHADE IN DAMAGED AREA 12 LIABILITY INSURANCE❑ INSURANCE CO 4 FROM TO 7t)P IN EFFECT &POLICY# 34 13 vewcEe YES NOEJ CITATION# CHARGE 1080TTOM ecauv sTANoINc MOTOR PEDAL_ ' 1:1PROPERTY : DAMAGE THRESHOLD MET PHONE 35 14 ❑ UNIT# VEHICLE CYCLE PEDESTRIAN OWNER YES NO 36 15 LAST NAME FIRST NAME NIT AL 16 ❑ STREET CITY ST' ZIP NEW ADDRESS" CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TANSF'ORTED INTERLOCK YES NO INTERLOCK YES N4 YES NO'. 17 37 RIVERSLLIICENSE# STATE SEX M ooY6 - 18 ❑ ❑ HELMET INJURY NATURE OF INJURIES 38 ON DUTY STATUS AIRBAG RESTR. EJECT USE CLASS 19 ❑ ❑ 39 LICENSE TAT vIN# PLATE# 20 TRAILER+ TRAILER 40 PLATE#.: STATE PLATE# - STATE ❑ 21 ❑ TRLR TRLR 41 VIN# VIN#Y 42 22 VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED DUE T ABLIN TOWED BY GOVT.VEHICLE DAMAGE YES NO YES NO El 23 REGISTERED OWNER INFO. SHADE IN DAMAC ED AREA 43 2 3 4 LIABILITY INSURANCE INSURANCE CO IN EFFECT I &POLICY# .. ) E 44 24 YES❑ NO CITATION# CHARGE OM STIWDING 8 3 G 1 CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT. KEVIN PETERSON 06-16-26 12:28 AM 25 INVESTIGATING OFFICER'S SIGNATURE OFFICER'S PHONE UNIT OR DIST DET DATED: PLACE SIGNED 26 BADGE 1 OR ID# 12808 O#RI WA0171300 APPROVED BY 7/115/2026 PAGE OF 3000-345-013(R 11/18) REPORT NO. CASE# 26-4667 DATE AND TIME 06/15/26 19:14 OF COLLISION S � + q + « fi a + + 3 t� lM1v, Nt 4 S W lC s PAGE 5 OF 5