HomeMy WebLinkAbout23-01504 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 1 27c
COLLISION REP FIT 1591971
CASE 23-01504 z
INTERSTATE ❑ CITY STREET FIRE ❑RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHIr.I F ❑ LOCAL AOENC 4Y00 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 3 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# ❑
cawsloN 02 - 1-- 2023 1834 17 ❑.= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓
SW 7TH ST BLOCK NO. e✓ 200
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ ❑ FEET e S ❑ W e 2 0 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
NO F,/ I D:5402888801 0 11
30
6� LAST NAME BRITO-BRITO FIRSTNAME ANDHY MIDDLE A 1 1 2 31
INITIAL
STREET ❑ 510 STEVENS AVE S W#Q408 CITY RENTON ST I WA ZIP 98057 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 4 EJECT 1 H U SE
ICNLJAUSSY 1 NATURE OF INJURIES z❑
3
LICENSE C85190U sTArI WAvIN# 1GCZGTCG8E1194985
10 F91 PI ATE#
TRAILER STATE TRAILER STATE
11 3 5 PLATE# PLATE# ROM ro
TRLR. TRLR 3 7 33
12 3 5 VIN#' VIN#
>; FROM TO
VEH.YEAR 2014 MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED By GOVT.VEHICLE 3 7 34
13 CHEV EXPRES VN DAMAGE YES NO YES[:] No✓
REGISTERED OWNER INFO WA RENT READY CONSTRUCTION 3619 JEFFERSON DAVIS HWY#107 STAFFORD VA 22554 D:5402888801 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
14 LIABILI INSURANCE INSURANCE CO LIBERTY MUTUAL BAS59747875 3 4
IN EFFECT &POLICY# 9TOP
VEHICLeEC
15 5 36
LALLvSTANDING YES[:]NO❑ CITATION# CHARGE 1 o BOTTOM
❑ 8 7 6
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES NO ,/ D:2068414420
16 a
LAST NAME WILLIAMS FIRSTNAME ARIAS MIDDLE ,/
INITIAL
17 STREET I❑ s❑' 13445 M.L.K.JR WAYS#R214 CITY' SEATTLE ST WA ZIP 98178 4❑ 37
NEW ADDREs
18❑ CDL IGNITION REQUIRED IGNITION PtR-E-S1ENT MEDICAL-T�RANSPORTED � 38
INTERLOCK YEs❑No� INTERLOCK yEs I I NOF YEs t l NOF,/
19 DRIVER'S STATE WA SEX M D.C.B. 09 _ 24 1987 39
LICENSE# MMDDYY
20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 JJ
HELMET INJURY 7 NATURE OF INJURIES 40
USE CLASS ARM PAIN
❑ILICENSE 21❑ PLA E# BZZ1564 TArE 41
WA VIN 1I 2HNYD2H25DH502216 1
42
22❑ PILER LATE# STATE PLATE# STATE
23❑ VIN#. 43
TRLR RLR
'IN#.
GoI
VEH YEAR 2013 MAKE /a CUR MODEL MDX STYLE UT —FEHICLE
TOWED NOO✓ BLIN TOWED BY vHyES NO 1/ 44
24❑ REGISTERED OWNER INFO OWNED SY DRIVER VEHICLE N0.2
SHADE IN DAMAGED AREA
2 3 4
LIABILITY
INSURANCE INSU&PORGY#E CO PROGRESSIVE 959025354IN 1 9TOP 5
vE""LE ❑ N J
,J� CITATION# CHARGE
LEG
25 i o BOTTOM
ALLY YES $
7TH
NAME(PRINT) OFFICER PHONE BADGE OR ID# GENCY
26MAN 11462 WA0171300
PART A PAGE 01 OF
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. ED35108
COLLISION REPORT III III III III III 111
1591972 CASE# 23-01504
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
PM 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 FIR57 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.
J.THIELMAN 02-05-23 08:19 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
J.THIELMAN 11462 211812023 4:25:08 AM
BADGE OR ID# 11462 OR]# WA0171300 TIME POLICE DISPATCHED: 6:36 PM TIME POLICE ARRIVED]6:38 PM
PART I PAGE IT]OF 4�
REPORT NO. ED35108 CASE# 23-01504 OF COLLISION
02/05/23 18:34
OF CbLLI510N
NARRATIVE
Case Number 23-1504
On 02/05/2023 at approximately 1836 hours, I was dispatched to an injury collision in the 300 block of
SW 7th ST within the City of Renton, King County, Washington.
While en route, dispatch relayed there was a two vehicle collision with one driver having arm pain.
I arrived and contacted the driver of both vehicles via their WADL:
Unit one WA/Lic C85190U, Andhy A. Brito-Brito DOB 05/09/1987
Unit two WA/Lic BZZ1564, Aris J. Williams DOB 09/24/1987.
Brito informed me of the following: Unit one was traveling westbound on SW 7th ST through the 200
block in lane two. As he was proceeding through the 300 block, unit two pass him in lane one and
moved into lane two. Unit two struck the front passenger fender/headlight, causing minor damage.
Williams informed me of the following: Unit two was traveling westbound on SW 7th ST through the
200 block in lane two. He believed unit one just turned west on SW 7th ST from the Walmart parking
lot (743 Rainier Ave S) and did not see unit two. Unit one struck the rear driver's side door and
fender, causing minor damage. Williams complained of arm pain due to the collision and was cleared
by Renton Fire of any obvious injuries.
Due to conflicting stores and the minor damage of each vehicle, I was unable to determine which
vehicle was at fault. Both were provided case numbers.
I certify (declare) under the penalty of perjury under the laws of the State of Washington that the
foregoing is true and correct.
Electronically signed J.Thielman/11462
02/05/2023 2015 Hours Renton, WA.
PAGE 3 OF 4
REPORT NO. ED35108 CASE# ' 23-01504 DATE AND TIME 02/05/23 18:34
OF COLLISION
200 BLOCK SW 7TH ST
PAGE 4 OF 4