HomeMy WebLinkAbout23-4183 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 1 27c
COLLISION REP FIT 1591971
CASE 23-4183 z
INTERSTATE ❑ CITY STREET FIRE ❑RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHICI F ❑ LOCAL AGENCI 4100 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 TOTAL#OF OBJECT 1 7 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#
cowsloN 04 - 1-- 2023 1801 17 ❑-= S 8 IN e 1070 3
4❑ oN (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
S 43RD ST BLOCK NO. e✓ 400 ❑
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ ❑ FEET e S ❑ W e TALBOT RD SOUTH
0 1 29
UNIT 01 MOTOR CYCLE
❑ YES ]NO
MET PHONE 0 1 30
6� LAST NAME UNKNOWN FIRSTNAME MIDDLE 1 1 2 31
INITIAL
STREET ❑ CITY RENTON ST ZIP 2
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
iNTERLOCKYEs NO INTERLOCK YES No YES No
8❑ LIRCIENSRE#
STATE I
SEX u MMDDYY '❑- 1 1 2 32
9 ON DUTY❑ STATUS I
AIRBAG 9 RESTR 9 EJECT 1 H U EEr 9 CLAY 0 NATURE OF INJURIES z❑
3
LICENSE sTATI urN#'
10❑ PI ATE 14
TRAILER STATE TRAILER STATE
11 3 5 PLATE# PLATE# ROM ro
TRLR. TRLR 7 3 33
12 3 5 VIN#' VIN#
>; FROM TO
FA-1
VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE 7 3 34
13 4 FORD ECONO VN DAMAGE YES NO YES❑ NO✓
REGISTERED OWNER INFO UNKNOWN RENTON VEHICLE NO. 1
SHADE IN DAMAGED AREA ❑ 35
14 ABILI INSURANCE❑ IN CO 3 4
IN EFFECT &POLICY# 9TOP
vErIICLE CHARGE 5 36
LECALLv YES❑NO❑ CITATION# 10 BOTTOM
15❑ STANDING 7 6
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT VEHICLE ❑ CYCLE' ❑ ❑ OWNER ❑ YES 1/ No D:6149299655 N:6149299655
16 a
LAST NAME FARAH FIRST NAME JAMILA MIDDLE I E
INITIAL
17❑ STREET NEW ADOREss❑' 3000 SE ROYAL HILLS DR APT 32 CITY RENTON ST WA ZIP 980583865 37
18❑ CDL IGNITION REQUIRED IGNITION PR-E-1SENT MEDICAL-TRANSPORTED � 38
INTERLOCKYES�NO� INTERLOCK YEs It I NOF YES I'✓]NO❑
19 D IVEW #
❑ ON DUTY STATUS AIRBAG,2 RESTR 4 EJECT 1 HE 2 INJURY 5 NATURE of INJURIES ❑ 40
USE CLASS C/O HEAD PAIN
LICENSE I ❑21❑ PLA E# BSF7627 TATE 41
WA VIN# 2T3BFREVXEW191977 4
42
22❑ PLATE# STATE TILER PLATE# STATE
TRLR
23❑ UIN#. IN#.
43
RLR
'
VEH YEAR 2014 MAKE TDY)' MODEL RA V4 STYLE (�T VEHICLE TOWED TO BLIN TOWEDBY GOV HI 44
L4❑ DAMAGE YES NO YES NO
REGISTERED OWNER INFO JAMILA FARAH 3000 SE ROYAL HILLS DR APT 32 RENTON WA 98058 D:6149299655 N:6149299655 VEHICLE NO.2
SHADE IN DAGELLAREA
z Cdd
INAEFFITY ECTNSURANCE❑ &POINSULICY#E CO I 9TOP 5
vE""LE ❑ ,J� CITATION# CHARGE i o BOTTOM
LEGALLY YES N J
25 s e
=UGENT
(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
26 11498 WA0171300
PAGE 01 OF
PART A
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. ED52599
COLLISION REPORT III III III III III 111
1591972 CASE# 23-4183
ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY)
NAME MIDDLE INITIAL) ABDIRAHMAN FAIZA B
(LAST FIRST,
ADDRESS&PHONE# D O.B. '
3000 SE ROYAL HILLS DR APT 32 RENTON WA 98058 6149299655 SEXi F MMDDYyry 02 - 18 - 2015
{� SEAT HELMET NJURY NATURE OF INJURIES
PASSENGER Z WITNESS� UNIT# 2 POS 7 AIRBAG 2 RESTR. 4 EJECT 1 USE 2 CLAS5 16 C/O R.HlP PA/N
NAME
(LAST,FIRST,MIDDLE INITIAL) ABDIRAHMAN MOHAMAD N
ADDRESS&PHONE# PRO.
O B
3000 SE ROYAL HILLS DR APT 32 RENTON WA 98058 6149299655 SEX' M MMDDYvvv 07 _ 30 _ 2016
SEAT HELMET INJURY NATURE OF INJURIES
PASSENGER Z WITNESS UNIT# 2 PCS 9 AIRBAG 2 RESTR. 4 EJECT 1 USE 2 CLASS 6 C/O R.ARM PAIN
NAME
(LAST FIRST,MIDDLE INITIAL) CAKIRLAR YASINBILAL
ADDREss&PHONE# 1020 S.23RD ST TACOMA WA 98405 6318228281 SEX M M D.O.B. 04 13 _ 2002
MDDYYYY _
PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET INJURY 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.
MATTHEW NUGENT 04-18-23 04:50 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
CO.JOHNSON 0505 4/19/2023 8:20:47 AM
BADGE OR ID# 11498 ORI# WA0171300 TIME POLICE DISPATCHED! 6:03 PM TIME POLICE ARRIVED 6:10 PM
PART I PAGE IT]OF
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. ED52599
COLLISION REPORT III III III III III 111
1591972 CASE# 23-4183
ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY)
NAME MIDDLE INITIAL) KANETRUJILLO EMILEEJ
(LAST FIRST,
ADDRESS&PHONE# D.0
.B.
9419 S 235TH PL KENT WA 98031 4253902015 SEX F MMDDYyry 02 - 03 - 2002
PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT ' HELMET NJURY NATURE OF INJURIES
❑ ❑✓ POS, USE CLASS
NAME
(LAST,FIRST,MIDDLE INITIAL) MINUCCIANI RELEVANT L
ADDRESS&PHONE# D O B
4060 LIND AVE SW RENTON WA 98057 2533681094 SEX M MMODYvvv 05 _ 30 _ 1972
PASSENGER WITNESS Z UNIT# SEAT AIRBAG RESTR. EJECT HELMET INJURY NATURE OF INJURIES
❑ POS. USE CLASS
NAME
(LAST FIRST,MIDDLE INITIAL) SCHEUERMANN GREGORY T
ADDREss&PHONE# 18821 E VALLEY HWY KENT WA 98032 9374744100 SEX MI. 27 _ 1993
MDDYYYY
PASSENGER UNIT# SEAT AIRBAG RESTR. EJECT HELMET INJURY NATURE OF INJURIES
[:]WITNESS 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.
MATTHEW NUGENT 04-18-23 04:50 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
CO.JOHNSON 0505 4/19/2023 8:20:47 AM
BADGE OR ID# 11498 ORI# WA0171300 TIME POLICE DISPATCHED! 6:03 PM TIME POLICE ARRIVED 6:10 PM
PART I PAGE IT]OF
REPORT NO. ED52599 CASE# 23-4183 OF COLLISION
04/13/23 18:01
OF CbLLI510N
NARRATIVE
23-4183
On 04/13/2023 at approximately 1803 hours, I was dispatched to a hit-and-run injury vehicle collision
that occurred at the intersection of South 43rd Street and Talbot Road South, within the City Limits of
Renton, County of King, State of Washington.
While en route, Dispatch advised that a white commercial van with a ladder rack on top had fled the
scene. Dispatch advised that Renton Fire would be simultaneously dispatched to the scene as the
other involved driver, including two young juvenile passengers, were complaining of injury.
Upon my arrival, I contacted the other involved party that remained on scene. Renton Regional Fire
Authority (RRFA) and a Tri-Med ambulance were already on scene evaluating the family of three (1
adult driver, 2 juvenile passengers). The adult driver was later transported to Valley Medical Center
(VMC) for further evaluation and was accompanied by her two children.
Based on witness statements and traffic camera review, Unit#1 was traveling eastbound in about the
400 block of S 43rd ST prior to the collision. There was no available description provided for the
driver of Unit#1 by any of involved parties or witnesses. Per traffic camera coverage of the event,
Unit#1 was traveling westbound in lane 2 of 4 and adjacent to Unit#2, which was traveling
westbound in lane 3 of 4, approaching the intersection of Talbot Road South. An uninvolved Tri-Med
ambulance was traveling southbound on Talbot Road South and had reached the intersection of S
43rd ST. The Tri-Med ambulance had emergency lights and sirens activated and was attempting to
cross the controlled intersection to continue south.
Witnesses described the Tri-Med ambulance as cautiously approaching the intersection and having
to slowly travel through the intersection while traffic on S 43rd ST appeared to not immediately
recognize the Tri-Med ambulance presence. The driver of Unit#2 was complaining of injury and had
a tough time recalling what happened but did state that she remembered having a green light for her
direction of travel.
The traffic camera revealed that the Tri-Med ambulance slowly approaches the intersection of Talbot
Road South and South 43rd Street. As the Tri-Med ambulance reaches the middle of the intersection,
it appears that Unit#2 did not see the ambulance until reaching the hillcrest of the intersection. Unit
#2 is seen swerving to the right and into Unit#1's lane of travel. Unit#1 and Unit#2 collide in the
roadway causing Unit#2 to spin out of control. Unit#1 does not stop or make any attempt to assist
the other involved driver and flees the scene eastbound onto South Carr Road.
Several witnesses, identified as Yasinbilal, Emilee Kane Trujillo, and Relevant Minucciani, confirmed
the white commercial-type van (Unit#1) had fled the scene after colliding with Unit#2. The witnesses
said that the Tri-Med ambulance had cautiously approached the intersection and that cross traffic did
not immediately notice the ambulance with its emergency lights activated. Another witness and Tri-
Med ambulance employee, Gregory Schuermann, stated that the ambulance was trying to enter the
intersection on a red light and had reached the middle of the intersection prior to Unit#1 and Unit#2
colliding. The Tri-Med employees stopped and provided immediate aid to the occupants of Unit#2 as
Unit#1 fled the scene. Schuermann informed me that he would provide dashcam footage from the
ambulance as soon as it was available.
Unit#1 committed one (1) count of Hit-and-Run Attended by being involved in an accident with
another vehicle, which is attended, and failing to stop and remain at the scene until fulfilling all
statutory duties (provide name, address, insurance company, policy, vehicle license, exhibit driver's
license and render reasonable assistance to any person injured).
PAGE 4 OF 6
REPORT NO. ED52599 CASE# 23-4183 OF COLLISION
04/13/23 18:01
OF CbLLI510N
NARRATIVE
A copy of the traffic camera footage for the aforementioned intersection was uploaded by Traffic
Sergeant C. Johnson. This includes the intersection where the collision took place as well as footage
of Unit#1 continuing east past the intersection of 108th Ave SE and SE Carr Road making no attempt
to stop and provide the required driving documentation.
RRFA was able to move Unit#2 into a nearby private parking lot. An exchange of information was
provided to Unit#2.
1 certify (or declare) under penalty of perjury under the laws of the State of Washington that the
foregoing is true and correct.
Electronically signed by Officer M. Nugent#11498 4/18/2023 4:45 PM Renton, King County, WA.
PAGE 5 OF 6
REPORT NO. ED52599 CASE# ' 23-4183 DATE AND TIME 04/13/23 18:01
OF COLLISION
0
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0
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'Dagrann not to scale::
TrFN9ed:Am6rs6ance
e--f
South 43rd Street
PAGE 6 OF s