HomeMy WebLinkAbout22-13587 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 0 27c
COLLISION REP FIT 1591971
CASE 22-13587 z
INTERSTATE ❑ CITY STREET FIRE ❑RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHICI F ❑ LOCAL AGENCI 4Y00 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2❑ TOTAL#OF OBJECT 1 ❑28
TRIBAL UNITS 02 STRUCK' FENCE
RESERVATION
z
3❑ DATE OF M M D D Y Y Y Y TIME(2400) COUNTY# MILES N E IN CITY# ❑
COLLISION.. 12 - 1-- 2022 0327 17 ❑.= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
EDMONDS AVE NE
BLOCK NO. e✓ --- ----� ❑
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ ❑ FEET ❑ S ❑ VV❑ NE 7TH ST
0 4 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
,/No D:4253516792 30
6❑ LAST NAME TAMBRIZ GUACHIAC FIRST NAME MARTIN MIDDLE L
INITIAL 1 2 31
STREET ❑ 826 HARRINGTON AVE NE APT B3 C{Ty RENTON ST WA 2jp, 98056 z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
INTERLOCK YES[:]NO 1/ INTERLOCKYEs NO�/ YES R No�/
8❑ LDRIVER # STATE WA SEX'M MID
LOB 10 - 29 - 1999 32
9 ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 HELMET
2 CLASS 1 NATURE OF INJURIES z❑
❑10❑ P1 aT�S� BWV3065 sTATI WWAurN# JA32U2FUXEU015719 3
TRAILER STATE TRAILER STATE
11 0 0 PLATE# PLATE# FRom ro
FT -R TPILF1 1 3 33
12❑ VIN#' VIN#.
Ro❑34
13❑ VEH.YEAR 2O14 MAKE MITS MODEL LANCER STYLE $D VEHICLE TOWEDNOO pLSSBLIN TQ yEq.BLRs yOS❑ENO
DAMAGE ILJI tSA1Vi�6
REGISTERED OWNER INFO OWNEDBYDRIVER VEHICLE NO. 1
SHADE IN DAMAGED AREA ❑ 35
3 4
14 LIABILITY INSURANCE❑ INSURANCE CO
IN EFFECT &POLICY# 9TOP
VE—LL CHARGE 10BOTTOM 5 36
LEGALLY YES No CITATION# 2A0521635,2A0521635, SPEED TOO FAST FOR CONDITIONS,
15❑ STANDING 7 6
MOTOR PEDAL- 'PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT U2 VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES 1/ NO D:4252273057
16❑
LAST NAME LANGLOIS FIRST NAME JERRY IN DOLE R
IN MIDDLE
17 STREET I7TH ST CITY' RENTON ST WA ZIP 98057 4❑ 37
NEW ADOREs�' 2503 NE
18� CDL IGNITION REQUIRED IGNITION PRESENT MEDICALTRANSPORTED ❑ 38
INTERLOCKYES�NOR INTERLOCK YEs❑NOF YEs❑NO❑
19 DRIVE # STATE SEX M M DDY
D.C.B.
10 _ 02 _ 195 5 39
WELMET INJURY NATURE OF INJURIES 4O
20❑ ON DUTY STATUS' AIRBAG RESTR EJECT USE CLASS ❑
❑21❑ TATE 41
LICENSE VIN# 1
PLATE#
42
22❑ PILER LATE# STATE pLATE# STATE
TRLR
23❑ VIN#. IN#. 43
RLR
'
VEH YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN
TOWED BY Gov HI 44
L4❑ DAMAGE YES NO YES NO
REGISTERED OWNER INFO VEHICLE NO.2
SHADE IN DAMAGED AREA
2 3 4
INAEFFIECTTY NSURANCE❑ &POINSULICY#E CO 1 9TOP 5
VE."Le ES❑ N J
,J� CITATION# CHARGE i o BOTTOM
LEGALLY Y
25 s 7 6
7BRYAN
NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
J
26GROZAV 1 12489 WA0171300
PAGE 01 OF
PART A
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. ED22013
COLLISION REPORT III III III III III 111
1591972 CASE# 22-13587
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 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.
BRYAN GROZAV 12-23-22 05:42 AM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
C.TOLLIVER 10540 11512023 2:34:12 AM
BADGE OR ID# 1Y489 ORI# WA0171300 TIME POLICE DISPATCHED 3:30 AM TIME POLICE ARRIVED',3:37 AM
PART I PAGE IT]OF 4�
REPORT NO. ED22013 CASE# 22-13587 OF COLLISION
12/23/22 03:27
OF CbLLI510N
NARRATIVE
CASE 22-13287
This incident was captured on my body worn video camera. This report is a summary of events that
occurred and is not an exact sequencing of events.
On Friday December 23rd, 2022 at approximately 03:34, 1 responded to a 911 call regarding a single
vehicle collision into a fence at 2503 Ne 7th St in the City of Renton, King County, Washington.
***CALL REMARKS: VEH VS RPS PARKED VEH, OTHER VEH TRYING TO LEAVE WITHOUT
PROVIDING INSURANCE INFO, LINK INJS. DRIVER OF VEH THROWING BEER BOTTLES OUT
OF HIS VEH: BLK MITS LANCER... HAD SECOND VEH WITH HIM THAT REPARKED UP THE
STREET POSS WAITING FOR HIM: BLK MITS L/CDU9298. DRIVER STILL AT LOCN ON FOOT:
HM, 20S, 500/140, BLK JCKT W/HOOD, GRN PANTS...INV'D IN COLLISION: MITS LANCER
L/BWV3065. DRIVER BEING VERBAL WITH RP ... BELIEVES THE GETAWAY VEH PARKED UP
THE STREET IS OCC'D X34 SUBJS.. RP OUTS AND TRYING TO KEEP THE SUBJ ONSC UNTIL
PD ARRIVE AS THERE IS DMG TO RPS FENCE.
-UNIT ONE: BLACK 2014 MITSUBISHI LANCER WASHINGTON LICENSE BWV3065
-UNIT ONE DRIVER: MARTIN L. TAMBRIZ GUACHIAC (DOB: 10.29.1999)
-PROPERTY OWNER: JERRY R. LANGLOIS (DOB:10.02.1955)
Upon arriving on scene, Officer J. Seibert was already on scene and talking to Martin. Martin was
sitting in the back of Officer J. Seibert's patrol car. Martin said he tried to make the left turn on to Ne
7th St from Edmonds Ave Ne but lost control because the roads were icy and crashed into the fence.
The initial call stated Martin was intoxicated, while talking to Martin I did not observe any signs
indicating Martin was under the influence.
Unit one had minor damage to the front end of the vehicle. Unit one was towed from the scene since
it was not safe to operate on the roadway and unable to move.
After talking to Martin, I contacted Jerry (fence owner) who reported hearing Martin crash into his
fence and attempt to leave. Martin's vehicle was stuck and not able to move.
Martin indicated he did not have insurance and a record check of Martin's DOL status showed his
license was suspended in the 3rd degree. I issued Martin a citation for the following violations:
SPEED TOO FAST FOR CONDITIONS RCW 46.61.400
OP MOT VEH W/OUT INSURANCE RCW 46.30.020
DWLS 3rd degree RCW 46.20.342.1 C (criminal citation)
I forwarded the criminal citation to the prosecutor que for filing and the traffic infraction to court for
mailing.
I provided Jerry a SECTOR exchange of information form while on scene. Martin left the scene before
providing him with his copy.
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 12.23.2022 at 04:45 hours in Renton, WA.
PAGE 3 OF 4
REPORT NO. ED22013 CASE# 22-13587 DATE AND TIME 12/23/22 03:27
OF COLLISION
EDMONDS AVE NE
NOT TO SCALE
NE7ST
PAGE 4 OF 4