HomeMy WebLinkAbout23-9287 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 5 27c
COLLISION REP FIT 1591971
CASE 23-9287 z
INTERSTATE ❑ CITY STREET FIRE ❑RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHICI F ❑ LOCAL AOENC 4200 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# ❑
cawsloN 08 - 1-- 2023 1045 17 ❑.= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓
RAINIER AVE S BLOCK NO. e✓ 700
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ ❑ FEET e S ❑ W e 0 1 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
✓NO D:2067692311 0 11
30
6� LAST NAME SCHOON FIRSTNAME RODNEY MIDDLE W 1 2 31
INITIAL
STREET ❑ 4845 AQUA DR E CITY BONNEY LAKE ST WA ZIP 98391 z
'NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
iNTERLOCKYEs NO 1/ INTERLOCKYEs NO�/ vEs No�/
8❑ DRIVERS
# STATE WA SEX'M I ELMIDI Y' 09 — 24 — 1960 1 2 32
9 ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 H USE ET ICNLJAURY 1 NATURE OF INJURIES z❑
SS
3
10 9❑ pICENS17 ATE 14 SH17358 STATE WA V N# 4USCJ3327WLC12360
11[-j- TRAILER STATE TRAILER STATE
11 3 5 PLATE# PLATE# FROM TO
TRLR. TRLR. 5 1 33
12 3 5 VIN#' VIN#
FROM TO
❑ VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TRQ�y,�p Y GOVT.VEHICLE 1 $ 34
13 2 1998 BMW Z3 CP DAMAGE YES NO d 9W9 MEYER YES❑ NO✓
REGISTEREDOWNER WFO JULIE LENNON 4845 AQUA DR E BONNEY LAKE WA 98391 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
14 LIABILI INSURANCE NSURANCE CO AMERICANFAMILYCONNECTA101236772 <1�3 4
IN EFFECT &POLICY# TOPvEHICLE CHARGE 36
LEGALLY YES❑NO❑ CITATION# 3A0610830 FLD TO DRIVE ON RIGHT SIDE OF orrom
15❑ STANDING 7 6
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT a2 VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES NO ,/ D:4255486925
16 a
LAST NAME PE CH LOPEZ FIRST NAME DAVID MIDDLE JE
INITIAL
17 STREET❑ NEW ADOREss❑' 856 CENTRAL AVE S TRLR 60 CITY KENT ST WA ZIP 98032 37
18❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL—T�RANSPORTED � 38
INTERLOCK YEs❑No� INTERLOCK Y�EsI I I NOF YES t l NO�
19 DRIVER # STATE WA SEX M M D.C.B. 12 _ 08 _ 1998 39
20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 HEJ EET NJAU EY 1 NATURE OF INJURIES 40
❑21❑ PLATE# C64738R TATE WA VIN# 41
STDZA23C55S301583 1
42
22❑ PLATE# STATE PLATE# STATE
23❑ UIN#. 43
TRLR RLR
'IN#.
VEH YEAR 2005 MAKE TOYT MODEL SIENNA STYLE VN VEHICLETOWED TO BLIN TOWEDBY GOV HI 44
L4❑ DAMAGE YES NO YES NO
REGISTERED OWNER INFO PRODUCTS GLOBAL FOOD 6012 S 196TH ST KENT WA 98032 VEHICLE NO.2
SHADE IN DAMAGED AREA
2 3 4
LIABILITY INSURANCE INSU8 PORGY#E CO SENTINAL INSURANCE CO 52 UEC ZD2197 STOP 5
IN EFFECT
VEHICLE YES[:] ,.I—I CITATION# CHARGE i o BOTTOM
LEGALLY N
25 0(
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# JAGENCY
26
STEVEN FAJARILLO 12847 WA0171300
PAGE 01 OF
PART A
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. ED89868
COLLISION REPORT III III III III III 111
1591972 CASE# 23-9287
ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY)
NAME MIDDLE INITIAL) PECH MARTIN JOSE I
(LAST FIRST,
ADDRESS&PHONE# D O.B.
856 CENTRAL AVE S TRLR 60 KENT WA 98032 4253718016 SEX M MMDOYyry 05 - 16 - 1976
PASSENGER I�I WITNESS UNIT# ! 2 PQS 3 AIRBAG j 2 RESTR. 4 EJECT ? I HELMET INJURY NAruRE of INJURIEs
L�!1 USE .CLASS 1
NAME
(LAST,FIRST,MIDDLE INITIAL)
ADDRESS&PHONE# DOB
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.
STEVEN FAJARILLO 08-13-23 01:12 PM
NVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
QUINT TIBEAU 07691 1 8/16/2023 3:33:07 PM
BADGE OR ID# ( 12847 OR]# WA0171300 TIME POLICE DISPATCHED; 10:46 AM TIME POLICE ARRIVED',10:47 AM
FART I PAGE IT]OF 4]
REPORT NO. ED89868 CASE# 23-9287 OF COLLISION
08/13/23 10:45
OF CbLLI510N
NARRATIVE
On 08-13-2023 1 was working as a police officer in the city of Renton. At approximately 1046 hours I
was dispatched to the report of a vehicle collision with injuries on 700 Rainier Ave S, City of Renton,
County of King, WA. This incident was captured on my Axob body worn camera.
According to the notes in the call, the Renton Fire Authority was on scene of a two vehicle collision
with injuries.
I arrived on scene and located both vehicles blocking the southbound outside lane. Vehicle 1 was
facing the wrong way in the road. Vehicle 1 had significant damage to the front end of the vehicle.
The driver did not know what happened. He said the last thing he remembered was trying to merge
onto 1405 from SR-167. Renton Fire Authority cleared him medically. 1 did not observe any signs of
impairment and he stated he did not have any alcohol or drugs. The damage to the front of the BMW
was not consistent with the collision. Washington State Patrol did not have any recent collision
reports near the interchange of 405/167.
The driver of Vehicle 1 had an arrest warrant he was taken into custody for. Officer Odalovic
completed the report for the arrest. Please see her report for more details.
I contacted the driver of Vehicle 2. He explained he was taking a south bound turn onto Rainier Ave S
when he collided with the front bumper of Vehicle 1. The driver advised Vehicle 1 was travelling at a
very slow speed and it appeared the driver was not paying attention. There was minor damage to the
front bumper of Vehicle 2. He nor the passenger of Vehicle 2 had any injuries.
I photographed the scene and uploaded the photographs to Evidence.com.
I provided both parties with a case number.
The driver of Vehicle 1 was driving on the wrong side of the road. He was issued an infraction for
RCW 46.61.100 Driving wrong side of road.
There is no further information available at this time.
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 S. Fajarillo #12847 on 08/13/2023 @ 1315 hours in Renton WA.
PAGE 3 OF 4
REPORT NO. ED89868 CASE# ' 23-9287 DATE AND TIME 08/13/23 10:45
OF COLLISION
icio 1 Not to.Scale
-Paint of Impact
IBM
Vehicle 2
PAGE 4 OF 4