HomeMy WebLinkAbout24-1171 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 0 27c
COLLISION REP FIT 1591971
CASE 24-1171 z
INTERSTATE ❑ CITY STREET FIRE ❑RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHIC;I F ❑ LOCAL AOENC 4Y00 3
HIT 8 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#
COLLISION 02 - 01 - 2024 0629 17 �. S 8 W H OF e 1070 3
4❑ oN (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
BENSON DR S BLOCK NO. e✓ 2100 ❑
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ ❑ FEET e S ❑ W e S 21ST ST
0 6 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
,/No D:2533407333 0 81
30
6 LAST NAME CAB PARRA FIRSTNAME CARLOS MIDDLE E 1 1 2 31
INITIAL
STREET ❑ 570 HARRINGTON AVE NE CITY RENTON ST WA 2jp, 980563736 z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
�/INTERLOCK YES[:]No INTERLOCKYEs NO YES R NO
8❑ LRIIVER #
ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 HELMET
2 CLASS 1 NATURE OF INJURIES z❑
3
LICENSE CFU0840 sTArI WAurN# JHMES16541S002945
10❑ PI ATE 14
TRAILER STATE TRAILER STATE
11 3 5 PLATE# PLATE# FROM TO
TRLR. A'RLR. 1 5 33
12 0 0 VIN#j VIN#
FROM TO
❑ VEH.YEAR 2001 HOND CIVIC 2D MAKE MODEL STYLE VEHICLE TOWED fn TO VBLINJ TOWED BY I GOVT.VEHICLE J 9 34
DAMAGE YES NO
13 4 YES[:] No
REGISTERED OWNER INFO CARLOS CAB PARKA 2324 SW 333RD ST FEDERAL WAY WA 98023 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
14 ❑ INSURANCE CO eq�T3 4
LIABILITY INSURANCE
IN EFFECT &POLICY# 9TOP 5
VEwcLE CHARGE 10 BOTTOM 36
LEGALLY YES No CITATION# 4A0196792,4A0196792, INATTENTIVE DRIVING,NO VALID
15❑ NDING 8 7 6
MOTOR PEDAL-: PROPERTY DAM THR OLD MET PHONE
UNIT 02 ❑✓ ❑ PEDESTRIAN ❑ ❑ YES 1/ No D:2537779015
VEHICLE CYCLE : OWNER
16 a
LAST NAME RIVERA FIRST NAME CARLOS MIDDLE A
INITIAL
17 STREET I❑ S❑' 22619 110TH CT SE CITY' KENT ST WA ZIP 980312688 4❑ 37
NEW ADDRES
18❑ CDL IGNITION REQUIRED IGNITION PR-E-1SENT MEDICAL-T�RANSPORTED � 38
INTERLOCK YEs❑No� INTERLOCK YEs It I NOF YES
t l No❑
19[-] LDI IVEW # STATE WA SEX M M D.C.B. 01 11 1985 39
20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 H U EET 2 NJAURSY 1 NATURE OF INJURIES ❑ 40
❑21❑ PLATE# D932746 TArE 41
WA VIN# 1C6RR6GT6KS697351 1
42
22❑ PLATE# STATE PLATE# STATE
23❑ VIN#. 43
TRLR RLR
'IN#.
VEH YEAR 2019 MAKE RAM MODEL 1500 STYLE PK VEHICLETOWED TO BLIN TOWEDBY GOV HI 44
24❑ DAMAGE YES NO YES NO
REGISTERED OWNER INFO CARLOS RIVERA 22619110TH CTSE KENT WA 98031 VEHICLE NO.2
SHADE IN DAMAGED AREA
2 3 4
LIABILITY
INSURANCE INSU PORGY#E CO PROGRESSIVE 957296311IN 1 9TOP 5
'E""LE CITATION# CHARGE i o BOTTOM
LEGALLY YES N(�
25❑ s
7CJA
R'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
26
COBS 1953 WA0171300
PART A PAGE 01 OF
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EE50257
COLLISION REPORT III III III III III 111
1591972 CASE# 24-1171
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.
C.JACOBS 02-01-24 10:13 AM
NVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
C.JACOBS 1953 2/14/2024 11:05:48 AM
BADGE OR ID# 1953 ORI# WA0171300 TIME POLICE DISPATCHED 6:33 AM TIME POLICE ARRIVED',6:46 AM
PART I PAGE IT]OF 4�
REPORT NO. EE50257 CASE# 24-1171 OF COLLISION
02/01/24 06:29
OF CbLLI510N
NARRATIVE
On 2-1-24 at about 0646 1 arrived at the intersection of Talbot Rd S Benson Dr S for a 2 vehicle hit
and run collision. Both vehicles were at the scene and pulled to the side of the road on Talbot Rd S. I
contacted both drivers in the roadway. Driver 1, Carlos Cab Parra identified himself via WAID card.
Driver 2, Carlos Rivera identified himself via WADL. Rivera told me;
He was stopped in lane 1 of Talbot Rd S, waiting for the traffic signal to change when unit 1 struck his
vehicle from the rear.
Unit 1 then made a U turn and fled. He had chased Unit 1 down and got him to return to the scene.
Driver 1 told him he did not have insurance.
Driver 1, Cab Parra told me in Spanish.
He does not speak English.
He was trying to stop behind unit 2 but his car slid into the rear of unit 2. He was scared so he drove
away. But he came back when contacted by driver 2.
He does not have insurance.
The damage to unit 1 was over $1000.00, but the vehicle was drivable. The damage to unit 2 was a
bumper, I'm not sure of the damage value.
Both drivers were able to remove their vehicles from the scene. I later ran Cab Para via my MDC .
The return showed that he was unlicensed but eligible.
I CITED Driver 1, Carlos Cab Parra via complaint for inattention, No insurance and No Valid operator
license with ID.
This incident occurred in the city of Renton, County of King.
I declare under penalty of perjury under Washington state law that the foregoing is true and correct.
C. Jacobs/1953
PAGE 3 OF 4
REPORT NO. EE50257 CASE# 24-1171 DATE AND TIME 02/01/24 06:29
OF COLLISION
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