HomeMy WebLinkAbout24-2077 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 5 27c
COLLISION REP FIT 1591971
CASE 24-2077 z
INTERSTATE ❑ CITY STREET FIRE ❑
RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHIC;I F ❑ LOCAL AGENCI 4250 3
HIT 8 RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 TOTAL#OF OBJECT 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 - 25 - 2024 1732 17 ❑.= S 8 IN e 1070 3
4❑ oN (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓
NE 10TH ST BLOCK NO. e✓ 3000
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ 10 00 FMILES EET e S ❑ E e JEFFERSON AVE NE
0 1 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
�/No D:4255835365 0 7 30
6� LAST NAME TRUJILLO-TORRES FIRSTNAME JESUS MIDDLE M 1 1 2 31
INITIAL
STREET ❑, 3030 NE 10TH ST#303 CITY RENTON ST WA 2jp, 98055 z
'NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
1/ I INTERLOCK YES[:]NO NTERLOCKYEs NO�/ YES R No�/
8❑ LRIIVERS STATE WA SEX'M MM DAY' 10 1— 23 — 1995 2 32
CENSE 9 ON DUTY❑ STATUS AIRBAG 2 RESTR 9 EJECT 1 HELMET
2 CLASS 1 NATURE OF INJURIES z❑
3
LICENSE CKW6163 sTArI WAurN# 5TDZA23C84S031716
10 F91 PI ATE#
TRAILER STATE TRAILED STATE
11 2 5 PLATE# PLATE# ROM To
TRLR. TRLR 3 7 33
12 2 5 VIN#' VIN#
>;. FROM TO
VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE J 9 34
13 2004 TOYT SIENNA VN DAMAGE YES NO YES[:] No
REGISTERED OWNER INFO UESUS IIZ.LO-TORRES 303O NE 10TH ST#303 RENTONWA 98055 D:4255835365 VEHICLE NO. 1 ❑
SHADE IN DAMAGEDAREA 35
14 ❑ INSURANCE CO <53 4LIABILITY INSURANCEIN EFFECT &POLICV# Q
vewcLE CHARGE 5 36
LEGALLY YES NO CITATION# 4A0210643,4A0210644, HIT AND RUN ATTENDED VEHICLE,
15❑ STANDING 7
�UNIT 'j MOTOR PEDAL- PEDESTRIAN : PROPERTY DAM THR OLDMET PHONE 02 VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES NO 1/ D:2533105903
16 a
LAST NAME COX FIRST NAME DOUGLAS MIDDLE lK
INITIAL
17 STREET I❑ S❑' 2021 81ST AVE E CITY EDGEWOOD ST' WA ZIP 98371 4❑ 37
NEW ADDRES
18❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED � 38
INTERLOCKYES�NO� INTERLOCK YEs❑NOF YEs❑NOF,/
19 F] DRIVER'S STATE WA SEX M D.C.B. O6 1_ 26 _ 1971 39
LICENSE# MMDDYY
20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 H U EET 2 NJAU EY 1 NATURE OF INJURIES 40
❑21❑ PLATE# C16061Y TArE 41
WA VIN# 3C6URSFLXMG637993 1
42
22❑ PLATE# STATE TILER PLATE# STATE
TRLR
23❑ VIN#. IN#. 43
RLR
'
VEH YEAR 2021 MAKE DODG MODEL RAM 2500 STYLE PK VEHICLE TOWED TO BLIN TOWED BY GOV HI 44
24❑ DAMAGE YES NO YES NO
REGISTERED OWNER INFO DOUGLAS COX 202181ST AVE E EDGEWOODWA98371 D:2533105903 VEHICLE NO.2
SHADE IN DAMAGEbAREA
2 3 Cd
LIABILITY
INSURANCE 8 POINSURGY#E CO USAA 01758-75-72UIN 1 9TOP
VE""LE CITATION# CHARGE
LEG
25 i o BOTTOM
ALLY YES NEI
❑ JAGENCY
s
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID#
26
R.PHILLIPS 11649 WA0171300
1
PART A PAGE 01 OF C7
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EE55577
COLLISION REPORT III III III III III 111
1591972 CASE# 24-2077
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.
R.PHILLIPS 02-29-24 11:55 AM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
P.KORDEL 9676 31312024 6:16:10 AM
BADGE OR ID# 11649 OR]# WA0171300 TIME POLICE DISPATCHED', 5:34 PM TIME POLICE ARRIVED',5:46 PM
PART I PAGE IT]OF 4�
REPORT NO. EE55577 CASE# 24-2077 OF COLLISION
02/25/24 17:32
OF CbLLI510N
NARRATIVE
On 02-25-2024 at 1734 hours I was dispatched to a hit and run at NE 10th Street and Jefferson Ave
NE in the City of Renton, King County WA.
I arrived on scene and spoke with the victim Douglas Cox. Cox told me he was driving westbound on
NE 10th Street at Jefferson Ave NE. He stopped in traffic and was rear ended by an older blue Toyota
Sienna. Cox's truck sustained rear end damage. The Sienna fled after the collision northbound on
Jefferson Ave NE. Cox was able to get the last four digits of the suspect's license plate, 6163 before it
fled. The Sienna was reported to have heavy front end damage.
I conducted an area check for the suspect vehicle, Cox was doing the same. Cox flagged me down in
the 1000 block of Kirkland Ave NE. Cox located the vehicle at 3030 NE 10th ST. I responded to the
address and located the Sienna, WA license plate CKW6163. The vehicle had heavy front end
damage consistent with a collision. Standing at the rear of the Sienna was a Hispanic male. I
informed the male he was being recorded. Using Language Line I asked if the Sienna was his van, he
said yes. I asked him why he fled after the collision, he said he was scared. I asked the suspect,
Jesus Trujillo for his driver's license and proof of insurance. Trujillo stated he had no insurance and
no driver's license. Trujillo was identified by his WA identification card. I informed Trujillo he would be
getting citations in the mail and gave him the case number.
I contacted Cox and gave him the other driver's information for the crash report and gave him the
case number. Cox stated he wanted to pursue charges for hit and run. Cox stated he has a bad back
and it already felt tight. Cox was thinking about going to the hospital for a check up.
I certify (declare) under penalty of perjury under the laws of the State of Washington that the
foregoing is true and correct. This report was electronically signed by Officer Phillips 11649, February
29th, 2024, Renton, WA.
PAGE 3 OF 4
REPORT NO. EE55577 CASE# ' 24-2077 DATE AND TIME 02/25/24 17:32
OF COLLISION
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PAGE 4 OF 4