HomeMy WebLinkAbout25-1045 )STATE
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Oc� RA EF62703
COLLISION REPRT 1591971
CASE# 25-1045 2
INTERSTATE CITY STREET❑ FIRE ❑
RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VEHICLE LOCAL AGENCY. 4100 3
CODING
COUNTY RD PRIVATE WAY ❑✓ INVOLVED 2❑ TRIBAL UNITS#OF 02 SO BJECT TRUCK 1 8 28
RESERVATION 2
3� M M D D Y Y Y Y TIME(2400) COUNTY# MILES CITY#
DATE OF'. N E
GDLLISION' 02 - 02 - 2025 1043 17 =.= S 8 W E IN OF M 1070 a
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION
NE 4TH ST BLOCK NO. e 4112 .�
4a❑ MILE POST
❑ DISTANCE OF(REFERENCE OR CROSS STREET)
5 1 C------�. FEET e S 8 W
1 9 29
MOTtlR PEDAL- DAMAG THRESHOLD MET PHON
UNIT 01 E
VEHICLE CYCLE' YES NO �/ D:2069402249 0 1 30
5 LAST NAME LE FIRST NAME MINH MIDDLE D 1 1 2 31
INITIAL
STREET E:1 5202 NE 10TH PL CITY RENTON ST WA ZIP 98059 2
NEW ADDRESS
7 CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED'. 3
INTERLOCKYEs NOW INTERLOCKYEs NO�/ YES NDF,/
8❑ DCIENSE# STATE WA SEX M MMDO
OCSYY' 07 - 15 - 1963 1 2 32
9 ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 N USEET 2 1 INJURY
CLASS 1 NAruRE of INJURIES 2
LICENSE, 225ZDH STATE WA VN# JTDBR32E130004250 3
10[9� PI ATP rt
11[-j— TRAILER STATE TRAILER ,STATE
11 0 0 PLATE# PLATE# FROM TO
TRLR TRL.R 7 1 33
12 0 o VIN# VIN#
FROM TO
VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED By GOVT VEHICLE
13 9 2003 TOYT COROL SD DAMAGE YES�NO� YES 1 5 34
REGISTERED OWNER INFO OWNEDBYDRIVER VEHICLE NO. 1
SHADE IN DAMAGED AREA 35
9 NSURANCE CO 3 4
14 LIABILITY INSURANCE GEIC04174380015
IN EFFECT &POLICY# Q�,Q,
VEHICLE CHARGE 36
LEcgLLY YES❑NO❑ CITATION# 515 sTnowc
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT OZ VEHICLE CYDLE' ❑ ❑ PROPSnWNF YEs No �/ D:2532277823
16�
LAST NAME LOPEZ FIRST NAME MICHELEAN MIDDLE I M
INITIAL
STREET ❑
17 ' 2307 NE 4TH ST,APT J107 CITY RENTON ST, WA ZIP 98056 4 37
NEW ADDRESS
18 CDL IGNITION REQUIRED3 IGNITION PRESENT MEDICAL TRANSPORTEDI 38
INTERLOCKYES ND [NTERLO'KYES NO vES No;�
19 �CIENSE# STATE WA SEXI M MMDDYY 05 04 1984 39
20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 HELMET 2 INJURY NATURE A INJURIES
6 40
USE CLASS BACK PAIN
21 LICENSLATE E BXV6154 TATE WA vIN# 3FADP4EJ5GM178991 41
22❑ [TILER TRAILER
PLATE# STATE PATE# STATE ❑ 42
23 TRLR kRLR 43
UIN#. 'IN#.
VEH.YEAR 2016 MAKE FORD MODEL FIESTA STYLE $D VEHICLE TOWED TO BLIN
TOWED BY GOV HI 44
24 DAMAGE YES NO YES NO
REGISTERED OWNER INFO OWNEDBYDRIVER VEHICLE NO,2
SHADE IN DAMAGED AREA
2 3 4
LIABILITY INSURANCE INSURANCE CO PROGRESSIVE 931154957
IN EFFECT &POLICY# t 9TOP
v ICLE ❑ ,.I—J I CITATION# CHARGE tO BOTTOM
LEGnLLY YES N.L` 6
25 OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
26
GLENN LATRONICO 13151 WA0171300
PAGE 01 OF
PART A 3000-345-159(R 11/18)
POLIICFETRAFFICN CORRECTION REPORT NO. EF62703
COLLISION REPORT III III III III III 111
1591972 CASE# 25-1045
ADDITIONAL PERSONS INVOLVED(PASSENGERS AND/OR WITNESSES ONLY)
NAME MIDDLE INITIAL} CLAUSNITZER KRISTINE M
(LAST,FIRST
ADDRESS&PHONE# DOB
16819 NE 18TH ST BELLEVUE WA 98008 4255998338 SEX' F MMDDYYYv 04 - 25 - 1987
SEAT HELMET INJURY NATURE OF INJURIES
PASSENGER z WITNESS UNIT 2 POS. 3 AIRBAG 12 RESTR. 4 EJECT 1 USE 2 GLASS '6 BACKPAIN
'NAME
(LAST FIRS,MIDDLE INITIAL)
ADDRESS&PHONE#
SEX' D.O.B.M -�
MDDYYYY
PASSENGER ❑WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET INJURY NATURE OF INJURIES
POS. : USE CLASS ----�
'.NAME
(LAST,FIRST,MIDDLE INITIAL)
ADDRESS&PHONE#
SEX' D.O.B.M -� II
MDDYYYY
PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET INJURY NATURE OF INJURIES
❑ Q PEA USE GLASS �---- I
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.
GLENN LATRONICO 02-02-25 03:21 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST.DET DATED PLACE SIGNED
APPROVED BY DATE
S.WOODWARD 11528 2/5/2025 10:28:08 AM
BADGE OR ID# 13151 ORI# ( WA0171300 TIME POLICE DISPATCHED'; 10:46 AM TIME POLICE ARRIVED 10:50 AM
PART B 3 Do-lmx-,ao(R11Y1s) PAGE 27 OF 47
EAN
REPORT NO.` EF62703 CASE# 25-1045 O OF COLLI COLLISION TIME 02/02/25 10:43
COLLI
NARRATIVE
25-1045
At approximately 1048 hours on 02/02/2025 1 responded to a two vehicle collision with injuries near
the Starbucks at 4112 NE 4th St, City of Renton, King County, Washington. Dispatch advised me that
"ALL INVLD CONS, 2 PTS IN FORD FIESTA -ADULT MALE AND FEM, BACK PAIN, PARTIALLY
BLKING IFO LOC."
I arrived on scene at approximately 1050 hours and observed a silver Ford Fiesta (BXV6154/WA -
U2) in the driveway entrance of the location parking lot facing S/B (exiting the drive) with minor
damage to the middle driver's side of U2. Driver of U2 identified via WADOL photo as Michelean M.
Lopez (05/04/1984). Front passenger of U2 identified via WADOL photo as Kristine M. Clausnitzer
(04/25/87).
1 also observed a white Toyota Corolla (225ZDH/WA- U1) in the same driveway entrance of the
location parking lot facing N/B (entering the drive) with minor damage to the front driver's side of U1.
Driver of U1 identified via WADOL photo as Minh D. Le (07/15/63)
Driver of U1 stated while traveling W/B in lane 1 of NE 4th St he was turning right (N/B) into the
Starbucks parking lot when he lost control of his vehicle on the snow and struck the middle driver's
side of U2 with the front driver's side of U1.
Driver of U2 stated while traveling S/B through the parking lot entrance/exit the middle driver's side of
U2 was struck by the front driver's side of U1 as U1 slid on the snow while attempting to enter the
parking lot off of NE 4th St.
I obtained all parties information and gave driver of U1 an exchange of information. I emailed driver of
U2 the same exchange of information.
Both parties have valid insurance. I obtained a medical release form for the driver of U2.
Photos uploaded via AXON.
The driver of U2 was transported to Valley Medical Center with minor injuries. U2 was relocated into
the Starbucks parking lot by Renton Fire Department into a legal parking spot.
This concludes my involvement with this case.
During this incident, I was equipped with a body-worn camera, which records both audio and video.
Portions of this incident were recorded. This report is merely a summary of the incident and is not
intended to be an exact transcription of the entire investigation or what may have been captured with
the recording system. I was operating a fully marked Police Tahoe which was equipped with
overhead emergency lights and sirens.
I declare under penalty of perjury under the laws of the State of Washington that the foregoing is true
and correct.
Electronically signed by G. Latronico #13151 on 02/02/2025 at 1215 Renton, WA
PAGE 3 OF 4
REPORT NO. EF62703 CASE# 25-1045 DATE AND TIME i 02/02/25 10:43
OF COLLISION
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