HomeMy WebLinkAbout25-1388 oucE WASHING ON II I f I) 1 Ilf I I ('I I (Illf If( f I I REPORT NO. 2 2 27
COLLISION REP FIT 1591971
SASE 25-1388 z
INTERSTATE ❑ CITY STREET FIRE ❑RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHICI F ❑ LOCAL AGENC 4100 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 TOTAL#pF OBJECT 1 F
1 8 28
TRIBAL UNITS OZ
RESERVATION STRUCK
z
3❑ DATE OF M M D D Y Y Y Y TIME(2400) COUNTY# MILES N E IN CITY#
COLLISION'. 02 - 1-- 2025 1657 17 ❑-= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
ROUSER WAY S
BLOCK NO. e✓ --- ----� ❑
❑ MILEPOST
4a
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ ❑ FEET e S ❑ W e WELLS AVE S
0 1 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
NO F,/ I D:2068238226 30
6 1❑ LAST NAME SEANGSANAO FIRSTNAME NATCHANA MIDDLE 1 1 2 31
INITIAL
STREET ❑ 4311 NE 5TH ST APT B201 CITY RENTON ST WA Zjp, 98059 z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
iNTERLOCKYEs 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
10 2❑ I Pi ATNES# CPD2341 sTAr WAv N# JHMGE8H32BCO25236
TRAILER STATE TRAILED STATE
11 0 0 PLATE# PLATE# FROM TO
TRLR. TRLR 3 7 33
12❑ vIN#' VIN#
:: FROM TO
❑ VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE $ 34
13 1 2011 HOND FIT UT DAMAGE YES NO ✓ ves❑ No✓
REGISTEREDOWNERINFO OWNEDBYDRIVER VEHICLE NO. 1
SHADE IN DAMAGED AREA ❑ 35
14 LIABILI INSURANCE INSURANCE CO BRISTOL WEST GOI-5690664.00 3 4
IN EFFECT &POLICY# 9TOP
VEHICLE CHARGE 5 36
LEGALLY YES❑No CITATION# 5A0273959 FAIL YIELD TO PEDESTRIAN o aorrom
15❑ STANDING 8 7 6
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
16 a UNIT 02 VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES✓ NO D:4254639092
LAST NAME MARINES FIRST NAME EMMANUEL MIDDLE E
INITIAL
17❑ NEW STREETREs7 10406 SE 174TH ST APT A306 CITY RENTON ST WA ZIP 98055 4❑ 37
18� CDL IGNITION REQUIRED IGNITION PtR—E—S1ENT MEDICAL TRANSPORTED 38
INTERLOCKYES�NOR INTERLOCK YEs I I NOF YEs t l NO❑
19 DRIVER # STATE WA SEX M M D.C.B. 11 26 _ 1988 39
NATURE OF INJURIES
20 ON DUTY STATUS 3 AIRBAG RESTR EJECT H U MEET 2 LASSY 7 SORE IN L HAND,L SHLDER,L RIBS ❑ 40
❑21❑ TArE 41
IN#LICENSE V 1
PLATE#
42
22❑ PLATE# STATE PLATE# STATE
TRLR
23❑ VIN#. IN#. 43
RLR
'
VEH YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN
TOWED By Gov HI 44
L4 Q 3 DAMAGE YES NO YES NO
REGISTERED OWNER INFO VEHICLE NO.2
SHADE IN DAMAGED AREA
2 3 4
LIABILITY
INSURANCE❑ INSURANCE
#E CO
IN EFFECT &PO IGQ
vE""LE ❑ ,J� CITATION# CHARGE
LEGALLY YES N`L J
25 s � e
7.1FTR NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
26
Y NGUYEN 13182 WA0171300
PART A PAGE 01 OF
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO.
COLLISION REPORT III III III III III 111
1591972 CASE# 25-1388
ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY)
NAME MIDDLE INITIAL) KREBS ROCHELLEA
(I.P.ST FIRST,
ADDRESS&PHONE# D O.B.
121 WELLS AVE N RENTON WA 98057 4259884771 SEXi F MMDOYyry 06 - 18 - 1973
PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT ' HELMET INJURY NATURE OF INJURIES
POS. + USE CLASS
NAME
'(LASTr FIRS' MIDDLE INITIAL)
ADDRESS&PHONE# DOB
SEX' MMDDYYYY
PASSENGER ❑WITNESS UNIT# SEAT I AIRBAG RESTR. EJECT HELMET NJURY 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.
TIMOTHY NGUYEN 02-12-25 06:30 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
MICAELA CASTAIN 12573 1 211212025 11:24:38 PM
BADGE OR ID# 13182 OR]# WA0171300 TIME POLICE DISPATCHED 5:02 PSI TIME POLICE ARRIVED',5:06 PM
PART I PAGE IT]OF 4�
REPORT NO. CASE# 25-1388 OF COLLISION
02/12/25 16:57
OF CbLLI510N
NARRATIVE
On 02/12/2025 at approximately 1702 hours within the city of Renton, King County, state of
Washington, I was dispatched to a collision involving a vehicle and a pedestrian at the intersection of
Houser Way S and Wells Ave S.
Upon arrival, I observed Vehicle 1 facing south in the intersection with heavy windshield damage.
also observed Pedestrian 1 standing, talking, and breathing normally.
I proceeded to interview Driver 1. In summary, Driver 1 was driving westbound in lane 1 of 1 on
Houser Way S and approaching the intersection of Houser Way S and Wells Ave S. For note, Houser
Way S is a one-way westbound-only road. Driver 1 reported that she saw Pedestrian 1 walking in the
crosswalk from north to south. Driver 1 meant to press her brakes but mistakenly pressed her gas
and collided with Pedestrian 1. Driver 1 did not appear impaired. Driver 1 provided all of the
necessary documentation.
Pedestrian 1 complained of soreness in his left hand and left shoulder. Firefighters responded and
medically cleared Pedestrian 1. Pedestrian 1 declined to be transported to a medical facility.
proceeded to interview Pedestrian 1. In summary, Pedestrian 1 was crossing the intersection of
Houser Way S and Wells Ave S from north to south. Pedestrian 1 advised that he was halfway across
the intersection when Vehicle 1 collided with him. I took photos of Pedestrian 1's left hand and his
entire person. I did not observe any obvious injuries on Pedestrian 1 at the time.
An assisting Officer interviewed Witness 1 who reported the same narrative as Driver 1 and
Pedestrian 1.
In parting, I provided Driver 1 and Pedestrian 1 with my business card and case number for follow-up.
I advised Driver 1 that she will be receiving an infraction in the mail for RCW 46.61.235.1 - FAIL
YIELD TO PEDESTRIAN CROSSWALK.
On 02/12/2025 at approximately 2204 hours, Pedestrian 1 called back and advised that he checked
himself into Valley Medical Center (400 S 43rd St) for rib pain. Pedestrian 1 had not been admitted
yet so there were no diagnoses at the time. 1 responded to VMC and had Pedestrian 1 complete a
medical release form.
Pedestrian 1 was also able to retrieve surveillance footage from Melrose Grill (819 Houser Way S).
Pedestrian 1 later submitted the footage via Evidence.com.
This ends my involvement on today's date.
PAGE 3 OF 4
REPORT NO. CASE# k 25-1388 DATE AND TIME 02/12/25 16:57
OF COLLISION
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