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Home My WebLink About25-631 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 5 27c COLLISION REP FIT 1591971 ❑ ❑ 25-631 z RESULTED ❑ CASE INTERSTATE CITY STREET FIRE 1 STOLEN STATE ROUTE ❑ OTHER ❑ VFHIC;I F ❑ LOCAL AGENCI 4200 3 HIT 8 RUN CODING COUNTY RD PRIVATE WAY INVOLVED 2 TOTAL#OF OBJECT 28 5 RESERVATION 1 TRIBAL UNITS 02 STRUCK 2 3❑ DATE OF M M D D Y Y Y Y TIME(2400) COUNTY# MILES CITY# ❑ CowsloN 01 - 19 - 2025 1936 17 ❑.❑ N E IN S 8 W H OF e 1070 3 4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑ 116TH AVE SE BLOCK NO. e✓ --- ----� ❑ 4a❑ MILEPOST DISTANCE OF(REFERENCE OR CROSS STREET) 5❑ ❑ FEET ❑ S ❑ W❑ SEPETROVITSKYRD 0 1 29 MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE UNIT 01 VEHICLE ❑ CYCLE El �/No D:4253709200 0 4 30 6� LAST NAME HUTTO FIRSTNAME D'ANDRE MIDDLE D 1 1 2 31 INITIAL STREET ❑✓ 12210 SE PETROVITSKY RD CITy RENTON ST WA Zjp, 98058 2 NEW ADDRESS 7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3 1/ I INTERLOCK YES[:]NO NTERLOCKYEs NO Z/ YES R No�/ 8❑ LRIIVER # ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 HELMET USE 2 CLASS 1 NATURE OF INJURIES 2❑ ❑10❑ P1 aT�S� CND4118 sTATI WWAurN# 5XXGM4A74EG303553 3 TRAILER STATE TRAILER STATE 11 3 5 PLATE# PLATE# FROM TO TRLR. TRLR 7 3 33 12 3 5 VIN#' VIN# >; FROM TO VEH.YEAR 2014 MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE 5 7 34 13 4 KIA OPTIMA SD DAMAGE YES NO YES[:] No ✓ REGISTERED OWNER INFO ZIPPORAH THOMPSON 12210 SEPETROVITSKYRD E301 RENTON WA 98058 VEHICLE NO. 1 ❑ ❑ SHADE IN DAMAGED AREA 35 14 LIABILITY INSURANCE❑ INSURANCE CO 4 IN EFFECT &POLICY# 9TOP VEHICLE CHARGE 1 5 36 LEGALLY YEs❑NO CITATION# 5AO180215 OP MOT VEH W/OUT INSURANCE 1 o eorro6 15❑ STANDING 8 7 6 MOTOR PEDAL PROPERTY DAM THR OLD MET PHONE UNIT 02 ❑ ❑ PEDESTRIAN ❑ ❑ D:4259884325 VEHICLE CYCLE OWNER YES�/ NO 16 a LAST NAME EN G FIRST NAME KATHERINE MIDDLE JA INITIAL 17❑ STREET ❑', 2912 NE 21 ST ST CITY RENTON ST WA ZIP 980562311 37 NEW ADDRESS ❑ 18� CDL IGNITION REQUIRED IGNITION PRESENT MEDICALTRANSPORTED ❑ 38 INTERLOCK YEs❑No� INTERLOCK YEs❑NOF YES ❑NOF,/ 19 DRIVER # {NJURY 1 NATURE OF INJURIES 40 20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 USE 2 CLASS ❑ 21❑ LICENSE I CKF4739 TATE WA VIN# 5J8TB41432FL014648 ❑ 41 PLATE# 42 22❑ PLATE# STATE PLATE# STATE TRLR 23❑ VIN#. IN#. 43 RLR ' VEH YEAR 2015 MAKE ACUR MODEL RDX STYLE SI/ VEHICLETOWED TO BLIN TOWEDBY GOV HI 44 L4❑ DAMAGE YES NO,/ YES NO REGISTERED OWNER INFO KATHERINE ENG 2912 NE 21ST ST RENTONWA98056 VEHICLE NO.2 SHADEDAMAGEDAREA 3 4 LIABILITY INSURANCE I PORGY#ECO STATE FARM 4482969-Cll-47BIN STOP 5 VEHICLE ❑ C[ CITATION# CHARGE 25 io BOTTOM LEGALLY YES N a OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# JAGENCY 26 ROBIN SMITH 12986 WA0171300 PART A PAGE 01 OF C7 3000-345-159 OR 11/181 STATE OF POLICETRAFFICN CORRECTION REPORT NO. EF60044 COLLISION REPORT III III III III III 111 1591972 CASE# 25-631 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. ROBIN SMITH 01-20-25 03:29 AM INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED APPROVED BY DATE QUINT TIBEAU 07691 1 112812025 3:03:46 AM BADGE OR ID# ( 12986 OR]# WA0171300 TIME POLICE DISPATCHED 7:39 Pry] TIME POLICE ARRIVED:7:39 PM FART I PAGE IT]OF 4� REPORT NO. EF60044 CASE# 25-631 OF COLLISION 01/19/25 19:36 OF CbLLI510N NARRATIVE 25-631 Unless otherwise stated, the following occurred in the City of Renton, County of King, State of Washington. On 01-19-2025 at approximately 1939 hours, I was dispatched to a non-blocking, non-injury, two vehicle collision that occurred at the intersection of 116th AVE SE and SE Petrovitsky RD. Upon arrival, I contacted the involved parties who all reported they did not need medical attention. I collected the involved parties driving documents and their independent recollection of events leading up to the collision. The driver of Unit#1 said he was traveling eastbound thru the intersection on SE Petrovitsky RD. The driver of Unit#1 stated he had a green traffic signal light when he collided into Unit#2 in the middle of the intersection. He said that Unit#2 was making a turn from northbound 116th AVE SE to westbound SE Petrovitsky RD. Unit#1 sustained damage to the rear passenger door. The driver of Unit#2 said she was traveling northbound on 116th AVE SE and was turning westbound onto SE Petrovitsky RD when Unit#1 collided into her. The driver of Unit#2 said she had a green traffic signal light. Unit#2 sustained damage to the front end of the vehicle. The driver of Unit#1 told me he does not have vehicle insurance. I cited the driver of Unit#1 in the mail for RCW 46.30.020, Operating Motor Vehicle without Insurance, which states: 1)(a) "No person may operate a motor vehicle subject to registration under chapter 46.16A RCW in this state unless the person is insured under a motor vehicle liability policy with liability limits of at least the amounts provided in RCW 46.29.090, is self-insured as provided in RCW 46.29.630, is covered by a certificate of deposit in conformance with RCW 46.29.550, or is covered by a liability bond of at least the amounts provided in RCW 46.29.090. Proof of financial responsibility for motor vehicle operation must be provided on the request of a law enforcement officer in the format specified under RCW 46.30.030." The driver of Unit#1 violated this when he failed to not only show proof of having vehicle insurance, but told me he did not carry it. Reference SECTOR citation #5A0180215. Based on the above statements, I do not have a unit responsible for the proximate cause of the collision because I cannot prove who had a green traffic signal light and there were no witnesses on scene. 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 Robin Smith #12986 on 01/20/2025 @ 0323 hours in Renton, WA. PAGE 3 OF 4 REPORT NO. EF60044 CASE# ' 25-631 DATE AND TIME 01/19/25 19:36 OF COLLISION I V& 1 4=y?y E t } i rl tl� .3 �3r Y � a 1 3:,,, .. ..... ..... a '�. , U � .;?z?�r ,; 1„��'y`J' 4S'Y�{z}, .,ig\�� ti `� '�: „tw�'\z•. t p .i � z Lr.ntpy,`.r 4#i) } } t v Y, } PAGE 4 OF 4