HomeMy WebLinkAbout25-1793 j ITFC II IIIII III IIIII II IIII IIIII I . 27I
OOLCERAF EF69423
COLLISION REPRT 1591971
CASE# 25-1793 2
INTERSTATE CITY STREET FIRE ❑
RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VEHICLE LOCCO A`GENC'Y 4100 3[--�
COUNTY RD NVOLVED CODING
2❑ TOTAL 1
PRIVATE WAY
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
coulsloN' 02 - 26 - 2025 0447 17 =.= S 8 W e IN 1070 a
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION
EASTVALLEYRD MILE POST
e 3100 .�
4a❑ MILE POST
❑ DISTANCE OF(REFERENCE OR CROSS STREET)
5 1800 MILES N FEET S 8✓ W e SW 34TH ST
0 4 29
MOTtlR ✓ PEDAL- DAM AG THRESHOLD MET PHONE
UNIT 01 VEHICLE CYCLE' YES ✓NO D:2068194964 0 1 30
5 LAST NAME THOMSON FIRST NAME RUSSELL MIDDLE J 1 1 2 31
INITIAL
STREET E:1 3604 WELLS AVE N CITY RENTON ST WA ZIP 980561512 2
NEW ADDRESS
7 CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
INTERLOCKYEs ✓NO INTERLOCK YES NO✓ YES D NO✓
8 LCEENSE# STATE WA SEX M MMDCSYY' 11 1 2 32
9 ON DUTY STATUS AIRBAG 4 RESTR 4 EJECT 1 N USEET 2 1 INJURY
CLASS 1 NAruRE of INJURIES 2
LICENSE, SM00586 STATE WA VN# 5J6YH28768LO13123 3
10[9� PI ATP rt
11[-j- TRAILER STATE TRAILER ,STATE ROM TO
11 3 5 PLATE# PLATE#
TRLR TRLR 5 7 33
12 3 5 VN# vN#
( FROM TO
VER YEAR MAKE MODEL STYLE VEHICLE TOWED TO BUN GOVT VEHICLE
13 2 200$ HOND ELEMEN DAMAGE ves ONO� IM{Z�RS TOWING ves_ No✓ 1 5 34
REGISTERED OWNER INFO OWNEDBYDRIVER VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
2 LIABILITY INSURANCE INSURANCE CO 2 3
14 ALLSTATE 976723192
IN EFFECT &POLICY# 4TOP
VEHICLE CHARGE t S 36
Lemur YES❑NO❑ CITATION# 7 0 80TTOM
15❑ sTnNowc s 7 e
MOTOR PEDAL ❑ YES�/ NO PHONE
UNIT PEDESTRIAN PROPERTY D:20 VEHICLECYCLE62553892 nWNFR
16�
LAST NAME PALTA SARASTY FIRST NAME CRISTIAN MIDDLE C
17 F1 INITIAL I
STREET ❑ 37
'NEW ADDRESS� 215 1 ST AVE N APT 509 CITY I SEATTLE ST, W 02q ZIP 9810948
1 g CDL IGNITION REQUIRED IGNITION PRESENTMEDICAL TRANSPORTED' 38
INTERLOCKYES No✓ INTERLOCK YES 424 Es No
19 DRIVERS STATE WA SEXM D.O.B. 08 29 1995 39
LICENSE# MMDDYY —
20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 HELMET 2 INJURY NATURE OF INJURE
6 S ❑ 40
USE CLASS BROKEN RIGHT INDEX FINGER,SORE LEFT LEG
21 LICENSLATE E CLY3377 rarE W/a vIN# JTDEAMDE8NJO47763 41
22❑ PLATE# STATE PATE# STATE ❑ 42
23 TRLR kRLR 43
UIN#. 'IN#.
TOWED BY GE, HI 44
VEH.YEAR 2Q22 MAKE TOYT MODEL COROLL STYLE DAMIAGE TOWED No BLIN BANKERS TOWING YES NI ✓
24
REGISTERED OWNER INFO OWNED BY DRIVER VEHICLE NO.2
SHADEDAMAGEDAREA
3 4
LIABILITY INSURANCE INSURANCE Co ALLSTATE 820793472
IN EFFECT &POLICY# 9TOP
ve
Melae OBOT
L YES❑ NCJ TO
25
8 6
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
26
C.STEED 8770 WA0171300
PAGE 01 OF
PART A 3000-345-159(R 11/18)
POLIICFETRAFFICN CORRECTION REPORT NO. EF69423
COLLISION REPORT III III III III III 111
1591972 CASE# 25-1793
ADDITIONAL PERSONS INVOLVED(PASSENGERS AND/OR WITNESSES ONLY)
'NAME
(LAST,FIRST MIDDLE INITIAL)
ADDRESS&PHONE#
SEX' D.O.B. - [----------�
MMDDVYYY
PASSENGER F-1 WITNESS El UNIT# SEAT AIRBAG RESTR. EJECT HELMET INJURY NATURE OF INJURIES--�
POS. USE CLASS
'NAME
(LAST FIRS,MIDDLE INITIAL)
ADDRESS&PHONE#
SEX' D.O.B. - L----------�
MMDDYYYY
PASSENGER DWITNESSD UNIT# SEAT AIRBAG RESTR. EJECT HELMET NJURY NATURE OF INJURIES
POS. : USE CLASS ----�
'.NAME
(LAST,FIRST,MIDDLE INITIAL)
ADDRESS&PHONE#
SEX D.O.B. - L----------�
MMDDVVYY
PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET INJURY NATURE OF INJURIES
❑ Q POS. USE CLASS �____ ----j
NARRATIVE
On 02/26/25 at about 0452 hrs I arrived in the 3100 block of East Valley Rd for an injury collision, in
the City of Renton, County of King, and State of Washington. Unit#1 had been traveling NB on East
Valley Rd and was turning left into a parking lot. Unit#2 was traveling SB on East Valley Rd when
Unit#1 turned in front of Unit#2. Unit#2 struck the rear passenger side tire area of Unit#1 with the
front of his vehicle. Unit#2 had the right of way. The driver of Unit#1 advised he was uninjured. The
driver of Unit#2 had a broken right index finger and left leg pain. He was treated by Renton Fire who
advised him to seek further treatment at a hospital. Both vehicles were towed by Bankers Towing.
This incident was captured on my body worn video camera. This report is a summary of events that
occurred and is not an exact sequencing of events. Statements have been paraphrased and
summarized. The video was uploaded to evidence.com.
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 Officer Steed on 02/26/25 0555 hrs, Renton Washington
Cassidy Steed/8770
I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT.
C.STEED 02-26-25 06:01 AM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST.DET DATED PLACE SIGNED
APPROVED BY DATE
D.SKELTON 9139 2/27/2025 3:48:06 AM
BADGE OR ID# 8770 ORI# ( WA0171300 TIME POLICE DISPATCHED'; 4:52 AM TIME POLICE ARRIVED 4:52 AM
PART B 3aaa-345-,aa(R11Y1s) PAGE 27OF 37
REPORT NO. EF69423 CASE# 25-1793 DATE AND TIME 02/26/25 04:47
OF COLLISION
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