HomeMy WebLinkAbout25-1629 iiTFiNII IIIII III IIIII II IIII IIIII I . 27c REPORT NO EF68547oc� RA
COLLISION REPORT 1591971
CASE# 25-1629 2
INTERSTATE CITY STREET FIRE ❑
RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VEHICLE ❑ LOCAL AGENC'Y 4100 3[--�
COUNTY RD ❑ NVOLVED CODING
PRIVATE WAY
2❑ TRIBAL TOTAL 1
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
cDUISION' 02 - 20 - 2025 1254 17 =.= S 8 W E IN OF M ?070 a
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION �✓ NON INTERSECTION ❑
BLOCK NO. e .�
4a
NE 4TH ST MILE POST
❑
❑ DISTANCE OF(REFERENCE OR CROSS STREET)
5 FEET e S 8 W e UNIONAVENE
0 4 29
MOTtlR PEDAL- DAM AG THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE ❑ YEs Vl No D:2534865592 0 1 30
5 LAST NAME CHIKIRIEV FIRST NAME IVAN MIDDLE N 1 1 2 31
INITIAL
STREET ❑ 109 S DIVISION ST APT 727 CITY AUBURN ST WA ZIP 980015310 2
NEW ADDRESS
7 CDL IGNITION REQUIRED? IGNITION PRESENT MEDICAL TRANSPORTED' 3
INTERLOCKYES ND INTERLOCKYES Na YES F NO
8 LICIENS# STATE WA SEX M MMDr YY' 02 1 2 32
9 ON DUTY STATUS AIRBAG 6 RESTR 4 EJECT, 1 HELMET INJURY 7 NAruRE of N3uRIEs 2
USE CLASS !N
LICENSE CRC3998 STATE WA VIN# WMWMF73579TW83775 3
10 Fl I PI ATP tt
TRAILER STATE TRAILER ,STATE
11 3 5 PLATE# PLATE# ROM TO
TRLR TRLR 7 1 33
12 3 5 VIN# vN#
FROM TO
VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN �tpyEN�I GOVT VEHICLE
13 2009 MNNI COOPS DAMAGE YES�NO� �"-"'"'�RS 3 7 34
YE NO
REGISTERED OWNER INFO KRYSTYNA GARMASH 109 S DIVISION STAPT 727 AUBURN WA 980015310 VEHICLE NO. 1
2 11SHADE IN DAMAGED AREA 35
LIABILITY INSURANCE
14 ❑ NSURANCECO
IN EFFECT &POLICY# 11 STOP _ S
L `LE CHARGE 10 BOTTOM 36
r Ly YES❑NO❑ CITATION# 5AO151282,5AO151282 NEGLIGENT DRIVING 2ND DEGREE,
15 sn c s 7 a
rL� MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT VEHICLE ❑ CYCLE' ❑ ❑ OWNER D:2065731443
16�
LAST NAME HAARSAGER FIRST NAME NANCY MIDDLE I K
INITIAL
? 37
17 STREET ❑'❑ 391?197TH AVE SE CITY RENTON ST, WA ZIP 980597811
NEW ADDRESS
18❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDIGALTRANSPORTED. 38
INTERLOCKYES No INTERLOCK YES 0No Yes NDi
19 DRIVER'S STATE WA SEXI F 0 0 B 09 25 1943 39
LICENSE# MMDLSYY —
HELMET INJURY NATURE OF INJURIES 40
20❑ ON DUTY STATUS' AIRBAG 2 RESTR 4 EJECT 1 USE CLASS ? ❑
21 LICENS C449226 rarE W/a vIN# 1FTYR14V1YPC?6155 41
22❑ PLATE# STATE PATE# STATE ❑ 42
23 TRLR kRLR 43
UIN#. 'IN#.
VEH.YEAR 2000 MAKE FORD MODEL RANGER STYLE VEHICLE TOWED TO BLIN
TOWED BY GOV HI 44
24 DAMAGE YES NO YES NO
REGISTERED OWNER INFO NANCYHAARSAGER13911197THAVESE RENTON WA 980597811 D:2065731443 VEHICLE NO.2
SHADEDAMAGEDAREA
3 4
LIABILITY INSURANCE INSURANCE CO TRAVELERS 915494944 1012
IN EFFECT &POLICY# 9TOP
veeiae ❑ ,J—I CITATION# CHARGE 1060TTOM
LecnllY YES N`[
25 s 7 e
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
26
M.LEVERTON 2517 WA0171300
PAGE 01 OF
PART A 3000-345-159(R 11/18)
POLIICFETRAFFICN CORRECTION REPORT NO. EF68547
COLLISION REPORT III III III III III 111
1591972 CASE# 25-1629
ADDITIONAL PERSONS INVOLVED(PASSENGERS AND/OR WITNESSES ONLY)
'NAME
(LAST,FIRST MIDDLE INTTIAL)
ADDRESS&PHONE#
SEX' D.O.B. — [----------�
MMDDYYYY
PASSENGER F-1 WITNESS Ej 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----------�
MMDDYYYY
PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET INJURY NATURE OF INJURIES
❑ Q POS. USE CLASS �____ ----j
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.
M.LEVERTON 02-20-25 03:01 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST.DET DATED PLACE SIGNED
APPROVED BY DATE
C.JACOBS 1953 212412025 1:25:40 PM
BADGE OR ID# Y517 ORI#' f WA0171300 TIME POLICE DISPATCHED'; 12:55 PM TIME POLICE ARRIVED 12:55 PM
PART B 3 Do-3mx-,ao(Rtlras) PAGE 27 OF 47
EAN
REPORT NO.` EF68547 CASE# 25-1629 O OF COLLI COLLISION TIME 02/20/25 12:54
COLLI
NARRATIVE
blue/2 lane wb gold It yellow
CC
Within the city limits of Renton/King/Wa I responded to a 2 vehicle blocking crash at NE 4th St at
Union Ave NE.
I contacted the driver of unit 2 who told me she was going about 35mph westbound lane 1 NE 4th St
on her green light when unit 1 turned left in front of her. Contact could not be avoided. She did not
complain of injury and damages required a tow truck.
I contacted the driver of unit 1 ID'd by his matching picture WADL. He told me he was eastbound
preparing to turn left northbound onto Union Ave NE. He told me his traffic light was blinking/flashing
yellow and he initated his left turn in front of unit 2. He told me she was going way too fast. I had him
clarify that he was making a left on a yellow flashing turn arrow and purposely turned left in front of a
car he had identified as driving way too fast and he said yes. He repeated she was going very fast.
He could not provide valid proof of insurance for his vehicle. He did not tell me how he was injured.
Unit 1 was checked by Renton Fire on scene and released. His vehicle was towed for damages.
Unit 1 did operate his vehicle in a manner that was both negligent and endangered or was likely to
endanger any person or property, by turning left with a requirement to yield in front of a vehicle he
said was going way too fast.
I cited Unit 1 ref RCW 46.61.525 Negligent Driving Second Degree and ref RCW 46.30.020 No valid
proof of insurance via complaint.
I certify (declare) under penalty of perjury under the laws of the State of Washington that the
foregoing is true and correct.
M.Leverton/2517 City of Renton/King/Wa 2/20/2024
PAGE 3 OF 4
REPORT NO. EF68547 CASE# 25-1629 DATE AND TIME i 02/20/25 12:54
OF COLLISION
� skis v,
s
t
Y, l4 t1i 4t r � y
r
s
z
r r
t�
s.
a
s.
rr1 7�4
5
v
ti
n aa,Y v
3.
}
is
Sl
s
a
v
PAGE 4 OF 4