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Home My WebLink About25-00369 iiTFiNII IIIII III IIIII II IIII IIIII I . 27c REPORT NO EF57228oc� RA COLLISION REPORT 1591971 ASE# 25-00369 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 GDLLISION' 0? - 11 - 2025 2135 17 =.= S 8 W E OF IN M ?070 a 4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION �✓ NON INTERSECTION ❑ NE 4TH ST BLOCK NO. e 4700 .� 4a❑ MILE POST ❑ DISTANCE OF(REFERENCE OR CROSS STREET) 5 . FEET S 8 W e DUVALL AVE NE OF 4 29 MOTtlR ✓ PEDAL- DAM AG THRESHOLD MET PHONE UNIT 01 VEHICLE ❑ CYCLE' ❑ YES ✓NO O 1 30 5 LAST NAME JOHNSON FIRST NAME STEVEN MIDDLE I W 1 1 2 31 INITIAL STREET ❑' 22925 NE 166TH ST CITY WOODINVILLE ST WA ZIP 98077 2 NEW ADDRESS 7 CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED3 INTERLOCKYEs ✓NO INTERLOCK YEs NO✓ YES Nb�/ 8 LICIENS# STATE WA SEK'M MMDQYY' 10 — 29 — 1962 1 2 32 9 ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 N USEET 2 1 INJURY CLASS ? NAruRE of INJURIES 2 LICENSE, CGG7797 STATE WA VN# 5NMJE3AE9NH043437 3 10 PI ATF# TRAILER STATE TRAILER ,STATE 11 3 5 PLATE# PLATE# ROM TO TRLR TRL.R 7 1 33 1 0 FROM TO 2 Q VIN# VIN# VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN �tpyEN�I GOVT VEHICLE 3 7 34 13 4 2022 HYUN TUCSO $V DAMAGE YES NO " "'"' R$ YES❑ NO✓ REGISTERED OWNER INFO STEVENJOHNSON 22925 NE 166TH ST WOODINVILLE WA 98077 VEHICLE NO. 1 ❑ SHADE IN DAMAGED AREA 35 LIABILITY INSURANCE❑ INSURANCE CO �m, 14 ✓ STATEFARM 569 378t-E01-47 IN EFFECT &POLICY# CHARGE36 YES❑NO❑ CITATION# 15❑ STM ING B 7 e rL� MOTCYR ✓ PEDAL- PEDESTRIAN PROPERTYEl DAM THR OLD MET PHONE UNIT 02 VEHICLE CYCLE' ❑ ❑ nWNFR YES�/ NO D:2067133455 16� LAST NAME HERNANDEZ FIRST NAME JOSHUA MIDDLEI F INITIAL STREET ❑ 17 '❑ ?2908 SE 202ND PL CITY WOODINVILLE ST, Wq ZIP 98077 4 37 NEW ADDRESS 18 CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 38 INTERLOCKYES ND✓ tNTERLOCK YES No✓ vEs NO✓ 19 DRIVER'S STATE WA SEX M DOB, 12 .: 18 1980 � 39 LICENSE# MMIIDYY - 20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 H UET 2 SE CLA ?Y NATURE OF INJURIES 40 21 LICENSLATE E CHD8693 TATE WA VIN# 3KPF54AD7PE619863 41 22❑ PLTL ATE# STATE TILER PATE# STATE ❑ 42 23 TRLR kRLR 43 UIN#. 'IN#. TOWED BY GOV HI 44 VEH.YEAR 2023 MAKE iQq MODEL FORTE STYLE $D IVE DAMIAGE TOWED✓ No BLIN BANKERS YES NO✓ 24 REGISTERED OWNER INFO MELYZATAYLOR 1817 GRANT AVES,APT 9 RENTON WA 98055 D:4253709233 VEHICLE N0.2 SHADE IN DAMAGED AREA 2 3 4 LIABILITY INSURANCE INSURANCE CO PROGRESSIVE 980167734 IN EFFECT &POLICY#YES 9TOP vewae ❑ N J ,.I—I CITATION# CHARGE 25 a tO BOTTOM A r OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY 26 JAMAAL KEARSE 12994 WA0171300 PAGE 01 OF PART A 3000-345-159(R 11/18) POLIICFETRAFFICN CORRECTION REPORT NO. EF57228 COLLISION REPORT III III III III III 111 1591972 CASE# 25-00369 ADDITIONAL PERSONS INVOLVED(PASSENGERS AND/OR WITNESSES ONLY) NAME MIDDLE INITIAL} TAYLOR MELYZA T (LAST,FIRST ADDRESS&PHONE# 1817 GRANT AVE S,APT 9 RENTON WA 98055 4253709233 SEX' F MMooYYvv 02 - 24 - 1993 SEAT HELMET INJURY NATURE OF INJURIES PASSENGER�WITNESS UNIT 2 POS 3 AIRBAG 2 RESTR. 4 EJECT 1 USE 2 CLASS 7 COMPLAINTS OF BACK PAIN 'NAME (LAST FIRS,MIDDLE INITIAL) ADDRESS&PHONE# SEX' D.O.B.M -F L----------� MDDYYYY PASSENGER ❑WITNESS D UNIT# SEAT AIRBAG RESTR. EJECT HELMET INJURY NATURE OF INJURES 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. JAMAAL KEARSE 01-12-25 12:14 AM INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST.DET DATED PLACE SIGNED APPROVED BY DATE CASEYPROCTER 12123 1/18/2025 3:35:02 AM BADGE OR ID# 12994 ORI# ( WA0171300 TIME POLICE DISPATCHED'; 9:37 Pry TIME POLICE ARRIVED 9:43 Pm PART B 3 Do-3mx-,ao(Burls) PAGE 27 OF 47 EAN REPORT NO.` EF57228 CASE# 25-00369 O OF COLLI COLLISION TIME 01/11/25 21:35 COLLI NARRATIVE Unless otherwise noted, all events took place in the City of Renton, in the County of King, in the State of Washington. This incident was captured on my body worn video camera and in-car cameras. This report is a summary of events that occurred and is not an exact sequencing of events. On 1/11/2025, at approximately 2137 hours I was dispatched to a report of a collision at the intersection of NE 4th ST and Duvall Ave NE. Dispatch advised 2 motor vehicle collision blocking westbound. At approximately 2143 hours 1 arrived on scene. The driver of Unit 1 confirmed he had no injuries. The driver of Unit 2 confirmed he had no injuries. The passenger of Unit 2 stated she had complaints of back pain. Renton Fire came out to evaluate her. All parties declined going to the hospital. Both drivers provided their license, registration, and insurance. The driver of Unit 1 advised the following. He was driving eastbound on NE 4th St approaching the intersection of Duvall Ave NE. He got in the turn lane preparing to turn northbound on Duvall Ave NE. He had a green left turn light and both eastbound lights were also green. He started to turn north onto Duvall Ave NE. Then the driver of Unit 2 traveling westbound on NE 4th St entered the intersection and hit the front passenger side fender and wheel well of Unit 1 with the front driver side bumper of Unit 2. There was no airbag deployment. There was significant damage to the front passenger side fender and wheel well of Unit 1. The vehicle was towed. The driver of Unit 2 advised the following. He was driving westbound on NE 4th St in lane 2 of 2 approaching the intersection of Duvall Ave NE. He had a green light, so he entered the intersection. He the noticed Unit 1 slowly entering the intersection and start to turn northbound onto Duvall Ave NE crossing into his lane. He was not able to stop in time and hit the front passenger side fender and wheel well of Unit 1 with the front driver side bumper of Unit 2. There was no airbag deployment. There was significant damage to front driver side bumper of Unit 2. The vehicle was towed. The passenger of Unit 2 had complaints of back pain. She appeared to be in shock and was not able to provide a statement. I was not able to determine proximate cause of the collision. 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 J. Kearse #12994 1/11/2025 2255 hrs Renton, King County, Washington PAGE 3 OF 4 REPORT NO. EF57228 CASE# 25-00369 DATE AND TIME i 01/11/25 21:35 OF COLLISION s �E k t Y a z Y f� 5, b t � 4 y.. PAGE 4 OF 4