HomeMy WebLinkAbout25-686 iiTFiNII IIIII III IIIII II IIII IIIII I . 27c REPORT NO EF59161oc� RA
COLLISION REPORT 1591971
❑ 0 RESULTED I
$ 25-686 2
INTERSTATE CITY STREET FIRESTOLENSTATE ROUTE OTHER VEHICLE LOCALANG 4100 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 TOTAL#OF OBJECT 1 8 28
TRIBAL UNITS 02 STRUCK ❑
RESERVATION : 1 1
2
3� M M D D Y Y Y Y TIME(2400) COUNTY# MILES CITY#
DATE OF N E IN eDL�ISION' 01 - 21 - 2025 1502 17 =.= S 8 W❑ OF M 1070 a
4� ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
SUNSET BLVD NE BLOCK ST e
4a MILE POST 500 .�
�
❑ DISTANCE OF(REFERENCE OR CROSS STREET)
5 1. FEET e S 8 W e 1405 ON RAMP
0 4 29
MOTOR ✓ PEDAL- DAM AG THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE ❑ YEs Vl No D:4254354067 0 1 30
6 LAST NAME NGUYEN FIRST NAME THUAN MIDDLE H 1 1 2 31
INITIAL
STREET ❑ 1512 148TH PL SW CITY; LYNNWOOD ST WA ZIP 98087 2
NEW ADDRESS
7 GDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
INTERLOCKYEs No�/ INTERLOCKYEs Nb�/ YES D No Z
8 DCIENSE# STATE WA SEXI M MMDDYY' 11 - 21 - 1966 t 1 2 32
-NJUR
9 ON DUTY STATUS' AIRBAG 3 RESTR 4 EJECT 1 N USEET 2 CLASSY 1 [NATURE of INJURIES 2❑
LICENSE, CGT1644 STATE WA VIN#; 4T3T6RFV1PU113092 3
10 Fq I as ATP rt
11 3 5 TRAILER STATE TRAILER STATE
PLATE# PLATE# FROM To
TRLR zRLR. 6 1 33
12 3 5 VIN# vIN#
FROM TO
13 4 VEH.YEAR2023 MAKE TOYT MODEL RAV4 STYLE UT VEHICLE TOYED NO�iS46LIN Tv4 EBYMEYERS GOs❑VT EHICLE
Np 1 5 34
DAMAGE IIII._IIII
REGISTERED OWNER INFO OWNED BY DRIVER VEHICLE R 1
SHADE IN DAMAGED AREA 35
3
14 LIABILITY INSURANCE NSURANCE CO COUNTRY FINANCIAL AA4250572 4
IN EFFECT &POLICY#VEHICLE 9TOP _
srnNoiNc ❑ ❑ 5AO102871 CHARGE FAIL YIELD AT YIELD
15 t s t a oorrob z 36
Yes NO CITATION#
❑
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT VEHICLE CYCLE nWNFR D:2068501941
16�
LAST NAME VERSEY FIRST NAME CHARLES MIDDLE E
INITIAL
17 F1 STREET ❑ 1501 MONTEREY AVE NE CITY RENTON ST, yyq ZIP 98056 4 37
NEW ADDRESS ❑
1 g❑ IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 38
CDL INTERLOCKYEs No INTERLOCK YEs NO ves No
19❑ DRIVER'S STATE WA SEX M I D.O.B. 12 11 2001 39
LICENSE# MMDDYY
20❑ ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 HELMET 2 INJURY 6 NATURE OF INJURIES 40
USE CLASS CHESTPAINS
21[ LICEN E BJC2035 rare WA vIN# 1C4NJDEB3GD723283 41
22❑ PLATE# STATE PLATE# STATE 42
23= TRLR RLR 43
UIN#. 'IN#
VEH.YEAR 2016 MAKE JEEP MODEL COMPAS STYLE UT VEHICLE TOWED TO BLIN TOWED BY GOV HI 44
24 DAMAGE YES �/ No GENE MEYERS ves No�/
REGISTERED OWNER INFO CANDACE VERSEY 1501 MONTEREY AVE NE RENTON WA 98056 VEHICLE NQ.2
SHADFY DAMAGED AREA
3 4
LIABILITY INSURANCE❑ INSURANCE CO PROGRESSIVE 901223491
IN EFFECT &POLICY# 9TOP
VEHICLE ❑ NCO—I CITATION# CHARGE t080TTOM
�'EI�Y YES N`
25 e
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
J
26
GREGORY BILLS 12495 WA0171300
❑
PAGE 01 OF
PART A 3000-348-189(R 11/18)
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EF59161
COLLISION REPORT III III III III III 111
1591972 CASE# 25-686
ADDITIONAL PERSONS INVOLVED(PASSENGERS AND/OR WITNESSES ONLY)
'.NAME
(LAST,FIRST,MIDDLE INITIAL)
ADDRESS&PHONE#
SEXi D.O.B. —
MMDDYYYY
PASSENGERQ WITNESS� UNIT SEAT AIRBAG RESTR. EJECT ; HELMET INJURY NATURE OF INJURIES
POS. ' USE GLASS 1 ----�
:NAME
(LAST FIRST MIDDLE INITIAL)
ADDRESS&PHONE#
SEX D.O.B. —
MMDDYYYY
PASSENGER❑WITNESS UNIT# : SEAT AIRBAG RESTR. EJECT HELMET INJURY: NATURECFINJURIES
POS. USE CLASS ----�
:NAME
(LOST,FIRST,MIDDLE INITIAL)
ADDRESS&PHONE#
SEX MMDDYY D.O.B.
YY
PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET NJURY NATURE OF INJURIES
POS. I 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.
GREGORYBILLS 01-21-25 04:22 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST.DET DATED PLAGE SIGNED
APPROVED BY DATE
J.TRADER 4553 1 112412025 2:14:35 PM
BADGE OR ID# 12495 ORI# WA0171300 TIME POLICE DISPATCHED 1 3:06 PM TIME POLICE ARRIVED i 3:11 PM
PAST B 3 Do-3mx—attar(t 1Mff) PAGE 2�OF 4
REPORT NO. EF59161 CASE# 25-686 OATS OF COLLI r�510NN + 01/21/25 15:02
L1
NARRATIVE
On 01/21/2025 at 1506 hours I was dispatched to 501 Grandey Way NE, in the City of Renton, King
County, Washington. 1 was responding to a report of an injury collision. I later determined the crash to
be in the 500 block of Sunset Blvd NE at the intersection of the i-405 on-ramp.
While en route, dispatch advised the following: automatic crash notification later confirmed with
another witness caller. Two vehicle crash, one patient complaining of chest pain.
In this report, unit 1 refers to a blue 2023 Toyota Rav4 (WA/CGT1644) driven by Thuan H. Nguyen
(DOB 11/21/1966, WA DL). Unit 2 refers to a silver 2016 Jeep Compass (WA/BJC2035) driven by
Charles E. Versey (DOB 12/11/2001, WA DL).
At approximately 1511 hours, I arrived on scene and found the units at the intersection of Sunset Blvd
NE /405 on ramp. Versey was clutching his chest and sitting in the driver seat. I couldn't tell if he had
physical injuries or was having an anxiety/panic episode. Renton Fire evaluated him medically on
scene. His mother was going to transport him in her car to the hospital or further evaluation.
My investigation determined the following:
Unit 1 was driving northbound on Sunset Blvd NE and making the left turn onto i-405. To complete
that turn, Unit 1 had to cross southbound traffic on Sunset Blvd NE. There is a yield sign controlling
the left turn for Unit 1. Nguyen said he was looking at the interstate directional signs and did not see
the yield sign. He entered the intersection without yielding and struck unit 2.
Both vehicles were towed by Gene Meyers. 1 provided both parties and exchange of information form.
I informed Nguyen he would be receiving a citation in the mail for failure to yield.
This concludes my involvement in this case.
I certify under penalty of perjury under the laws of the State of Washington that the foregoing is true
and correct.
Electronically signed by Ofc. Gregory Bills #12495, 01/21/2025 at 1557 hours in Renton, Washington.
PAGE 3 OF 4
REPORT NO. E F59161 CASE# 25-686 DATE AND TIME 01/21/25 15:02
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