HomeMy WebLinkAbout25-746 iiTFiNII IIIII III IIIII II IIII IIIII I . 27c REPORT NO EF63652oc� RA
COLLISION REPORT 1591971
❑ 0 RESULTED I
CASE 25-746 z
INTERSTATE CITY STREET FIRESTOLENSTATE ROUTE OTHER VEHICLE LOCAI-A`NG 4200 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 TOTAL#OF OBJECT 1 1 s 28
TRIBAL UNITS 02 STRUCK
RESERVATION : 2
3n M M D D Y Y Y Y TIME(2400) COUNTY# MILES CITY#
eaCL s on' 01 - 23 - 2025 1722 17 =.[� S 8 W e OF IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓
NORTH 6TH ST BLOCK NO. e 500 .�
4a❑ MILE POST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ 50 00 FEET e✓ S 8 W e LOGAN AVE NORHT
2 0 29
MOTOR PEDAL- DAM G THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE ❑ YES'Vl No D:2065748412 0 1 30
6❑ LAST NAME HAJI FIRST NAME RUWEYDA MIDDLE O 1 2 31
INITIAL
STREET ❑ 2442 S 138TH ST
NEW ADDRESS CITY': $EATAC ST: WA ZIP: 98168 2
7 CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
INTERLOCKYEs NO✓ INTERLOCKYEs E ✓ YEs No;✓
8❑ DRIVER # STATE WA SEXI F MMDDYY' 11 - 23 - 2004 1 2 32
-NJUR
9 ON DUTY STATUS' AIRBAG 2 RESTR 4 EJECT 1 HELMET
2 CLASSY 1 [NATURE of INJURIES 2
10 PI ENSrtEI AIC4876 STATE WA VIN# 2HNYD18825H558601 3
0 TRAILER STATE TRAILER STATE
11 0 0 PLATE# PLATE# ROM To
TRLR rRLR. 7 1 3 33
12 0 0 VIN#' VIN#
FROM TO
13 4 VEH.YEAR2005 MAKE ACUR MODEL MDX STYLE UT VEHICLE TOYED NO�iS46LIN Tv4 EBvMEYERS GOSI�`�I VEHICLE
Np✓ 7 3 34
DAMAGE IIII._IIII IUJ
REGISTERED OWNER INFO OWNED BY DRIVER VEHICLE NO. 1
SHADE IN DAMAGED AREA 35
❑ ❑ NSURANCE CO 3 4
14 LIABILITY INSURANCE
IN EFFECT &POLICY# i 4TOP 5
vEnicLE CHARGE 7 0 80TTOM 36
15
srnc NoiN yes❑NO❑ CITATION# SA0128809,5A0128809 FLD SIGNAL STOPS/TURNS-UNSAFE
MOTOR ✓ PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT VEHICLE CYCLE nWNFR D:2067071668
16�
LAST NAME BLANCHETTE FIRST NAME JAMIE MIDDLE' L
INITIAL
17 F1 STREET ❑ 3006 NE STH ST CITY RENTON ST, yyq ZIP 98056 4 37
NEW ADDRESS ❑
18� IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED. 38
CDL INTERLOCKYEs No✓ INTERLOCK YES
STATEA No✓
19 DRIVER'S DOB YES NO✓
18 1975 39
LICENSE# MMDDYY —
20❑ ON DUTY STATUS AIRBAG 1 RESTR 4 EJECT 1 H U ET 2 INJURY
1 NATURE OF INJURIES 40
21 LICENSEPLATE# CHP1457 rarE WA vIN# 1 C4HJXCG8PW642880 41
22❑ STATE PLAAILER TE# STATE 42
PLATE#
23 TRLR RLR 43
UIN#. 'IN#
VEH.YEAR 2023 MAKE JEEP MODEL WRANGL STYLE UT VEHICLE TOWED TO BLIN TOWED BY GOV HI 44
24 DAMAGE YES �/ No GENE MEYERS vEs No✓
REGISTERED OWNER INFO OWNEDBYDRIVER VEHICLE NO.2
SHADE IN DAMAGED AREA
2 3 4
LIABILITY INSURANCE[Z INSURANCE CO SAFECO
IN EFFECT &POLICY# 9TOP
vew1— ❑ ,.I—I CITATION11 CHARGE to BOTTOM
L GA—Y YES N
25 a s
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
J
26
BRYAN GROZAV 12489 WA0171300
PAGE 01 OF
PART A 3000-345-189(R 11/18)
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EF63652
COLLISION REPORT III III III III III 111
1591972 CASE# 25-746
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 CLASS 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.
BRYAN GROZAV 01-23-25 10:17 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST.DET DATED PLAGE SIGNED
APPROVED BY DATE
P.SUMMERS 888 1 21812025 4:34:13 AM
BADGE OR ID# 12489 ORI# WA0171300 TIME POLICE DISPATCHED 1 5:24 PM TIME POLICE ARRIVED i 5:25 PM
PAST B 3 Do-3mx—attar(t 1Mff) PAGE 2�OF 4
REPORT NO. EF63652 CASE# 25-746 O OF COLLI 510N TIME 01/23/25 17:22
COLLISION
NARRATIVE
CASE 25-746
SECTOR CITATION: 5AO128809
This incident was captured on my body worn video camera and/or in-car dash camera. This report is
a summary of events that occurred and is not an exact sequencing of events.
On Thursday January 23rd, 2025, at approximately 17:24, 1 responded to a 911 call regarding a two-
vehicle collision in the 500 block of North 6th St within the City of Renton, King County, Washington.
The reporting party called 911 to report they were just involved in a vehicle collision.
***CALL REMARKS: JEO INTERSECTION...2 VEHS, ATLEAST 1 IS TOTALLED, NI/BLOCKING.
I arrived on scene and contacted the involved drivers who reported they were not injured. They did
not appear to be injured and declined aid. The driver of unit one Ruweyda O. Haju (DOB:11.23.2004)
reported she was changing lanes when unit two crashed into her. Unit one was traveling east on
North 6th St in the right lane. Unit one sustained damage to the left front area of the vehicle but was
drivable, Ruweyda was able to move the vehicle off the road.
I contacted the driver of unit two Jamie L. Blanchette (DOB:12.18.1975) reported similar
circumstances. She was driving east on north 6th St when unit attempted to either make a U-turn or
change lanes crashing into her. Unit two was not able to drive due to the damage and was towed
from the scene.
Both drivers had valid driver's licenses, but Ruweyda did not have valid vehicel insurance. Based on
the circumstances 1 issued Ruweyda a traffic citation for the following violations.
RCW 46.61.305- FLD SIGNAL STOPS/TURNS-UNSAFE LANE
RCW 46.30.020- OP MOT VEH W/OUT INSURANCE
I provided both drivers a SECTOR exchange of information form and provided Ruweyda her copy of
the traffic citation.
This concludes my involvement in this case.
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 B. Grozav#12489 on 1.23.2025 at 22:15 hours in Renton, WA.
PAGE 3 OF 4
REPORT NO. E F63652 CASE# 25-746 DATE AND TIME 01/23/25 17:22
OF COLLISION
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