HomeMy WebLinkAbout25-0710 POLICETRAFF'c" III !�� I IIIllI111IN II II I REPORT NO. EF58689 170
27
COLLISION REP FIT 1591971
❑ ❑ FIRE ❑ CASE# 2$-0710 z 0 5
INTERSTATE CITY STREET RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHIr.I F ❑ LOCAL AOENC 4Y00 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 1 TOTAL#OF OBJECT 1 1 8 28
TRIBAL UNITS OZ STRUCK
RESERVATION
2
3❑ DATE of M M D D Y Y Y Y TIME(2400) COUNTY# MILES N E IN CITY# ❑
COLLISION'. 01 - 1-— 202$ 1247 17 ❑.= S 8 IN e 1070 3
4❑ oN (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓
NE 12TH ST BLOCK NO. e✓ 3200
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ ❑ FEET e S ❑ W e 0 4 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
No ,/ I D:2063534371 0 11
30
6� LAST NAME NGUYEN FIRSTNAME TRAV/S MIDDLE 1 1 2 31
INITIAL
STREET El 834 LYNNWOOD AVE NE CITY RENTON ST WA 7jp, 98056 2
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
,/ I INTERLOCK YES[:]NO NTERLOCKYEs Z/NO YES R NoF,/
LRIIVER # STATE WA SEX'M MI MIT Y
8❑ ' 08 — 01 — 2002 1 2 32
9 ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 H USEET ICNLJAURY 1 NATURE OF INJURIES 2❑
3
10 9❑ Pi aT�S� CNK9441 sTArr WAurN# 5YJ3E1EA3RF866084
TRAILER STATE TRAILER STATE
11 2 5 PLATE# PLATE# FROM TO
TRLR. TRLR. 5 7 33
12 0 0 VIN#' VIN#'
>; FROM TO
VEH.YEAR 2024 MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE 3 7 34
13 4 TESL MODEL SD DAMAGE YES NO YES[:] NO✓
REGISTERED OWNER INFO OWNEDBYDRIVER VEHICLE NO. 1
❑
SHADE IN DAMAGED AREA ❑ 35
14 LIABILI INSURANCE INSURANCE CO TRAVELLERS 61606881112031 3 4
IN EFFECT &POLICY# 9TOP
vECALLv HICLe 1 5 36
res❑NO❑ CITATION# CHARGE 1 o BOTTOM
15❑ LE STANDING 8 6
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
iT 02 VEHICLE ❑ CYCLE ❑ ❑ : OWNER [:]EA.
YES,/ No D:2539214942
16 a
LAST NAME CHARLES FIRST NAME HOPE MIDDLE C
INITIAL
17❑ STREET ❑', 4652 NE 1ST CT CITY' RENTON ST WA ZIP 98059 37
NEW ADDRESS ❑
18� CDL IGNITION REQUIRED IGNITION PR—E-1SENT MEDICAL TRANSPORTED 38
INTERLOCK YES❑NO� INTERLOCK yEs It I NOF YES
t l NOF,/
19[—] LICENSE IVE STATE WA ]SEX IF M .C... 10 �_ 21 2006 El 39
WELMET INJURY1 NATURE OF INJURIES 40
20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 USE CLASS ❑
21❑ LICENSE I CBU3986 TAre WA vIN# 3VWJP7AT3EM608999
❑ 41
PLATE#
42
22❑ PLATE# STATE PLATE# STATE
TRLR
23❑ VIN#. IN#. 43
RLR
'
TOWED BY Gov HI 44
VEH YEAR 2014 MAKE YOLK MODEL BEETLE STYLE HB DAMAGE TOWED NOO✓ BLIN YES
NO,�
24❑ REGISTERED OWNER INFO OWNED SY DRIVER VEHICLE N0.2
SHADE IN DAMAGED AREA
2 3 4
LIABILITY
INSURANCE INSU&POLICY#E CO GEICO 6167390902IN 1UQI
'E""LE ❑ ,J� CITATION# CHARGELEGALLYYES N`L J25
=Kl
(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
J
26 12598 WA0171300
PART A PAGE 01 OF C7
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EF58689
COLLISION REPORT III III III III III 111
1591972 CASE# 25-0710
ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY)
NAME MIDDLE INITIAL) FORLIN COLLINS O
(/AST FIRST,
ADDRESS&PHONE#
2821 MORRIS AVE S RENTON WA 98055 2064761407 SEX M MMDOYyry 09 - 25 - 2006
PASSENGER WITNESS UNIT# J 2 SEA 3 AIRBAG 2 RESTR. q EJECT ? 1 HELMET INJURY NATURE OF INJURIES
L�!1 USE CLASS 1
NAME
(LAST,FIRST,MIDDLE INITIAL)
ADDRESS&PHONE# DOB
SEX MMDDYYYY
PASSENGER ❑WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET NJURY NATURE OF INJURIES
POS. USE CLASS
NAME
(LAST FIR57 MIDDLE INITIAL)
AppRESS&PHONE#
SEX D.O.B.
MMDDYYYY. -
PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET NJURY NATURE OF INJURIES
❑ ❑ POS. 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.
J.WISNIEWSKI 01-22-25 02:01 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
s.w000wARo I�5za 112312025 9:05:17 AM
BADGE OR ID# 12598 OR]4f WA0171300 TIME POLICE DISPATCHED 12:51 PM TIME POLICE ARRIVED]12:52 PM
PART I PAGE IT]OF 4�
REPORT NO. EF58689 CASE# 25-0710 OF COLLISION
01/22/25 12:47
OF CbLLI510N
NARRATIVE
On Wednesday, January 22, 2025 at 1251 hours, I was dispatched to a two-vehicle collision in the
area of the NE Sunset Blvd and NE 12th St, in Renton, WA, King County.
The following occurred within the City of Renton, King County; Unit 1 - WA/ CNK9441 was being
driven by Travis Nguyen and headed west on NE 12th St in the 3200 block after a left turn From NE
Lynwood St. Unit 2 - WA/CBU3986 was being driven by Hope Charles and was travelling westbound
NE 12th St toward NE Sunset Blvd in lane 1.
Travis stated he had just turned left onto NE 12th ST and did not observe Unit 2 coming down the hill
resulting in a collision. The right front tire collided with the front bumper of Unit 2. Travis also showed
me video footage from the on-board camera system which showed him not come to a complete stop
and turn into the lane Unit 2 had already occupied striking Unit 2.
Hope stated she was travelling down the hill on NE 12th St toward the intersection and Unit 1 pulled
out in front of her after not stopping at the stop sign at NE Lynwood St, which resulted in Unit 1
striking the front bumper and quarter panel of Unit 2.
Based on both statements, it appears that Unit 1 did not grant right of way to Unit 2 as they came
down the hill and failed to come to a complete stop at the stop sign before proceeding into the lane at
NE 12thst, which ultimately caused the collision. Neither vehicle needed to be towed.
I 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. Wisniewski/#204 on 01/22/2025 at 1347 in Renton, WA
PAGE 3 OF 4
REPORT NO. EF58689 CASE# 25-0710 DATE AND TIME 01/22/2512:47
OF COLLISION
� aft
t
s1��gt
t
,
� r
t j �
;,5.
4
�s
pp
t{�
yet,'
� t4ti.
� r
a
PAGE 4 OF 4