HomeMy WebLinkAbout25-1016 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 0 27c
COLLISION REP FIT 1591971
SASE 25-1016 2
INTERSTATE ❑ CITY STREET FIRE ❑
RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHIr.I F ❑ LOCAL AOENC 4Y00 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 3 TOTAL#OF OBJECT 1 1 8 28
TRIBAL UNITS OZ STRUCK
RESERVATION
z
3❑ DATE OF M M D D Y Y Y Y TIME(2400) COUNTY# MILES N E IN CITY# ❑
cawsloN 01 - 1-- 2025 1831 17 ❑.= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓
SE CARR RD BLOCK NO. e✓ 10600
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ ❑ FEET e S ❑ W e 1 2 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
NO F,/ I D:2066973798 0 11
30
6� LAST NAME HO FIRSTNAME JUSTIN MIDDLE 1 1 2 31
INITIAL
STREET ❑ 2007 NE 18TH PL CITY RENTON ST WA 21p 98056 z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
1/ I iNTERLOCKYEs NO NTERLOCKYEs NO Z/ YES R No�/
8❑ LRIIVER #
ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 HELMET USE 2 CLASS 1 NATURE OF INJURIES z❑
3
10� Pi aTES� BHA3738 sTATe WA vIN# 3VWF17AT3HM616063
TRAILER STATE TRAILER STATE
11 3 5 PLATE# PLATE# FR.. ro
TRLR. A'RLR. 1 3 33
12 0 0 VIN#' VIN#
>; FROM TO
VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE 3 ] 34
13 8 2017 VOLK BEETLE SD DAMAGE YES NO YES❑ NO✓
REGISTERED OWNER INFO OWNEDBYDRIVER VEHICLE NO. 1
SHADE IN DAMAGED AREA ❑ 35
14 LIABILITY INSURANCE INSURANCE CO PROGRESSIVE 966542961 3 4
IN EFFECT &POLICY# 9TOP
VEHlcl.e CHARGE 5 36
LEGALLY YES❑NO❑ CITATION# 10 BOTTOM
15❑ STANDING 6
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT 02 VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES 1/ NO D:4259431167
16 a
LAST NAME GUNTER JR FIRST NAME LARRY MIDDLE L
INITIAL
17 STREET❑ NEW ADDRESS❑' 129 CORRIN AVE NW CITY ORTING ST WA ZIP 98360 4❑ 37
18❑ CDL IGNITION REQUIRED IGNITION PR-E-1SENT MEDICAL-T�RANSPORTED � 38
INTERLOCKYES�NO� INTERLOCK YEs It I NOF YES
t l NOF,/
19 LDI IVER # STATE WA SEX M M .C... 04 O6 _ 1964 39
20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 H U EET 2 NJAU EY 1 NATURE OF INJURIES 40
❑21❑ PLATE# CRK1995 TATE 41
WA VIN# JTDBCMFE4SJ037687 1
42
22❑ PLATE# STATE PLATE# STATE
23❑ VIN#. 43
TRLR RLR
'IN#.
VEH YEAR 2025 MAKE TOYT MODEL COROLL STYLE SD VEHICLETOWED TO BLIN TOWEDBY GOV HI 44
24❑ DAMAGE YES NO�/ YES NO✓
REGISTERED OWNER INFO LARRY GUNTER 129 CORRIN AVE NW ORTWG WA 98360 D:4259431167 VEHICLE NO.2
SHADEDAMAGEDAREA
3 4
LIABILITY
INSURANCE INSU&PORGY#E CO ALLSTATE 817866070IN 1ULlliKOTlTlfll;0-
NAME--E ❑ ,J� CITATION# CHARGEYES N`L J25 =AS
(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
26
SWAN 7 12965 WA0171300
PART A PAGE 01 OF C7
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EF61823
COLLISION REPORT III III III III III 111
1591972 CASE# 25-1016
ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY)
NAME
(LAST FIRST,MIDDLE INITIAL)_
ADDRESS&PHONE#
SEX D.O.B. - -
MMDDYYYY.
PASSENGER❑WITNESS UNIT# SEAT AIRBAG RESTR. EJECT ' HELMET INJURY NATURE OF INJURIES
PM USE CLASS
NAME
'(LAST,FIRST MIDDLE INITIAL)
ADDRESS&PHONE# D D B
SEX MMDDYYYY
PASSENGER ❑WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET INJURY NATURE OF INJURIES
POS. USE CLASS
NAME
(LAST FIR57 MIDDLE INITIAL)
AppRESS R 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.
NICHOLAS SWAN 02-01-25 05:59 AM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
CASEY PROCTER 12123 2/2/2025 10:23:30 PM
BADGE OR ID# 12965 OR]# WA0171300 TIME POLICE DISPATCHED' 6:33 PM TIME POLICE ARRIVED 6:44 PM
PART I PAGE IT]OF 4�
TIME
REPORT NO. EF61823 CASE# 25-1016 OF COLLISION01/31/25 18:31
NARRATIVE
#25-1061
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 01/31/2025 at approximately 1833 hours I was dispatched to the 10619 SE Carr Rd in the city of
Renton, King County, WA, for a non-injury blocking accident between two vehicles.
Unit#1 was a grey 2017 Volkswagen Beetle with WA LIC: BHA3738 (VIN: 3VWF17AT3HM616063)
Unit#2 was a black 2025 Toyota Corolla with WA LIC: CRK1995 (VIN: JTDBCMFE4SJ037687)
I arrived on scene and found that both vehicles were able to move out of the road and into the
Wendy's parking lot. Both drivers were wearing their seatbelts and neither of them reported having
any injuries.
Driver 1 of Unit 1 stated he was exiting the parking lot of CVS and turning east bound on to SE Carr
Rd. He stated that he looked to his left, and did not see any cars approaching so he turned left in to
the center turn lane on SE Carr Rd. As he was exiting the parking lot from CVS, the two vehicles
collided, damaging the front driver side corner of his vehicle.
Driver 2 of Unit 2, stated that he had turned right, to head west bound and down hill on SE Carr Rd
from Benson Dr S. He stated he was in lane #1, when he saw Unit 1 pulling out of the CVS parking
lot. He attempted to maneuver around Unit 1 by entering into lane #2 in an attempt to not collide, but
the two units collided, hitting the front passenger corner of his vehicle.
Unit 2 stated that he had some damage that was rubbing in the passenger front wheel well of his
vehicle. He had a private tow enroute for his vehicle.
I took pictures of the vehicles and uploaded them to Axon Evidence.
An exchange of information was emailed to the drivers of both vehicles involved.
At the conclusion of my investigation, I determined that the proximate cause of the collision is due to
Unit 1 not confirming that it was safe and clear to turn left out of the CVS parking and drive east
bound on SE Carr Rd.
If the driver of Unit 1 would have confirmed there was no oncoming traffic, driving westbound on SE
Carr Rd, then this collision would not have occurred.
This concludes my report.
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 N. Swan #12965 on 1/31/2025 at 2039 hours in the City of Renton.
PAGE 3 OF 4
REPORT NO. EF61823 CASE# ' 25-1016 DATE AND TIME 01/31/25 18:31
OF COLLISION
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