HomeMy WebLinkAbout25-637 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 1 27c
COLLISION REP FIT 1591971
❑ ❑ RESULTED ❑ CASE 25-637 2
INTERSTATE CITY STREET FIRE
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHICI F ❑ LOCAL AGENCI 4Y00 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 TOTAL#OF OBJECT 1 28
TRIBAL UNITS 01 STRUCK' UT/LITYPOLE
RESERVATION
2
3❑ DATE OF M M D D Y Y Y Y TIME(2400) COUNTY# MILES N E IN CITY# ❑
GawsloN 01 - 19 - 2025 2018 17 ❑.= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓
NE 3RD ST BLOCK NO. e✓ 2000
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ �.❑ FEET e S ❑ W e 2 0 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
✓NO D:2532045822 30
6❑ LAST NAME ROTHSCHILD FIRSTNAME KION MIDDLE G 1 1 2 31
INITIAL
STREET ❑, 27823 50TH PL S CITY AUBURN ST WA ZIP 98001 2
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
iNTERLOCKYEs NO 1/ INTERLOCKYEs NO�/ YES R No�/
8❑ LDRIVER # STATE WA SEX'M MID
LOB 05 — 09 — 2000 32
9 ON DUTY❑ STATUS AIRBAG 6 RESTR 9 EJECT 1 H USEET 2 CLASS 1 NATURE OF INJURIES 2❑
3
,OF]
0❑ P1 ATE 14 BFH0408 STATE WA VIN#' JTHBD192830076107
TRAILER STATE TRAILER STATE
11 3 5 PLATE# PLATE# FR.. ro
TRLR. TRLR 3 7
2❑ 33
1 VIN#' VIN#'
Rom 34
13 VEH.YEAR2003 MAKE LEXS MODEL 1S300 STYLE 4C VEHICLE TOWED0NOOffBLIN TSIgWgYMEYERS vOs❑ENo /
DAMAGE IILLJJII (S�IV6
REGISTERED OWNER INFO .1 ROTHSCHILD 2782350TH PL S AUBURN WA 98001 D:2532045822 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
14❑ LIABILITY INSURANCE❑ INSURANCE CO <53 4
IN EFFECT &POLICY# TOPVEIi" CHARGE 36
LEGALLv YEs❑NO CITATION# OTTOM
15❑ STAIN."' 6
UNIT 02 VE ICCLE ❑ CYCLE ❑ PEDESTRIAN ❑ OWNER YES
❑ DYES NO OLD MET PHONE
16❑
LAST NAME FIRST NAME MIDDLE
INITIAL
STREET
CITY' ST ZIP 4❑ 37
17❑ NEW ADDRESS❑'
18❑ CDL IGNITION REQUIRED IGNITION PtR—E—S1ENT MEDICAL—T�RANSPORTED ❑ 38
INTERLOCKYES�NOR INTERLOCK YEs I I NOF YES t l NO❑
19 LLIICENS # STATE SEX MMDDYY —�_ 39
HELMET INJURY NATURE OF INJURIES 40
20❑ ON DUTY STATUS' AIRBAG RESTR EJECT USE CLASS ❑
❑21❑ LICENSE TATE vIN# 41
1
PLATE#
42
22❑ PLATE# STATE PLATE# STATE
23❑ 43
TRLR RLR
UIN It 'IN#.
VEH YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN
TOWED BY Gov HI 44
L4❑ DAMAGE YES NO YES NO
REGISTERED OWNER INFO VEHICLE NO.2
SHADE IN DAMAGED AREA
2 3 4
INAEFFITY ECTNSURANCE❑ &POINSULICY#E CO I 9TOP 5
VEHICLE ❑ C[:] CITATION# CHARGE i o BOTTOM
LEGALLY YES N
25 s e
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
26
JOSEPH MELLO 13020 WA0171300
PART A PAGE 01 OF
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EF62702
COLLISION REPORT III III III III III 111
1591972 CASE# 25-637
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
POS. 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'
On 01-1 9-2025 1 was working as a police officer in a fully marked, department issued uniform,
patrolling in a marked police vehicle for the city of Renton. At approximately 2025 hours I was
dispatched to blocking accident at the 1800 block of NE 3rd St, City of Renton, County of King, State
of Washington.
Unit 1 was driving westbound in the number two lane on NE 3rd St towards Bronson Way NE. The
driver of Unit 1 began to lose control of his vehicle and hit the curb of his lane. The driver changed
lanes to the number one lane and continued to lose control of his vehicle. The driver turned into
eastbound traffic of NE 3rd St and collided with a street pole near the NE 3rd St/Bronson Way NE
intersection. When I arrived on scene, I observed various airbags were deployed of Unit-1, all four
tires on Unit 1 were flat, and all four tires were off of the rim of Unit 1. The driver who was positively
identified as Kion G. Rothschild (DOB 05-09-2000) via WADOL photo showed no signs of impairment
or injuries. Renton Fire Authority conducted an evaluation of Kion, and his vehicle was towed by
Gene Meyers. The proximate cause for the collision, was Kion's inability to drive his vehicle with due
care.
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 J. Mello #13020 on 01/22/2025 @ 1800 hours in Renton WA.
I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT.
JOSEPH MELLO 01-22-25 06:33 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
S.WOODWARD 11528 1 21512025 10:28:27 AM
BADGE OR ID# 13020 OR]# WA0171300 TIME POLICE DISPATCHED' 8:22 Pry TIME POLICE ARRIVED f 8:25 PM
PART I PAGE IT]OF
REPORT NO. EF62702 CASE# ' 25-637 DATE AND TIME 01/19/25 20:18
OF COLLISION
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a:
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