HomeMy WebLinkAbout25-0736 POLICETRAFF'c" III !�� I IIIllI111IN II II I REPORT NO. EF61026 170
27
COLLISION REP FIT 1591971
❑ ❑ FIRE ❑ CASE## 25-0736 z 0 5
INTERSTATE CITY STREET RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHIC;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 02 STRUCK
RESERVATION
z
3❑ DATE of M M D D Y Y Y Y TIME(2400) COUNTY# MILES N E IN CITY# ❑
cowsloN 01 - 1-- 2025 1145 17 ❑.= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓
BLOCK
NE SUNSET BLVD M4000
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 I D:9075383339 0 11
30
6� LAST NAME MANN FIRSTNAME MICHAEL MIDDLE L 1 2 31
INITIAL
STREET ❑ 1200 HARRINGTON AVE NE CITY RENTON ST WA ZIP 98056 z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
INTERLOCK YES[:]NO INTERLOCKYEs NO YES R NO
8❑ LRIIVER #
ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 H U SE
ICNLJAUSSY 1 NATURE OF INJURIES z❑
3
10 9❑ PI ATFBit D77960E sTATI WA urN#' 1FTPW12VX9FB35928
TRAILER STATE TRAILER STATE
11 3 5 PLATE# PLATE# FROM TO
rRLR TRLR 7 3 33
12 3 5 VIN#' VIN#
>; FROM TO
❑ VEH.YEAR 2009 FORD F150 PK MAKE MODEL STYLE VEHICLE TOWED fn TO VBLINJ TOWED BY I GOVT.VEHICLE 7 3 34
13 4 DAMAGE YES NO YES[:] NO✓
REGISTERED OWNER INFO OWNEDBYDRIVER VEHICLE NO. 1
SHADE IN DAMAGED AREA ❑ 35
14 LIABILITY INSURANCE❑ INSURANCE CO eq�T3 4
IN EFFECT &POLICY# 9TOP
VEwcLe CHARGE 1 5 36
LEGALLY YEs❑NO❑ CITATION# 10 BOTTOM
15❑ STANDING 8 7 6
MOTOR PEDAL- PEDESTRIAN PROPERTY THR OLD MET PHONE
UNIT VEHICLE ❑ CYCLE ❑ ❑ OWNER [:][LAM ES 1/ NO D:4257530722
16 a
LAST NAME FARWELL FIRST NAME JANELL MIDDLE K
INITIAL
17❑ STREET ❑', 14813 SE 145TH PL CITY RENTON ST WA ZIP 98059 37
NEW ADDRESS ❑
18� CDL IGNITION REQUIRED IGNITION PR-E-1SENT MEDICAL TRANSPORTED 38
INTERLOCKYES�NOR INTERLOCK YEs It I NOF YES
t t- l NO❑
19 DRIVER'S STATE WA ]SEX IF D.C.B. 12 _ 07 1975 0 39
LICENSE# MMDDYY
WELMET INJURY1 NATURE OF INJURIES 40
20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 USE CLASS ❑
21❑ LICENSE I BBP3338 TATe WA vIN# JTEEW44A392033991
❑ 41
PLATE#
42
22❑ PLATE# STATE PLATE# STATE
TRLR
23❑ VIN#. IN#. 43
RLR
'
GoI
VEH YEAR 2009 MAKE 7'Dy7' MODEL yIGHLAN STYLE —YEHICLE
TOWED NOO✓ BLIN TOWED BY v HYES NO 44
24❑ fj
REGISTERED OWNER INFO OWNED SY DRIVER VEHICLE N0.2
SHADE IN DAMAGED AREA
2 3 4
LIABILITY
INSURANCE INSU PORGY#E CO ALLSTATE 976406058IN I STOP 5
'E""LE ❑ N`L J
,J� CITATION# CHARGE
LEG i o BOTTOM
ALLY YES
25 =KI
(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
J
26 12598 WA0171300
PAGE 01 OF
PART A
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EF61026
COLLISION REPORT III III III III III 111
1591972 CASE# 25-0736
ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY)
NAME MIDDLE INITIAL) FARWELL AIDEN
(IAST FIRST,
ADDRESS&PHONE# D O.B. '
14813 SE 145TH PL RENTON WA 98059 SEX M MMDOYyry 02 - 03 - 2009
PASSENGER WITNESS❑ UNIT# 2 POS 3 AIRBAG'2 RESTR. 4 EJECT ? 1 HEL EET ICLAS� 1 NATURE OF INJURIES
NAME
(LAST,FIRST,MIDDLE INITIAL) SCHROLLER JESSICA E
ADDRESS&PHONE# D O B
7857130806 SEX IF MMDDYYYY 03 _ 23 _ 1998
PASSENGER UNIT# SEAT AIRBAG RESTR. EJECT HELMET INJURY NATURE OF INJURIES
[:]WITNESS POS. USE CLASS
NAME
(LAST FIR57 MIDDLE INITIAL)
AppRESS&PHONE#
SEX D.Q.B.MMDD -❑
YYYY.
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.WISN/EWSKI 01-23-25 01:53 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
s.wooDWARD 11528 113112025 4:45:46 AM
BADGE OR ID# 12598 OR]# WA0171300 TIME POLICE DISPATCHED; 12:06 PM TIME POLICE ARRIVED 12:17 PM
PART I PAGE IT]OF 4�
REPORT NO. EF61026 CASE# 25-0736 OF COLLISION
01/23/25 11:45
OF CbLLI510N
NARRATIVE
On Thursday, January 23, 2025 at 1217 hours, I responded to a two-vehicle collision in the area of
the NE Sunset Blvd and Union Ave NE, in Renton, WA, King County.
The following occurred within the City of Renton, King County; Unit 1 - WA/ D77960E was being
driven by Michael Mann and headed east on NE Sunset Blvd in the 4000 block in lane #2. Unit 2 -
WA/BBP3338 was being driven by Janel Farwell and was travelling eastbound on NE Sunset Blvd in
lane 1.
Michael stated he was driving straight ahead and began to change lanes and did not observe Unit 2
that was in lane #1 resulting in a collision. The right front tire, quarter panel and side mirror collided
with the left front quarter panel, both side doors and part of the rear fender of Unit 2. Michael stated
his vehicle insurance had lapsed and did not provide valid proof of insurance when I requested it.
Janel stated she was travelling eastbound on NE Sunset Blvd when Unit 1 was speeding and made
an erratic lane change which resulted in Unit 1 striking the driver's side of Unit 2 causing significant
damage.
I captured digital images of both vehicles, which were later uploaded to evidence.com. Also, a
witness came forward and provided video, which was also uploaded to evidence.com.
I was able to watch the video and observed Unit 1 travelling lane 2 and approach a slow-moving
vehicle very quickly, then swerve in lane 1 colliding with Unit 2. It appeared as if Unit 2 was avoiding a
collision with the slow-moving vehicle when he swerved not lane 1.
Based on both statements, it appears that Unit 1 did not grant right of way to Unit 2 and failed to
make a safe lane change before proceeding into the lane 1, which ultimately caused the collision.
Both vehicles were damaged, however 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 01/23/2025 at 1334 in Renton, WA
PAGE 3 OF 4
REPORT NO. EF61026 CASE# 25-0736 DATE AND TIME 01/23/2511:45
OF COLLISION
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