HomeMy WebLinkAbout25-1254 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 0 27c
COLLISION REP FIT 1591971
CASE 25-1254 z
INTERSTATE ❑ CITY STREET FIRE ❑RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHIr.I F ❑ LOCAL AGENC 4100 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 CITY# ❑
COLLISION.. 02 - 08 - 2025 1225 17 ❑.❑ N E IN S 8 W H OF e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓
SW 43RD ST BLOCK NO. e✓ 200
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ 400 00 FMILES EET e S ❑ W e EAST VALLEYRD
0 4 29
MOTOR PEDAL- DAMAGE THRESHOLDHONE
UNIT 01 VEHICLE ❑ CYCLE El MET P
YES ✓NO D:3177288023 0 11
30
6� LAST NAME WANG FIRSTNAME JUE MIDDLE 1 2 31
INITIAL
STREET ❑ 3616 35TH AVE S CITY SEATTLE ST WA ZIP 98144 z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
1/ I iNTERLOCKYEs NO NTERLOCKYEs NO�/ YES R No�/
8❑ LRIIVER #
ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 HELMET
2 CLASS 1 NATURE OF INJURIES z❑
3
10 9❑ PI ATFBit CMN7744 sTArI WA VIN#' WA1ABAFY6P2112795
TRAILER STATE TRAILER STATE
11 0 0 PLATE# PLATE# FROM TO
TRLR. A'RLR. 1 3 33
12 3 5 VIN#' VIN#
>; FROM TO
VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE 3 ] 34
13 9 2023 AUDI O5 5D DAMAGE YES NO YES[:] No✓
REGISTERED OWNER INFO OWNEDBYDRIVER VEHICLE NO. 1
SHADE IN DAMAGED AREA ❑ 35
14 LIABILI INSURANCE INSURANCE CO ALLSTATE 820841839 3 4
IN EFFECT &POLICY# 9TOP
VEHCLE CHARGE 5 36
LEGALLY YES❑NO❑ CITATION# 10 BOTTOM
15❑ STANDING 6
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT VEHICLE ❑ CYCLE ❑ ❑ : OWNER ❑ YES 1/ NO D:2533536205
16 2
LAST NAME CIRA CORNELIO FIRST NAME EDGAR MIDDLE
INITIAL
17❑ STREET ❑' 7816 57TH ST E SPC B15 CITY' PUYALLUP ST WA ZIP 98371 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[-] DRIVER'S STATE WA SEX M D.C.B. 01 02 _ 1984 0 39
LICENSE# MMDDYY
HELMET {NJURY 6 NATURE OF INJURIES 40
20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 USE 2 CLASS SORE SHOULDER ❑
21❑ LICENSE CAE8150 TAre 41
WA VIN1 1HGCR2F3XDA027014
❑
PLATE#
42
22❑ PILER LATE# STATE PLATE# STATE
23❑ UIN#. 43
TRLR RLR
'IN#.
GoI
VEH YEAR 2013 MAKE yOND MODEL ACCORD STYLE 4D DAMAGE TOWED NOO✓ BLIN TOWED BY v HYES NO 1/ 44
24❑ ES
REGISTERED OWNER INFO OWNED SY DRIVER VEHICLE N0.2
SHADE IN DAMAGEbAREA
2 3 Cd
LIABILITY
INSURANCE INSU&PORGY#E CO STATE FARM 574-5248-A21-47IN I 5
VEwGLE ❑ ,J� CITATION# CHARGE
25 GQ
LEGALLY YES N`L J
s � e
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# JAGENCY
26
C.STEED 8770 WA0171300
PART A PAGE 01 OF C7
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EF63756
COLLISION REPORT III III III III III 111
1591972 CASE# 25-1254
ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY)
NAME MIDDLE INITIAL) WANG CADEN
(LAST FIRST,
ADDRESS&PHONE#
3616 35TH AVE S SEATTLE WA 98144 3177288023 SEX M MMDDYyry 10 - O6 - 2021
PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT H USE 2 INJURY L 1 NATURE OF INJURIES
❑✓ 1 POS. 9 2 10 1
NAME
(LAST,FIRST,MIDDLE INITIAL) LIRA CORNELIO EDGAR
ADDRESS&PHONE# D O B- 08 7816 57TH ST E SPC B15 PUYALLUP WA 98371 2533536205 SEX M -;50- _ O6 _ 2001
SEAT HELMET INJURY NATURE OF INJURIES
PASSENGER
Z WITNESS� UNIT# 2 POS 3 AIRBAG'2 RESTR. 4 EJECT 1 USE 2 CLASS 6 SORE SHOULDER
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'
On 02/03/25 at about 1230 hrs I arrived in the 300 block of SW 43rd St for an Injury Collision, in the
City of Renton, County of King, and State of Washington. Both drivers were identified by their WADL.
Unit#1 was exiting the driveway of 302 SW 43rd St and turning EB on SW 43rd St. Unit#2 was
traveling WB on SW 43rd St in the outside lane with the right of way. The driver and passenger of
Unit#2 said they swerved trying to avoid the collision when Unit#1 struck them in the rear passenger
side of their vehicle with the front of Unit#1. Unit#1 said she thought it was clear when she pulled out
on to SW 43rd St. Both occupants of Unit#2 were treated by fire for shoulder pain. The occupants of
Unit#1 advised they were uninjured.
This incident was captured on my body worn video camera. This report is a summary of events that
occurred and is not an exact sequencing of events. Statements have been paraphrased and
summarized. The video was uploaded to evidence.com.
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 Steed on 02/08/25 1318 hrs, Renton Washington
Cassidy Steed/8770
I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT.
C.STEED 02-08-25 01:29 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
D.SKELTON 9139 2/8/2025 2:40:12 PM
BADGE OR ID# 8770 OR]# ! WA0171300 TIME POLICE DISPATCHED 12:28 PM TIME POLICE ARRIVED',12:30 PM
PART I PAGE IT]OF 3�
REPORT NO. EF63756 CASE# ' 25-1254 DATE AND TIME 02/08/25 12:25
OF COLLISION
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