HomeMy WebLinkAbout25-1694 iiTFiNII IIIII III IIIII II IIII IIIII I . 27c REPORT NO EF68061oc� RA
COLLISION REPORT 1591971
CASE# 25-1694 2
INTERSTATE CITY STREET FIRE I
RESULTED
STOLENSTATE ROUTE OTHER VEHICLE LOCCODIOENC'Y 4200 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2❑ TRIBAL i UNITS TRUCK
#OF 02 SO"" CONCRETE/JERSEY BARRIER 1 1 8 28
i RESERVATION : 2
3� M M D D Y Y Y Y TIME(2400) COUNTY# MILES CITY#
eaCL s o v' 02 - 22 - 2025 1541 17 =.[� S 8 W e OF IN 8 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
LAKE WASHINGTON BL N BLOCK NO. e 1500 .�
4a❑ MILE POST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ �. FEET e S 8 W e LK WASHINGTON BL NE
0 4 29
MOTOR ✓ PEDAL- DAM AG THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE ❑ YEs Vl No D:5628814715 0 1 30
6� LAST NAMEJ SANCHEZ FIRST NAME VINCE MIDDLE R 1 2 31
INITIAL
STREET ❑) 4426 HENDERSON BLVD SE CITY; OLYMPIA ST WA ZIP; 98501 2
NEW ADDRESS
7 CDL IGN(TIUN REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED' 3
INTERLOCKYEs No✓ INTERLOCKVES NO✓ YES NO;✓
8 DCIENSE# STATE WA SEXI M MMDDYY' 01 - 04 - 1982 1 2 32
9 ON DUTY STATUS' AIRBAG 2 RESTR 4 EJECT 1 N USEET CLASSYI 1 NATURE of INJURIES 2
LICENSE, CKK6412 STATE WA VIN# WAILHAF70JD012587 3
10 Fq I as ATP tt
TRAILER STATE TRAILER STATE
11 3 5 PLATE# PLATE# 11ROM To
TRLR zRLR. 1 3 33
12 3 5 VIN# VIN#
FROM TO
VEH.YEAR 2018 MAKE AUDI MODEL Q7 STYLE UT VEHICLE TOWED fn TO ZBUN TOWEDBY GOVT VEHICLE 7 3 34
13� DAMAGE YES II_II NO YESII_I) NO✓
REGISTERED OWNER INFO OWNEDIRYDRIVER VEHICLE NO. 1
SHADE IN DAMAGED AREA 35
3
14❑ LIABILITY INSURANCE� INSURANCE CO USAA 0229935407108 4
IN EFFECT &POLICY# 4TOP _
srgNOLNG
Yes❑NO❑ CITATION# 5AO170977 CHARGE FAIL STOP AT STOP s t a ooTro�m z 36
15
MOTOR ✓ PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT 02 VEHICLE CYCLE nWNFR D:4253063776
16�
LAST NAME CHE FIRST NAME JAEDIS MIDDLE E
INITIAL
17 F1 STREET ❑
❑ 1208 N 34TH ST CITY RENTON ST, WA ZIP 98056 37
NEW ADDRESS
18❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICALTRANSPORTED 38
INTERLOCKYEs ND✓ INTERLOCK YES No✓ vEs NO✓
19 DRIVER'S STATE WA SEX M D.O.s, 1 06 27 2008 39
LICENSE# MMDDYY —
HELMET INJURY: NATURE OF INJURIES 4Q
20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT I USE CLASS 0 ❑
21 LICENSE BXT8003 rare WA vIN# SHHFK7H69MU206798 41
22❑ STATE PLAAILER TE# STATE 42
PLATE#
23 TRLR RLR 43
UIN#. 'IN#
VEH.YEAR 2021 MAKE HOND MODEL CIVIC STYLE 4H VEHICLE TOWED TO BLIN
TOWED BY GOV HI 44
24 DAMAGE YES NO✓ VES NO✓
REGISTERED OWNER INFO CAM CHE 1208 N 34TH ST RENTON WA 98056 D:2063517512 VEHICLE NO.2
SHADE IN DAMAGFAREA
2 3
LIABILITY INSURANCE✓ INSURANCECO STATE FARM 4868071.819.47
IN EFFECT &POLICY# 1 STOP
vewaE ❑ CITATION11 CHARGE
25 to BOTTOM
EEGnEEY YES N
� e
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
26
R.ONISHI 5738 WA0171300
PAGE 01 OF
PART A 3000-345-189(R 11/18)
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EF68061
COLLISION REPORT III III III III III 111
1591972 CASE# 25-1694
ADDITIONAL PERSONS INVOLVED(PASSENGERS AND/OR WITNESSES ONLY)
'.NAME
(LAST,FIRST,MIDDLE INITIAL)
ADDRESS&PHONE
SEXi D.O.B. —
MMDDYYYY
PASSENGERQ WITNESS UNIT# SEAT AIRBAG RESTR. EJECT ; HELMET NJURY NATURE OF INJURIES
POS. ' USE CLASS 1 ----�
:NAME
(LAST FIRST MIDDLE INITIAL)
ADDRESS&PHONE#
SEX D.O.B. —
MMDDYYYY
PASSENGER❑WITNESS UNIT# : SEAT AIRBAG RESTR. EJECT HELMET INJURY: NATURECFINJURIES
POS. USE CLASS ----�
:NAME
(LOST,FIRST,MIDDLE INITIAL)
ADDRESS&PHONE#
SEX MMDDYY D.O.B.
YY
PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET NJURY NATURE OF INJURIES
POS. I USE CLASS
NARRATIVE
Unit 1 entering cross traffic on e/b Lake Washington Blvd N from s/b 1-405 ramp. Unit 2 e/b on Lake
Washington Blvd N. Unit 1 waited at stop sign until cross traffic in w/b left turn lane cleared, then
started into turn. Unit 2 was e/b in curb lane, with no traffic control. Unit 1 struck unit 2 on driver's
door; impact spun unit 2 180 degrees, and rear of unit 2 hit jersey barricade (no damage to
barricade). No injuries, driver 1 Sanchez admitted that he did not see unit 2 and that unit 2 driver Che
had right of way. Sanchez cited for failing to yield right of way from stop sign.
I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT.
R.ONISHI 02-22-25 04:57 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST.DET DATED PLACE SIGNED
APPROVED BY DATE
D.SKELTON 9139 212312025 3:32:44 AM
BADGE OR ID# 5738 ORI# WA0171300 TIME POLICE DISPATCHED 3:45 PM TIME POLICE ARRIVED i 3:56 PM
PAST B 3 Da-3mx—attar(txIMR) PAGE 2�OF F3
REPORT NO. EF68061 CASE# 25-1694 DATE AND TIME 02/22/2515:41
OF COLLISION
d
a
PAGE 3 OF 3