HomeMy WebLinkAbout25-3027 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 5 27c
COLLISION REP FIT 1591971
CASE 25-3027 z
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 1 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# ❑
cowsloN 04 - 1-- 2025 0800 17 ❑.= S 8 W IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓
MONROEAVENE BLOCK NO. M600
4a❑ MILEPOST
❑ DISTANCE OF(REFERENCE OR CROSS STREET)
5 MILES N�.❑ FEET e S B W e S 6TH P!
0 1 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
�/No D:2063304324 0 7 30
6� LAST NAME KIEU FIRSTNAME HOUNG MIDDLE T 1 1 2 31
INITIAL
STREET ❑ 3625 NE 9TH ST CITY RENTON ST WA ZIP 98056 z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
1/ I INTERLOCK YES[:]NO NTERLOCKYEs NO�/ YES R No�/
8❑ LRIIVER #
ON DUTY❑ STATUS AIRBAG 3 RESTR 4 EJECT 1 H USE 2 1 CLASS NATURE OF INJURIES z❑
3
10 9❑ PICENS11 ATE 14 AVF7012 STATE WAa VIN# 5FNYF4H28FB064117
TRAILER STATE TRAILER STATE
11 3 5 PLATE# PLATE# FROM To
rRLR. YRLR. 5 1 33
12 3 5 VIN#j VIN#
FROM TO
VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE J 9 34
13 2 2015 HOND PILOT UT DAMAGE YES NO YES[:] NO✓
REGISTERED OWNER INFO OWNEDBYDRIVER VEHICLE NO. 1
SHADE IN DAMAGED AREA ❑ 35
14 LIABILITY INSURANCE INSURANCE CO FOREMOST G01571070800 4
LI EFFECT I SUR N# TOPVEHICLE CHARGE 36
LEGALLYYES NO CITATION# 5A0338854 INATTENTIVE DRIVING <1�3
orrom
15❑ STANDING 7 6
1.' MOTOR PEDAL- PROPERTY DAM THR OLD MET PHONE
UNIT VEHICLE CYCLE ❑ PEDESTRIAN ❑ OWNER ❑ YES�/ NO D:2068325152
16 a
LAST NAME KENNEDY FIRST NAME CHERYL MIDDLE A
INITIAL
17 STREET I❑ 3040 60TH AVE SW APT 1 CITY SEATTLE ST WA ZIP 98116 37
NEW ADDREss❑'
18❑ CDL IGNITION REQUIRED IGNITION PtR-E-S1ENT MEDICAL-T�RANSPORTED � 38
INTERLOCK YES❑No� INTERLOCK YEs I I NOF YES
t l NO/
19 DRIVER # STATE WA SEX F M D.C.B.
01 26 _ 1994 39
20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 H U EET 2 NJAURSY 1 NATURE OF INJURIES 40
❑ 41
21❑ PLATE# AUA2635 TATE WA VIN# 2TIBURHE4FC320342 1
42
22❑ PLATE# STATE PLATE# STATE
TRLR
23❑ VIN#. IN#. 43
RLR
'
VEH YEAR 2015 MAKE 7'Dy7' MODEL CORO!! STYLE SD VEHICLE TOWED TO BLIN
TOWED BY Gov HI 44
L4❑ DAMAGE YES NO YES NO
REGISTERED OWNER INFO (NEWJ VEHICLE NO.2
SHADE IN DAMAGEbAREA
2 3 Cd
LIABILITY
INSURANCE INSU PORGY#ECO STATE FARM 0323455E2647GIN 1 9TOP
'E""LE CITATION# CHARGE
LEG
25 i o BOTTOM
ALLY YES N�
❑ J s
7NE
NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
26
ON 12327 WA0171300
PART A PAGE 01 OF C7
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EF81600
COLLISION REPORT III III III III III 111
1591972 CASE# 25-3027
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'
25-3027
Unless otherwise noted, the following occurred in the City of Renton, County of King, WA.
On 04-04-2025 at approximately 0806 hours I was dispatched to Monroe AVE NE and NE 7th ST for
an unknown type collision. Dispatch advised they received an automatic crash notification from the
aforementioned location but had no further details.
I arrived and located the involved vehicles in northbound lane 1 of Monroe AVE NE. Unit 1, a white
Honda pilot, had front end damage and unit 2, a Toyota Corolla, had rear end damage.
The driver of unit 1, Kieu, stated she was travelling northbound on Monroe AVE NE in lane 2 when
she struck unit 2 from behind in the 600 block of Monroe AVE NE. The driver of unit 2, Kennedy,
advised that she was awaiting to make a left turn, with her left turn signal indicator on, when she was
struck from behind by unit 1.
What was relayed to me was consistent with my observations of the collision and I determined unit
1's inattention was the proximate cause of the collision.
I provided each driver with a copy of the exchange of information.
Unit 2 was inoperable and was towed.
Kieu was cited for inattentive driving.
I declare under penalty of perjury under the laws of the State of Washington that the foregoing is true
and correct.
Electronically signed by T. Nelson 12327 on 04-04-2025 at 1027 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.
T.NELSON 04-04-25 10:40 AM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
M.LEVERTON 2517 1 411112025 7:50:58 AM
BADGE OR ID# 12327 ORI# WA0171300 TIME POLICE DISPATCHED; 8:04 AM TIME POLICE ARRIVED 8:06 AM
PART I PAGE IT]OF 3�
REPORT NO. EF81600 CASE# 25-3027 DATE AND TIME 04/04/25 08:00
OF COLLISION
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