HomeMy WebLinkAbout25-1127 iiTFiNII IIIII III IIIII II IIII IIIII I . 27c REPORT NO EF71821oc� RA
COLLISION REPORT 1591971
CASE# 25-1127 2
INTERSTATE CITY STREET FIRE I
RESULTED STOLENSTATE ROUTE OTHER VEHICLE LOCAI-AGENCY 4200 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY ❑ INVOLVED
2 TOTAL#OF OBJECT 1 s 28
TRIBAL UNITS 02 STRUCK
RESERVATION : 1 1
2
3� M M D D Y Y Y Y TIME(2400) COUNTY# MILES CITY#
eDCL s on' 02 - 04 - 2025 1107 17 =.= S 8 W e OF IN e 1070 s
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
BLOCK NO.
HARD/E AVE SW
4a❑ MILE POST
❑ DISTANCE OF(REFERENCE OR CROSS STREET)
5 MILES 1.1 FEET e S 8 W e SW 5TH PL
0 1 29
MOTOR ✓ PEDAL- DAM AG THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE ❑ YES ✓NO o 1 30
5 LAST NAME MARIANO SIMON FIRST NAME LUIS MIDDLE G 1 1 2 31
INITIAL
STREET ] 415 SW 5TH PL APT A CITY; RENTON ST WA ZIP; 980572364 2
NEW ADDRESS
7 CDL IGNITION REQUIRED IGNITION PRESENT MEflIGAL TRANSPORTED 3
INTERLOCKYEs No INTERLOCKYEs NO YES NO
8 DRIVER # STATE WA SEXI M MMDDYY' 03 - 16 - 2000 1 2 32
9 ON DUTY❑ STATUS' AIRBAG 3 RESTR 4 EJECT 1 NELM USEET 2 CLASSY',1 NATURE of INJURIES 2
LICENSE, CLY2911 STATE WA VIN# 1ZVBP8EN9A5122719 3
10 Fq I PI ATP rt
TRAILER STATE TRAILER STATE
11 3 0 PLATE# PLATE# ROM To
TRLR TRLR 3 1 7 33
12 3 0 VIN#' vIN#
' FROM TO
13 2 VEH.YEAR2010 MAKE FORD MODEL MUSTAN STYLE VEHICLE TOYED NO�iS46LIN Tv4 EBYMEYERS GOS❑VT EHICLE
Np 5 1 34
DAMAGE IIII._IIII
REGISTERED OWNER INFO LUIS MARIANO SIMON 415 SW 5TH PL APTA RENTON WA 98057 VEHICLE NO. 1
SHADE IN DAMAGED AREA 35
14❑ LIABILITY INSURANCE ElNSURANCE CO 3 4
11
IN EFFECT &POLICY# 9TOP
VEnic'E CHARGE 5 36
STML IN YES❑NO❑ CITATION# t a BOTTOM
15❑ srnNowc 7 6
PROPERTY
MOTOR PEDAL- PEDESTRIAN Y DAM THR OLD MET PHONE
UNIT 02 VEHICLE ❑ CYCLE ❑ ❑ nWNRR vEs�/ No D:4062234337
16�
LAST NAME CRUZ FIRST NAME SHEENA MIDDLE
INITIAL
17 F1 STREET ❑
❑ 5741 S 152ND ST APT 421 CITY TUKWILA ST, WA ZIP 98188 37
NEW ADDRESS
18❑ CDL IGNITION REQUIREd IGNITION PRESENT MEDICAL TRANSPORTEd ❑ 38
INTERLOCKYES NO INTERLOCK YES NO vEs No
19[—] DRIVER'S STATE MT SEX IF D.O.B. 1 10 11 1978 39
LICENSE# MMDDYY —
HELMET INJURY: NATURE OF INJURIES 4Q
20❑ ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 USE 2 CLASS 1 ❑
21 LICENSE CRK2924 TATE WA VIN# 1FM5K8F85FGB90921 41
22❑ [TILER TRAILER
PLATE# STATE PLATE# STATE 42
23 TRLR r RLR 43
UIN#. 'IN#
VEH.YEAR 2Q15 MAKE FORD MODEL EXPLORE STYLE VEHICLE TOWED TO BLIN TOWED BY GOV HI 44
24 DAMAGE YES �/ No GENE MEYERS TOWING
REGISTERED OWNER INFO SHEENA CRUZ 5741 S 152ND ST APT 421 TUKWILAWA 98188 VEHICLE NO.2
SHADE IN DAGEAREA
2
LIABILITY INSURANCE INSURANCE CO PROGRESSIVE 928606240
IN EFFECT &POLICY# 9TOP
HICL
L'—L YES❑ NJ—I, CITATION11 CHARGE tO BOTTOM
VEE
25 8
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
J
26
C.CATALAN 12007 WA0171300
PAGE 01 OF
PART A 3000-345-189(R 11/18)
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EF71821
COLLISION REPORT III III III III III 111
1591972 CASE# 25-1127
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 INJURY 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
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.
C.CATALAN 02-04-25 12:39 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST.DET DATED PLAGE SIGNED
APPROVED BY DATE
M.LEVERTON 2517 31712025 2:18:07 PM
BADGE OR ID# 12007 ORI# WA0171300 TIME POLICE DISPATCHED 11:08 Aryl TIME POLICE ARRIVED i 11:16 AM
PAST B 3 Do-3mx—attar(t 1Mff) PAGE 2�OF 4
REPORT NO. EF71821 CASE# 25-1127 OF DATE AND r�N + 02/04/25 11:07
O�COLLISION
NARRATIVE
On February 4, 2025, at approximately 1107 hours, I was dispatched to a blocking vehicle collision in
the intersection of Hardie Ave SW and SW 5th PL, within the City Limits of Renton, County of King,
State of Washington.
Upon my arrival, I confirmed there were no complaints of injury. While on scene, I collected each
involved party's driving documents and their independent involvement leading up to the collision.
The driver of Unit 1, identified by his WADL as Luis G. Simon, stated he was the sole occupant of his
vehicle and was attempting to exit a private property parking lot, located at on the westside of 365
Renton Center Way, and on the east side of the roadway. Luis stated that he was intending to make a
right turn out of the parking lot to proceed northbound onto Hardie Ave SW following the turn. Luis
stated that he failed to notice that his floor mat was caught onto the accelerator and therefore he was
unable to control his vehicle. When he attempted to break, the floor mat pushed the accelerator
forward. Luis stated that he was unable to avoid the collision after having pulled out into the roadway
and that Unit 1 struck the rear right wheel of Unit 2, causing significant damage.
The driver of Unit 2, identified by her WAID as Sheena Cruz, said she was the sole occupant of her
vehicle and was traveling northbound in about the 365 block of Hardie Ave SW and in the northbound
lane. Sheena stated she was intending to continue north on Hardie. Upon reaching the location of
where Unit 1 was coming out from, Sheena observed Unit 1 pull out into the roadway but was unable
to avoid the collision. Both vehicles collided in the roadway and Unit 1 suffered significant damage to
the front driver's side, including the wheel of the vehicle.
Based on the above statements, I determined that the Driver of Unit 1 (Luis) is the proximate cause
for the collision due to inattention causing a collision. Luis should have been paying closer attention
to his vehicle.
I gave the driver of Unit 1 (Luis) a verbal warning for inattention.
Both Unit 1 and Unit 2 had to be towed due to extensive damage. An exchange of information was
provided to all involved parties.
No citation. Information only.
I certify (declare) under penalty of perjury under the laws of the State of Washington that the
foregoing is true and correct.
C. Catalan 03/07/2025 Renton
PAGE 3 OF 4
REPORT NO. EF71821 CASE# 25-1127 DATE AND TIME 02/04/25 11:07
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