HomeMy WebLinkAbout25-1766 IT si " II IIIII III IIIII II IIII IIIII I . 27c REPORT NO EF71842OLCERA
COLLISION REPORT 1591971
INTERSTATE CITY STREET FIRE I
CASE# 25-1766 2
RESULTED STOLENSTATE ROUTE OTHER VEHICLE LOL`CODIQENC'Y 4200 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 TOTAL#OF OBJECT 1 T 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 - 25 - 2025 0641 17 =.= S 8 W e OF IN e 1070 s
4� ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
NE SUNSET BLVD BLOCK ST e
4a MILE POST 600 .�
�
❑ DISTANCE OF(REFERENCE OR CROSS STREET)
5 1. FEET e S 8 W e ONRAMP NB I-405
0 4 29
MOTOR PEDAL- DAMAG THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE ❑ YES No �/ D:2065965264 0 3 30
6 LAST NAME KAUR FIRST NAME HARMIK MIDDLE N 1 1 2 31
INITIAL
STREET ] 12502 SE 264TH ST CITY; KENT ST WA ZIP; 980300000 2
NEW ADDRESS
7 CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
INTERLOCKYES ND INTERLOCKVES NO YES ND
8❑ LCEENSE# STATE WA SEXI F MMDDYY' 09 - 02 - 1967 1 2 32
9 ON DUTY STATUS' AIRBAG 2 RESTR 4 EJECT 1 N USE ET CLASSY 1 [NATURE of INJURIES 2
LICENSE, CKV1459 STATE WA VIN# 5TDKDRBH4RS529384 3
10 Fq I PI ATP rt
TRAILER STATE TRAILER STATE
11 3 5 PLATE# PLATE# IE.M To
TRLR zRLR 7 1 33
12 3 5 VIN# vIN#
FROM TO
VEH.YEAR ZO24 MAKE I.O�- MODEL HIGHLA STYLE VEHICLE TOWED[n TO ZBLIN TOWEDBY GOVT VEHICLE 3 1 34
13� DAMAGE YES II_II NO YESII_I) NO
REGISTERED OWNER INFO HARMIK KAUR 12502 SE 264TH ST KENT WA 980300000 D:2065965264 VEHICLE NO. 1
SHADE IN DAMAGED AREA 35
2 LIABILITY INSURANCE NSURANCE CO 4
14 ST FARM 507 4405-A15-47
IN EFFECT &POLICY# 9TOP
VEHICLE CHARGE t 5 36
Lemur YES❑NO❑ CITATION# t a 80TTOM
15❑ srANowG s 7 e
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT VEHICLE CYCLE nWNFR YES f/ NO D:4254796501
16�
LAST NAME ESCOTO CRUZ FIRST NAME JAFET MIDDLE' O
INITIAL
17F1 STREET ❑
❑ 430 W/NDSORWAYNE CITY' RENTON ST, Wq ZIP 98056 37
NEW ADDRESS
18❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED: ❑ 38
INTERLOCKYES ND INTERLOCKYEs NO Yes No
19[ LICENS# STATE SEX U MDOB.
O B. —= E 39
HELMET INJURY: NATURE OF INJURIES 4Q
20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 USE CLASS 1 ❑
21 LICENSE
LATE# CMW7556 rarE WA VIN 2HGFG12636H579455 41
22❑ TILER PLATE# STATE TAILER PLATE# STATE E 42
43
23 VfN RLR
UIN#. 'IN#
VEH.YEAR 2006 MAKE HOND MODEL CIVIC STYLE VEHICLE TOWED TO BLIN
TOWED BY GOV HI 44
24 DAMAGE YES NO�/ VES NO�/
REGISTERED OWNER INFO HECTOR HERNANDEZAMADOR 2400350TH PL W MOUNTLAKE TERRACE WA 98043 VEHICLE NO.2
SHADE IN DAMAGED AREA
2 3 4
LIABILITY INSURANCE❑ INSURANCE CO
IN EFFECT &.POLICY# t STOP
VEH1CLE YESO NCO CITATION# 5A0151292,5AO151292 CHARGE NO VALID OPER LICENSE WITH VALID to sorTOM
LEGALLY
25 s
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
26
M.LEVERTON 2517 WA0171300
PART A PAGE 01 OF
3000-348-189(R 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EF71842
COLLISION REPORT III III III III III 111
1591972 CASE# 25-1766
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 GLASS 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.
M.LEVERTON 02-25-25 04:02 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST.DET DATED PLAGE SIGNED
APPROVED BY E
DAT
M.LEVERTON 2517 31712025 2:41:49 PM
BADGE OR ID# ; 2517 ORI# WA0171300 TIME POLICE DISPATCHED 6:41 AM TIME POLICE ARRIVED i 6:43 AM
PAST B 3 Do-3mx—attar(t 1Mff) PAGE 2�OF 4
REPORT NO. EF71842 CASE# 25-1766 OF DATE AND r�N + 02/25/25 06:41
O�COLLISION
NARRATIVE
unit 1 gry It onto ramp unit 1 blue rt onto ramp
CC
Within the city limits of Renton/King/Wa I responded to a 2 vehicle crash that was dispatched as
happening at Sunset Blvd NE at Bronson Way NE, but it actually took place on the on-ramp to
northbound 1-405.
1 contacted the driver of unit 1 who told me she was turning left from Sunset Blvd NE onto the
northbound 1-405 when she and unit 2 contacted each other. She did not complain of injury and
damages did not require a tow truck.
I contacted the driver of unit 2 ID'd by Honduras passport. A WACIC/DOL check revealed he did not
have a drivers license. He was unable to provide valid proof of insurance for the vehicle he was
driving at the time. He told me he just lives up the hill and was making a right/merge onto northbound
1-405. He explained that unit 1 basically merged into the side of his vehicle. He did not complain of
injury and damages did not require a tow truck.
I cited unit 2 ref RCW 46.20.015 NVOL 2nd and ref RCW 46.30.020 No insurance via complaint.
Information/Insurance only.
I certify (declare) under penalty of perjury under the laws of the State of Washington that the
foregoing is true and correct.
M.Leverton/2517 City of Renton/King/Wa 2/25/2025
PAGE 3 OF 4
REPORT NO. EF71842 CASE# 25-1766 DATE AND TIME 02/25/2506:41
OF COLLISION
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