HomeMy WebLinkAbout25-1797 iiTFiNII IIIII III IIIII II IIII IIIII I . 27c REPORT NO EF72929oc� RA
COLLISION REPORT 1591971
INTERSTATE CITY STREET FIRE I
CASE# 25-1797 2
RESULTEDSTOLENSTATE ROUTE OTHER VEHICLE LOCCOAGENCY 4100 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 - 26 - 2025 0821 17 =.= S 8 W e OF IN e 1070 s
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓
SW 12TH ST BLOCK NO. e 511 .�
4a❑ MILE POST
❑ DISTANCE OF(REFERENCE OR CROSS STREET)
5 125 00 FEET e✓ S 8 W e SENECA AVE SW
IF 2 29
MOTOR ✓ PEDAL- DAM AG THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE ❑ YEs Vl No D:2066762713 0 1 30
5 LAST NAME PEREZ ZAMUDIO FIRST NAME LUIS MIDDLE A 1 1 2 31
INITIAL
STREET ❑ 9960 3RD LN SW
NEW ADDRESS CITY I $EATTLE ST WA ZIP: 981063168 2
7 CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSf ORTED 3
INTERLOCKYES Na INTERLOCKYEs NO YEs ND
8❑ DRIVER # STATE WA SEXI M MMDDYY' 04 — 05 — 1982 1 2 32
9 ON DUTY STATUS' AIRBAG 2 RESTR 4 EJECT '.. 1 N U EET LA SY 7 LATURE WRISTF INJURIES 2
LICENSE, CFP1034 STATE WA VIN# KL8CB6SAXNCO29083 3
10 Fq I as ATP tt
TRAILER STATE TRAILER STATE
11 2 5 PLATE# PLATE# 11ROM To
TRLR TRLR 3 7 33
12 2 5 TRLR vIN#
FROM TO
VEH.YEAR 2O22 MAKE CHEV MODEL SPARK STYLE VEHICLE TOWED[n TO ZBUN TOWEDBY GOVT VEHICLE 3 7 34
13� DAMAGE YES II_II NO YESII_I) NO
REGISTERED OWNER INFO LUIS PEREZ ZAMUD.99603RD LN SW SEATTLE WA 981063168 D:2066762713 VEHICLE NO. 1
SHADE IN DAMAGED AREA 35
14 LIABILITY INSURANCE NSURANCE CO AM FAM41012-64433-58 3 4
IN EFFECT &POLICY# 4TOP _
CHARGE fi 36
Lr LNYes❑NO❑ CITATION# INATTENTIVE DRIVINGgG
I I Q
15
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT 02 VEHICLE CYCLE nWNFR D:4255286637
16�
LAST NAME GORODENCO FIRST NAME TATIANA MIDDLE N
INITIAL
STREET ❑ 37
17 ❑ 3910 S 34TH ST CITY', TACOMA ST, WA ZIP 984093144
NEW ADDRESS
18❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDfCALTRANSPORTED. 38
INTERLOCKYES ND INTERLOCK YES R No Yes NO
19 DRIVER'S ' STATE WA SEX F I D.O.B. 05 18 1991 � 39
LICENSE# MMDDYY -
20❑ ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 HELMET I INJURY 7 NATURE OF INJURIES ❑ 40
USE CLASS TBA
21 LICENSE CDV5437 TATE WA VIN# KMHL24JA4NA230871 41
22❑ PLATE# STATE PLATE# STATE 42
23 TRLR RLR 43
UIN#. 'IN#
VEH.YEAR 2022 MAKE HYUN MODEL SONATA STYLE VEHICLE TOWED TO BLIN
TOWED BY GOV HI 44
24 DAMAGE YES NO VES NO
REGISTERED OWNER INFO RENAT GORODENCO 19010135TH STREET CT E BONNEY LAKE WA 98391 VEHICLE NO.2
SHADFY DAGEAREA
LIABILITY INSURANCE INSURANCE CO ST FARM 4813792F01.047C
IN EFFECT &POLICY# 9TOP
YemaE ❑ ,J—I CITATION# CHARGE t080TTOM
LE—LY YES NIL]25a ' e
7'0FFLIC"ER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
26
VERTON 2517 WA0171300
PAGE 01 OF
PART A 3000-348-189(R 11/18)
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EF72929
COLLISION REPORT III III III III III 111
1591972 CASE# 25-1797
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 CIASS ----�
: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 GLASS
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 02-26-25 03:30 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST.DET DATED PLAGE SIGNED
APPROVED BY DATE
M.LEVERTON 2517 311112025 3:25:47 PM
BADGE OR ID# ; 2517 ORI# WA0171300 TIME POLICE DISPATCHED 6:21 AM TIME POLICE ARRIVED i 8:43 AM
PAST B 3 Do-3mx—attar(t 1Mff) PAGE 2�OF 4
REPORT NO.` EF72929 CASE# 25-1797 OF DATE AND r�N + 02/26/25 08:21
O�COLLISION
NARRATIVE
wht/1 merge wht/2 straight
CC
Within the city limits of Renton/King/Wa I responded to a 2 vehicle crash near the 511 block of SW
12th St.
I contacted the driver of unit 2 who told me she was west on SW 12th St when unit 1 pulled from a
stopped/parked position into the side of her vehicle. Damages did not require a tow truck. She was
checked and released on scene by Renton Fire.
I contacted the driver of unit 1 ID'd by matching picture WADL. He told me he was merging into traffic
from a stopped/parked position west on SW 12th St. He told me he did not see unit 2. Then told me
she was speeding. I asked him did he not see unit 2 or was she speeding and he said both. Damage
did not require a tow truck and he was checked and released by Renton Fire on scene.
I cited unit 1 ref RMC 10-12-25 Inattentive driving 2 vehicle injury crash via complaint.
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 2/26/2025
PAGE 3 OF 4
REPORT NO. EF72929 CASE# 25-1797 DATE AND TIME 02/26/2508:21
OF COLLISION
k t
a
4}
r
t 1,:S �� �,.�Viz;,� � ``�� �•a,� �.�'~� 1
1 �
if 2➢ �Y2 }t '.
\
� t +
zt
s-
t l
PAGE 4 OF 4