HomeMy WebLinkAbout25-2470 IT si " II IIIII III IIIII II IIII IIIII I . 27c REPORT NO EF75392OLCERA
COLLISION REPORT 1591971
CASE# 25-2470 2
INTERSTATE ❑ CITY STREET FIRE I
RESULTEDSTOLENSTATE ROUTE OTHER VEHICLE LOCALANG 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#
DATE OF N E IN eDL�ISION' 03 - 19 - 2025 0812 17 =.= S 8 W❑ OF M 1070 a
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
BLOCK NO. e .�
4a
LK WA BL N MILE POST
❑
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ C------ 1.1 FEET e S 8 W e RIPLEY LANE
0 4 29
MOTOR ✓ PEDAL- DAM AG THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE ❑ YEs Vl No D:4258321668 0 1 30
5 LAST NAME LI FIRST NAME ZHENGUO MIDDLE N 1 1 2 31
INITIAL
STREET ] 5034 117TH AVE SE CITY; BELLEVUE ST I WA Zlp; 980062731 2
NEW ADDRESS
7 CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
INTERLOCKYEs No INTERLOCKVEs No YES NO
8 DCIENSE# STATE WA SEXI M MMDDYY' 10 - 04 - 1985 1 2 32
9 ON DUTY STATUS' AIRBAG 2 RE
4 EJECT 1 N USE CLASSY ? [NATURE of INJURIES 2❑
LICENSE, CN✓?151 STATE WA VIN#; JTDKN3DU4A0185454 3
10 Fq I PI ATP rt
TRAILER STATE TRAILER STATE
11 2 5 PLATE# PLATE# FROM To
TRLR zRLR 1 3 33
12 2 5 VIN#' VIN#
FROM TO
VEH.YEAR 2010 MAKE TOYT MODEL PRIUS STYLE V Y EHICLE TOWED TO BLIN TOWED By GOVT V 7 $EHICLE 34
13� DAMAGE YES II_II NO `/ YESII_] NO
REGISTERED OWNER INFO ZHENGUOL11034117THAVESE BELLEVUE WA 980062731 D:4258321668 VEHICLE NO. 1
SHADE IN DAMAGED AREA 35
3 14 LIABILITY INSURANCE❑ INSURANCE CO DIRECT 2025299771 4
IN EFFECT &POLICY# 9TOP _
srnNowc ❑ ❑ 5A0333542 CHARGE FA►L YIELD LEFT TURN MOTOR t a oorrob z 36
Yes NO CITATION#
15❑
MOTOR PEDAL- PEDESTRIAN1:1 PROPERTY DAM THR OLD MET PHONE
UNIT 02 VEHICLE CYCLE nWNFR YES�/ NO D:4253066561
16�
LAST NAME DO FIRST NAME JACQUELINE MIDDLE D
INITIAL
17 STREET ❑ 17318 SE 187TH ST CITY' RENTON ST, WA ZIP 98 37
0587327
NEW ADDRESS I I I I I 1
❑
18❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED: ❑ 38
INTERLOCKYEs No INTERLOCK YEs NO YEs NO
19 DRIVER'S
MMDDYY -
HELMET INJURY: NATURE OF INJURIES 40
20❑ ON DUTY� STATUS AIRBAG 2 RESTR 4 EJECT 1 USE CLASS ? ❑
21 LICENSE I PATE# AVN2222 rare WA vIN# JTMRFREV7FD126159 41
22❑ [TILER TAILER
PLATE# STATE PLATE# STATE 42
23 TRLR RLR 43
UIN#. 'IN#
VEH.YEAR 2015 MAKE TOYT MODEL RAV4 STYLE VEHICLE TOWED TO BLIN
TOWED BY GOV HI 44
24❑ DAMAGE YES NO VES NO
REGISTERED OWNER INFO JACQUELINE DO 17318 SE 187TH ST RENTON WA 980587327 VEHICLE NO.2
SHADE IN DAMAGED AREA
2 3 4
LIABILITY INSURANCE❑ INSURANCE CO FARMERS 188094795
IN EFFECT &POLICY# I STOP
LY—ve ❑ ,J—I CITATION# CHARGE to BOTTOM
EEGnE YES N`[
25= s e
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
26
M.LEVERTON 2517 WA0171300
❑
PAGE 01 OF
PART A 3000-345-189(R 11/18)
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EF75392
COLLISION REPORT III III III III III 111
1591972 CASE# 25-2470
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 0,SS ----�
: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 03-19-25 04:23 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST.DET DATED PLAGE SIGNED
APPROVED BY E
DAT
M.LEVERTON 2517 312012025 7:10:25 AM
BADGE OR ID# ; 2517 ORI# WA0171300 TIME POLICE DISPATCHED 8:12 Aryl TIME POLICE ARRIVED i 8:21 AM
PAST B 3 Do-3mx—attar(t 1Mff) PAGE 2�OF 4
REPORT NO. EF75392 CASE# 25-2470 OF DATE AND r�N + 03/19/25 08:12
O�COLLISION
NARRATIVE
slv left turn from riply ino ther side of white unit 2
CC
Within the city limits of Renton/King/Wa I responded to a 2 vehicle blocking crash near Lk Wa BI N at
Ripley Lane. AKA N 44th st and Seahawks Way
I arrived and found both cars had pulled to the south shoulder out of the roadway.
I contacted the driver of unit 2 who told me she was eastbound on Lk Wa BI N when unit 1 made a left
turn from Ripley Lane into the side of her car. She was hit about the B pillar driver side. She did not
complain of injury and damages did not require a tow truck. However, neither driver side doors would
open from damage.
I contacted the driver of unit 1. We used a translater device. He told me he pulled out from Ripley
but did not see unit 2 contacting her vehicle on her driver side. He did not complain of injury and
damages did not require a tow truck.
I cited unit 1 ref RCW 46.61.185 FTYROW-Left turn 2 car 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 3/19/2025
PAGE 3 OF 4
REPORT NO. EF75392 CASE# 25-2470 DATE AND TIME 03/19/2508:12
OF COLLISION
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PAGE 4 OF 4