HomeMy WebLinkAbout25-2034 ITFF' "POLCERA II I !�� I III I III I IIII III II I . B 27c
COLLISION REP FIT 1591971
CASE 25-2034 z
INTERSTATE ❑ CITY STREET FIRE ❑RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHICI 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 03 - 1-- 2025 1632 17 ❑-= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
EARLINGTON AVE SW
BLOCK NO. e✓ --- ----� ❑
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ �.❑ FEET e S ❑ VV a SW SUNSET BLVD
0 3 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
,/No D:4255453752 0 11
30
6� LAST NAME GADIAGA FIRSTNAME SERIGNE MIDDLE F 1 0 4 31
INITIAL
STREET ❑ 611 SW 5TH CT APT A201 CITY RENTON ST WA 2jp, 980572337 z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
INTERLOCK YES[:]NO INTERLOCKYEs NO YES R NO
8❑ LRIIVER #
ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 HELMET
2 CLASS 1 NATURE OF INJURIES z❑
3
LICENSE CPD0606 sTArI WAurN# 1FADP3K26GL293608
10 F91 PI ATE#
TRAILER STATE TRAILER STATE
11 3 5 PLATE# PLATE# FROM TO
TRLR. TRLR 5 3 33
12 3 5 VIN#' VIN#
>; FROM TO
VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN T /[g GOVT.VEHICLE 7 3 34
13 2016 FORD FOCUS DAMAGE YES NO � '` RS TOWING YES[:] No✓
REGISTERED OWNER INFO SERIGNE GADIAGA 611 SW5TH CTAPTA201 RENTON WA 98057 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
3 4
14� LIABILITY INSURANCE INSURANCE CO GEICO 6181 13 27 28
IN EFFECT &POLICY# 9TOP
VEHlcl.e CHARGE 5 36
LEGALLY YES❑NO❑ CITATION# 10 BOTTOM
15❑ STANDING 8 7
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES NO ,/ D:2532210638
16 a
LAST NAME JAMES FIRST NAME ANITA MIDDLE I M
INITIAL
17❑ STREET ❑', 9929 12TH AVENUE CT E CITY TACOMA ST WA ZIP 984454545 37
NEW ADDRESS ❑
18� CDL ., IGNITION REQUIRED IGNITION PtR-E-S1ENT MEDICAL TRANSPORTED ❑ 38
INTERLOCK YEs❑NoR INTERLOCK YEs I I NOF YES
t l NO❑
19[ LICENSE# STATE WA SEX IF M DDY
D.C.B.
08 1_ 25 _ 1971 39
—NATURE OF INJURIES
H USE ET LASSY LOW BACK PAIN/POSSIBLE INJURY ❑ 40
20❑ ON DUTY STATUS AIRBAG,2 RESTR 4 EJECT 1 2 7
21❑ LICENSE I B8632C TAre GOV VINE 5FYH8YU07GF050793
❑ 41
PLATE#
42
22❑ PLATE# STATE pLATE# STATE
23❑ UIN#. 43
TRLR RLR
'IN#.
VEH YEAR 2016 MAKE UNKN MODEL DUNE STYLE BU VEHICLETOWED TO BLIN TOWEDBY GOV HI 44
24❑ DAMAGE YES NO YES NO
REGISTERED OWNER INFO KING DEPARTMENT OF TRANSPORT 201 SJACKSON ST SEATTLEWA98104 VEHICLE NO.2
SHADE IN DAMAGED AREA
2 3 4
LIABILITY INSURANCE INSU&PORGY#E CO KING COUNTY METRO SELF INSURED STOP 5
IN EFFECT
'E""LE ❑ ,J CITATION# CHARGE i o BOTTOM
LEGALLY YES Nu
25 s � a
7CA
NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
J
26LAN 12007 WA0171300
PART A PAGE 01 OF
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EF77254
COLLISION REPORT III III III III III 111
1591972 CASE# 25-2034
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
PM 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'
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 03-04-25 06:29 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
M.LEVERTON 2517 312612025 2:44:05 PM
BADGE OR ID# 12007 OR]#` WA0171300 TIME POLICE DISPATCHED 4:34 PM TIME POLICE ARRIVED',4:39 PM
PART I PAGE IT]OF 5�
REPORT NO. EF77254 CASE# 25-2034 OF COLLISION
03/04/25 16:32
OF CbLLI510N
NARRATIVE
On March 4, 2025, at approximately 1632 hours, I was dispatched to a blocking vehicle collision at
the intersection of SW Sunset Blvd and SW 4th PL, within the City Limits of Renton, County of King,
State of Washington. Witness reported that the collision was between a bus and sedan, and the
sedan had rolled over.
Upon arrival, I contacted the involved parties and determined that the driver of Unit 2 was
complaining of lower back pain. I also confirmed that the sedan (unit 1) had not rolled over but spun
around instead. The Renton Regional Fire Authority (RRFA) later arrived on scene and treated the
involved drivers. RRFA released all involved parties at the scene. While on scene, I collected the
involved parties driving documents and their independent recollection of events leading up to the
collision.
The driver of Unit 1 stated he was the sole occupant of his vehicle and was attempting to make a right
turn from SW 4th PI to SW Sunset Blvd, and on the south side of the roadway. The driver of Unit 1
believed he had time to make a right turn in front of Unit 2 and therefore proceeded out into the
roadway. As Unit 1 reached lane 1 of 2, Unit 1 was met by Unit 2. The driver of Unit 1 stated that he
was unable to avoid the collision after having pulled out into the roadway and that Unit 2 struck the
rear of Unit 1, specifically on the driver's side quarter panel and wheel, causing significant damage.
The driver of Unit 2 she was traveling eastbound in about the 500 block of SW Sunset Blvd and in
lane 1 or 2. The driver of Unit 2 stated he was intending to continue east past SW 4th PI. Upon
reaching the location of where Unit 1 was turning out from, Unit 2 observed Unit 1 pull out into the
roadway but was unable to avoid the collision. Both vehicles collided in the roadway and Unit 2
suffered minor damage to the front bicycle rack.
It is important to note that Unit 2 is a King County Metro Bus. The bicycle rack and a small part of the
front bumper was damaged. The damage was minor, but the driver stated she possibly sustained a
minor injury to her lower back. The passengers did not provide their personal information and left the
scene after the collision occurred. They walked to the nearest bus stop left the location.
*ALSO, I was unable to locate a make or model for the King County Metro Bus, so I noted "Unknown"
and "Dune Buggy" instead.
Based on the above statements, 1 determined that the rider of Unit 1 is the proximate cause for the
collision as the driver violated RCW 46.61.290 which covers right turns and stated that "both the
approach for a right turn and a right turn shall be made as close as practicable to the right-hand curb
or edge of the roadway."
Unit 1 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 5
SUPPLEMENTAL REPORT NO. EF772554
r`) POLICE TRAFFIC 1 27
COLLISION REPORT CASE# 25-2034
1 COMMERCIAL MOTOR CARRIER INTERSTATE ✓ INTRASTATE G
UNIT'# 2 USDOT 0 ICC# ' 0 VEHICLE TYPE 1 CARGO 6ODY 1
;TYPE
2 ❑ 1 28
CARRIER KING COUNTY METRO BUS
NAME
3 CARRIER
ADDRESS 201 S JACKSON ST
CITY SEATTLE ST WA ZIP'', 98104
4 ❑ NAME # PLACARD: :❑
NAME IF NO NUMBER
SOURCE 1 AXLES 03 GI40000 +
4a ❑ ADDITIONAL UNITS
MOTOR PEDAL- PROPERTY DAMAGE THRESHOLD MET PHONE
5 ❑ UNIT# VEHICLE I_J CYCLE _) PEDESTRIAN � OWNER � YES NO
i MIDDLE'... 29
LAST NAME FIRST NAME INITIAL
STREET 30
NFW AnnRFrtP. CITY ST ZIP
6 g
CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TANSPORTED 1 31
INTERLOCK YES No zERLOCK YES E]NOE] vES N
LLIICIENSE STATE I SEX M��DYRYY' 2
7 F-1
ON DUTYl STATUS AIRBAG' RESTR. EJECT HELMET INJURY NATURE OF INJURIES
USE CLASS
8 ❑ ' 1 32
LICENSE+ rar VIN.#
PLATE#
9 TRAILER TRAILER
PLATE# STATE PLATE# STATE
10 ❑ TRLR TRLR
VIN.#. VIN.#.
11 VEH.YEAR MAKE MODEL STYLE VEHICLE TOWS T SABLIN TOWED BY anvi vEHIG P FROM TO
DAMAGE Y EES NO YES NO
REGISTERED OWNER INFO. m 33
12 SHADE IN DAMAGED AREA
FROM TO
LIABILITY INSURANCE❑ INSURANCE CO
IN EFFECT &POLICY# tGQ
VEHICLE 34
13 ❑ LEGALLY YES[:] NO❑ CITATION# CHARGE
STANDING S} 8 7 6
14 ❑ UNIT Tr Vd 1RE O CYDCLE OWNER
YES AGE NOHRESHOLD MET PHONE El
35
PEDESTRIAN
15 LAST NAME FIRST NAME MIDDLE': INITIAL36
STREET"[—]
❑
16 NFln+AnnRFs.� CITY'. ST SIP
CDL IGNITION REQUIRED IGNITtGN PRESENT MEDICALTANSPORTED
INTERLOCK YES No INTERLOCK YEs NO YEs NO El
17 37
LICENSE# STATE SEX MMDDDYBYY
18 ❑ ON DUTY� STATUS AIRBAG RESTR. ; EJECT HELMET INJURY NATURE of INJURIES 38
USE (CLASS
19 ❑ vIN# 39
LICENSE
PLATE# rnr
20 ❑ TRAILER TRAILER ❑ 40
PLATE# STATE PLATE# STATE
21 ❑ TRLR TRLR 41
VIN# YIN#i
42
22 VEH.YEAR MAKE I MODEL STYLE I VEHICLE TO DUET SABLIN TOWED BY GOVT.VEHICLE
DAMAGE YES NO YES NO
23 REGISTERED OWNER INFO SHADE IN DAMAGED 3 4 4 AREA F 43
z
LIABILITY INSURANCE INSURANCE CO '
VE EFFECT &POLICY# i 970P - 4 E:l
44
24 VEHICLE YES❑ NO❑ CITATION# CHARGE iq 60TiOM
C=DLv
STANDING 8 7 6
1 CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT.
C.CATALAN 03-04-25 06:29 PM
25 INVESTIGATING OFFICER'S SIGNATURE OFFICER'S PHONE UNIT OR DIST DET DATED: PLACE SIGNED
26 � OR ID# 12007 O#I',WA0171300 APPROVED BY
3%2E6/2025 PAGE F OF
3000-345-013(R 11118)
REPORT NO. EF77254 CASE# ' 25-2034 DATE AND TIME 03/04/25 16:32
OF COLLISION
t
lc<�
i
Y'S' {fit}>Y ✓ �� �; �fti th
i n {
F
4 {1
�=t
�Yz�
{
f
i s tZ Y
Sty al
N' N jy {'3�' 17S err
-!"Of t
PAGE 5 OF 5