HomeMy WebLinkAbout25-2418 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 1 27c
COLLISION REP FIT 1591971
CASE 25-2418 z
INTERSTATE ❑ CITY STREET FIRE ❑RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHIr.I F ❑ LOCAL AOENC 4Y00 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 6 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 2257 17 ❑.= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓
SE CARR RD BLOCK NO. e✓ 10200
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ ❑ FEET e S ❑ W e 2 3 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
,/NO D:2068300319 0 11
30
6� LAST NAME BEREKET FIRSTNAME YISHAK MIDDLE 1 2 31
INITIAL
STREET ❑, 17902 110TH PL SE CITY RENTON ST WA Zlp' 98055 z
'NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
iNTERLOCKYEs NO 1/ INTERLOCKYEs NO Z/ YES R No�/
8❑ LRIIVER #
ON DUTY❑ STATUS AIRBAG 6 RESTR 9 EJECT 1 HELMET USE 9 CLASS 1 NATURE OF INJURIES z❑
3
LICENSE CFG9606 sTArI WAvIN# JM16L1H69A1110927
10 F91 PI ATE i4
TRAILER STATE TRAILED STATE
11 3 5 PLATE# PLATE# FROM To
TRLR. TRLR 3 7 33
12 3 5 VIN#' VIN#
>;. FROM TO
❑ VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TR Y GOVT.VEHICLE 7 3 34
13 2 2010 MAZE) MAZDA3 SD DAMAGE YES NO MEYERS YES[:] NO✓
REGISTERED OWNER INFO YISHAK BEREKET 17102110TH PL SE RENTON WA 98055 D:2068300319 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
14 LIABILI INSURANCE INSURANCE CO GEICO 6153974289 4
IN EFFECT &POLICY# 9TOP
VE"'CLE CHARGE 5 36
LEGALLY YES❑NO❑ CITATION# 1 o BOTTOM
15❑ STANDING 6
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES 1/ NO D:4252210168
16 a
LAST NAME SINGH FIRST NAME DEEPESH MIDDLE K
INITIAL
17❑ NEW STREETR 21920 S
7 E 240TH PL CITY MAPLE VALLEY ST WA ZIP 98038 37
18❑ CDL IGNITION REQUIRED IGNITION PR-E-1SENT MEDICAL-T�RANSPORTED � 38
INTERLOCK YEs❑No� INTERLOCK YEs It I NOF YES
t l NOF,/
19 DRIVER'S STATE WA SEX M D.C... 03 _ O6 _ 1993 39
LICENSE# MMDDYY
20❑ ON DUTY STATUS AIRBAG 6 RESTR 9 EJECT 1 HEJ EET 9 INCLAJURYSS 1 NATURE OF INJURIES 40
❑21❑ PLATE# BXJ5110 TArE 41
WA VIN# 2T3RFREVSJW725637 1
42
22❑ PLATE# STATE PLATE# STATE
23❑ UIN#. 43
TRLR RLR
'IN#.
TOWED BV Gov HI 44
VEH YEAR 2018 MAKE 7'Dy7' MODEL RAV4 STYLE 4H DAMAGE TOWED✓ NOO BLIN GENE MEYERS YES No�/
24❑ REGISTERED OWNER INFO OWNED SY DRIVER VEHICLE N0.2
SHADE IN DAMAGED AREA
2 3 4
LIABILITY
INSURANCE &POINSURGY#E CO PROGRESSIVE 946108149IN STOP 5
VEHICLE YES❑ N,.I—I CITATION# CHARGE i o BOTTOM
LEGALLY
25 $
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# JAGENCY
26
JAMES ELFER/NG 13002 WA0171300
PAGE 01 OF
PART A
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EF77336
COLLISION REPORT III III III III III 111
1591972 CASE# 25-2418
ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY)
NAME MIDDLE INITIAL) HUMPHREY SCOTTRE Q
(LAST FIRST,
ADDRESS&PHONE# D.0
.B.
12210 SE PETROVITSKY RD RENTON WA 98058 SEX M MMDOYyry 05 - 18 - 2005
PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT ' HELMET INJURY NATURE OF INJURIES
❑✓ ❑ 1 POS. 3 6 9 1 USE 9 CLASS 1
NAME
'(LAST,FIRST MIDDLE INITIAL)
ADDRESS&PHONE# DOB
SEX MMDDYYYY
PASSENGER ❑WITNESS❑ UNIT# SEAT AIRBAG RESTR. EJECT HELMET NJURY NATURE OF INJURIES
POS. USE CLASS
NAME
(LAST FIR57 MIDDLE INITIAL)
AppRESS&PHONE#
SEX D.Q.B.MMDD -❑
YYYY.
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.
JAMES ELFER/NG 03-18-25 01:53 AM
NVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
J.THIELMAN 11462 1 312612025 10:05:52 PM
BADGE OR ID# 13002 ORI# WA0171300 TIME POLICE DISPATCHED 11:01 PM TIME POLICE ARRIVED',11:09 PM
PART I PAGE IT]OF 4�
REPORT NO. EF77336 CASE# 25-2418 OF COLLISION
03/17/25 22:57
OF CbLLI510N
NARRATIVE
CASE NO. 25-2418
Narrative
Unless otherwise noted: the following occurred within the City of Renton, County of King, State of
Washington. This report is a summary of events that occurred and is not an exact sequencing of
events. Statements have been paraphrased and summarized.
On 03/17/2025 at approximately 2301 hours while on duty with my assigned Field Training Officer
Girello I was dispatched to a report of a collision that occurred on SE Carr RD near 103rd Ave SE.
While enroute another officer requested that a tow truck also respond.
Upon my arrival I observed unit 2 on the south side of SE Carr RD on the curb facing westbound. Unit
1 was approximately two blocks west of Unit 2 in the center of the road facing westbound. Both
vehicles had heavy damage and were obviously totaled. I requested a second tow truck respond.
I facilitated an exchange of information between both parties. Both parties declined aid and stated
that they were not injured. I spoke with both parties and determined the following.
Unit 1 was travelling westbound on SE Carr Rd in the 10400 block when it lost control. Unit 2 was
travelling eastbound on SE Carr Rd in the 10300 block when Unit 1 entered its lane of travel and
struck Unit 2 on the driver's side, totaling both vehicles. The weather was dark and raining/hailing
with a large amount of slush on the roadway. Due to the inclement weather conditions, I believe that
neither unit is the proximate cause of the collision.
Both vehicles were privately towed. 1 provided both parties with the case number. This concludes my
involvement in this case.
I certify (declare) under penalty of perjury under the laws of the State of Washington that the
foregoing is true and correct.
ELECTRONICALLY SIGNED BY J. ELFERING R13002 03/18/2025, 0135 HOURS, RENTON WA
PAGE 3 OF 4
REPORT NO. EF77336 CASE# 25-2418 DATE AND TIME 03/17/25 22:57
OF COLLISION
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PAGE 4 OF 4