HomeMy WebLinkAbout25-2736 )STATE
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Oc� RA EF78684
COLLISION REPRT 1591971
CASE# 25-2736 2
INTERSTATE CITY STREET FIRE ❑
RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VEHICLE ❑ LOCAL AGENC'Y 4200 3
COUNTY RD NVOLVED CODING
PRIVATE WAY
2❑ TRIBAL TOTAL 1
UNITS#OF 02 SO BJECT TRUCK 1 8 28
RESERVATION 2
3� M M D D Y Y Y Y TIME(2400) COUNTY# MILES CITY#
DATE OF'. N E
coLLISION' 03 - 26 - 2025 2032 17 =.= S 8 W E IN OF M 1070 a
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION �✓ NON INTERSECTION ❑
NE SUNSET BLVD BLOCK ST e 4700 .=
4a❑ MILE POST
❑ DISTANCE OF(REFERENCE OR CROSS STREET)
5 . FEET S 8 W e DUVALL AVE NE
0 1 29
MOTOR PEDAL- DAM AG THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE ❑ YEs Vl No D:4257577320 0 8 30
5 LAST NAME BUSTILLOS FIRST NAME JONAH MIDDLE I 1 2 31
INITIAL
STREET ❑ 5163 NE 7TH PL CITY RENTON ST I WA ZIP 980594474 2
NEW ADDRESS
7 CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED: 3
INTERLOCKYEs NO Z/ INTERLOCKYEs NO�/ YES No,/
8❑ DRIVER # STATE WA SEX M MMOCSYY' 01 — 03 — 2008 1 2 32
9 ON DUTY STATUS AIRBAG 3 RESTR 4 EJECT 1 HELM
USEET CLASS I NATURE of INJURIES 2
10 LICENSE
AOH8236 STATE WA VN# KMHCT4AE5DU554988 3
TRAILER STATE TRAILER ,STATE
11 0 0 PLATE# PLATE# ROM TO
TRLR TRLR 7 3 33
1 0
( FROM TO
2 Q VIN# VIN
VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN 7 Y GOVT VEHICLE 9 9 34
13 4 2013 HYUN ACCEN7 SD DAMAGE YES ONO
MEYER ves❑ No
REGISTERED OWNER INFO VIVIAN BUSTILLOS 5163 NE 7TH PL RENTON WA 98059 VEHICLE NO. 1
SHADE IN DAMAGED AREA 35
4 LIABILITY INSURANCE INSURANCE CO 3 4
14 PEn4co ca oslssss
IN EFFECT &POLICY# 4TOP
vEnic�E CHARGE 7 0 80TTOM 36
LEGALLY YES❑NO❑ CITATION# 5
15❑ STM ING 7 e
MOTOR PEDAL- PROPERTY DAM THR OLD MET PHONE
UNIT(� Q ❑ PEDESTRIAN ❑ D:2068588077
VEHICLE CYCLE OWNER YES NO
16�
LAST NAME SUTTLES FIRST NAME TYLER MIDDLE C
INITIAL
17 F1 STREET ❑❑ 5 37507 NE 5TH CIR CITY RENTON ST, WA ZIP 980598628 4
NEW ADDRESS
18❑ CDL IGNITION EQUIRE NITION RI IGNITION PRESENT MEDIGALTRANSPORTED 38
INTERLOCK YEs No� jNTERLOC}�YEs No� ves NO
19 DRIVER'S STATE WA SEX M DO.B. 08 01 2001 39
LICENSE# MMDDYY —
20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 H U ET INJ 1 RY NATURE OF INJURIES � 40
21 LICENSLATE E CND7319 TATE WA VIN# WAILFAFP6EA054338 41
22❑ PLTL ATE# STATE TILER PATE# STATE ❑ 42
23 TRLR kRLR 43
UIN#. 'IN#.
VEH.YEAR 2Q14 MAKE gUDI MODEL Q5 STYLE UT VEHICLE TOWED TO BLIN TOWED BY GOV HI 44
24 DAMAGE YEs i/ No GENE MEYER YES No
REGISTERED OWNER INFO OWNEDBYDRIVER VEHICLE NO,2
SHADE IN DAMAGEJAAREA
2 3 �A
LIABILITY INSURANCE INSURANCE CO USAA CIC181716527101
IN EFFECT &POLICY#VEHICLE
t STOP
EIAIL LEGALLY YES� N CL J CITATION# CHARGE to BOTTOM
L
25 s
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
26
RYAN KARLO RIVERA 12649 WA0171300
PAGE 01 OF
PART A 3000-345-159(R 11/18)
POLIICFETRAFFICN CORRECTION REPORT NO. EF78684
COLLISION REPORT III III III III III 111
1591972 CASE# 25-2736
ADDITIONAL PERSONS INVOLVED(PASSENGERS AND/OR WITNESSES ONLY)
NAME REBECCA JONES P
(LAST,FIRST MIDDLE INITIAL}
ADDRESS&PHONE#
11513 PRIMROSE LN ROCKVILLE VA 231461745 8043472078 SEX' F MMoovvvv 03 - 24 - 1950
PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET NJURY NATURE OF INJURIES
2 POS. 3 2 4 1 USE CLASS 1 ---�
'NAME
(LAST FIRS,MIDDLE INITIAL)
ADDRESS&PHONE#
' D.O.B.
SEX MMDD -F L----------�
YYYY
PASSENGER DWITNESSD UNIT# SEAT AIRBAG RESTR. EJECT HELMET NJURY NATURE OF INJURIES
POS. : USE CLASS ----�
'.NAME
(LAST,FIRST,MIDDLE INITIAL)
ADDRESS&PHONE#
SEX' D.O.B.M -T L----------�
MDDYYYY
PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET INJURY NATURE OF INJURIES
❑ Q 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.
RYAN KARLO RIVERA 03-26-25 10:00 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST.DET DATED PLACE SIGNED
APPROVED BY DATE
CASEY PROCTER 12123 41112025 2:02:11 AM
BADGE OR ID# 12649 ORI# ( WA0171300 TIME POLICE DISPATCHED'; 8:34 PM TIME POLICE ARRIVED 8:37 Pry]
PART B 3 Do-3mx-,ao(Burls) PAGE 27 OF 47
EAN
REPORT NO.` EF78684 CASE# 25-2736 O OF COLLI COLLISION TIME 03/26/25 20:32
COLLI
NARRATIVE
On 03/26/2025, 1 was working uniformed patrol in a marked police car as 3R23. At approximately
2034 hours, I was dispatched to an injury collision at the intersection of NE Sunset Blvd/Duvall Ave
NE, which is located within the city limits of Renton, County of King, Washington. Dispatch advised
that an involved party in the collision had called reporting a 2-motor vehicle accident at the location.
The caller also reported chest pain from the seatbelt and that the accident was blocking both lanes.
When 1 arrived at the dispatch location, 1 identified both Units 1 and 2 and their respective occupants
as listed above.
I saw that both vehicles were blocking both straight eastbound lanes of NE Sunset Blvd just west of
Duvall Ave NE. Unit 2 appeared to be the first car in line just before the signal with Unit 1 directly
behind Unit 2.
1 spoke to the occupant of Unit 1 about the circumstances that led to the collision. My conversation
with him is summarized as follows:
Unit 1 stated he was the sole occupant inside of his vehicle.
Unit 1 was headed eastbound on NE Sunset Blvd in the #2 lane. This lane continues eastbound on
NE Sunset Blvd. Unit 1 stated he momentarily took his eyes off the roadway before he suddenly
crashed the front end of his vehicle into the rear end of Unit 2.
Unit 1 stated he was uninjured and that he was wearing his seatbelt.
I took a look around Unit 1. 1 saw that the entire front end of Unit 1 was dented with parts of the
bumper hanging off. 1 also saw that his front airbags had been deployed.
I then spoke with other officers at the location who spoke with Unit 2. Other officers relayed the
following:
Unit 2 was stopped just west of Duvall Ave NE in the #2 eastbound lane of NE Sunset Blvd at the red
light. Unit 2 then said that Unit 1 impacted the rear side of their vehicle.
Both occupants of Unit 2 appeared uninjured and both subjects were wearing their seatbelts.
I took a look around Unit 2. 1 saw that the entire back end of Unit 2 was dented with parts of the
bumper hanging off. They also relayed that none of their airbags had deployed.
All parties in the collision were evaluated by the fire department at the scene and eventually left under
their own power.
Both vehicles were taken by Gene Meyer tow to be impounded.
Based on the circumstances described, I believe that Unit 1 was the proximate cause of the collision.
This concludes my report.
1 certify (declare) under penalty of perjury under the laws of the State of Washington that the
foregoing is true and correct.
Signed: Ryan Rivera (#12649) Date & Place: 03/26/2025 @ Renton, Washington
PAGE 3 OF 4
REPORT NO. EF78684 CASE# 25-2736 DATE AND TIME i 03/26/25 20:32
OF COLLISION
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