HomeMy WebLinkAbout25-3350 ("7—
STATE.w,-" .:.. TFFiNCERA �I I ��� III I I Iil I I�I1 II{ II I 5 27c .
,one COLLISION REP F 1591971
CASE 25-3350 2
INTERSTATE CITY STREET FIRE ❑
RESULTED
STOLEN
1 1 STATE ROUTE ❑ OTHER ❑ VFHICI F ❑ LOCAL AGENCY 4200 3[�
HIT 8 RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 TRIBAL UN 75 TOTAL#OF STRUCK OBJECT 11 8 2$
RESERVATION 2
3 M M D D Y Y Y Y TIME I2400) COUNTY# MILES CITY#
coAT sloN 04 - 14 - 2025 0815 17 ❑. e W❑ OF IN 8 1070 3
S
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓
S 43RD ST BLOCK NO. 8✓ 400 .�
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ 150 1. 00 MILES N FEET e✓ S ❑ W 8 DAMS AVE S
OF11
29
MOTOR PEDAL- DAM ETHRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ cycLE, ❑ Yes ,/No D:2536709980 0 6 30
5 LAST NAME CEVALLO$ FIRST NAME JIMENA MIDDLE' [; 2 31
INITIAL
STREET E:1' 1710 VALLEY AVE E APT B3 CITY SUMNER WA
NEW ADDRESS 98390 z
S7 ZIP
7❑ COL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
INTERLOCKYEs No,/ INTERLOCKYEs NOW YES Na,/
DRIVE STATE WA SEX'F MM flYY 06 — 13 — 2002 1 2 32
8❑ L
9 F] ON DUTY❑ STATUE' AIRBAG 2 RESTR 4 EJECT 1 H U5 E7 CLASS 1 NATURE OF INJURIES 2
LICnNS3e BNL7611 STATE
WA WIN# 2HNY02H28BH545266
10 9❑ 3
11 3 5 PLATE# STATE PLATE# STATE ROM To
RA
TRLR TRLR.. 7 3 33
12 3 5 vIN#' VIN#
FROM TO
13 3 VEH.YEAR2011 MAKE ACUR MODEL MDX STYLE UT VEHICLDAMAGE TOWED Ft1 T02fBLIN TOWED BY GOVT.VEHIICLNOF✓ 7 3 34
❑ REGISTERED OWNER INFO ARACELY TOSCANO MENDOZA 1710 VALLEYAVE EAPT 63 SUMNER WA 98390 IL—llll VEHICLE ccNJO..'II 1
SHADE 1N DAMAGED AREA ❑ 35
14 ABILITY INSURANCE INSURANCE CO STATE FARM 459 9978-D24.47 4
IN EFFECT &POLICY# STOP
VtwCLt CHARGE 5 ❑ 36
eGAL, Yes❑No❑ CITATION# 5A0399259 INATTENTIVE DRIVING o BOTTOM
15❑ --Nyc 6
MOTOR � PEDAL- PROPERTY DAM THR OLD MET PHONE
UNIT p2 ICJ ❑ PEDESTRIAN ❑ ❑ D:2063040730
VEHICLE CYCLE. OWNER YES NO
16�
LAST NAME SANCHEZ RODRIGUEZ FIRST NAME LESLY MIDDLE q
INITIAL
17❑ STREET El 2625 MT MCKINLEY CT CITY PUYALLUP I ST WA ZIP 98374 37
NEW ADDRESS I I 1 1 7 ❑
18❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDI.CALTRANSPORTED ❑ 38
WTERLOCKYes ND INTERLOCK Es Ho✓ YES No,�
19 F DRIVER'#
ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 N U MEET INJUCLA RY 1 NATURE of INJURIES 40
21❑ LICENSE I gpy6190 TATf'WA v)N# 4S38NAN68G3006148
❑ 41
PLATE#
TRAILER TRAILER ❑22 PLATE# STATE PLATE STATE 42
23� 43
TRLR RLR
VIN#. '[N#,
VEH.YEAR 2016 MAKE $1/gq MODEL LEGACY STYLE $D DAMIAGE TOWED ND✓ BLIN TOWED BY GO YES N HI 44
YES O
24
REGISTERED OWNER INFO OWNED BYDRIVER VEHICLE NQ.2
SHADE IN DAMAGED AREA
2 3 4
LIABILITY INSURANCE INSURANCE CO NATIONAL GENERAL 2024072498
IN EFFECT &POLICY# t 4TOP
venue YES❑ N J
.1-1 CITATION# CHARGE tOBOTTOM
�ecn��v
25 I B 7 e
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
26
R.ONISHI 5738 WA0171300
PART A . PAGE 01 OF
9000-345-159(R 11(181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EF82603
COLLISION REPORT III III III III III 111
1591972 CASE# 25-3350
ADDITIONAL PERSONS INVOLVED(PASSENGERS AND/OR WITNESSES ONLY)
'.NAME
(LAST,FIRST,MIDDLE INITIAL)
ADDRESS&PHONE
SEXi D.O.B. -
MMDDYYYY
PASSENGER❑WITNESS❑;UNIT# SEAT AIRBAG RESTR. EJECT HELMET INJURY NATURECFINJURIES
POS. ' USE CLASS 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 CLASS ----�
: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
Unit 2 eastbound in curb lane of S 43rd St, slowed while driver Lesly Sanchez Rodriguez checked
next lane preparatory to making left lane change. Unit 1 eastbound behind unit 2, also preparing for
left lane change. Driver 1 Jimena Cevallos told me that she slowed for unit 2, then saw unit 2 start to
accelerate. Cevallos then accelerated, and looked to her left to see if the lane was clear. At the same
time, unit 2 slowed, and unit 1 ran into the back of unit 2.
I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT.
R.ONISHI 04-14-25 10:29 AM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST.DET DATED PLACE SIGNED
APPROVED BY DATE
D.SKELTON 9139 r 411512025 3:53:21 AM
BADGE OR ID# 5738 ORI# WA0171300 TIME POLICE DISPATCHED 8:99 Aryl TIME POLICE ARRIVED i 8:31 AM
PART B 3000-345.160(R1Vt8) PAGE 0 OF F3
REPORT NO. EF82603 CASE# 25-3350 DATE AND TIME 04/14/25 08:15
OF COLLISION
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