HomeMy WebLinkAbout25-3502 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 6 27c
COLLISION REP FIT 1591971
CASE 25-3502 z
INTERSTATE ❑ CITY STREET FIRE ❑
RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHIC;I F ❑ LOCAL AGENCI 4900 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2� 1 1 8 28
TOTAL#OF OBJECT
TRIBAL UNITS 03 STRUCK' RETAINING WALL
RESERVATION
z
3❑ DATE OF M M D D Y Y Y Y TIME(2400) COUNTY# MILES N E IN CITY# ❑
CtLLISION' 04 - 18 - 2025 2117 17 ❑.= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓
NE 4TH ST BLOCK NO. e✓ 3700
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ 100 00 FEET e S ❑ W e QUEEN AVE NE
0 1 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
✓NO D:8087789738 0 11
30
6� LAST NAME KEALOHA FIRSTNAME JOY MIDDLE H 1 2 31
INITIAL
STREET 01 704 N 4TH ST CITY RENTON WA
NEW ADDRESS ST zIP', 96057 2
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
1/ I iNTERLOCKYEs NO NTERLOCKYEs NO�/ YES R No�/
8❑ LRIIVERS STATE WA SEX'F MM DAY' 12 1- 28 - 1996 2 32
CENSE 9 ON DUTY❑ STATUS AIRBAG 6 RESTR 4 EJECT 1 HELMET INJURY NATURE OF INJURIES z❑
USE CLASS BRUISING COLLARBONE AREA FROM SEA TBELT
10 99 P1 ATE 14 CLC6891 STATE WA v N#' ZACNJDBB9MPN29422 3
0 TRAILER STATE TRAILED STATE
11 0 0 PLATE# PLATE# FROM TO
TRLR. TRLR 3 7 33
12 0 0 VIN#' VIN#
FROM TO
❑ VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TR Y GOVT.VEHICLE 3 7 34
13 4 2021 JEEP RENEG UT DAMAGE YES NO �MEYER YES❑ NO✓
REGISTERED OWNER INFO OWNEDBYDRIVER VEHICLE NO. 1
SHADE IN DAMAGED AREA 35
14 LIABILITY INSURANCE❑ INSURANCE CO 3� 4
IN EFFECT &POLICV# OOP
❑ LEGA LE CHARGE 5 ❑ 36
15 1 srA'CLL YEs❑NO CITATION# 5AO115117 OP MOT VEH W/OUT INSURANCE aorrob
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT 02 VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES 1/ NO D:4258320202
16 a
LAST NAME MA ON FIRST NAME ANA-MARIA MIDDLE
INITIAL
17 STREET NEW ADDRESS❑' 521 QUEEN AVE NE CITY RENTON ST WA ZIP 98056 37
18� CDL IGNITION REQUIRED IGNITION PR-E-1SENT MEDICAL TRANSPORTED 38
INTERLOCK YEs❑No� INTERLOCK YEs It I NOF YES
t l NOF,/
19 RRS LDI IVE STATE WA ]SEX IF M .C... 02 _ 21 1982 39
20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 HEJ MET NJAURSY 1 NATURE OF INJURIES 40
❑ILICENSE 21❑ PLA E# AYL9826 TATE 41
WA VIN# STDJKRFHXFS206142 1
42
22❑ PLATE# STATE PLATE# STATE
TRLR
23❑ VIN#. IN#. 43
RLR
'
VEH YEAR 2015 MAKE TOYT MODEL HIGHLAN STYLE UT I VEHICLE TOWED TO BLIN TOWEDII GOV HI 44
24 DAMAGE YES NO GENE MEYER YES NO
REGISTERED OWNER INFO MARCO MAZON 521 QUEEN AVE NERENTONWA98056 VEHICLE NO.2
SHADEDAMAGEDAREA
3 4
LIABILITY
INSURANCE INSU PORGY#ECO ALLSTATE 807 132 343IN STOP
VE"LE
L
CHARGE
25 LEGALY ❑ � BOTTOM
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
J
26
RYAN KARLO RIVERA 1
12649 WA0171300
PART A PAGE 01 OF
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EF85880
COLLISION REPORT III III III III III 111
1591972 CASE# 25-3502
ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY)
NAME MIDDLE INITIAL) MAZON DAVID
(LAST FIRST,
ADDRESS&PHONE#
521 QUEEN AVE NE RENTON WA 98056 4255472600 SEX i U MMDOYyry 07 - 11 - 2011
PASSENGER Z WITNESS UNIT# ; 2 p0S CLASS
USE 3 AIRBAG 2 RESTR. 4 EJECT ? 1 HELMET CLASS NATURE OF INJURIES
'�
NAME
'(LAST,FIRS MIDDLE INITIAL)
ADDRESS&PHONE# DOB
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.
RYAN KARLO RIVERA 04-19-25 01:10 AM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
CASEY PROCTER 12123 4/25/2025 9:46:33 PM
BADGE OR ID# 12649 OR]# WA0171300 TIME POLICE DISPATCHED 9:98 Pry] TIME POLICE ARRIVED]9:21 PM
PART I PAGE IT]OF 6�
REPORT NO. EF85880 CASE# 25-3502 OF COLLISION
04/18/25 21:17
OF CbLLI510N
NARRATIVE
On 04/18/2025, 1 was working uniformed patrol in a marked police car as 3R23. At approximately
2118 hours, I was dispatched to an unknown injury at around the 3700 block of NE 4th St, which is
located within the city limits of Renton, County of King, Washington. Dispatch advised that multiple
passersby had called about a collision at the location.
As I was driving to the call location, dispatch advised that they had also received an automatic crash
notification from a phone near the location.
When I arrived at the call location, I was able to locate the two involved units as listed above with
each of their respective occupants.
I saw that both vehicles were facing in the westbound direction. Both vehicles had driven up onto the
sidewalk and into a small retaining wall at 3612 NE 4th St, Renton. All occupants were outside of their
vehicles and walking.
Other officers that were present at the location and I was able to speak to the driver of Unit 1. Unit 1
described the following:
The driver of Unit 1 was the sole occupant of her vehicle.
Unit 1 stated she was driving westbound on NE 4th St in the number 2 (leftmost) lane. Unit 1 stated
that around the 3700/3800 block of NE 4th St, she noticed that an unknown 4-door silver sedan was
pulling out of one of the nearby business parking lots. Unit 1 described that this unknown silver sedan
was pulling out from the south side of the street and was headed toward the westbound lanes of
travel on NE 4th St.
Unit 1 stated that when the unknown silver sedan had turned, the vehicle had begun to encroach on
her lane (lane 2). Unit 1 stated she had to swerve out of the way, toward lane 1 of westbound NE 4th
St traffic, to avoid a collision with the unknown sedan. As a result of swerving, the front end of her
vehicle impacted the rear side of Unit 2. Based on the resting point of the collision, it appeared that
the momentum of the crash pushed both vehicles into a nearby retaining wall on the north side of the
street at 3612 NE 4t St, resulting in damage to the retaining wall.
When Unit 1 was asked for her documentation, Unit 1 stated she did not have any insurance for her
vehicle.
I also took a look around Unit 1 1 noticed that there were large dents along the front bumper and front
driver's side door panel. There was also visible damage to the undercarriage of the vehicle and was
undriveable. I also saw that a combination of airbags had deployed inside of the vehicle.
Unit 1 stated she was wearing her seatbelt at the time of the collision. She had visible bruising around
her collarbone area which appeared to be from the seatbelt. She was evaluated at the scene of the
crash by aid.
I also noticed that Unit 1 had the slight odor of intoxicants emanating from her breath. She also had
slightly glossy eyes. Unit 1 consented to voluntary standardized field sobriety tests (SFSTs) which I
conducted. Based on the tests she had completed and my observation; I could not establish probable
cause for any crime.
I was able to also speak to the driver of Unit 2. My conversation with her is summarized as follows:
Unit 2 was occupied by another front-seat passenger as listed above.
Unit 2 stated she was facing southbound on Queen Ave NE preparing to turn westbound onto NE 4th
St. When Unit 2 began to turn into lane 1 of NE 4th St, from Queen Ave NE, she stated that Unit 1
struck the rear of her vehicle, pushing both of their vehicles into the nearby retaining wall. The front
end of Unit 2 also appears to have struck the nearby retaining wall resulting in damage to the front of
her vehicle.
I took a look around Unit 2. 1 saw that the rear driver's side bumper had a large dent in it. I also saw
that the entire front bumper was damaged. There was also damage to the undercarriage of the
vehicle near the front bumper. I also saw that no airbags appeared to have deployed inside of their
vehicle.
Unit 2 and her passenger advised me they both were wearing their seatbelts. Both subjects also
declined any injury at the time of the collision.
Gene Meyers's tow eventually arrived and towed both vehicles from the incident location.
PAGE 3 OF 6
REPORT NO. EF85880 CASE# 25-3502 OF COLLISION
04/18/25 21:17
OF CbLLI510N
NARRATIVE
Unit 1 left the location with a friend shortly after.
Unit 2 and her passenger also left the location with another family member a short time later.
Both parties were provided a copy of the exchange of information before their departure.
I was unable to locate the property contact information for 3612 NE 4th St to relay information about
the damaged retaining wall.
No other information was available to fully identify the occupant of the unknown 4-door sedan.
Based on the fact that Unit 1 was unable to provide police valid proof of motor vehicle insurance and
was operating a motor vehicle at the time of the collision, I found that there was reasonable cause to
cite the driver of Unit 1 for RCW 46.30.020 -operating a motor vehicle without insurance. This citation
was completed and mailed to the violator.
Based on the totality of circumstances described above, it appears that Unit 1 is the proximate cause
of the collision.
This completes my report.
I certify (declare) under penalty of perjury under the laws of the State of Washington that the
foregoing is true and correct.
Signature: Ryan Rivera (#12649) Date and Place: 04/19/2025 @ Renton, WA
PAGE 4 OF 6
SUPPLEMENTAL REPORT NO. EF85880
r`I POLICE TRAFFIC 1 27
COLLISION REPORT CASE# 25-3502
1 COMMERCIAL MOTOR CARRIER INTERSTATE INTRASTATE G
UNIT'# USL70r ICC# VEHICLE TYPE CARGO BODY
TYPE
2 ❑ 1 28
CARRIER
NAME
3 CARRIER L
ADDRESS `
CITY ST' ZIP'
4 ❑ NAME # PLACARD: :❑
GI NAME IF NO NUMBER
SOURCE AXLES +
4a ❑ ADDITIONAL UNITS
MOTOR PEDAL- PROPERTY DAMAGETHRESHOLD MET PHONE
UNIT# 3 PEDESTRIAN � ✓�' YEs NO
5 VEHICLE CYCLE OWNER ✓ D:9713015481
MIDDLE.. 29
LAST NAME MANOR FIRST NAME RENTON HIGHLAND INITIAL
STREET 30
NEW AnDRFSP' 3612 NE 4TH ST CITY RENTON ST WA ZIP 98056
6
CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TANSPORTED 1 31
INTERLOCK YEs No INTERLOCK YESE]Na� YEs N
DRIVER'S STATE I SEX U M��DVSYv' —� 2
LICENSE
7F-ION DUTY STATUS AIRBAG RESTR. EJECT HELMET INJURY NATURE OF INJURIES
F�
USE CLASS
8 ❑ ' 1 32
LICENSE+ rar V1N.#
PLATE#
9 TRAILER TRAILER
PLATE# STATE PLATE# STATE
10 ❑ TRLR TRLR
VIN.#. VIN.#.
11 VEH.YEAR MAKE I MODEL STYLE I VEHICLE TOWS E T SABLIN TOWED BY anvi vEHIG P FROM TO
DAMAGE YES NO YES NO
REGISTERED OWNER INFO. m 33
12 SHADE IN DAMAGED AREA
FROM TO
IIABiLITY 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
STREETIAL
❑
16 NEn+AnnRFs.�' CITY'. ST ZIP
CDL IGNITION REdUiRED 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 ICLASS
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 AREA 43
3 4 71
LIABILITY INSURANCE INSURANCE CO '
VEHICLE
EFFECT &POLICY# I 970P - 4 44
24 VEHICLE YES NO❑ CITATION# CHARGE iq 60TiOM
E:l
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.
RYAN KARLO RIVERA 04-19-25 01:10 AM
25 INVESTIGATING OFFICER'S SIGNATURE OFFICER'S PHONE UNIT OR DIST DET DATED: PLACE SIGNED
APPROVED BY DATE
26 OR ID# 12649 O#I',WA0171300 PROCTER 4/25/2025 PAGE OF 6
3000-345-013(R 11118)
REPORT NO. EF85880 CASE# 25-3502 DATE AND TIME 04/18/25 21:17
OF COLLISION
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PAGE 6 OF 6