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Home My WebLink About25-3490 a ITFFi "POLCERA II IfI) 1 IlfII ('II (Illf If( fI I . 0 27c COLLISION REP FIT 1591971 CASE 25-3490 z INTERSTATE ❑ CITY STREET FIRE ❑RESULTED 1 STOLEN STATE ROUTE ❑ OTHER ❑ VFHIr.I F ❑ LOCAL AOENC 4200 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 CITY# ❑ COLLISION'. 04 - 18 - 2025 1159 17 ❑.❑ N E IN S 8 W H OF e 1070 3 4❑ oN (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓ NE 4TH ST BLOCK NO. e✓ 3800 4a❑ MILEPOST DISTANCE OF(REFERENCE OR CROSS STREET) 5❑ ❑ FEET e S ❑ W e 0 4 29 MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE UNIT 01 VEHICLE ❑ CYCLE El ,/No D:2063591642 0 11 30 6� LAST NAME SHUBINA FIRSTNAME ANASTASIYA MIDDLE A 1 1 2 31 INITIAL STREET ❑ 4223 5TH AVE NE CITY SEATTLE ST WA ZIP 981056517 z NEW ADDRESS 7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3 INTERLOCK YES[:]NO INTERLOCKYEs NO YES NO 8❑ LRIIVER # ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 H USEET ICNLJAURY 1 NATURE OF INJURIES 2❑ 3 10 9❑ Pi aT�S� AJT8064 sTArI WAurN# 4S46RBGC4D3225158 TRAILER STATE TRAILER STATE 11 3 5 PLATE# PLATE# FROM TO TRLR. TRLR $ 7 33 12 3 5 VIN#' VIN# >; FROM TO VEH.YEAR 2013 MAKE MODEL STYLE VEHICLE TOWED TO BLIN 7 3 TOWED BY GOVT.VEHICLE 34 13 4 SUBA OUTBA DAMAGE YES NO YES[:] No ✓ REGISTERED OWNER INFO OWNEDBYDRIVER VEHICLE NO. 1 ❑ SHADE IN DAMAGED AREA ❑ 35 14 LIABILITY INSURANCE INSURANCE CO AMICA MUTUAL INSURANCE 95094623HE 3 4 IN EFFECT &POLICY# 9TOP VEH" CHARGE 5 36 LEGALLY YES❑NO❑ CITATION# 5AO407893 FAIL YIELD PRIVATE RD MOTOR 1 o eorrom 15❑ STANDING 7 6 MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE UNIT VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES V No D:6155455183 16 a LAST NAME THATCH FIRST NAME AAYANA MIDDLE I C INITIAL 17❑ STREET ❑', 13117 3RD AVE SE UNIT J3 CITY EVERETT ST WA ZIP 982086670 37 NEW ADDRESS ❑ 18� CDL IGNITION REQUIRED IGNITION PtR-E-S1ENT MEDICAL t-T�RANSPORTED 38 INTERLOCKYES�NOR INTERLOCK YEs I I No� YES t l NO❑ 11 19[—] D IVEW # I INJURY NATURE OF INJURIES 40 20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 USE CLASS 1 ❑ 21❑ LICENSE BVN3694 TAre WA vIN1t 2G1FD3D3XF9165193 ❑ 41 PLATE# 42 22❑ PILER LATE# STATE PLATE# STATE 23❑ 43 TRLR RLR VIN#. IN#. VEH YEAR 2015 MAKE CHEV MODEL CAMARO STYLE VEHICLETOWED TO BLIN TOWEDBY GOV HI 44 L4❑ DAMAGE YES NO YES NO REGISTERED OWNER INFO PAMELA ROBERTS 1202 N 10TH PL APT 1501 RENTON WA 98057 VEHICLE NO.2 SHADE IN DAGED AREA 2 4 LIABILITY INSURANCE INSU&PORGY#E CO PROGRESSIVE 967134290IN 1GQV'""LE ❑ ,J� CITATION# CHARGE LEGALLY YES N`L J 25 OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY J 26 C.ARNOLD 12509 WA0171300 PART A PAGE 01 OF C7 3000-345-159 OR 11/181 STATE OF POLICETRAFFICN CORRECTION REPORT NO. EF84743 COLLISION REPORT III III III III III 111 1591972 CASE# 25-3490 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.ARNOLD 04-18-25 12:41 PM NVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED APPROVED BY DATE M.LEVERTON 2517 4/22/2025 2:29:57 PM BADGE OR ID# 12509 OR]#` WA0171300 TIME POLICE DISPATCHED 12:01 PM TIME POLICE ARRIVED]12:07 PM PART I PAGE IT]OF 4� REPORT NO. EF84743 CASE# 25-3490 OF COLLISION 04/18/25 11:59 OF CbLLI510N NARRATIVE CC 25-3490 On 4/18/2025 at 1201 hours I was dispatched to a motor vehicle collision at the 3800 block of NE 4th St in the City of Renton, King County, Washington. Pre-Collision Driver 2 stated that she was traveling East on NE 4th St approaching the 3800 block in the #1 lane. Driver 2 had her righthand turn signal activated to indicate a lefthand turn, which she intended to complete at 3901 NE 4th St, past Unit 1. Driver 1 stated that she was stopped and preparing to turn left from a private driveway at around the 3800 block of NE 4th St and saw that Unit 2 had their right turn signal activated. Collision Driver 2 stated that as she approached the 3800 block, Unit 1 pulled into traffic in front of her. Driver 2 stated that she turned to avoid a collision by moving from the #1 lane to the #2 lane. Driver 2 stated that she was unable to avoid the collision, and the front driver side bumper of Unit 1 struck the passenger side door of Unit 2, shattering the window and causing significant damage to Unit 2. Driver 1 stated that she thought that Unit 2 was indicating to turn into the same private driveway that she was stopped at. Driver 1 stated that she thought it was clear and began to pull into traffic. Driver 1 stated that when doing so, Unit 2 maneuvered to the #2 lane of Eastbound NE 4th St and the front drivers side bumper of Unit 1 collided with the passenger side door of Unit 2. Injuries No injuries Vehicle Disposition Both vehicles were able to be driven. Proximate Cause I determined that Driver 1 is the proximate cause for this collision because the driver of a vehicle about to enter or cross a highway from a private road or driveway shall yield the right-of-way to all vehicles lawfully approaching on said highway. If Driver 1 had yielded to the right of way of Unit 2, this collision would not have happened. Driver 1 was cited per RCW 46.61.205. 1 certify (declare) under penalty of perjury under the laws of the State of Washington that the foregoing is true and correct. Electronically signed by Officer C. Arnold #12509 at 12:32 on 4/18/2025 in the City of Renton, King County, Washington. PAGE 3 OF 4 REPORT NO. EF84743 CASE# ' 25-3490 DATE AND TIME 04/18/25 11:59 OF COLLISION 3 vf� f t 4 s ti k, l E f. �j T � J 4 , 4 ti I t a ar 0 � r M1 l s PAGE 4 OF 4