HomeMy WebLinkAbout25-3509 �oLcRaiTFFi " II I ��� III I I III I IIII III II I Q 7 27c REPORT N0. EF84044
"i ,one COLLISION REP F 1591971
CASE# 25-3509 2
INTERSTATE CITY STREET FIRE ❑
RESULTED
STOLEN
1 1 STATE ROUTE OTHER VFHICI F LOCAL AGENCY 4100 3[�
HIT&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 - 19 - 2025 1248 17 a. S e W 8 IN
OF 8 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓
NE4THST BLOCK NO. 8✓ 4700 .�
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ 20 00 MILE eFEET ✓ S e W 8 DUVALL AV NE
0 1 29
MOTOR PEDAL- DAM ETHRESHOLD MET PHONE
UNIT 01 VEHICLE CYCLE a YEs NO �/ D:4254173803 0 1 30
5� LAsrNan�E oSGOODBYIII FIRST NAME BRUCE MIDDLE' S 1 2 31
INITIAL
STREET F-1' 13456 156TH AVE SE CITY RENTON WA
NEW ADDRESS S7 ZIP 980596713 z
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL-1 NOFORTED 3
INTERLOCK YEs No,/ INTERLOCKYEs NO YES Na,/
8❑ LDICENS STATE WA SEX'M MM flYY 05 - 07 - 2002 1 2 32
9 F] ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 H U5 E7 2 CLASS 1 NATURE OF INJURIES 2
LICnNS#, BQG1548 srArE WA WIN#' 3C4PDDGG2JT450041
10 9❑ 3
11 3 5 PLATE# STATE PLATE# STATETRAILER TRAILER
ROM To
TRLR TRLR. 7 3 33
12 3 5 VIN#' VIN#
FROM TO
13 4 VEH.YEAR2018 MAKE DODG MODEL JOURNE STYLE VEHICLDAMAGE TOWED Ft1 T02fBLIN TOWED BY GOVT.VEHIICLNOF✓ 7 3 34
❑ REGISTERED OWNER INFO JULIE OSGOODBY 13456156TH AVE SE RENTON WA 98059 II—ll VEHICLE cNIIO—.II 1
SHADE 1N DAMAGED AREA ❑ 35
14 LIABILITY INSURANCE❑ NSURANCE CO 4
IN EFFECT &POLICY# 9TOP
VE"LE CHARGE 5 ❑ 36
EG, v YES❑NO❑ CITATION# 10 BOTTOM
15❑ sranomc 1 a i 6
MOTOR PEDAL- 'PEDESTRIAN PROPERTY 01 DAM THR OLD MET PHONE
UNIT 02 VEHICLE CYCLE OWNER YES NO �/ D:2064669664
16�
LAST NAME FASHAW FIRST NAME JAYLA MIDDLE R
INITIAL
17❑ STREET El 11017 16TH AVE SW APT 11 CITY SEATTLE ST', WA ZIP 981462046 4
NEW ADDRESS 37
❑
18❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDI.CALTRANSPORTED � 38
W7ERLOCKvF No INTERLOCK Es N YES No,�
19[ DRIVER'#
ON DUTY❑ STATUS AIRBAG!2 RESTR 4 EJECT 1 H U SET 2 INJAU RY 1 NATURE OF INJURIES 40
❑21❑ LICENSE CJ60144 TATf'W 41
A vIN KM8SM4HFOHU176057 1
PLATE# #
42
22 PLATE#TRAILER STATE PLATE TRAILER STATE
23 43
TRLR RLR
VIN#. '[N#,
VEH.YEAR 2017 MAKE HYUN MODEL SApJTA STYLE VEHICLE TOWED TO BLIN
TOWED BY GO HI 44
24 DAMAGE YES NO YES NO
REGISTERED OWNER INFO JAYLAFASHAW1101716THAVESWAPT11 SEATTLE WA 981462046 D:2064669664 VEHICLE NO.2
SHADE IN DAMAGED AREA
LIABILITY INSURANCE[2] INSURANCE CO PROGRESSIVE 990063260 2 3 4
IN EFFECT &POLICY# t 4TOP
—1-1 ❑ CITATION# CHARGE
25 tOBOTTQM
LEGALLY YES NU
s e
7DNE
'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
26
SON 12421 WA0171300
PART A . PAGE 01 OF
9000-345-159(R 11(181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EF84044
COLLISION REPORT III III III III III 111
1591972 CASE# 25-3509
E NA ADDITIONAL PERSONS INVOLVED(PASSENGERS AND/OR WITNESSES ONLY)
M
(LAST,FIRST,MIDDLE INITIAL) ARNOLD ALISHA L
ADDRESS&PHONE# D.0
16159 126TH AVE SE RENTON WA 980585562 2065718990 SEXi F M B.Y 07 — 18 — 1976
PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET NLASS NATURE OF INJURIES
❑ 2 POS. 13 2 4 1 USE 2 CLASS ''1 ----�
:NAME
Lgsr FIRs7 MIDDLE INITIAL) ARNOLD JHURNII A
ADDRESS&PHONE# D O B
11017 16TH AVE SW APT 11 SEATTLE WA 98146 SEX'' F MMoavvvr 08 _ 22 _ 2017
SEAT HELMET NJURY NATURE OF INJURIES
PASSENGER a WITNESS❑!UNIT# ' 2 POS. ' 9 AIRBAG'2 RESTR. 10 'EJECT 1 USE 2 CLASS I 7 COMPLAINT OF NECK PAIN
:NAME
(LOST,FIRST,MIDDLE INITIAL)
ADDRESS&PHONE#
SEX/ D.O.B. -
MMDDYYYY
PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET NJURY NATURE OF INJURIES
❑ ❑ POS. I 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.
D.NELSON 04-19-25 02:40 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST.DET DATED PLACE SIGNED
APPROVED BY DATE
J.TRADER 4553 1 4/20/2025 1:15:13 PM
BADGE OR ID# 12421 ORI# WA0171300 TIME POLICE DISPATCHED 12:49 PM TIME POLICE ARRIVED i 12:54 PM
PART B 3000-345.160(RIVM) PAGE F2 --]OF 47
TIM
REPORT NO. EF84044 CASE# 25-3509 OF COLLI ION 04/19/25 12:48
OF COLLISION
NARRATIVE
25-3509 ACC I N P
On 4/19/2025 1 was working as a uniformed patrol Officer and driving a marked patrol vehicle for the
City of Renton. I was dispatched to a report of a two-motor vehicle collision with injury near the
intersection of Duvall Ave NE and NE 4th St Renton/King/WA. The caller advised that both vehicles
had pulled into the parking lot of the nearby Dairy Queen.
I located both vehicles in the Dairy Queen parking lot and both drivers advised they were uninjured,
the driver of Unit 2 advised that her seven-year-old daughter had a complaint of neck pain. RRFA
Personnel were called to the scene for an evaluation.
I spoke with the driver of Unit 1, a gray 2018 Dodge Journey WA/BQG1548, the driver was identified
by his WADL as Bruce S Osgoodby DOB: 5/7/2002. Bruce returned as clear and valid. Bruce said
that he was driving eastbound in the number one lane when Unit 2 came to a sudden stop in front of
him. Bruce said that he was unable to stop in time and collided with the rear end of Unit 2. There was
minor damage to the Dodge's front bumper.
I then spoke with the driver of Unit 2, a 2017 Hyundai Santa Fe WA/ CJB0144. The driver was
identified as Jayla R Fashaw DOB: 5/24/2001 by her WADL. Jayla said that she was also driving east
in the number 1 lane when a vehicle in front suddenly slowed down to make a right turn. Jayla said
that she was able to slow down but was rear-ended by Unit 1. Jayla's daughter, Jhurnii A Arnold
DOB: 8/22/2017, was in a child booster seat and had a complaint of neck pain. RRFA personnel
evaluated Jhurnii and cleared her at the scene. There was minor damage to the Hyundai's rear
bumper.
Jayla's other passenger, Alisha L Arnold DOB: 7/18/1976, was also uninjured.
I provided both parties with an exchange of information form.
I then cleared the scene.
Nothing further.
I certify under penalty of perjury under the laws of the State of Washington that the foregoing is true
and correct.
D Nelson #191 4/19/2025 Renton Washington
PAGE 3 OF 4
REPORT NO. EF84044 CASE# 25-3509 DATE AND TIME 04/19/2512:48
OF COLLISION
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