HomeMy WebLinkAbout25-1701 POLICETRAFF'c" III !�� I IIIllI111IN II II I REPORT NO. EF68041 170
27
COLLISION REP FIT 1591971
CASE 25-1701 z
INTERSTATE ❑ CITY STREET FIRE ❑RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHICI F ❑ LOCAL AOENC 4Y00 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 3 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 N E IN CITY#
COLLISION.. 02 - 1-— 2025 2125 17 ❑-= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
BLOCK NO.
WILLIAMS AVE S
e✓ --- ----� ❑
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ �,❑ FEET e S ❑ W e S 3RD ST
0 4 29
MOTU '�01 VEHtOR PI CLE CYDCLE. El �ESAGE NHORE✓LD MET PHONE 0 1 30
6� LAST NAME ROBERTS FIRSTNAME ANGEL MIDDLE L 1 2 31
INITIAL
STREET ❑ 3821 144TH ST NW CITY GIG HARBOR ST WA ZIP' 983329009 z
'NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
iNTERLOCKYEs NO 1/ INTERLOCKYEs NO�/ YEs No�/
8 D
RI
VER # STATE WA SEX'F MM ovY' 03 - 12 - 196.9 1 2 32
9 ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 1HELM
U EET 2 CLASS 1 NATURE OF INJURIES z❑
3
10 1❑ P1 ATE 14 D51152F STATE WA u N# 3GNEK13T52G266471
TRAILER STATE TRAILER STATE
11 2 5 PLATE# PLATE# FROM TO
TRLR. TRLR. 7 1 33
12 2 5 VIN# VIN#
;. FROM TO
❑ VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE 3 3 34
13 1 2002 CHEV AVALAN DAMAGE YES�NO YES❑ NO✓
REGISTERED OWNER INFO ANGEL ROBERTS 3821 144TH ST NW GIG HARBOR WA 98332 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
14 LIABILI INSURANCE❑ INSURANCE CO 3 4
IN EFFECT &POLICY# 9TOP
CHARGE
VEHICLe t 5 36
LEGALLY,
res❑NO❑ CITATION# 5A0252085 BOTTOM
15❑ STANDING 8 6
UNIT 02 VE ICCLE CYCLE ❑ PEDESTRIAN ❑ OWNERRTY ❑ DYES NO rOLD MET PHONE
16 a
LAST NAME DAVIS FIRST NAME JEFFERY MIDDLE $
INITIAL
STREET I
17❑ NEW ADOREss❑' 2100 LAKE WASHINGTON BLVD N S-110 CITY RENTON ST WA ZIP 98056 4❑ 37
18❑ CDL IGNITION REQUIRED IGNITION PR—E-1SENT MEDICAL—T�RANSPORTED � 38
INTERLOCKYES�NO� INTERLOCK YEs It I NOF YES
t l NOF,/
19 D IVEW #
❑ ON DUTY STATUS I
AIRBAG 2 RESTR 4 EJECT 1 H U EET 2 NJAURSY 1 NATURE OF INJURIES ❑ 40
❑ILICENSE 21❑ PLA E# BU64322 TATE 41
WA VIN# 1VWBH7A33CC097603 1
42
22❑ PLATE# STATE PLATE# STATE
TRLR
23❑ UIN#. IN#.
43
RLR
'
VEH YEAR 2012 MAKE VOLK MODEL PASSAT STYLE VEHICLETOWED TO BLIN TOWEDBY GOV HI 44
L4❑ DAMAGE YES NO YES NO
REGISTERED OWNER INFO RA'DIYA RODRIGUEZ 362133RD AVE S APT 223 SEATTLEWA98144 VEHICLE NO.2
SHADEDAMAGEDAREA
3 4
LIABILITY INSURANCE❑ INSURANCE CO
IN EFFECT &POLICY# t 9TOP 5
vEwcLE YES N(� CITATION# W25039098 CHARGE to BOTTOM
LecALLv `LJ
25 s � a
7ER
R'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGE26 DEIGHAN 13030 WA0171300
PART A PAGE 01 OF
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EF68041
COLLISION REPORT III III III III III 111
1591972 CASE# 25-1701
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.
HUNTER DEIGHAN 02-22-25 11:49 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY E
DAT
J.CHRISTIANSEN 10437 2/23/2025 12:38:36 AM
BADGE OR ID# 13030 OR]#' WA0171300 TIME POLICE DISPATCHED; 9:27 PM TIME POLICE ARRIVED',9:Y9 Pm
PART I PAGE IT]OF 4]
REPORT NO. EF68041 CASE# 25-1701 OF COLLISION
02/22/25 21:25
OF CbLLI510N
NARRATIVE
Case 25-1701
Unless otherwise noted, the following happened within the City Limits of Renton, County of King,
State of Washington.
On 02/22/25 at approximately 2127 hours, I was dispatched to an accident with injury at JP's
Barroom at 214 Williams Ave S. Renton Fire Department was called to the scene for the injuries.
After assessing all involved parties it was determined that there were no injuries.
The driver of Unit#1 said that she was driving eastbound on S 3rd St in lane 1. She stopped at the
red light at Williams Ave S. When the light turned green she attempted to make a left turn onto
Williams Ave S from lane 1. As she was turning Unit#2 continued straight and collided with the
driver's side of Unit#1.
The driver of Unit#2 said he was driving eastbound on S 3rd St in lane 2 and stopped at the red light
at Williams Ave S. When the light turned green he proceeded straight and said that Unit#1 turned left
from lane 1 and struck Unit#2 on the front passenger side of the vehicle.
Both vehicles had minor damage and were able to drive away from the scene. The driver of Unit#1
was citied by mail for failure to provide auto insurance and required position and method of turning at
intersections. The driver of unit#2 was given a warning for expired registration, and driving without a
driver's license with ID.
Based on the above statements, 1 determined that the Driver of Unit#1 (Roberts) is the proximate
cause for the cause of collision as Roberts did not use the extreme left-hand lane lawfully available
to traffic moving in the direction of travel of the vehicle to make her left turn.
I certify (declare) under penalty of perjury under the laws of the state of Washington that the foregoing
is true and correct.
Electronically signed by H. Deighan 13030 on 02/22/25 @ 2253 hours in Renton WA.
PAGE 3 OF 4
REPORT NO. EF68041 CASE# 25-1701 DATE AND TIME 02/22/25 21:25
OF COLLISION
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PAGE 4 OF 4