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Home My WebLink About25-3650 ("7— STATE.w,-" .:.. TFFiN27CERAc REPORT NO. EF89257 COLLISION REP F 1591971 CASE 25-3650 2 INTERSTATE CITY STREET El 1 1 STATE ROUTE OTHER LOCAL AGENCY 4250 3 CODING COUNTY RD PRIVATE WAY 2 TRIBAL UN 75 TOTAL#OF STRUCK OBJECT 11 8 2$ RESERVATION I 2 3 M M D D Y Y Y Y TIME I2400) COUNTY# MILES CITY# coAT NION 04 - 24 - 2025 0835 17 a. e W 8 OF IN 8 1070 3 S 4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑ BLOCK RAINIER AVE S 8✓ .� 4a❑ MILEPOST DISTANCE OF(REFERENCE OR CROSS STREET) 5❑ 1.= FEET e S e WHI ADYWAY 0 1 29 ♦� MOTOR PEDAL- DAM ETHRESHOLD MET PHONE UNIT 01 VEHICLE CYCLE YES NO 0 1 30 6 LAST NAME : UNKNOWN FIRST NAME MIDDLE 1 2 31 INITIAL STREET F� CITY ST ZIP 2 NEW ADDRESS 7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICALTRANSPORTED 3[� INTERLOCK YEs No INTERLOCK YES No YES Na $❑ LLIICENSE# STATE I SEX'.U ID MMDDYY -=-[__________� 1 1 2 32 9 ON DUTY STATUS AIRBAG 9 RESTR 9 EJECT 1 H U5 ET 9 CLASS Q NATURE OF INJURIES 2 LICENSE 3 10� PI ATF it STATE VIN# FTRAILER TRAILER 11 FT5I PLATE# STATE PLATE# STATE FROM To TRLR TRLR.. 5 1 33 12 3 5 VIN#' VIN# FROM TO VEH.YEAR MAKE I MODEL I STYLE VEHICLE TOWED fj TO BLIN 5 1 TOWED BY GOVT.VEHICLE 34 13 DAMAGE YES NO ✓ YES❑ NO J�jREGISTERED OWNER INFO (NEWJ VEHIC19 LE NO. 1 SHADE 1N DAMAGED AREA ❑ 35 14 LIABILITY INSURANCE❑ NSURANCE CO 4 IN EFFECT &POLICY# 9TOP V""�t CHARGE i 5 ❑ 36 ecnu v YES❑NO❑ CITATION# 10 BOTTOM 15❑ sranomc MOTOR PEDAL- 'PEDESTRIAN PROPERTY DAM THR OLD MET PHONE UNIT 02 VEHICLE CYCLE OWNER YES NO D:3603100802 16� LAST NAME KUYKENDALL FIRSTNAME ROBERT MIDDLE I D INITIAL 17❑ STREET El 106 ROBERTSON RD CITY LEBAM I ST WA ZIP 985540000 5 NEW ADDRESS ❑ 37 1$❑ CDL _. IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED ❑ 3$ 1NTERLOCKYEs No INTERLOCK YEs N YES No 19❑ DRIVER'# ❑ ON DUTY❑ STATUS AIRBAG 1 RESTR 4 EJECT 1 N U MEET C`AUSS 1 NATURE OF INJURIES ❑ 40 21❑ LICENSE 3837695 TATfI/N VIN# ❑3HSDZSZR9TN449829 41 4 PLATE# ❑ 42 22 TRAILER HV55328 STATE OR I TRAILER I STATE PLATE# PLATE 43 23 VINE# 1UYVS2538L3115819 INL# VEH.YEAR 2026 MAKE //I/TL MODEL TRAVELA STYLE DAMIAGE TOWED YES NOO✓ BLIN TOWED BY GO YES NOT HI O 44 24 REGISTERED OWNER INFO JB HUNT TRANSPORT 9200E146TH ST NOBLESVILLE IN 46060 D:4798200274 VEHICLE NO.2 SHAD DAMAGEDAREA LIABILITY INSURANCE INSURANCE CO ACEXSAH11348592 3 4 IN EFFECT 'INSURANCE t 4TOP 5 Venice ❑ C[ CITATION# CHARGE 25 tO eOTTQM LecnsLv YES N ] s e 7E1FFLIIIR�S NAME(PRINT) 26 OFFICER PHONE BADGE OR ID# JAGENCY VERTON 2517 WA0171300 PART A . PAGE 01 OF 9000-345-159(R 11(181 STATE OF POLICETRAFFICN CORRECTION REPORT NO. EF89257 COLLISION REPORT III III III III III 111 1591972 CASE# 25-3650 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 semi In 3 nb h/r wht suv maybe honda pass step CC Within the city limits of Renton/King/WA I responded to semi vs car hit and run crash occuring at/near the intersection of Rainier Ave S at S Grady Way. I contacted unit 1 at the Fred Meyer loading dock/365 Renton Center Way. He told me that he was northbound in and/or crossing the intersection of S Grady Way in lane 3 on his green light when he was hit on the passenger door step side of his brand new 2026 semi tractor. He was unable to obtain a license plate of driver description. He said it was maybe a white Honda medium sized SUV. Unit 2 did not complain of injury and damages did not require a tow truck. Nothing further-Information/insurance only. I certify (declare) under penalty of perjury under the laws of the State of Washington that the foregoing is true and correct. M.Leverton/2517 City of Renton/King/Wa 4/24/2025 I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT. M.LEVERTON 04-28-25 08:51 AM INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST.DET DATED PLACE SIGNED APPROVED BY DATE G.BARFIELD 647 1 51712025 9:18:23 AM BADGE OR ID# ; 2517 ORI# WA0171300 TIME POLICE DISPATCHED 8:36 AM TIME POLICE ARRIVED i 8:39 AM PART B 3000-345.160(Brute) PAGE 0 OF 47 SUPPLEMENTAL REPORT NO. EF892557POLICE TRAFFIC 1 27 4COLLISION REPORT CASE#+ 25-3650 1 COMMERCIAL MOTOR CARRIERT INTERSTATE ✓ INTRASTATE L UNIT# CARGO BODY 2 USDOT 0080806 ICC# VEHICLE TYPE 6 TYPE 2 2 ❑ 1 28 CARRIER NAME. JB HUNT ; 3 CARRIER ADDRESS 1 9200 E 146TH ST CITY NOBLESVILLE ST' IN I ZIP 46060 4 NAME ?# PLACARD ❑ NAME IF NO NUMBER SOURCE 1 AXLES 05 GWVR 80000 + 4a ❑ ADDITIONAL UNITS 5 ❑ U N CT MOTOR E j PEDAL- PEDESTRIAN PROPERTY YES A ID AGENOHRESHOLO MET PHONE VEHICLE u CYCLE OWNER MIDDLE 29 LAST NAME FIRST NAME INITIAL STREET 30 NEW AnnREF CITY ST ZIP 6 1 PRESENT MEDICAL TANSF+ORTED 1 31 CDL IGNITION RE IGNITION INTERLOCK YES NO '.INTERLOCK YES NO xE9 N' DRIVERS I LLICENSE 7 STATE SEX MMD DYYY ON DUTY� STATUS AIRBAG RESTR. EJECT HELMET INJURY NATURE OF INJURIES USE CLASS 8 ❑ 1 32 LICENSE: TnT viN PLATE# 9 TRAILER': TRAILER 2 PLATE# STATE PLATE:# STATE 10 ❑ TRLR TRLR .YIN..#. VIN.#. 11 VEH.YEAR MAKE I MODEL I STYLE VEHICLE TOWS E T ABLIN TOWED BY arrir.VEHIC!E FROM TO DAMAGE YES NO YES NO REGISTERED OWNER INFO. SHADE m 33 SHAD 12 2 DAMAGED AREA 4 FROM TO LIABILITY INSURANCE❑ INSURANCE CO 9,FC1P IN EFFECT &POLICY# 13 vewcLe YES NOEll CITATION# CHARGE 7CkBOTTOM m 34 IFGALIY sTn"olNc R T 6 14 ❑ UNIT MOTOR PEDAL- El PEDESTRIAN. PROPERTY ❑ : DAMAGE THRESHOLD MET PHONE 1:1 35 VEHICLE CYCLE OWNER YES NO 15 LAST NAME FIRST NAME MIDDLE ❑ITIAL 36 16 ❑ STREET CITY ST' ZIP NEW An17RFSC CDL IGNITION RE.tDUIRED IGNITION PRESENT MEDICAL 7ANSPORTED INTERLOCK YES .01:1 (INTERLOCK YES NO YES No' 17 37 DRIVER'S STATE I SEX MOD 18 ❑ LICENSE# MMDDYY Y ON DUTY STATUS I AIRBAG I RESTR. EJECT HELMET I INJURY NATURE OF INJURIES ❑ 38 USE CLASS 19 ❑ LICENSE YIN# ❑ 39 TAT PLATE# 20 TRAILER TRAILER 40 PLATE# STATE PLATE# STATE 21 TRLR TRLR 41 UIN#i TR#; 42 22 VEH.YEAR MAKE I MODEL I STYLE VEHICLE TOWED DUET ABLIN TOWED BY GOVT.VEHICLE DAMAGE YES NO YES NO 23 REGISTERED OWNER INFO. SHADE IN DAMAGED AREA 43 2 3 4 LIABILITY INSURANCE INSURANCE CO IN EFFECT � &POLICY# 1 _4 T()F'`"' �. 44 24 YES[:] verncLe NO❑ CITATION# CHARGE 70 k3C1TT061 LEcnuy srnNOlNc S 7 6 I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT, K LEVERTON 04-28-25 08:51 AM 25 INVESTIGATING OFFICER'S SIGNATURE OFFICER'S PHONE UNIT OR DIST DET DATED: PLACE SIGNED [-� BADGE FORID# BARREL 5n/2 PAGE 26 2517 IWA0171300 AP OF 3000-345-013(R 11/181 REPORT NO. EF89257 CASE# 25-3650 DATE AND TIME 04/24/25 08:35 OF COLLISION YYY 1 � 1�4 i r i ;•y, } aciti4, L� Wis s s, tyr �t S' t 1 � y I �> i � t it r, r PAGE 4 OF 4