HomeMy WebLinkAbout25-4125 IT si " II IIIII III IIIII II IIII IIIII I . 27c REPORT NO EF90302OLCERA
COLLISION REPORT 1591971
CASE# 25-4125 2
INTERSTATE CITY STREET FIRE I
RESULTEDSTOLENSTATE ROUTE OTHER VEHICLE LOCAI-A`NG 4200 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 TOTAL#OF OBJECT 1 s 28
TRIBAL UNITS 02 STRUCK
RESERVATION : 1 1
2
3� M M D D Y Y Y Y TIME(2400) COUNTY# MILES CITY#
DATE OF N E
cDLLISION' 05 - 10 - 2025 1129 17 =.= S 8 W e OF M 1070 a
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓
108TH AVE SE BLOCK NO. e 10800 .�
4a❑ MILE POST
❑ DISTANCE OF(REFERENCE OR CROSS STREET)
5 20 1.1 00 FEET e✓ S 8 W e SE CARR RD
0 4 29
MOTOR ✓ PEDAL- DAM AG THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE ❑ YEs Vl No D:4255779634 0 1 30
6❑ LAST NAME CARR FIRST NAME TARA MIDDLE F 1 2 31
INITIAL
STREET ❑ 18429 135TH PL SE CITY; RENTON ST I WA ZIP; 98058 2
NEW ADDRESS
7 CDL IGN(TIUN REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED' 3
INTERLOCKYEs No✓ INTERLOCKYEs Nb✓ YES NO✓
8 DRIVER # STATE WA SEXI F MMDDYY' 05 - 26 - 1989 1 2 32
-NJUR
9 ON DUTY STATUS' AIRBAG 2 RESTR 4 EJECT 1 HELMET
2 CLASSY',1 [NATURE of INJURIES 2
10 LI ENSE', BTF1668 STATE WA V(N# 2C4RC1GG1KR673461 3
TRAILER STATE TRAILER STATE
11 3 0 PLATE# PLATE# ROM To
TRLR TRLR. 1 1 3 33
12 3 0 VIN#' vIN#
FROM TO
VEH.YEAR 2019 MAKE CHRY MODEL PACIFIC STYLE 4C VEHICLE TOWED TO BLIN TOWED By GOVT VEHICLE 3 7 34
13� DAMAGE YES II_II NO ✓ YESII_I) NO
REGISTERED OWNER INFO OWNEDBYDRIVER VEHICLE NO. 1
SHADE IN DAMAGED AREA 35
2 3 4
$ LIABILITY INSURANCE INSURANCE CO
14 Z PROGRESSIVE 9434t8664
IN EFFECT &POLICY# i 4TOP 5
11
VEHICLE CHARGE 7 0 80TTOM 36
srnNoiNc yes❑NO❑ CITATION# 5A0425851,5AO425851 FAIL YIELD LEFT TURN MOTOR
15 s
MOTCSR ✓ PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT VEHICLE CYCLE nWNFR D:2065568460
16�
LAST NAME TRAN FIRST NAME THAT MIDDLE' V
INITIAL
17 F1 STREET ❑
❑ 19528 120TH PL SE CITY KENT ST, WA ZIP 98031 q 37
NEW ADDRESS
18❑ CDL IGNITION REtYUIRED IGNITION PRESENT MEDICAL TRANSPORTED 38
INTERLOCKYEs No✓ INTERLOCK YES No✓ vEs No✓
19 DRIVE #
INJURY: NATURE OF INJURIES 40
20❑ ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 USE 2 CLASS 1 ❑
21 LICENSE SH17642 TATE WA VIN# JTJBM7FX1J5195697 41
22❑ PLATE# STATE PLATE# STATE 42
23 TRLR r RLR 43
UIN#. 'IN#
VEH.YEAR 201$ MAKE LEXU MODEL GX 450 STYLE 4C VEHICLE TOWED TO BLIN
TOWED BY GOV HI 44
24 DAMAGE YES NO✓ NO✓
REGISTERED OWNER INFO OWNED BY DRIVER VEHICLE
NQ.2
SHADE IN DAMAGED AREA
2 3 4
LIABILITY INSURANCE INSURANCECO STATE FARM 4424145-EOB-47A
IN EFFECT &POLICY# t9,Q
YEwcLE ❑ ,.I—I CITATION CHARGE L,EI�Y YES N25
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
26
JOSEPH MELLO 13020 WA0171300
PAGE 01 OF
PART A 3000-348-189(R 11/18)
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EF90302
COLLISION REPORT III III III III III 111
1591972 CASE# 25-4125
E NA ADDITIONAL PERSONS INVOLVED(PASSENGERS AND/OR WITNESSES ONLY)
M
(LAST,FIRST,MIDDLE INITIAL) LAM TRAN K
ADDRESS&PHONE#
19528 120TH PL SE KENT WA 98031 SEXi F MMDDD B. 03 — 16 — 1981
PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET INJURY NATURE OF INJURIES
2 POS. 3 2 4 1 USE 1 2 CLASS j 1 ----�
:NAME
(LAST FIRST MIDDLE INITIAL)
ADDRESS R 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
PC& 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.
JOSEPH MELLO 05-10-25 02:29 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST.DET DATED PLACE SIGNED
APPROVED BY DATE
S.WOODWARD 11528 511112025 8:21:16 AM
BADGE OR ID# j 13020 ORI# WA0171300 TIME POLICE DISPATCHED 11:40 AM TIME POLICE ARRIVED i 11:45 AM
PAST B 3 Do-lmx—attar(t 1Mff) PAGE 2�OF 4
REPORT NO. EF90302 CASE# 25-4125 OF DATE AND r�N + 05/10/25 11:29
O�COLLISION
NARRATIVE
25-4125
This incident was captured on my body worn video camera. This report is a summary of events that
occurred and is not an exact sequencing of events. Statements have been paraphrased and
summarized.
On 05-10-2025 1 was working as a police officer in a fully marked, department issued uniform,
patrolling in a marked police vehicle for the city of Renton. At approximately 1140 hours I was
dispatched to a non-injury/non-blocking accident at the intersection of 108th Ave SE/SE Carr Rd, City
of Renton, County of King, State of Washington.
I gathered from the call notes, both parties of the motor vehicle collision would be at the CVS parking
lot for contact.
I arrived on scene and observed a white 2018 Lexus GX450 (license plate#SH 1 7642/WA) and a red
2019 Chrysler Pacifica (license plate#BTF1668/WA) that had obvious rear driver side damage. The
rear driver side door was dented inwards that also had white paint which matched the color of the
Lexus involved in the collision. The Lexus had minor scrapes and broken plastic on the front left
fender. No one on scene had any complaint of pain, and none of the vehicles needed a tow.
I spoke with the driver of the Lexus who was positively identified as That V. Tran (DOB 12-31-1981)
via WADL. That advised the following: That was in the car with Tran K. Lam (DOB 03-16-1981) who
was in the front passenger seat, and his two sons who were in the back. That's sons are ages 8 and
10. That drove northbound on 108th Ave SE and was in the left turn lane to turn west onto SE Carr
Rd. That completed his turn and continued westbound on SE Carr Rd in the number one lane directly
next to the left turn lane. That approached the area of the CVS pharmacy and observed the Pacifica
turn left directly in front of him. That pushed on his brake in an attempt to avoid a collision but collided
with the Pacifica in the middle of the roadway. That then met with the driver of the Pacifica in the
parking lot of CVS to await police contact.
I contacted the driver of the Pacifica who was positively identified as Tara F. Carr (DOB 05-26-1989)
via WADL. Tara advised the following occurred: Tara was in the parking lot of CVS stopped by a stop
sign with the intention of turning left eastbound onto SE Carr Rd. Tara said she observed the Lexus
driving down the hill towards her. Tara thought she had a big enough gap to complete her left turn
into the left turn lane of eastbound traffic on SE Carr Rd. Tara started her left turn and observed the
Lexus was quickly approaching her. Tara observed the Lexus push on their brakes a couple of times
before they collided together in the middle of the roadway. After the collision, they both met in the
CVS parking lot to await police contact.
The proximate cause for the collision is that Tara failed to yield to the right of way of the Lexus when
she turned left onto SE Carr Rd.
That and Tara were able to provide their WADL's, phone numbers, and valid proof of insurance.
I provided an exchange of information sheet to both That and Tara.
took photos of both vehicles and uploaded them to evidence.com.
I issued Tara Sector citation#5A0425851 and sent it to the Prosecutor's Queue to be mailed to her
address.
This concludes my involvement in this case.
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 J. Mello #13020 on 05/10/2025 @ 1428 hours in Renton WA.
PAGE 3 OF 4
REPORT NO. EF90302 CASE# 25-4125 DATE AND TIME 05/10/2511:29
OF COLLISION
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PAGE 4 OF 4