HomeMy WebLinkAbout25-4312 ("7—
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,one COLLISION REP F 1591971
CASE# 25-4312 2
INTERSTATE CITY STREET FIRE ❑
RESULTED
STOLEN
1 2 STATE ROUTE OTHER VFHICI F LOCAL AGENCY 3[�
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 TRIBAL LIN 7S 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 05 - 15 - 2025 1551 17 a. 8 W 8 OF IN 8 1070 3
S
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
NE4THST BLOCK NO. 8✓ 6000 .�
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ 1.= FEET e S e W B ROSAR/O AVE NE
0 1 29
MOTOR PEDAL- DAM E THRESHOLD MET PHONE
UNIT 01 VEHICLE CYCLE YEs ,/NO D:8608189849 N:8608991617 0 11
30
6❑ LAST NAME : SHERLIN FIRST NAME DIVA MIDDLE' N 1 2 31
INITIAL
STREET E:1' 6106 NE 3RD CT CITY RENTON WA
NEW ADDRESS S7 ZIP 980598579 z
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
INTERLOCK YES No INTERLOCKYES No YES NO
DRIVE STATE WA SEX'F MM flYY 08 - 23 - 2008 1 2 32
8❑ L
9 F] ON DUTY STATUS AIRBAG 3 RESTR 3 EJECT 1 H U5 E7 CLASS 7 NECKE of INJURIES 2
LICENSE
DILIYAS STATE WA Wm# JTJBC1BA4B2039660
10 9❑ PI 3
11 0 0 PLATE# STATE TRAIPLATE# STATE ROM To
RA
7RL R TRLR 5 1 33
12 0 0 vIN#' VIN#
FROM TO
13 p VEH.YEAR2011 MAKE LEXS MODEL RX300 STYLE P4 VEHICLETOWEED2NO fBLIN TOWED BY GOVT.VEHIICL✓ 3 7 34
❑ REGISTERED OWNER INFO OWNED BYDR/VER II1IIIII VEHICLENJIIOO..'II 1
SHADE 1N DAMAGED AREA ❑ 35
A LIABILITY INSURANCE INSURANCE CO Z
14 STATE FARM 4270787A0547D
IN EFFECT &POLICY# i STOP
VEHICLE CHARGE ❑ 36
EGALI Y YES[:]NO[:] CITATION# 10 ftOTTOM
15❑ ET—IN. a e
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT VEHICLE CYCLE OWNER YES NO D:2065539991
16�
LA5T NAME SM/TH FIRST NAME JAMIE MIDDLE L
INITIAL.
17❑ NEW ADDRESS STREET P 3233 NE 12TH ST APT 210 CITY RENTON ST', Wq ZIP 9805E 37
: ❑
18❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED ❑ 38
INTERLOCK YES No INTERLOCK YES NO YES No
19❑ DRIVER'#
❑ ON DUTY STATUS AIRBAG 3 RESTR y EJECT 1 N U MEET CLASS 7 �NATURE OF RIGHT HAND INJURIES ❑ 40
21❑ LICEN� BTY3890 _WA vIN# 4S3BNAN65H3060878 ❑ 41
PLATETRAILER TRAILER ❑22 PLATE# STATE PLATE STATE 42
23 43
TRLR RLR
VIN#. '[N#,
TOWED BY GO HI 44
VEH.YEAR 2017 MAKE $UBA MODEL LEGACY STYLE P4 DAMIAGE TOWED✓ NOO BLIN YES NO
24
REGISTERED OWNER INFO JAMIE SMITH 3233 NE 127H ST APT 210 RENTON WA 9805E D:206553999] VEHICLE NQ.2
SHAD DAMAGED AREA
LIABILITY INSURANCE INSURANCE CO PROGRESIVE 901206886 3 4
IN EFFECT &POLICY# 4TOP
- 5
LEGALLY
❑ „I�1 CITATION# CHARGE tO eOTTQM
LEGALLY YES N —1
25 e
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
26
SULIASI TAMAIVENA 12788 WA0171300
PART A . PAGE 01 OF
9000-345-159(R 11(181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EF91785
COLLISION REPORT III III III III III 111
1591972 CASE# 25-4312
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 GLASS 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 0,SS ----�
:NAME
(LOST,FIRST,MIDDLE INITIAL)
ADDRESS&PHONE#
SEX MMDDYY D.O.B.
YY
PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET NJU S' NATURE OF INJURIES
❑ ❑ POS. I USE GLASS
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.
SULIASI TAMAIVENA 05-15-25 06:00 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST.DET DATED PLAGE SIGNED
APPROVED BY DATE
P.SUMMERS 8887 511512025 6:13:00 PM
BADGE OR ID# 12788 ORI#' i WA0171300 TIME POLICE DISPATCHED 1 3:53 PM TIME POLICE ARRIVED i 4:10 PM
PART B 3000-345.160(R1Vt8) PAGE F2 --]OF 47
REPORT NO. EF91785 CASE# 25-4312 OF COLLI ION 05/15/25 15:51
OF COLLISION
NARRATIVE
25-4312
On 5/15/2025 At 1553 hours, I was dispatched to a motor vehicle collision at NE 4TH ST/ROSARIO
AVE NE in the City of Renton, King County, Washington. The dispatcher advised that two vehicles,
with unknown injuries, are blocking the intersection.
When I arrived on the scene, I observed Unit#1's vehicle on Rosario Ave NE in the northbound lane,
but facing southbound. This street has two lanes, and Unit#1 was in lane #2 (lane #1 being closer to
the sidewalk).
Unit#2 vehicle was on NE 4th ST between lanes #1 and #2, facing westbound. Unit 2's vehicle was
unable to move.
Collision
Driver#2 stated she was on NE 4th ST traveling westbound in lane #2 (there are only two lanes and
a shared middle turn lane in both directions). While attempting to cross Rosario Ave NE intersection,
she advised that Unit #1 drove in front of her, which she could not stop, causing her to hit Unit#1's
vehicle.
Driver 1 stated she was stopped at the stop sign on Rosario Ave NE on the south side of the
intersection when she claimed that the road was clear and that no vehicle was passing. She drove
across NE 4th ST and was then hit by Unit#2. Driver 1 said that the road was clear and that no cars
were on the road. She also believed that Unit#2 was coming down fast, so she did not see Unit#2.
Injuries
Unit#1 advised that she had pain in her neck, but believes it was from the seatbelt that she was
wearing.
Unit#2 advised that she had pain in her right hand, but also believed it was from her seat belt.
Both units were checked out by fire and were medically cleared.
Vehicle Disposition
Unit#1's vehicle had damage on the rear right side of the fender, back bumper, and back right tire,
which was slightly bent.
Unit#2's vehicle had damage on the front left fender and front bumper. The hood of the vehicle was
also bent.
Bankers towed both vehicles at their request.
Proximate Cause
After viewing the collision video, I believe the proximate cause was that Unit#1 failed to yield to
vehicles traveling on NE 4th ST who had the right-of-way. Due to Unit#1 not yielding to traffic, she
attempted to cross the intersection, which shows Unit #2 traveling westbound in her lane #2 and Unit
#1 crossing in front of Unit#2, which led to the accident.
The video will be uploaded as evidence.
I certify (declare) under penalty of perjury under the laws of the State of Washington that the
foregoing is true and correct. This report was electronically signed by Officer S. Tamaivena #12788,
May 15th, 2025, at 1800, Renton, WA.
**** AUTO-POPULATED SECTION ****
THE FOLLOWING ARE DESCRIPTIONS ENTERED FOR ITEMS SELECTED AS "OTHER":
Light Condition: FOGGY
**** END OF AUTO-POPULATED SECTION ****
PAGE 3 OF 4
REPORT NO. EF91785 CASE# 25-4312 DATE AND TIME 05/15/2515:51
OF COLLISION
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