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Home My WebLink About25-4046 IT si " II IIIII III IIIII II IIII IIIII I . 27c REPORT NO EF92076OLCERA COLLISION REPORT 1591971 CASE# 25-4046 2 INTERSTATE CITY STREET FIRE I RESULTED LVED 1 STOLEN STATE ROUTE ❑ OTHER ❑ VEHICLE LDCAI-A`NG 4200 3 COUNTY RD NT&RUN CODING PRIVATE WAY 2 TOTAL#OF OBJECT 1 s 28 TRIBAL UNITS 03 STRUCK RESERVATION : 1 1 2 3� M M D D Y Y Y Y TIME(2400) COUNTY# MILES CITY# eOCL s on' 05 - 07 - 2025 1820 17 =.= S 8 W e OF IN e 1070 3 4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION �✓ NE 12TH ST BLOCK NO. e 2600 .� 4a❑ MILE POST ❑ DISTANCE OF(REFERENCE OR CROSS STREET) 5 MILES 1.1 FEET B S B W e 0 1 29 MOTOR ✓ PEDAL- F DAM AG THRESHOLD MET PHONE UNIT 01 VEHICLE CYCLE YES ✓NO 1 4 30 6 LAST NAME VERCHEAK FIRST NAME LISA MIDDLE D 1 1 2 31 INITIAL STREET Q 17811 SE 110TH ST CITY; RENTON ST WA ZIP; 980595324 2 NEW ADDRESS 7� +CDL IGN(TIUN REQUIRED IGNITION PRESENT MEDICAL TRANSSPORTED 3 INTERLOCK YES NO INTERLOCKVEs NO YES NO[ 8 DRIVER # STATE WA SEX F MD.03. 08 - 10 - 1959 t 32 9 ON DUTY STATUS' AIRBAG 6 RESTR 4 EJECT 1 H U ET �JAU SY 1 NAruRE of INJURIES 2 10 LI ENSE', BYJ5825 STATE WA VIN# 7FART6H80ME014973 3 TRAILER STATE TRAILER STATE 11 2 5 PLATE# PLATE# ROM To TRLR TRLR. 3 1 7 33 12 0 0 VIN#' VIN# FROM TO 13 4 VEH.YEAR2021 MAKE yOND MODEL CRV STYLE VEHICLE TOWED 2TOIyS46LIN ajWgYMEYERS GOESEEHI m 34 DAMAGE IIII._IIII REGISTERED OWNER INFO OWNED BY DRIVER VEHICLE NO. 1 SHADE IN DAMAGED AREA 35 14❑ LIABILITY INSURANCE[%/] INSU&POLIRANCECY# CO STATE FARM 491 1492-F09-47A 3 4 IN EFFECT 9TOP _ Lrn Lyc ❑ ❑ 5AO407919 CHARGE INATTENTIVE DRIVING taoorrob z 36 Yes NO CITATION# 15 UNIT 02 MOTOR PEDAL- ❑ PEDESTRIAN1:1 PROPERTY DAM THR OLD MET PHONE VEHICLE CYCLE CIWNRR 16❑ LAST NAME UNKNOWN FIRST NAME MIDDLE' INITIAL 17❑ STREET F-1 CITY, RENTON ST ZIP ❑ 37 NEW ADDRESS 18❑ IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED'. 38 CDL INTERLOCKYES NO INTERLOCK YES NO YEs NO: 19[ DRIVER'S # STATE SEX U M .O.B. —= � 39 HELMET INJURY: NATURE OF INJURIES 4Q 20❑ ON DUTY STATUS AIRBAG 9 RESTR 9 EJECT 1 USE 9 CLASS 0 ❑ 21 PLATE# CCW0884 raTE WA vIN# USE 41 22❑ PLATE# STATE[TILER I PLATE# STATE 42 23 TRLR r RLR 43 UIN#. 'IN# VEH.YEAR 2011 MAKE JEEP MODEL COMPAS STYLE UT VEHICLE TOWED TO BLIN TOWED BY GOV HI 44 24 DAMAGE YES NO UNK VES NO REGISTERED OWNER INFO UVALDO SAZAN HERNANDEZ 1140 EDMONDS AVE NE APT 116 RENTON WA 98056 D:4254965118 VEHICLE NO.2 SHADE IN DAMAGEAREA 2 3 LIABILITY INSURANCE INSURANCE CO IN EFFECT &POLICY# 9TOP 1-1— YES❑ NIL] CITATION11 CHARGE to BOTTOM EEGnEEY 25 a OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY 26 C.ARNOLD 12509 WA0171300 PART A PAGE 01 OF 3000-345-189(R 11/181 STATE OF POLICETRAFFICN CORRECTION REPORT NO. EF92076 COLLISION REPORT III III III III III 111 1591972 CASE# 25-4046 ADDITIONAL PERSONS INVOLVED(PASSENGERS AND/OR WITNESSES ONLY) '.NAME (LAST,FIRST,MIDDLE INITIAL) ADDRESS&PHONE SEXi D.O.B. — MMDDYYYY PASSENGERQ WITNESS� UNIT SEAT AIRBAG RESTR. EJECT ; HELMET INJURY NATURE OF INJURIES 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 0,SS ----� :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 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. C.ARNOLD 05-07-25 07:14 PM INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST.DET DATED PLAGE SIGNED APPROVED BY DATE G.BARFIELD 647 1 511612025 4:02:57 PM BADGE OR ID# 12509 ORI# WA0171300 TIME POLICE DISPATCHED 1 6:21 Pry] TIME POLICE ARRIVED i 6:28 PM PAST B 3 Do-3mx—attar(t 1Mff) PAGE 2�OF F5 REPORT NO. EF92076 CASE# 25-4046 O OF COLLI r�510NN + 05/07/25 18:20 COLL1 NARRATIVE CC 25-4046 On 5/7/2025 at 1821 hours I was dispatched to a motor vehicle collision at the 2600 block of NE 12th St in the City of Renton, King County, Washington. Pre-Collision Unit 2 was legally parked and unoccupied at around the 2600 block of NE 12th St facing West on the North side of the roadway Driver 1 stated that she was traveling West on NE 12th St approaching the 2600 block in the #1 lane. Collision Driver 1 stated that she must have been tired and did not realize that she was drifting in her lane. Driver 1 stated that the front bumper of Unit 1 collided with the rear bumper of Unit 2. This caused Unit 2 to move forward and collide with a light pole on the North side of NE 12th St (Pole # 03270). Injuries No injuries reported. Vehicle Disposition Unit 1 was towed from the scene and Unit 2 was also privately towed from the scene by a friend of the registered owner. Proximate Cause I determined that Driver 1 was the proximate cause of this collision because it shall be a traffic infraction, subject to RCW 7.80.120(1)(a), for any person to drive a motor vehicle on any public highway, street, alley, or road in an inattentive manner in the City of Renton. "Inattentive manner" in this section means a lack of: 1) attentiveness required to safely operate the vehicle under the prevailing conditions, including, but not limited to, the nature and condition of the roadway, the weather conditions, the presence of pedestrians, the presence of other traffic, or by the driver focusing or directing the driver's attention to something other than driving the motor vehicle; or 2) attentiveness that would permit the driver of a motor vehicle to observe anything resting on, or traveling on, or entering the roadway in time to take appropriate action as circumstances require. Driver 1 was cited per RMC 10-12-25. 1 certify (declare) under penalty of perjury under the laws of the State of Washington that the foregoing is true and correct. Electronically signed by Officer C. Arnold #12509 at 18:57 on 5/7/2025 in the City of Renton, King County, Washington. PAGE 3 OF 5 SUPPLEMENTAL REPORT No. EF92076POLICE TRAFFIC 1 27 ... ^'� COLLISION REPORT CASE# 25-4046 013197 1 COMMERCIAL MOTOR CARRIER INTERSTATE INTRASTATE UNIT# USDOT ICC# VEHICLE TYPE CARGO BODY TYPE 2 ❑ 1 28 CARRIER NAME 3 CARRIER L ADDRESS CITY ST ZIP 4 ❑ NAME # PLACARD GWVR NAME IF NO NUMBER SOURCE AXLES + 4a ❑ ADDITIONAL UNITS 'J MOTOR PEDAL- PROPERTY DAMAGE THRESHOLD MET PHONE 5 ❑ UNIT 3 VEHICLE ❑ CYCLE ❑ PEDESTRIAN OWNER :� YES✓ NO 29 LAST NAME CITY OF RENTON FIRST NAME MIDDLE INITIAL STREET 30 NFW AnnRFG 1055 S GRADY WAY CITY RENTON I ST WA ZiP gg057 6 ❑ PRESENT MEDICALTANSPORTED. 1 31 CDL IGNITION REQUIRED I{iNiTiON .. INTERLOCK YES NO .INTERLOCK YESO NO YES N L DRIVER'S STATE SEX (/ .D-OB -�- LICENSE; 7 ONDUTYqSTATUS AIRBAG RESTR. EJECT HELMET INJURY NATUREOFINJURIES USE CLASS 8 ❑ 1 32 LICENSE TAT UIN. PLATE# 9 TRAILER TRAILER L PLATE# STATE PLATE# STATE 0 10 TRLR TRLR VIN.#. VIN#. 11 VEH.YEAR MAKE MODEL I STYLE VEHICLE TOWE E T ABLIN TOWED BY GDVT.VFHICI E FROM TO DAMAGE YES NOI I YES n NOF11 REGISTERED OWNER INFO. m 33 12 � SHADE IN DAMAGED AREA 4 FROM TO LIABILITY INSURANCE INSURANCE CO 11 TP IN EFFECT &POLICY# 34 13 YES NO CITATION# CHARGE 1080TTOM ecauv sTnNoiNc MOTOR PEDAL_ ' 1:1PROPERTY : DAMAGE THRESHOLD MET PHONE 35 14 ❑ UNIT# VEHICLE CYCLE PEDESTRIAN OWNER YES NO 36 15 LAST NAME FIRST NAME IN L 16 ❑ STREET �' CITY ST' ZIP NEW ADDRESa CDL IGNITIGN REQUIRED IGNITION PRESENT MEDICAL TANSPORTED INTERLOCK YES NO INTERLOCK YEs Net YES NO 17 37 LLIICENSE# STATE SEX MD.00.6 18 ❑ ❑ HELMET 'INJURY NATURE OF INJURIES 38 ON DUTY STATUS' AIRBAG RESTR. EJECT USE CLASS. 19 ❑ ❑ 39 LICENSE TAT vIN# PLATE# 20 TRAILER' TRAILER 40 PLATE#, STATE STATE PLATE# - ❑ 21 ❑ TRLR TRLR 41 VIN#�, VIN#Y 42 22 VEH.YEAR MAKE I MODEL I STYLE I VEHICLE TOWED DUE T SABLIN 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 I &POLICY# 1 .. K-99 y 44 24 YES❑ NO CITATION# CHARGE STF_ G 3 3 G 1 CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT. C.ARNOLD 05-07-25 07:14 PM 25 INVESTIGATING OFFICER'S SIGNATURE OFFICER'S PHONE UNIT OR DIST DET DATED: PLACE SIGNED 26 OR ID# 12509 O#RI WA0171300 APPROVED 51116/2025 PAGE�OF 3000-345-013(R 11/18) REPORT NO. E F92076 CASE# 25-4046 DATE AND TIME 05/07/25 18:20 OF COLLISION CID 4 } t utir � t 0 u SY dj Ff� 4 t " Y ; t tY i 1 4g�b Q S r �ii��ttji' s s 1 � i V 4 \ t y§y F I S " t � � i y# PAGE 5 OF 5