HomeMy WebLinkAbout25-3873 IT si " II IIIII III IIIII II IIII IIIII I . 27c REPORT NO EF92934OLCERA
COLLISION REPORT 1591971
❑ FIRE I
�/�$E$ 25-3873 2 s 0
INTERSTATE CITY STREET ✓ RESULTEDSTOLENSTATE ROUTE OTHER VEHICLE LOCALAGENCY 4200 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 TOTAL#OF OBJECT 1 8 28
TRIBAL UNITS 02 STRUCK ❑
RESERVATION : 1 1
2
3� M M D D Y Y Y Y TIME(2400) COUNTY# MILES CITY#
eDCL s on' 05 - 02 - 2025 0110 17 =.= S 8 W❑ OF IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION BLO❑
EASTVALLEYRD MILE POST
e 4300 .�
4a❑ MILE POST
❑ DISTANCE OF(REFERENCE OR CROSS STREET)
5 MILES 1.1 FEET e S 8 W e SW 43RD ST
0 1 29
MOTOR ✓ PEDAL- DAM AG THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE ❑ YEs Vl No D:2066571194 0 1 30
5 LAST NAME PITAYO GARCIA FIRST NAME JOSE MIDDLE T 1 1 2 31
INITIAL
STREET ] 2534 S 371ST ST UNIT 55 CITY; FEDERAL WAY ST WA ZIP; 980037600 2
NEW ADDRESS
7 CDL IGN(TIUN REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED. 3
INTERLOCKYES NO✓ INTERLOCKYES NO✓ YES NO�/
8❑ DCIENSE# STATE WA SEXI NI MMDDYY' 09 — 15 — 2005 1 2 32
-NJUR
9❑ ON DUTY STATUS' AIRBAG 3 RESTR 4 EJECT 1 HELMET
2 CLASSY 1 [NATURE of INJURIES 2❑
LICENSE, CMA3341 STATE WA VIN#; 3VWCB21C42M405254 3
10 Fl I as ATP rt
11❑ TRAILER STATE TRAILER STATE
3 5 PLATE# PLATE# ROM To
TRLR zRLR 1 5 33
12 3 5 VIN# vIN#
FROM TO
13 $ VEH.YEAR2002 MAKE VOLK MODEL BEETLE STYLE SD VEHICLE TOYED NO�iS46LIN T�VyED.6LRS GES❑END 3 34
DAMAGE IIII._IIII HHttVVii((tt
REGISTERED OWNER INFO JOSEFINA PJTAYO pARCIA 2534 S371ST ST UNIT 55 FEDERAL WAY WA 980037600 D:206fi571194 VEHICLE NO. 1
SHADE IN DAMAGED AREA 35
14❑ LIABILITY INSURANCE❑ NSURANCE CO B 4
IN EFFECT &POLICY# 9TOP _
srnNowc ❑ ❑ 5AO090682 CHARGE NO VALID INSURANCE taoorrob z 36
Yes NO CITATION#
15❑
MOTOR ✓ PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT VEHICLE CYCLE nWNFR D:2066985226
16�
LAST NAME DUCKWORTH FIRST NAME FARRAH MIDDLE M
INITIAL
17 F1 STREET ❑
❑ 1613 FIELD AVE NE CITY RENTON ST, WA ZIP 98059 4 37
NEW ADDRESS
18❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTEDI 38
INTERLOCKYES NO✓ INTERLOCK YES No✓ YES NO✓
19 DRIVE # STATE SEX IF MMDaYY 06 03 2006 39
❑ ON DUTY STATUS AIRBAG 3 RESTR 4 EJECT 1 HELMET 2 INJURY 7 NATURE OF INJURIES 40
USE CLASS CHEST PAIN,POSSIBLE CONCUSSION
21 LICENSE
LATE# CNC3536 rare WA vIN# 3N1CN8EV1ML864794 41
22❑ PLATE# STATE PLATE# STATE 42
23 r TRLR RLR 43
UIN#. 'IN#
TOWED BY GOV HI 44
VEH.YEAR 2021 MAKE pJJss MODEL VERSA STYLE SD DAMIAGE TOWED V No BLIN BANKERS ves No✓
24❑ REGISTERED OWNER INFO OWNED BY DRIVER VEHICLE NQ.2
SHADFY DAGED AREA
4
LIABILITY INSURANCE❑ INSURANCECO HORACE MANN 46-86610440
IN EFFECT &POLICY# 9TOP
VEHICLE ❑ ,J—I CITATION11 CHARGE tO BOTTOM
LE
—Y YES N J 6
25 OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# JAGENCY
26
NICHOLAS SWAN 12965 WA0171300
❑
PAGE 01 OF
PART A 3000-348-189(R 11/18)
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EF92934
COLLISION REPORT III III III III III 111
1591972 CASE# 25-3873
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 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 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.
NICHOLAS SWAN 05-04-25 09:49 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST.DET DATED PLAGE SIGNED
APPROVED BY DATE
QUINT TIBEAU 7691 1 511912025 11:11:39 PM
BADGE OR ID# 12965 ORI# WA0171300 TIME POLICE DISPATCHED 1:11 AM TIME POLICE ARRIVED i 1:18 AM
PAST B 3 Do-3mx—attar(t 1Mff) PAGE 2�OF 4
REPORT NO. EF92934 CASE# 25-3873 OF DATE AND r�N + 05/02/25 01:10
O�COLLISION
NARRATIVE
#25-3873
Unless otherwise noted, all events took place in the City of Renton, in the County of King, in the State
of Washington.
This incident was captured on my body worn video camera and in-car cameras. This report is a
summary of events that occurred and is not an exact sequencing of events.
On 05/02/2025 at approximately 0111 hours I was dispatched to the intersection of East Valley Hwy
and SW 43rd St in the city of Renton, King County, WA, for a blocking accident between two vehicles.
Unit#1 was a red 2002 Volkswagen Beetle with WA LIC: CMA3341(VIN: 3VWCB21 C42M405254)
Unit#2 was a blue 2021 Nissan Versa with WA LIC: CNC3536 (VIN: 3N1 CN8EV1 ML864794)
I arrived on scene and found that both vehicles were unable to move under their own power and
would be blocking the intersection. The drivers of both vehicles were okay and stated they were both
wearing their seatbelts.
Renton Fire arrived on scene and medically cleared each driver.
Driver 1 of Unit 1 stated he was got off work at approximately 0040 hours and was driving from north
to south on East Valley Hwy at approximately 40mph. He stated he went through a red light while
crossing SW 43rd St. As he drove through the light he collided with driver side of Unit 2.
Driver 2 of Unit 2, stated she had just left Jack In the Box located at 8829 S 180th St and was driving
east on SW 43rd St. She stated she had a green light as she drove through the intersection but was
hit by the driver of Unit 2 in the driver side door of her vehicle. This pushed her up on to the SE corner
of the intersection into a utility box on the City of Kent sidewalk in front of 7-11 located at 18010 E
Valley Hwy, Kent, WA.
Both vehicles were unable to be driven away from the accident location. Banker's towing was
dispatched to remove the vehicles. Both drivers signed a tow form for their vehicles with Banker's.
I took pictures of the vehicles and uploaded them to Axon Evidence.
An exchange of information was printed and provided to the drivers of both vehicles involved.
At the conclusion of my investigation, I determined that the proximate cause of the collision is due to
Unit 1 being inattentive to traffic signals and not stopping when he had a red light. The driver of Unit 1
was issued citation #5A0090682.
If the driver of Unit 1 would have stopped at the redlight on East Valley Hwy and SW 43rd St driving
then this collision would not have occurred.
This concludes my report.
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 Officer N. Swan #12965 on 5/2/2025 at 0224 hours in the City of Renton.
PAGE 3 OF 4
REPORT NO. E F92934 CASE# 25-3873 DATE AND TIME 05/02/25 01:10
OF COLLISION> '
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