HomeMy WebLinkAbout25-4060 iiTFi " II IIIII III IIIII II IIII IIIII I . Q 27c REPORT NO EF95165oc� RA
COLLISION REPORT 1591971
CASE# 25-4060 2
INTERSTATE ❑ CITY STREET FIRE I
RESULTEDLVED
STOLENSTATE ROUTE OTHER VEHICLE LOCALANG 4200 3
COUNTY RD NT&RUN CODING
PRIVATE WAY
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#
eDCL s on' 05 - 08 - 2025 0806 17 =.= S 8 W❑ IN OF e 1070 s
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
BLOCK NO.
SE PETROV/TSKY RD
4a❑ MILE POST
❑ DISTANCE OF(REFERENCE OR CROSS STREET)
5 1.� FEET e S 8 W e 111THAVESE
0 4 29
MOTOR ✓ PEDAL- DAM AG THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE ❑ YEs Vl No D:8312359880 0 4 30
6 LAST NAME POWERS FIRST NAME STEPHANIE MIDDLE A 1 1 2 31
INITIAL
STREET ] 11100 SE PETROVTISKY RD APT H2O3 CITY; RENTON ST WA ZIP; 98055 2
NEW ADDRESS
7 CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
INTERLOCK YEs No INTERLOCKYEs E vEs No
8 DRIVER # STATE NM SEXI F MMDDYY' O6 - 01 - 1991 1 2 32
9 ON DUTY STATUS' AIRBAG 2 RESTR 4 EJECT 1 N USEET CLASSY 1 NATURE of INJURIES 2❑
LICENSE, CFU1646 STATE WA V 1N4AL3AP4FC155883 3
10� as ATP rt IN#
❑ TRAILER STATE TRAILER STATE
11 3 5 PLATE# PLATE# FROM To
TRLR zRLR. 1 3 33
12 3 5 VIN# vIN#
FROM TO
VEH.YEAR 2015 MAKE NISS MODEL ALTIMA STYLE VEHICLE TOWED TO BLIN TOWED By GOVT VEHICLE 3 $ 34
13� DAMAGE YES�NO� YES❑ NO
REGISTERED OWNER INFO OWNEDBYDRIVER VEHICLE NO. 1
SHADE IN DAMAGED AREA 35
3 14 LIABILITY INSURANCE❑ INSURANCE CO PROGRESSIVE 991427104 4
IN EFFECT &POLICY# 9TOP _
srn Nowc Yes❑NO❑ CITATION# 5AO407920 CHARGE FAIL YIELD PRIVATE RD MOTOR s a oorrob z 36
15❑
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT 02 VEHICLE CYCLE nWNFR D:2067789117
16�
LAST NAME TESFAY FIRST NAME BINIAM MIDDLE' /
INITIAL
17 F1 STREET ❑❑ 10508 SE 232ND PL CITY KENT ST, WA ZIP 980313351 37
NEW ADDRESS
18❑ IGNITION RE(2UIRED fGNITION PRESENT MEDICAL TRANSPORTED: 38
CDL INTERLOCKYEs No INTERLOCI£YES N YEs No'
19 DRIVE # STATE WA SEX M MD DO-B. 01 26 1972 39
CEN :
20❑ ON DUTY STATUS AIRBAG 6 RESTR 4 EJECT 1 HELMET INJURY NATURE OF INJURIES 40 USE CLASS 1 ❑
21 LICENSE ASK3076 TATe WA VIN# 2T3DFREV3FW230788 41
22❑ PLATE# STATE PLATE# STATE 42
23 TRLR RLR 43
UIN#. 'IN#
VEH.YEAR 2Q1$ MAKE TOYT MODEL RAV4 STYLE VEHICLE TOWED TO BLIN TOWED BY GOV HI 44
24 DAMAGE YES �/ No GENE MEYERS E
REGISTERED OWNER INFO OWNED BY DRIVER VEHICLE N0.2
SHADFjy DA GE AREA
LIABILITY INSURANCE INSURANCE CO SAFECO H2377299 �$
IN EFFECT &POLICY# 6`dTOP
Yewae L'—LY YES❑ N,.I—J I CITATION# CHARGE G�760TTOM
`.L
25 OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
26
C.ARNOLD 12509 WA0171300
❑
PAGE 01 OF
PART A 3000-345-189(R 11/18)
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EF95165
COLLISION REPORT III III III III III 111
1591972 CASE# 25-4060
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 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.
C.ARNOLD 05-08-25 09:01 AM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST.DET DATED PLACE SIGNED
APPROVED BY DATE
C.JACOBS 1953 512712025 10:05:14 AM
BADGE OR ID# 12509 ORI# WA0171300 TIME POLICE DISPATCHED 8:07 AM TIME POLICE ARRIVED i 8:11 AM
PAST B 3 Do-3mx—attar(t 1Mff) PAGE 2�OF 4
REPORT NO. EF95165 CASE# 25-4060 OF DATE AND r�N + 05/08/25 08:06
O�COLLISION
NARRATIVE
CC 25-4060
On 5/8/2025 at 0807 hours I was dispatched to a motor vehicle collision at the intersection of SE
Petrovitsky Rd and 111th Ave SE in the City of Renton, King County, Washington.
Pre-Collision
Driver 2 stated that he was traveling West on SE Petrovitsky Rd in the 2 way center turn lane,
preparing to perform a lefthand turn to proceed South on 111th Ave SE.
Driver 1 stated that she was leaving the Benson Downs Apartments located at 11100 SE Petrovitsky
Rd facing South and preparing to perform a lefthand turn to proceed East on SE Petrovitsky Rd.
Collision
Driver 2 stated that as he approached the intersection of SE Petrovitsky Rd and 111th Ave SE, Unit 1
emerged from the #2 lane of Westbound traffic. Driver 2 stated that he did not have time to slow and
avoid a collision, and the front bumper of Unit 1 collided with the passenger side doors of Unit 2.
Driver 2 stated that the force of this impact then forced his vehicle to roll onto the drivers side doors.
Unit 2 then came to a rest on all 4 tires shortly after without assistance.
Driver 1 stated that traffic in the #1 and #2 lanes of Westbound SE Petrovitsky Rd stopped to allow
her through. Driver 1 stated that prior to crossing into the 2 way center turn lane, her view was
blocked by a large SUV. Driver 1 stated that as she entered the 2 way center turn lane, she did not
have time to stop or react to Unit 2 and the front bumper of Unit 1 collided with the passenger side
doors of Unit 2.
Injuries
No injuries reported.
Vehicle Disposition
Unit 2 was rendered inoperable and was towed from the scene.
Proximate Cause
I determined that Driver 1 is the proximate cause of this collision because the driver of a vehicle about
to enter or cross a highway from a private road or driveway shall yield the right-of-way to all vehicles
lawfully approaching on said highway. If Driver 1 had yielded to the right of way of Unit 2, this collision
would not have happened.
Driver 1 was cited per RCW 46.61.205.
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 08:50 on 5/8/2025 in the City of Renton, King
County, Washington.
PAGE 3 OF 4
REPORT NO. E F95165 CASE# 25-4060 DATE AND TIME 05/08/25 08:06
OF COLLISION
H AVE SE
{
�4
1
{
T
t �t
cZ
FG s t
t+"
1 t':4 54it i ti b5t >�
4
.�>.-
s�.
4 +
Y4s �4
Y
... ryry�k 4
�. 4i ii f3
Y
F
PAGE 4 OF 4