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Home My WebLink About25-4694 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 1 27c COLLISION REP FIT 1591971 INTERSTATE ❑ CITY STREET FIRE ❑ CASE 2s-4ssa z RESULTED 1 STOLEN STATE ROUTE ❑ OTHER ❑ VFHIC;I F ❑ LOCAL AOENC 4900 3 HIT&RUN CODING COUNTY RD PRIVATE WAY INVOLVED 2 1 TOTAL#OF OBJECT 1 1 8 28 TRIBAL UNITS 03 STRUCK RESERVATION z 3❑ DATE of M M D D Y Y Y Y TIME(2400) COUNTY# MILES N E IN CITY# ❑ cawsloN 05 - 1-- 2025 1902 17 ❑.= S 8 IN e 1070 3 4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓ SW GRADY WAY BLOCK NO. e✓ 4a❑ MILEPOST DISTANCE OF(REFERENCE OR CROSS STREET) 5❑ 200 00 FEET MILES e S ❑ W e LIND AVE SW 2 0 29 MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE UNIT 01 VEHICLE ❑ CYCLE El ✓NO D:3602296375 2 01 30 6� LAST NAME HUNTER FIRSTNAME KEVIN MIDDLE G 1 2 31 INITIAL STREET ❑, 13204 MILITARY RD S CITY TUKWILA ST WA ZIP 98168 z NEW ADDRESS 7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3 INTERLOCK YES NO 1/ I INTERLOCK YES NO YES 1/ NO 8❑ DRIVERS E# ON DUTY❑ STATUS' AIRBAG 1 RESTR 13 . EJECT 1 HELMETU E 7 CLASS 6 [NATURE OF INJUR ES LEFT ARM AND LEFT SIDE z❑ 3 10� PI ATE 14 6K9761 sTATe WAV N# 1 HFSC55099A500984 C7 TRAILER STATE TRAILER STATE 11 3 5I PLATE# PLATE# FROM TO TRLR 7 3. TRLR 33 12 3 5 VIN#' VIN# FROM TO ❑ VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TR Y GOVT.VEHICLE 7 3 34 13 8 2009 HOND VTX1300 MC DAMAGE YES NO MEYER YES[:] NO✓ REGISTERED OWNER INFO OWNEDBYDRIVER VEHICLE NO. 1 SHADE IN DAMAGED AREA ❑ 35 14 LIABILITY INSURANCE INSURANCE CO PROGRESSIVE 3 4 IN EFFECT &POLICY# 9TOP VE"C CHARGE 5 36 LEGALLY res❑NO❑ CITATION# 10 BOTTOM 15❑ STANDING 8 6 MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE UNIT VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES 1/ NO D:2064594576 16 a LAST NAME HOLMES FIRST NAME JOYCE MIDDLE A INITIAL 17❑ STREET NEW ADDREss❑' 411 BAKER BLVD UNIT 634 CITY' TUKWILA ST WA ZIP 98188 37 18❑ CDL IGNITION REQUIRED IGNITION PtR—E—S1ENT MEDICAL t—T�RANSPORTED � 38 INTERLOCKYES�NO� INTERLOCK Y�EsI I I NOF YES t l NO� 19 LICENSE STATE WA ]SEX IF M D.C.B. 09 _ 23 _ 1941 39 20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 H U EET 2 NJAURSY 1 NATURE OF INJURIES 40 ❑ILICENSE 21❑ PLA E# BVP9432 TATE 41 WA VIN# 2HKRW2H57LH660478 1 42 22❑ PLATE# STATE PLATE# STATE TRLR 23❑ VIN#. IN#. 43 RLR ' Gov HI VEH YEAR 2020 MAKE HOND MODEL CRV STYLE $V D TOWE O YES NO 1/ D N ✓O BLIN TOWED BY 44 24❑ AMAGE ES REGISTERED OWNER INFO OWNED SY DRIVER VEHICLE N0.2 SHADE DA GEbAREA LIABILITY INSURANCE &POLICY#E CO PEMCO CA0344653IN 5 VEHICLE ❑ C—I CITATION# CHARGE GQ LEGALLY YES N`LJ 25 s � e OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# JAGENCY 26 ROBIN SMITH 12986 WA0171300 PART A PAGE 01 OF C7 3000-345-159 OR 11/181 STATE OF POLICETRAFFICN CORRECTION REPORT NO. EF98953 COLLISION REPORT III III III III III 111 1591972 CASE# 25-4694 ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY) NAME (LAST FIRST,MIDDLE INITIAL)_ ADDRESS&PHONE# SEX D.O.B. - - MMDDYYYY. PASSENGER❑WITNESS UNIT# SEAT AIRBAG RESTR. EJECT ' HELMET INJURY NATURE OF INJURIES POS. USE CLASS NAME '(LAST,FIRST MIDDLE INITIAL) ADDRESS&PHONE# D D B SEX MMDDYYYY PASSENGER ❑WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET INJURY NATURE OF INJURIES POS. USE CLASS NAME (LAST FIR57 MIDDLE INITIAL) AppRESS R PHONE# SEX D.O.B. MMDDYYYY. - PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET NJURY NATURE OF INJURIES ❑ ❑ POS. 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. ROBIN SMITH 05-29-25 08:59 PM INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED APPROVED BY DATE QUINT TIBEAU 7691 1 6/9/2025 5:17.01 AM BADGE OR ID# 9Y988 OR]# WA0171300 TIME POLICE DISPATCHED; 7:03 PM TIME POLICE ARRIVED',7:06 PM FART I PAGE IT]OF 5� REPORT NO. EF98953 CASE# 25-4694 OF COLLISION 05/29/25 19:02 OF CbLLI510N NARRATIVE 25-4694 Unless otherwise stated, the following occurred in the City of Renton, County of King, State of Washington. On 05/29/2025 at approximately 1902 hours, I was dispatched to a blocking 3-vehicle collision with reports of injuries just west of the intersection of SW Grady Way and Lind AVE SW. Upon arrival, I contacted the involved parties and Renton Regional Fire Authority (RRFA) was already on scene administering aid to the driver of Unit#1. 1 collected the involved parties driving documents and their independent recollection of events leading up to the collision. The driver of Unit#1 said he was driving his motorcycle eastbound on SW Grady Way approaching Lind AVE SW and had signaled to move from lane 2 to the left-hand turn lane. The driver of Unit#1 said he did not see any vehicles behind him and as he was switching lanes his motorcycle was struck from behind. He then fell on the ground and felt pain in his left arm and left side of his body. The driver of Unit#1 told me he had Progressive insurance, but he did not have any proof or know the policy number. The driver of Unit#2 said she was traveling eastbound on SW Grady Way approaching Lind AVE SW and had signaled to move from lane 2 to the left-hand turn lane. She did not see any other vehicles or motorcycles in her way and then was struck by Unit#1 on the rear passenger side of her vehicle. There is damage to Unit#2 that extends from the rear passenger side door to the front passenger side door. The driver of Unit#2 had no reports of injuries. The driver of Unit#3 said she was traveling eastbound on SW Grady Way approaching Lind AVE SW traveling in lane 2. She saw the traffic signal at the intersection was red and had started to slow down in preparation to stop. She was not switching lanes and as she continued straight in lane 2 the driver side rear and driver side rear door of her vehicle were struck causing damage. The driver of Unit#3 had no reports of injuries. Based on the above statements, 1 did not determine any of the three drivers to be the proximate cause of the collision. I was unable to determine if either the driver of Unit#1 or Unit#2 entered the turn lane before it was permitted. There were no witnesses on scene. The driver of Unit#1 was transported to Valley Medical Center for injuries. Complaints of pain were to his left arm and left side of his body. His motorcycle was impounded to Gene Meyer Towing. He was provided a copy of the impound form. The driver of Unit#2 and Unit#3 were able to drive away safely from the scene. An exchange of information was provided to all involved parties. 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 Robin Smith #12986 on 05/29/2025 @ 2045 hours in Renton, WA. PAGE 3 OF 5 SUPPLEMENTAL REPORT NO. EF989553 r`I POLICE TRAFFIC 1 1 8 27 COLLISION REPORT CASE# 25-4694 1 COMMERCIAL MOTOR CARRIER INTERSTATE INTRASTATE G UNIT'# USL70r !CC# VEHICLE TYPE CARGO BODY TYPE 2 ❑ 1 28 CARRIER NAME 3 CARRIER ADDRESS ` CITY ST' ZIP' 4 ❑ NAME # PLACARD: :❑ GI NAME IF NO NUMBER SOURCE AXLES + 4a ❑ ADDITIONAL UNITS MOTOR PEDAL- PROPERTY DAMAGE THRESHOLD MET PHONE 5 ❑ UNIT# 3 VEHICLE tSJ CYCLE _) PEDESTRIAN � OWNER � YES� NO D:2064194840 rFO 1 29 LAST NAME BUSTOS OROZCO FIRST NAME : IDALIA MIDDLE INITIAL STREET 30 NEW AnnRFrtP 14005 42ND AVE S TRLR 56 CITY TUKWILA ST WA ZIP 98168 6 ❑ 1 1 2 31 CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TAN5PORTED INTERLOCK YEs NO zERLOCK YES❑N0� YEs N DRIVER'S LICENSE STATE I WA SEX F MMDDYYv 11 - 23 - 1996 7 ON DUTY� STATUS AIRBAG' 2 RESTR. Q EJECT 1 HELMET 2 INJURY 1 1 NATURE OF INJURIES USE CLASS 8 ❑ 1 32 LICENSE CLE7771 TAr WA VIN# 1HGCS22838AO10387 PLATE# 9 TRAILER TRAILER PLATE# STATE PLATE# STATE 10 1-1TRLR TRLR VIN.#. VIN.#. 11 3 5 VEH.YEAR MAKE MODEL STYLE VEHICLE TOME E T SABLIN TOWED BY anvi vEH1C E FROM TO 2008 HOND ACCORD CP DAMAGE YES NO YES NO REGISTERED OWNER INFOIDALIA BUSTOS OROZCO 1400542ND AVE S TRLR 56 TUKWILA WA 98168 D:2064194840 ] $ 33 12 � SHADE IN DAMAGED AREA 34 FROM TO LIABILITY INSURANCE INSURANCE CO IN EFFECT &POLICY# tGQ EHICLE 34 CITATION# CHARGE 13 LEGALLY YES NO STANDING �} � 6'& 14 ❑ UNIT Tr Vd 1RE O CYDCLE OWNERRTY YES AGE NOHRESHOLD MET PHONE ❑ 35 PEDESTRIAN 15 LAST NAME FIRST NAME INITIAL 36 ❑ STREET 16 TEETEs.�' CITY ST ZIP CDL IGNITION REdUiRED IGNITtGN PRESENT MEDICALTANSPORTED INTERLOCK YES No INTERLOCK YEs NO YEs NO ❑ 17 4 37 LICENSE# STATE SEX MMDDDYBYY 18 ❑ ON DUTY� STATUS AIRBAG RESTR. ; EJECT HELMET INJURY NATURE of INJURIES 38 USE CLASS 19 ❑ LICENSE TAT VIN# 39 PLATE# 20 ❑ TRAILER TRAILER El40 PLATE#< STATE PLATE# STATE 21 ❑ ❑ 41 TRLR TRLR VIN# YIN#i 42 22 VEH.YEAR MAKE I MODEL STYLE I VEHICLE TO DUET SABLIN TOWED BY GOVT.VEHICLE DAMAGE YES NO YES NO 23 REGISTERED OWNER INFO_ SHADE IN DAMAGED AREA 43 3 4 71 LIABILITY INSURANCE INSURANCE CO ' VINE EFFECT &POLICY# i 970P - 4 E:l 44 24 LEwcLE YES❑ NO❑ CITATION# CHARGE iq 60TiOM LEGALLv STANDING 8 7 6 1 CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT. ROBIN SMITH 05-29-25 08:59 PM 25 INVESTIGATING OFFICER'S SIGNATURE OFFICER'S PHONE UNIT OR DIST DET DATED: PLACE SIGNED APPROVED BY DATE 26 OR ID# 12986 O#IL WA0171300 TIBEAU 6/9/2025 PAGE F OF 3000-345-013(R 11118) REPORT NO. EF98953 CASE# ' 25-4694 DATE AND TIME 05/29/25 19:02 OF COLLISION c` 0 � tr 5 PAGE 5 OF 5