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Home My WebLink About25-4797 IT si " II IIIII III IIIII II IIII IIIII I . 27c REPORT NO EF98094OLCERA COLLISION REPORT 1591971 CASE�# 25-4797 2 INTERSTATE CITY STREET FIRE ❑RESULTED 1 STOLEN STATE ROUTE ❑ OTHER ❑ VEHICLE ❑ LOCAL A`GENC'Y 4200 3 COUNTY RD INVOLVED CODING PRIVATE WAY TOTAL 1 2❑ TRIBAL UNITS#OF 02 SO BJECT TRUCK 1 8 28 RESERVATION 2 3� M M D D Y Y Y Y TIME(2400) COUNTY# MILES CITY# DATE OF'. N E coulsloN' 06 - 02 - 2025 0805 17 =.= S 8 W E IN OF M 1070 a 4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION �✓ NON INTERSECTION ❑ BLOCK NO. e .� 4a NE 4TH ST MILE POST ❑ ❑ DISTANCE OF(REFERENCE OR CROSS STREET) 5 . FEET S 8 W e DUVALL AVE NE 0 1 29 MOTOR PEDAL- DAM AG THRESHOLD MET PHONE UNIT 01 VEHICLE ❑ CYCLE ❑ YEs Vl No D:3608506711 0 3 30 6 LAST NAME MONTANA FIRST NAME BRANDON MIDDLE J 1 1 2 31 INITIAL STREET ❑ 1500 LYLE AVE CITY BREMERTON WA NEW ADDRESS ST ZIP' 983122112 2 7 CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3 INTERLOCKYES NO INTERLOCKYES NO YES No 8 I LICENSEDRIVER' STATE WA SEX M MMOS. 11 — 17 — 1972 1 2 32 ❑ 9 ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 HELM USEETj INJURY CLASS 1 NATURE of INJURIES 2 10 LICENSE BSB9798 STATE WA VIN# 5N1AN08U46C537311 3 11[-j- TRAILER STATE TRAILER ,STATE ROM TO 11 3 5 PLATE# PLATE# TRLR TRLR 7 3 33 12 3 5 VIN# vI. ( FROM TO VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWEDBY GOVT VEHICLE 13 4 2006 N/SS XTERRA DAMAGE YES DNO ✓ YEs❑ No 7 5 34 REGISTERED OWNER INFO DANIEL PACUT 1500 LYLE AVE BREMERTON WA 98312 VEHICLE NO. 1 ❑ SHADE IN DAMAGED AREA 35 3 14 LIABILITY INSURANCE INSURANCE CO STATE FARM 4625501-F10-47 4 IN EFFECT &POLICY# 4TOP _ YEs IALLNG ❑NO CITATION#❑ 5A0512659 CHARGE FOLLOW VEHICLE TOO CLOSELY B o ooTrob 36 15 STM MOTOR PEDAL- PROPERTY DAM THR OLD MET PHONE UNIT 02 Q ❑ PEDESTRIAN ❑ D:2067152471 VEHICLE CYCLE (7WNFR YES NO 16� LAST NAME TUMBER FIRST NAME KAMALJIT MIDDLE $ INITIAL 37 STREET ❑ 17 '❑ 6209 NE 1ST ST CITY RENTON ST, WA ZIP 980598592 NEW AbORESS 18❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDIGALTRANSPORTED. 38 INTERLOCK YEs No INTERLOCK YES No Yes NO i 19 DRIVER'S STATE WA SEXI M D.0.8. 09 19 1978 39 LICENSE# MMDDYY — HELMET INJURY NATURE OF INJURIES 40 20❑ ON DUTY❑ STATUS' AIRBAG 2 RESTR 4 EJECT 1 USE CLASS 1 ❑ 21 LICENLATE SE C53998V TATE WA VIN# 1GT49REY6LF345237 41 22❑ PLATE# STATE PAAILER TE# STATE ❑ 42 23 TRLR kRLR 43 UIN#. 'IN#. VEH.YEAR 2Q2Q MAKE GNjC MODEL SIERRA STYLE VEHICLE TOWED TO BLIN TOWED BY GOV HI 44 24 DAMAGE YES NO YES NO REGISTERED OWNER INFO OWNEDBYDRIVER VEHICLE NO.2 SHADE IN DAMAGED AREA 2 3 4 LIABILITY INSURANCE INSURANCE CO TRAVELERS 6164263512031 IN EFFECT &POLICY# t 9TOP Ve — ,lALLr ❑ N,.I—I CITATION# CHARGE tO BOTTOM `.L J 25 YES a OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY 26 C.ARNOLD 12509 WA0171300 PAGE 01 OF PART A 3000-345-159(R 11/18) POLIICFETRAFFICN CORRECTION REPORT NO. EF98094 COLLISION REPORT III III III III III 111 1591972 CASE# 25-4797 ADDITIONAL PERSONS INVOLVED(PASSENGERS AND/OR WITNESSES ONLY) 'NAME (LAST,FIRST MIDDLE INTTIAL) ADDRESS&PHONE# SEX' D.O.B. - [----------� MMDDYYYY PASSENGER F-1 WITNESS Ej UNIT# SEAT AIRBAG RESTR. EJECT HELMET INJURY NATURE OF INJURIES--� POS. USE CLASS 'NAME (LAST FIRS,MIDDLE INITIAL) ADDRESS&PHONE# SEX' D.O.B. - L----------� MMDDYYYY PASSENGER DWITNESSD UNIT# SEAT AIRBAG RESTR. EJECT HELMET NJURY NATURE OF INJURIES POS. : USE CLASS ----� '.NAME (LAST,FIRST,MIDDLE INITIAL) ADDRESS&PHONE# SEX D.O.B. - L----------� MMDDYYYY PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET INJURY NATURE OF INJURIES ❑ Q POS. USE CLASS �____ ----j 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 06-02-25 09:58 AM INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST.DET DATED PLACE SIGNED APPROVED BY DATE 6/5/2025 3:05:46 PM C.JACOBS 1953 BADGE OR ID# 12509 ORI# ( WA0171300 TIME POLICE DISPATCHED'; 9:07 AM TIME POLICE ARRIVED 9:20 AM PART B 3 Do-3mx-,ao(Burls) PAGE 27 OF 47 EAN REPORT No.` EF98094 CASE# 25-4797 O OF COLLI COLLISION TIME 06/02/25 09:05 COLLI NARRATIVE CC 25-4797 On 6/2/2025 at 0907 hours I was dispatched to a motor vehicle collision at the 4700 block of NE 4th St in the City of Renton, King County, Washington. Pre-Collision Driver 2 stated that he was traveling East on NE 4th St in the #1 lane approaching his workplace at 4735 NE 4th St. Driver 1 stated that he was traveling East on NE 4th St in the #1 lane behind Unit 2. Collision Driver 2 stated that as he began to turn right to proceed South in the parking of of 4735 NE 4th St, the front passenger side bumper of Unit 1 collided with the rear drivers side bumper and tailgate of Unit 2. Driver 1 stated that as he was passing the 4700 block, he looked up and did not have time to stop to avoid a collision. Driver 1 stated that the front passenger side bumper of Unit 1 collided with the rear drivers side bumper and tailgate of Unit 2. Injuries No injuries reported. Vehicle Disposition Both vehicles were operational. Proximate Cause I determined that Driver 1 is the proximate cause of this collision because the driver of a motor vehicle shall not follow another vehicle more closely than is reasonable and prudent, having due regard for the speed of such vehicles and the traffic upon and the condition of the highway. Driver 1 was cited per RCW 46.61.145 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 09:50 on 6/2/2025 in the City of Renton, King County, Washington. PAGE 3 OF 4 REPORT NO. EF98094 CASE# 25-4797 DATE AND TIME i 06/02/25 09:05 OF COLLISION VALL AVE NE,f t { 1 t 4 n, t � t t� �`ar t€• , r Q i"S"•, `�c,t Ttt� �44 � tts�li tY ry � u PAGE 4 OF 4