HomeMy WebLinkAbout25-4714 j ITFC II IIIII III IIIII II IIII IIIII I . 27I
OOLCERAF EF98095
COLLISION REPRT 1591971
CASE# 25-4714 2
INTERSTATE CITY STREET FIRE ❑
RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VEHICLE ❑ LOCAL AGENCY 4100 3
COUNTY RD NVOLVED COWING
PRIVATE WAY
2❑ TRIBAL TOTAL 1
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
COLL.ISION'. 05 - 30 - 2025 1333 17 =.= S 8 W E IN OF M 1070 a
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION �✓ NON INTERSECTION ❑
BLOCK NO.
LOGAN AVE N
4a❑ MILE POST
❑ DISTANCE OF(REFERENCE OR CROSS STREET)
5 �. FEET e S 8 W e N 3RD ST
0 4 29
MOTtlR PEDAL- DAM AG THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE ❑ YEs Vl No D:2536938165 0 1 30
5 LAST NAME WORKMAN FIRST NAME BONITA MIDDLE R 1 1 2 31
INITIAL
STREET ❑ 19614 19TH ST CT KPS CITY LAKEBAY ST WA ZIP 983499841 2
NEW ADDRESS
7 CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED: 3
INTERLOCK YES No INTERLOCKYEs NO YES NO
8 DRIVECEN STATE WA SEX F MMDr YY' 05 — 02 — 1963 1 2 32
9 ON DUTY STATUS AIRBAG 6 RESTR 4 EJECT 1 H EET ASS 1 NAruRE of INJURIES 2
10 LI ENSE'ti�, BGN8569 STATE WA VN# 1C3CDFBA4DD148942 3
TRAILER STATE TRAILER ..STATE
11 3 5 PLATE# PLATE# FROM TO
TRLR TRLR 1 3 33
1 3 5 VIN# vN#
( FROM TO
2
VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN GOVT VEHICLE g 1 34
13 4 2013 DODG DART DAMAGE ves ✓ TO {� RS YE No
REGISTERED OWNER INFO MARIA STAROSTANKO 4722215TH STREET CT E SPANAWAY WA 98387 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
14❑ LIABILITY INSURANCE NSURANCE CO USAA 013662084-7102
IN EFFECT &POLICY#VEHICLE
9TOP _
srgNOLNG ❑NO❑ 5A0512658 CHARGE FAIL YIELD LEFT TURN MOTOR s o¢oTrob 36
YES CITATION#
15
III MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT VEHICLE CYCLE nWNFR YES 1/ NO D:2068613699
16�
LAST NAME MARTINEZ FIRST NAME MARK MIDDLE A
INITIAL
17 STREET'❑ ❑1412 SW 312TH ST APT D6 CITY FEDERAL WAY ST, WA ZIP 37
NEW ADDRESS
18❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICALTRANSPORTED ❑ 38
INTERLOCKYEs No INTERLOCKYES No ves No
19 DRIVER'S STATE WA SEX M E.O.B. 06 21 1981 ❑ 39
LICENSE# MMD[7YY -
HELMET INJURY' NATURE OF INJURIES 40
20❑ ON DUTY STATUS' AIRBAG 3 RESTR 4 EJECT 1 USE CLASS 1 ❑
21 PLATE# US192V rare NV vIN# 1 GTP9EEL3NZ178637 41
22❑ PLATE# STATE PATE# STATE ❑ 42
23 TRLR kRLR 43
UIN#. 'IN#.
TOWED BY GOV HI 44
VEH.YEAR 2Q22 MAKE GMT' MODEL SIERRA STYLE AMA NO
TOWED No BLIN BANKERS YES No�/
24
REGISTERED OWNER INFO OWNED BY DRIVER VEHICLE NO.2
SHADE IN DAMAGED AREA
2 3 4
LIABILITY INSURANCE INSURANCECO GEICO SECURE INSURANCE COMPANY 6125663549
IN EFFECT &POLICY#vewaE ❑ .I—I CITATION# CHARGE C�Ql
LEcnLLY YES N`.LJ
2rJ 8 6
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. EF98095
COLLISION REPORT III III III III III 111
1591972 CASE# 25-4714
ADDITIONAL PERSONS INVOLVED(PASSENGERS AND/OR WITNESSES ONLY)
NAME MIDDLE INITIAL} STAROSTANKO MAR/A
(LAST,FIRST
ADDRESS&PHONE# DOB
4722 215TH STREET CT E SPANAWAY WA 983876018 2533062450 SEX' F MMDDYYYY 04 - 18 1- 1991
SEAT HELMET INJURY NATURE STOMACH INJURIES
PASSENGER WITNESS UNIT# 1 SEA 3 AIRBAG;6 RESTR. 4 EJECT 1 USE CLASS 7 NATURE PAIWCUTS ONARZM
'NAME
LAsr F RST,MIDDLE INITIAL) GOOD-STAROSTANKO PENELOPE R
ADDRESS&PHONE# D C,B
4722 215TH STREET CT E SPANAWAY WA 98387 SEX' F MMDovVYv 12 _ 31 _ 2024
SEAT HELMET NJURY NATURE OF INJURIES
PASSENGER WITNESSEj
UNIT# i 1 POS. 9 AIRBAG 6 RESTR. 4 EJECT 1 USE CLASS 1
NAME MIDDLE INITIAL) BOETTCHER NOAH P
',(LAST,FIRST,
AOQREss&PHONE# 27447124TH PL SE KENT WA 98030 2066362225 SEX' M18 _ 2002
MMDDYYYY
PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET INJURY NATURE OF INJURIES
❑ Q 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.
C.ARNOLD 05-30-25 02:44 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST.DET DATED PLACE SIGNED
APPROVED BY DATE
6/5/2025 3:11:18 PM
C.JACOBS 1953
BADGE OR ID# 12509 ORI# ( WA0171300 TIME POLICE DISPATCHED'; 1:34 pry TIME POLICE ARRIVED 1:38 PM
PART B 3 Do-3mx-,ao(Burls) PAGE 27 OF 47
EAN
REPORT NO.` EF98095 CASE# 25-4714 O OF COLLI COLLISION TIME 05/30/25 13:33
COLLI
NARRATIVE
CC 25-4714
On 5/30/2025 at 1334 hours I was dispatched to a motor vehicle collision at the intersection of Logan
Ave N and N 3rd St in the City of Renton, King County, Washington.
Pre-Collision
Driver 2 stated that he was traveling North on Logan Ave N in the #2 lane approaching N 3rd St.
Driver 1 stated that she was in the lefthand turn lane on Southbound Logan Ave N preparing to
perform a lefthand turn.
Collision
Driver 2 stated that as he entered the intersection, Unit 1 began its lefthand turn and he was unable
to slow or stop to avoid a collision. Driver 1 stated that the front bumper of Unit 2 collided with the rear
wheel and rear door of Unit 1.
Driver 1 stated that she miscalculated her turn and thought that she had more time. Driver 2 stated
that as she began her turn, the front bumper of Unit 2 collided with the rear passenger side door and
wheel of Unit 1.
Injuries
Passenger 1 reported minor injuries of stomach pain from a prior cesarian operation and had minor
scrapes and cuts on her right arm.
Vehicle Disposition
Both vehicles were towed from the scene.
Proximate Cause
I determined that Driver 1 is the proximate cause of this collision because the driver of a vehicle
intending to turn to the left within an intersection or into an alley, private road, or driveway shall yield
the right-of-way to any vehicle approaching from the opposite direction which is within the intersection
or so close thereto as to constitute an immediate hazard.
Driver 1 was cited per RCW 46.61.185
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 14:35 on 5/30/2025 in the City of Renton, King
County, Washington.
PAGE 3 OF 4
REPORT NO. EF98095 CASE# 25-4714 DATE AND TIME i 05/30/25 13:33
OF COLLISION
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