HomeMy WebLinkAbout25-4104 CE TRAFFicNREPORT NO. EF99994 5 127
COLL' ,®N REP'(�F 1591971
("7—
STATE CASE 25-4104 2
INTERSTATE CITY STREET FIRE ❑
RESULTED
1 1 STATE ROUTE OTHER STOLEN
vEwcLE ❑ LOCALAGENC, 4100 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 TRIBAL UN TS#OF 02 STRUCK' 1 8 2$
RESERVATION: 2
3 M M D D Y Y Y Y TIME(2400) COUNTY# MILES CITY#
goislon 05 - 09 - 2025 1757 17 =.= S e W e OF 8 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓
TALBOT RD S BLOCK NO. 8✓ 800 .�
4a❑ MILEPOST
❑ DISTANCE OF(REFERENCE OR CROSS STREET)
6 1000 .� FEET e✓ S e W 8 S GRADYWAY
0 3 29
MOTOR PEDAL- DAM ETHRESHOLD MET PHONE
UNIT 01 VEHICLE CYCLE' YEs No ,/ D:2064739342 30
6 LAST NAME TUBLE FIRST NAME RENATO MIDDLE C 1 2 31
INITIAL
STREET [:] 7724 52ND AVE S CITY SEATTLE WA
NEW ADDRESS ST ZIP 98118 2
]❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED. 3
1NTERLOCKYEs No Z/ INTERLOCKYES No�/ YES No,/
8❑ LDRIV # STATE WA SEX'M MMDDYY 05 - 06 - 1944 I 32
9 ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 H USE T INJCLA RSY 1 NATURE OF INJURIES 2
�Pi ATF A' 691062V STAT] WA VIN# JT4VN13G7M5052028 3
10 9❑
11 ILER 2 5 PLATE# STATE PLATE# STATE ROM TO
RA TRLR. TRLR: 3 1 33
12� VIN# VIN#
FROM TO
❑ VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED ✓TO BLIN TOWED BY GOVT. NO
13 2 1991 TOYT PICKUP PK DAMAGE YES NO YES NO 5 35
1 34
REGISTERED OWNER INFO OWNEDSYDRIVER VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA
A INSURANCE CO 2 3 4
14❑ LIABILITY INSURANCE� ALLSTATE JT4VN13G7M5052028
IN EFFECT &POLICY# t to BOTTOM 9TOF $
VtC�L ❑ 36
I LLY YES[:]NO❑ CITATION#
w CHARGE
15
sTANo NG 8 7 6
MOTOR ` PEDAL PROPERTY DAM THR OLD MET PHONE
UN I T 02 VEHICLE E] CYCLE PEDESTRIAN' ❑ OWNER YES,/ No D:3603203444
16F1
LAST NAME BLUNK FIRST NAME CHELSEA MIDDLE' A
INITIAL
17❑ STREET 756 140TH AVE SE,BELLEVUE WA CITY BELLEVUE ST WA ZIP 98005 ❑ 37
NEW ADDRESS
18� IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 38
CDL INTERLOCK YES NOF INTERLOCK YES Nb YES R NO
19[ DRIVER'Si STATE WA SEX F D.O.B. 12 16 1985 39
LICENSE# MMDDYY -
20 ON DUTY URE
STATUS 3 AIRBAG RESTR EJECT HEM EE7 INJURY 6 [NATURE 01 KNEE PAIN,SUPERFICIAL ABRASIONS ON LEG ❑ 40
21❑ PLATES# TATE vIN# ❑ 41
❑ 42
22❑ PLATE# STATE PLATE#ILER TRAILER STATE
23 43
TRCR RLft
UIN#. IN#
VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN
TOWED BY GO HI 44
24 1 ] DAMAGE YES NO YES NO
REGISTERED OWNER INFO VEHICLE NO.2
SHADE IN DAMAGED AREA
3 4
LIABILITY INSURANCE INSURANCE CO
IN EFFECT &POLICY# i 4TOP 5
Veer ' ❑ .1-1 CITATION# CHARGE tOBOTTOM
�EGALLY YES N J
25 a e
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
26
ISABELLA DANILYUK 13001 WA0171300
PARTA3000-345-159 rR 11/1M PAGE 01 OF
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EF99994
COLLISION REPORT III III III III III 111
1591972 CASE# 25-4104
E NA ADDITIONAL PERSONS INVOLVED(PASSENGERS AND/OR WITNESSES ONLY)
M
(LAST,FIRST,MIDDLE INITIAL) TUBLE ERLINDA B
ADDRESS&PHONE#
7724 52ND AVE S SEATTLE WA 98118 SEXi F MMDDD BYYY 02 — 18 — 1942
PASSENGER WITNESS UNIT# SEAT ' AIRBAG RESTR. EJECT HELMET INJURY NATURE OF INJURIES
z 1 POS. 3 2 4 1 USE CLASS i 1 ----�
:NAME
(LAST FIRST MIDDLE INITIAL)
ADDRESS R 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
❑ ❑ 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.
ISABELLA DANILYUK 05-10-25 05:00 AM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST.DET DATED PLAGE SIGNED
APPROVED BY DATE
QUINT TIBEAU 7691 1 6/12/2025 3:36:51 AM
BADGE OR ID# j 13001 ORI# WA0171300 TIME POLICE DISPATCHED 1 5:58 PM TIME POLICE ARRIVED i 6:00 PM
PART B 30e0-345.160(R1Vt8) PAGE 0 OF 47
E AND
REPORT NO.i EF99994 CASE# 25-4104 OF C COLLISION
05/09/25 17:57
OF ca�.�isiaN
NARRATIVE
25-4104
On 05/09/2025 at approximately 1757 hours I was dispatched to an accident with injury, vehicle vs
pedestrian, just north of the intersection of Talbot Rd S and S Grady Way in the City of Renton,
County of King, and the State of Washington.
Upon arrival on scene, I saw a female subject, conscious and sitting up with her legs extended in
front of her. She was at the entry way into the Chevron located at 800 S Grady Way.
Next to the female pedestrian, later identified as BLUNK, CHELSEA ANN (DOB 12-16-1985) via her
WA DOL, was a vehicle that was positioned to the south of Blunk and parked in a manner indicating it
was attempting to turn northbound on Talbot Rd S.
Renton Fire Department and an ambulance were requested on scene immediately as dispatch
created the call. Renton Fire Department came on scene shortly after PD and spoke to Blunk about
her injuries.
The vehicle was a 1991 maroon Toyota Pickup bearing the license plate of (B91062V). The driver
was also the registered owner and identified himself as TUBLE, RENATO C (DOB 05-06-1944) via
WA DOL. The front passenger in his vehicle was his wife, identified as TUBLE, ERLINDA BONCATO
(DOB 02-18-1942) also verified via WA DOL.
While Renton Fire Department was further examining Blunk's injuries, Tuble agreed to leave me a
recorded statement.
Tuble stated he was driving out of the Chevron at 800 S Grady Way and turning northbound onto
Talbot Rd S. He stated he did not see Blunk walking and struck her with the passenger side of his
vehicle. He explained due to the stop he could not have been driving above 3 or 5 miles and hour.
Tuble and his wife, who was the passenger inside the vehicle, denied needing to get checked for
injuries by the Renton Fire Department. Pictures of the vehicle were taken and as the vehicle
sustained no damages, Tuble and his wife left the scene shortly after.
I spoke to Blunk who explained she was walking northbound on Talbot Rd S, crossing the Chevron
entrance and was struck by the vehicle in question. When I attempted to ask about the positioning of
the car and where she was in the crosswalk Blunk stated she is unsure. All she remembered was
falling and then having her foot getting caught under the tire of the vehicle right as she crossed the
intersection. She stated she didn't quite remember the sequence of events but just remembered her
foot getting caught and her being on the ground.
Due to the circumstance Renton Fire Department decided to get TriMed to transport BLUNK,
CHELSEA ANN (DOB 12-16-1985) to Valley Medical Center where she would be further examined
due to her injuries. I followed Blunk to Valley Medical where she filled out the Medical Release
paperwork. Blunk denied providing a statement and was provided with her case number.
Back at the Chevron located at 800 S Grady Way, I spoke to employees who stated their cameras
can possibly capture as far as the street however are unable to access them. I was provided with the
on site manager number and sent the provided number an AXON community request. Employees
stated the video, if captured, will be provided 05/12/2025.
This concludes my involvement with this case.
My involvement in this case was captured on my department-issued Axon body camera. This report is
a summary of events that occurred and is not an exact sequencing of events. Statements have been
paraphrased and summarized. At the time of this call, I was in a full police uniform equipped with a
Renton Police badge and police patches.
I certify under penalty of perjury under the laws of the State of Washington that the foregoing is true
and correct.
Electronically signed by Ofc. 1. Danilyuk #13001, 05/10/2025 at 0346 hours in Renton, Washington.
PAGE 3 OF 4
REPORT NO. E F99994 CASE# 25-4104 DATE AND TIME 05/09/25 17:57
OR COLLISION
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