HomeMy WebLinkAbout25-4826 OLICETRAFFIC II I III I III I I III I I IIII III III REPORT NO. EGO0205 0 5 27
j COLLISION REPORT 1591971
CASE# 25-4826 2
INTERSTATE CITY STREET FIRE ❑
RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VEHICLE ❑ LOL`CO A`OENCY. 4100 3
COUNTY RD NVOLVED CODING
2❑ TOTAL 1
PRIVATE WAY
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 IN coulsloN' 06 - 04 - 2025 1201 17 =.= S 8 W e OF M 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION Z NON INTERSECTION ❑
BLOCK NO. e .�
4a
N 2ND ST MILE POST
❑
❑ DISTANCE OF(REFERENCE OR CROSS STREET)
5 C------�.� FEET H S 8 W e WELLSALYN
0 1 29
MOTOR PEDAL- DAMAG THRESHOLD MET PHON
UNIT 01 E
VEHICLE ❑ CYCLE' ❑ YES NO �/ D:9168329675 0 1 30
5 LAST NAME BADIOLA FIRST NAME NOEL MIDDLE A 1 1 2 31
INITIAL
STREET ❑ 814 N 2ND ST APT B CITY RENTON ST WA ZIP 980575627 2
NEW ADDRESS
7 CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED. 3
INTERLOCKYES NO INTERLOCKYES Na YES R NO
8 LCEENSE# STATE WA SEX M MMOCSYY' 08 1 2 32
9 ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 N USEET INJURY
CLASS 1 NAruRE of INJURIES 2
LICENSE, CCK9772 STATE WA VN# JT8BF28G810303208 3
10[9� PI ATF#
11[—j— TRAILER STATE TRAILER ,STATE
11 2 5 PLATE# PLATE# FROM TO
TRLR TRLR 5 1 33
12 2 5 VIN# VIN
FROM TO
VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWEDBY GOVT VEHICLE
13 7 2001 LEXS ES DAMAGE YES NO YES❑ NO 7 3 34
REGISTERED OWNER INFO SUSAN ALMACHAR 542957TH AVE S SEATTLEWA98118 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
14 LIABILITY INSURANCE NSURANCE CO AMERICAN FAMILY CONNECT PROP.A104171225 3 4
IN EFFECT &POLICY# 4TOP _
srgNOLNGVEHICLE
❑ CITATION# 5A0512671 CHARGE FLO TO YIELD FROM DRIVEWAY OR B o ooTrofi 36
Yes NO
15
MOTOR PEDAL- PROPERTY DAM THR OLD MET PHONE
UNIT 02 Q ❑ PEDESTRIAN ❑ D:2065384508
VEHICLE CYCLE nWNFR YES NO
16�
LAST NAME SOLANO NUNEZ FIRST NAME KATHIA MIDDLE M
INITIAL
37
17 STREET'❑ 251 WEL ❑LS AVE N CITY RENTON ST, WA ZIP 980575612
NEW ADDRESS
18❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDIGALTRANSPORTED 38
INTERLOCKYEs NO INTERLOCKYES NO Yes NO
19 DRIVER'S STATE WA SEX F I D.O.e, 07 21 1996 39
LICENSE# MMDDYY —
HELMET INJURY NATURE OF INJURIES 4Q
20❑ ON DUTY STATUS' AIRBAG 2 RESTR 4 EJECT 1 7 ❑
USE CLASS COMPLAINT OF BACK PAIN
21 LICENSEBFP7405 TATE WA vIN# 3N1BC1CP4BL517583 41
PLATE#
22❑ STATE TILER PATE# STATE ❑ 42
PLATE#
23 TRLR kRLR 43
UIN#. 'IN#.
VEH.YEAR 2011 MAKE pJJ$$ MODEL VERSA STYLE VEHICLE TOWED TO BLIN
TOWED BY GOV HI 44
24 DAMAGE YES NO YES NO
REGISTERED OWNER INFO OWNEDBYORIVER VEHICLE NO.2
SHADE IN DAGED AREA
2 4
LIABILITY INSURANCE INSURANCECO STATE FARM 3805589-CO9.47B
IN EFFECT &POLICY# 9TOP
vewaE ❑ CITATION11 CHARGE tO BOTTOM
LEGn,v YES N J
25 s 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. EGO0205
COLLISION REPORT III III III III III 111
1591972 CASE# 25-4826
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 06-04-25 01:46 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST.DET DATED PLACE SIGNED
APPROVED BY DATE
C.JACOBS 1953 6/12/2025 3:04:51 PM
BADGE OR ID# 12509 ORI# ( WA0171300 TIME POLICE DISPATCHED'; 12:04 PM TIME POLICE ARRIVED 12:15 PM
PART B 3 Do-3mx-,ao(Burls) PAGE 27 OF 47
REPORT NO.` EGO0205 CASE# 25-4826 O COLLI COLLISION TIME
OF 06/04/25 12:01
COLLI
NARRATIVE
CC 25-4862
On 6/4/2025 at 1204 hours I was dispatched to a motor vehicle collision at the intersection of Wells
Aly N and N 2nd St in the City of Renton, King County, Washington.
Pre-Collision
Driver 2 stated that she was traveling East on N 2nd St approaching the intersection of Wells Aly N
and N 2nd St in the #1 lane.
Driver 1 stated that he was traveling North on Wells Aly N approaching N 2nd St.
Collision
Driver 2 stated that Unit 1 exited Wells Aly N in front of her and she was unable to stop or slow to
avoid a collision. Driver 2 stated that the front bumper of Unit 1 collided with the rear passenger side
door of Unit 2.
Driver 1 stated that he exited Wells Aly N into N 2nd St and did not see Unit 2. Driver 1 stated that the
front bumper of Unit 1 collided with the rear passenger side door of Unit 2.
Injuries
Driver 2 complained of back pain but refused treatment by Renton Fire Authority. Driver 2 stated that
she would self transport to an urgent care.
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 vehicle
within a business or residence district emerging from an alley, driveway or building shall stop such
vehicle immediately prior to driving onto a sidewalk or onto the sidewalk area extending across any
alleyway or driveway, and shall yield the right-of-way to any pedestrian or personal delivery device as
may be necessary to avoid collision, and upon entering the roadway shall yield the right-of-way to all
vehicles approaching on said roadway.
Driver 1 was cited per RCW 46.61.365.
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 13:25 on 6/4/2025 in the City of Renton, King
County, Washington.
PAGE 3 OF 4
REPORT NO. EGO0205 CASE# 25-4826 DATE AND TIME i 06/04/25 12:01
OF COLLISION
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