HomeMy WebLinkAbout25-5089 IT si " II IIIII III IIIII II IIII IIIII I . 27c REPORT NO EG00324OLCERA
COLLISION REPORT 1591971
CASE�# 25-5089 2
INTERSTATE CITY STREET FIRE ❑RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VEHICLE ❑ LOCAL AGENCY 4150 3
COUNTY RD NVOLVED CODING
PRIVATE WAY
2❑ BJECT 1
TRIBAL UNITS#OF 02 TOTAL TRUCK 1 7 28
RESERVATION 2
3� M M D D Y Y Y Y TIME(2400) COUNTY# MILES CITY#
DATE OF'. N E
COLLISION' 06 - 10 - 2025 1845 17 =.= S 8 W E IN OF M 1070 a
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION �✓ NON INTERSECTION ❑
LIND AVE SW BLOCK NO. e 1900 .�
4a❑ MILE POST
❑ DISTANCE OF(REFERENCE OR CROSS STREET)
5 �. FEET S 8 W e SW 19TH ST
0 1 29
PEDAL- DAMAG THRESHOLD MET E
UNIT 01 VEHICLEMOTtlR PHON
❑ CYCLE' ❑ YES NO ✓ O 1 30
5 LAST NAME BURLAKOVA FIRST NAME ANASTASIA MIDDLE 1 1 2 31
INITIAL
STREET ❑ 10930 SE 172ND ST APT J306 CITY RENTON ST WA ZIP 98055 2
NEW ADDRESS
7 CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED: 3
INTERLOCKYEs NOW INTERLOCKYEs NO�/ YES D NO�
8❑ DRIVER'CENS # STATE WA SEx F MMor YY' 10 — 20 — 1999 1 2 32
9 ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 HELMET 2 INJURY 6 NATURE of INJURIES2
USE CLASS COMPLAINT OF HEAD AND LEG PAIN
LICENSE CJL8064 STATE WA VIN# 1HGCY2F69RA000102 3
10 PI ATP rt'
TRAILER STATE TRAILER ..STATE
11 3 5 PLATE# PLATE# ROM TO
TRLR TRLR 7 3 33
1 0 0 VIN# VIN
( FROM TO
2
VER YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED By GOVT VEHICLE
13 $ 2024 HOND ACCOR SD DAMAGE YES NO ✓ YEs❑ No 5 1 34
REGISTERED OWNER INFO OWNEDBYDRIVER VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
3 4
14❑ LIABILITY INSURANCE NSURANCE CO PROGRESSIVE 975971050
IN EFFECT &POLICY# 4TOP
VEHICLE CHARGE 5 36
ec LnLLY YES❑NO❑ CITATION# 7 o BOTTOM
15❑ sTANowc 7 e
UNIT 02 MOTOR PEDAL ❑ PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
1 VEHICLE CYCLE. nWNFR YES NO
16�
LAST NAME UNKNOWN FIRST NAME MIDDLE'
INITIAL
17❑ STREET ❑ CITY RENTON ST ZIP 4❑ 37
NEW ADDRESS
—
IGNITION❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 38
INTERLOCKYES NO INTERLOCK YES NO YEs NO
19 LICIENSE# STATE SEX U MMDDYY' 3❑ 39
HELMET INJURY' NATURE OF INJURIES 40
20❑ ON DUTY STATUS' AIRBAG g RESTR g EJECT 1 USE 9 CLASS 0 ❑
ATE# rarE vIN
21 LICENSE P # 41
22❑ [TILER TRAILER
PLATE# STATE PATE# STATE ❑ 42
23 TRLR kRLR 43
UIN#. 'IN#.
VEH.YEAR MAKE MODEL STYLE VN VEHICLE TOWED TO BLIN
TOWED BY GOV HI 44
24 DAMAGE YES NO YES NO
REGISTERED OWNER INFO UNKNOWN RENTON VEHICLE NO,2
SHADE IN DAMAGED AREA
2 3 4
LIABILITY INSURANCE❑ INSURANCE CO
IN EFFECT &POLICY# 9TOP
vewaE ❑ ,.I—I CITATION# CHARGE tO BOTTOM
LEGA��Y YES N`LJ
25 a a
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
26
JEREMY ENGEL 13006 WA0171300
PAGE 01 OF
PART A 3000-345-159(R 11/18)
POLIICFETRAFFICN CORRECTION REPORT NO. EGO0324
COLLISION REPORT III III III III III 111
1591972 CASE# 25-5089
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.
JEREMY ENGEL 06-11-25 01:06 AM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST.DET DATED PLACE SIGNED
APPROVED BY DATE
QUINT TIBEAU 7691 1 6/12/2025 8:41:55 PM
BADGE OR ID# 13006 ORI# ( WA0171300 TIME POLICE DISPATCHED'; 8:03 PM TIME POLICE ARRIVED 8:32 Pm
PART B 3 Do-3mx-,ao(Rtrras) PAGE 27 OF 47
REPORT NO.` EGO0324 CASE# 25-5089 O COLLI COLLISION TIME
OF 06/10/25 19:45
COLLI
NARRATIVE
RTF
25-5089
This incident was captured on my body worn video camera. This report is a summary of events that
occurred and is not an exact sequencing of events. Statements have been paraphrased and
summarized.
On 06/10/2025 at approximately 2003 hours I was dispatched to a hit and run collision report by
phone. The collision had occurred at the intersection of Lind Ave SW and SW 19th St, City of Renton,
County of King, Washington.
I contacted the victim, Anastasia Burlakova (10/20/1993), by phone. Burlakova speaks Ukrainian so
her friend Parminderpreet K. Sohi translated for her.
Burlakova stated she was traveling eastbound on SW 19th St in a 2024 Honda Accord bearing
WA/CJL8064 (Unit#2). She was proceeding through a green light crossing over Lind Ave SW. While
passing through the intersection a white minivan (Unit#1), which she stated was either a Honda
Odyssey or a Chrysler Pacifica, was traveling northbound on Lind Ave SW and ran a red-light
crossing SW 19th St. Burlakova swerved to avoid a collision with the minivan. While swerving, the
front driver's side of Unit#2 collided with the rear driver's side of Unit#1.
Burlakova pulled off the roadway and stated Unit#1 proceeded northbound and did not stop to
exchange information.
Burlakova complained of pain in her head and left leg. She was evaluated by Renton Regional Fire
Authority and cleared from the scene. She stated she may go to the hospital at a later time if she
needed to.
I determined Unit#1 to be the proximate cause for the cause of collision due to Entering an
Intersection against a Steady Red Circle (RCW 46.61.055(3A)).
Unit#1 (Unidentified) committed one (1) count of Hit-and-Run -Attended by being involved in an
accident with another vehicle, which is attended, and failing to stop and remain at the scene until
fulfilling all statutory duties (provide name, address, insurance company, policy, vehicle license,
exhibit driver's license and render reasonable assistance to any person injured).
There is no suspect information at this time.
I certify (or declare) under penalty of perjury under the laws of the State of Washington that the
foregoing is true and correct.
Electronically signed by Officer J. Engel #13006 6/11/2025 12:59 AM Renton, King County, WA.
PAGE 3 OF 4
REPORT NO. EGO0324 CASE# 25-5089 DATE AND TIME i 06/10/25 19:45
OF COLLISION
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