HomeMy WebLinkAbout25-4932 IT si " II IIIII III IIIII II IIII IIIII I . 27c REPORT NO EG00529OLCERA
COLLISION REPORT 1591971
ASE# 25-4932 2
INTERSTATE CITY STREET FIRE ❑
RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VEHICLE ❑ LOCCO A`GENC'Y 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
coulsloN' 06 - 06 - 2025 2009 17 =.= S 8 W e IN OF M 1070 a
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION �✓ NON INTERSECTION ❑
BLOCK NO.
MAPLE VALLEY HWY
4a❑ MILE POST
❑ DISTANCE OF(REFERENCE OR CROSS STREET)
5 C------�. FEET H S 8 W e 131ST AVE SE
0 1 29
MOTtlR ✓ PEDAL- DAM AG THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE' ❑ YES ✓NO D:2069606592 0 4 30
5 LAST NAME FINOL FINOL FIRST NAME YOSMER MIDDLE J 1 1 2 31
INITIAL
STREET ❑ 211 SHATTUCK AVE S APT A5 CITY RENTON ST I WA ZIP 980572052 2
NEW ADDRESS
7 CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED. 3
INTERLOCKYES ✓No INTERLOCKYEs NO✓ YES D NO✓
8 DRIVE STATE WA SEX M MMOCSYY' 05 — 31 — 1987 1 2 32
9 ON DUTY STATUS AIRBAG 6 RESTR 4 EJECT, 1 HELMET 2 CLASS INJURY 6 —NATURE of INJURIES 2
USE PAIN IN BOTH KNEES AND COLLAR BONE
LICENSE', CNS0958 STATE WA VN# 1J8FF47WX7D156035 3
10 PI ATF#'
TRAILER STATE TRAILER ,STATE
11 4 5 PLATE# PLATE# FROM TO
TRLR TRLR 3 7 33
12 4 5 VN# VN#
( FROM TO
VER YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN 7 Y GOS VEHICLE 1 3 34
13 4 2007 JEEP COMPA 4D DAMAGE ves ✓ No � �MEYERS ves❑ No✓
REGISTERED OWNER INFO YOSMER FINOL FINOL 211 SHATTUCK AVE S APTA5 RENTONWA980572052 D:2069606592 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
LIABILITY INSURANCE❑ INSURANCE CO 2
14 ✓ PROGRESSIVE 989275978
IN EFFECT &POLICY# i 9TOP
VEHICLE CHARGE 36
Lemur yes[:]NO[:] CITATION# 7 0¢OTTOM
15❑ sTnNowc s
MOTOR PEDAL ❑ PHONE
UNIT PEDESTRIAN PROPERTY D:25 VEHICLECYCLE38805675 nWNFR
16�
LAST NAME ANDERSON FIRST NAME MARY MIDDLE L
INITIAL
17 F1 STREET ❑'❑ 511 SCENIC WAY CITY KENT ST, WA ZIP 37
980306020 4
NEW ADDRESS
18❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDIGALTRANSPORTEti: 38
INTERLOCKYEs NO✓ INTERLOCK YES No✓ vEs NO✓
19 DRIVER'S STATE WA SEX F D.O.B. 05 10 1951 39
LICENSE# MMDCIYY: -
20❑ ON DUTY STATUS AIRBAG 6 RESTR 4 EJECT 1 5 HELMET 2 INJURY NATURE OF INJURIES 40
USE CLASS BROKEN RIGHT WRIST AND UNKNOW OTHER
21 LICENS AND7964 rarE WA VIN# 5FNYG1H81RB035742 41
PLATE#22❑ PLATE# STATE PATE# STATE ❑ 42
23 TRLR kRLR 43
UIN#. 'IN#.
VEH.YEAR 2024 MAKE HOND MODEL PILOT EX STYLE 4p VEHICLE TOWED TO BLIN TOWED BY GOV HI 44
24 DAMAGE YE
s�/ No GENE MEYERS YES No✓
REGISTERED OWNER INFO MARY ANDERSON 511 SCENIC WAY KENT WA 980306020 D:2538805675 VEHICLE NO.2
SHADE IN DAMAGED AREA
2 3 4
LIABILITY INSURANCE INSURANCE CO ALLSTATE 817343698
IN EFFECT &POLICY# 9TOP
VeeicLe ❑ ,J—I CITATION# CHARGE to BOTTOM
LecnLLr YES N`[
25 OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# JAGENCY
26
KEVIN PETERSON 12808 WA0171300
PAGE 01 OF
PART A 3000-345-159(R 11/18)
POLIICFETRAFFICN CORRECTION REPORT NO. EGO0529
COLLISION REPORT III III III III III 111
1591972 CASE# 25-4932
ADDITIONAL PERSONS INVOLVED(PASSENGERS AND/OR WITNESSES ONLY)
NAME MIDDLE INITIAL} JEBAMONY JEBARSON V
(LAST,FIRST,
ADDRESS&PHONE# DOB
17821 SE 134TH ST RENTON WA 98059 5624126244 SEX' M MMDDYYYY 07 - 07 - 1982
PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET INJURY NATURE OF INJURIES
1:1 �' POS. USE CLASS ---�
'NAME
(LAST FIRS,MIDDLE INITIAL)
ADDRESS&PHONE#
S ' D.O
EX .B.MMDD -F L----------�
YYYY
EAT HELMETNJURY URE OF
PASSENGER ❑WITNESS UNIT# S AIRBAG RESTR. EJECT NAT INJURIESPOS. : USE CLASS ----�
'.NAME
(LAST,FIRST,MIDDLE INITIAL)
ADDRESS&PHONE#
SEX D.O.B. — L----------�
MMDDVVYY
PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET INJURY NATURE OF INJURIES
❑ Q' POS. USE CLASS r— ----�
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.
KEVIN PETERSON 06-07-25 02:07 AM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST.DET DATED PLACE SIGNED
APPROVED BY DATE
P.SUMMERS 8887 1 6/13/2025 2:14:51 PM
BADGE OR ID# 12808 ORI# ( WA0171300 TIME POLICE DISPATCHED'; 8:10 pry/ TIME POLICE ARRIVED 8:45 PM
PART B 3 Do-3mx-,ao(Rtrras) PAGE 27 OF 47
REPORT NO.` EGO0529 CASE# 25-4932 O COLLI COLLISION TIME
OF 06/06/25 20:09
COLLI
NARRATIVE
I was dispatched to a collision on 06/06/25 at 2010 hours at Maple Valley HWY and 131st Ave SE, in
city Renton, King County WA.
Unit 1 CNS0958 Driver: Yosmer J. Finol Finol (DOB 05/31/1987)
Unit 2 AND7964 Driver: Mary L. Anderson (DOB 05/10/1951)
Upon arriving I could see Unit 2 was stuck in her vehicle and the other unit was still in his vehicle. I
approached Unit 2, and she held up her right hand and told me her wrist was broken. I could see that
it was fully broken. Unit 2 told me that she was leaving Maple Wood Gold Course parking lot and was
waiting at the light to turn East onto Maple Valley HWY. She told me when the light turned green, she
started to go when suddenly Unit 1 drove through the intersection and smashed into her. She stated
that her light was green, and that Unit 2 was speeding.
I spoke to Unit 2, and he stated that he was traveling West on Maple Valley HWY in lane 1. When he
was approaching the intersection of Maple Valley HWY and 131st Ave SE he said that Unit 2 pulled
out in front of him, and he attempted to swerve to avoid hitting her but still collided with her. He said
that he was driving normal and that he had a green light, and she drove into the intersection.
Both drivers were seen on scene and medically transported to Valley Medical Center. Unit 1 had
complaints of pain in both knees and collar bone. Unit 2 had a broken right wrist and unknown other
injuries.
I spoke to a witness Jebarson V. Jebamony (DOB 07/07/1982) who said that he only pulled up to the
crash, but his car possibly had video he would share. I sent him a citizen link for the video to be
uploaded.
Both drivers were given an information exchange with the case number as reference. Pictures were
taken on scene and uploaded to evidence.
I certify (declare) under penalty of perjury under the laws of the State of Washington that the
foregoing is true and correct.
Electronically signed: Officer Kevin L. Peterson Date and Place: 06/07/2025, 0051 hours at Renton,
WA
PAGE 3 OF 4
REPORT NO. EGO0529 CASE# 25-4932 DATE AND TIME i 06/06/25 20:09
OF COLLISION
rr55 3
PAGE 4 OF 4