HomeMy WebLinkAbout25-5057 )STATE
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Oc� RA EG01270
COLLISION REPRT 1591971
CASE# 25-5057 2
INTERSTATE CITY STREET FIRE ❑
RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VEHICLE ❑ LOCAL AGENC'Y 4100 3[--�
COUNTY RD ❑ NVOLVED CODING
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
coulsloN' 06 - 10 - 2025 0756 17 =.= S 8 W e IN OF M 1070 a
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION �✓ NON INTERSECTION ❑
BLOCK NO.
RAINIER AVE S
4a❑ MILE POST
❑ DISTANCE OF(REFERENCE OR CROSS STREET)
5 �. FEET e S 8 W e S 3RD PL
0 1 29
MOTtlR PEDAL- DAM AG THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE ❑ YEs Vl No D:8133457253 0 8 30
5 LAST NAME DURAN FIRST NAME REBECCA MIDDLE K 1 1 2 31
INITIAL
STREET ❑ 3005 S 47TH ST APT 90 CITY TACOMA ST WA ZIP 984096563 2
NEW ADDRESS
7 CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
INTERLOCKYEs NO INTERLOCK YEs NO YES Nt
8 DRIVERS
STATE WA SEX F MMor YY' 12 - 25 - 1992 1 2 32
URY
9 ON DUTY STATUS AIRBAG 3 RESTR 4 EJECT 1 N U SETO= I ASS 7 FINGER F INJURIES 2
LICENSE, CLF4901 STATE WA VN# JF2SJAEC5EH537035 3
10 Fl I PI ATP rt
TRAILER STATE TRAILER ,STATE
11 3 5 PLATE# PLATE# ROM TO
TRLR TRLR 5 1 33
12 Q 0 VIN# VIN#
FROM TO
VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO 9 9 34 BLIN �tpyEN�{"(g GOVT VEHICLE
13 2 2014 SUBA FOREST DAMAGE YES�NO� �"-"'"'�RS YES❑ NO
REGISTERED OWNER INFO REBECCA DURAN 3005 S 47TH ST APT 90 TACOMA WA984096563 D:8133457253 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
3
14❑ LIABILITY INSURANCE INSURANCE CO USAA 0215789887101 4
IN EFFECT &POLICY# 4TOP _
srgNOLNG Yes❑NO❑ CITATION# 5A0333596 CHARGE INATTENTIVE DRIVING a ooTro�m z 36
15
THR MOTCYR PEDAL- PEDESTRIAN PROPERTY DAM OLD MET PHONE
❑ ❑
UNIT 02 VEHICLE ❑ CYCLE' nWNFR YES,/NO D:4253060457
16�
LAST NAME CAPASSO FIRST NAME GARRY MIDDLE L
INITIAL
STREET ❑ 37
17 ❑ 18314 142ND A VE SE CITY RENTON ST, WA ZIP 980589334
NEW ADDRESS
1 g❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED' ❑ 38
INTERLOCKYES No INTERLOCK YES NO vEs NO
19 DRIVER'S STATE WA SEXI M D O B 06 05 1975 39
LICENSE# MMDLSYY —
20❑ ON DUTY❑ 11
STATUS AIRBAG 2 RESTR 4 EJECT 1 HELMET INJURY 6 NATURE OF INJURIES ❑ 40
USE CLASS NECK/BACK
21[ LICENSE C90761J rarE WA vIN# 5TFLU4ENXEX096960 41
22❑ [TILER TILER PLATE# STATE P ATE# STATE ❑ 42
23 TRLR kRLR 43
UIN#. 'IN#.
VEH.YEAR 2Q14 MAKE TOYT MODEL TACOMA STYLE VEHICLE TOWED TO BLIN
TOWED BY GOV HI 44
24= DAMAGE YES NO�/ YES NO�/
REGISTERED OWNER INFO GARRY CAPASSO 18314142NDAVESE RENTON WA 980589334 D:4253060457 VEHICLE NO.2
SHADE IN DAMAGED AREA
2 3 4
LIABILITY INSURANCE INSURANCE CO ST FARM 325 5913-826.470
IN EFFECT &POLICY# t 9TOP
VEHICLE LEGALLY ,.ILJ
—I CITATION CHARGE tO BOTTOM
25 YES N` a 7 a
--J
OFFICER'S NAME(PRINTI OFFICER PHONE BADGE OR ID# AGENCY
26
M.LEVERTON 2517 WA0171300
PAGE 01 OF
PART A 3000-345-159(R 11/18)
POLIICFETRAFFICN CORRECTION REPORT NO. EG01270
COLLISION REPORT III III III III III 111
1591972 CASE# 25-5057
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.
M.LEVERTON 06-11-25 01:13 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST.DET DATED PLACE SIGNED
APPROVED BY DATE
C.JACOBS 1953 1 6/16/2025 1:59:32 PM
BADGE OR ID# 2517 ORI# ( WA0171300 TIME POLICE DISPATCHED'; 8:00 AM TIME POLICE ARRIVED 8:07 AM
PART B 3 Do-3mx-,ao(Rtrras) PAGE 27 OF 47
REPORT No.` EGO1270 CASE# 25-5057 O COLLI COLLISION TIME
OF 06/10/25 07:56
COLLI
NARRATIVE
wht/1 lane 3 rear finger gry stopped red
CC
Within the city limits of Renton/King/Wa I responded to a 2 vehicle blocking crash at the intersection
of Rainier Ave S at S 3rd PI.
I contacted the driver of unit 2 who told me he was stopped in the northbound lane 3 of Rainier Ave S
when he was hit from behind by unit 1. He complained of neck/back pain and was checked on scene
by Renton Fire. His vehicle did not require a tow truck.
I contacted the driver of unit 1 ID'd by picture WADL. She told me she was northbound lane 3 Rainier
Ave S when she noticed she was bleeding from her hand. She showed me this complaint and it
appeared to be a tiny blood spot at the low point of a cuticula on one of her fingers. This didnt appear
to be anything concerning, but seemed to be by unit 1. Unit 1 told me this discovery caused her to
focus on her hand and basically drove into the back of unit 2. She was checked and released by
Renton Fire on scene. Her vehicle required a tow truck.
Based on Unit1 showing me a tiny/minor red spot that may or may not have been bleeding I believe
this was an excuse to her not paying attention to her driving and traffic around her. I cited unit 1 ref
RMC 10-12-25 Driver inattention 2 vehicle injury crash via complaint.
Unit 2 told me that unit 1 also showed him her hand and he was in disbelief that this was the cause of
the crash.
I certify (declare) under penalty of perjury under the laws of the State of Washington that the
foregoing is true and correct.
M.Leverton/2517 City of Renton/King/Wa 6/11/2025
PAGE 3 OF 4
REPORT NO.'; EGO1270 CASE# 25-5057 DATE AND TIME i 06/10/25 07:56
OF COLLISION
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PAGE 4 OF 4