HomeMy WebLinkAbout25-5219 ("7-
STATECE TRAFFicNREPORT NO. EG02115 0 5 27
COLLISION REP F 1591971
CASE# 25-5219 2
INTERSTATE CITY STREET FIRE ❑
RESULTED
STOLEN
1 1 STATE ROUTE OTHER VFHICI F LOCAL AGENCY 4200 3[�
HIT 8 RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 TRIBAL UN 75 TOTAL#OF STRUCK OBJECT 11 8 2$
RESERVATION 2
3 M M D D Y Y Y Y TIME I2400) COUNTY# MILES CITY#
coAT sloN 06 - 15 - 2025 1449 17 a. e W 8 OF IN 8 1070 3
S
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓
BENSON RD S BLOCK NO. 8✓ 2900 .�
4a❑ MILEPOST
❑ DISTANCE OF(REFERENCE OR CROSS STREET)
5 1.= FEET e S e W B
0 1 29
MOTOR PEDAL- DAM THRESHOLD MET E
/NoUNIT 01 VEHICLE CYCLE Yes IPHON
D:2536524374 0 7 30
g LAST NAME : TOOR FIRST NAME DAVINDER MIDDLE' K [; 2 31
INITIAL
STREET E:1' 19428 SE 266TH ST CI7y COVINGTON WA
NEW ADDRESS S7 ZIP 98042 z
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
INTERLOCK YEs NO INTERLOCK VES NO YES NO,/
DRIVE STATE WA SEX'F MM flYY 06 - 01 - 1978 1 2 32
$❑ L
9 ON DUTY STATUS AIRBAG 3 RESTR 9 EJECT 1 HELMET 9 USE ���� 1 NATURE OF INJURIES 2
LICnNSE CHR5627 srnrF WA WIN#' 1HGCR2F54FA193565 3
10 9❑
11 3 5 PLATE# STATE TRAILER PLATE# STATE ROM To
TRLR TRLR. 1 5 33
12 3 5 VIN#' VIN#
FROM TO
13 2 VEH.YEAR2015 MAKE HOND MODEL ACCOR STYLE SD VEHICLE TOWED 2NO ll-IN TvR&LBYMEYERS Govv VEHICLE g 9 34
❑ DAMAGE II1I._IIII -IIJJ
REGISTERED OWNER INFO OWNED BY DRIVER VEHICLE NO. 1
SHADE 1N DAMAGED AREA ❑ 35
2 LIABILITY INSURANCE INSURANCE CO ft 4
14 NATIONAL GENERAL 9036672
IN EFFECT &POLICY# STOP
VEHICLE YES CHARGE 5 ❑ 36
EGALI v ❑NO❑ CITATION# 10 ftOTTOM
15❑ sTAnowG 6
MOTOR PEDAL PROPERTY DAM THR OLD MET PHONE
UNIT PEDESTRIAN ❑ HO 2068862980
VEHICLE CYCLE OWNER YES NO
16�
LAST NAME ORLANDO JOSE FIRST NAME HERNANDEZ MIDDLE A
INITIAL
17 STREET El 704 S KENYA ST CITY SEATTLE ST', WA ZIP 98108 37
NEW ADDRESS ❑
18 CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED ❑ 3$
W7ERLOCKves No INTERLOCkCYEs NO FA NI
19 LICENSE# STATE SEX M MMDDYY 03 30 1966 39
20 ON DUTY STATUS AIRBAG 2 RESTR 9 EJECT 1 H�SET 9 INJAUSRSY' 1 NATURE OF INJURIES 40
21❑ LICENSE,CLZ4474 rAre WA UIN# 1C3CDFBA7DD136624
❑ 41
PLATE#
AILER TRAILER ❑22� PRLATE# STATE PLATE STATE 42
23 43
TRLR RLR
VIN#. '[N#,
VEH.YEAR 2013 MAKE DODG MODEL DART STYLE $D DAMIAGE TOWED NOO✓ BLIN TOWED BY GO YES N HI 44
YES O
24
REGISTERED OWNER INFO JA/ME GOMEZ LOPEZ t24f5AMBAUM BLVD SW APT 306 BURIEN WA 98146 VEHICLE NQ.2
SHADE IN DAMAGAREA
LIABILITY INSURANCE INSURANCE CO 3
IN EFFECT &POLICY# t 4TOP
Venice YES 12] N C[:] CITATION# CHARGE tOBOTTQM
LEGALLY
25 s
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
26
JAMES ELFERING 13002 WA0171300
PART A . PAGE 01 OF
9000-345-159(R 11(181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EG02115
COLLISION REPORT III III III III III 111
1591972 CASE# 25-5219
ADDITIONAL PERSONS INVOLVED(PASSENGERS AND/OR WITNESSES ONLY)
'.NAME
(LAST,FIRST,MIDDLE INITIAL)
ADDRESS&PHONE#
SEXi D.O.B. -
MMDDYYYY
PASSENGER❑WITNESS❑;UNIT# SEAT AIRBAG RESTR. EJECT HELMET INJURY NATURECFINJURIES
POS. ' USE CLASS 1 ----�
:NAME
(LAST FIRST MIDDLE INITIAL)
ADDRESS&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 NJU S' 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.
JAMES ELFER/NG 06-15-25 04:29 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST.DET DATED PLAGE SIGNED
APPROVED BY DATE
D.SKELTON 9139 1 6/19/2025 4:34:32 AM
BADGE OR ID# j 13002 ORI# WA0171300 TIME POLICE DISPATCHED 1 2:49 Pry/ TIME POLICE ARRIVED i 2:53 PM
PART B 3000-345.160(Brute) PAGE 0 OF 47
TIM
REPORT NO. EG02115 CASE# 25-5219 OF COLLI ION 06/15/25 14:49
OF COLLISION
NARRATIVE
CASE NO. 25-5219
Narrative
Unless otherwise noted the following events occurred within the City of Renton, County of King, State
of Washington while I was working uniformed patrol. This report is not an exact sequencing of events
and statements have been paraphrased and summarized.
On 06/15/2025 at approximately 1449 hours I was dispatched to a report of a collision with injury that
occurred in the 2900 block of Benson Rd S. The off-duty officer who called it in noted that there was
airbag deployment and a female complaining of pain.
Upon my arrival alongside the fire department, I contacted the driver of unit 2, who is from Nicaragua
and spoke no English. Using language line, I determined that he had been stopped in the southbound
lane behind two cars that were waiting to turn east onto SE 166th St. While stopped, he was rear-
ended by unit 2.
Once the driver of unit 2 had been medically cleared by the fire department, I spoke with her and
determined the following. She had been driving southbound on Benson Rd S when she noticed traffic
was stopped ahead of her. She braked, but was unable to stop in time, causing a collision. She was
experiencing chest pain but stated that it was possibly due to her blood pressure.
Based on the facts and circumstances of this case, the driver of unit 1 is the proximate cause of the
collision.
I facilitated an exchange of information between parties and provided the case number. The driver of
unit 2 was unable to provide a valid driver's license, so he contacted a friend to pick him and the
vehicle up. I advised that he contacted the Department of Licensing to make sure he was allowed to
drive in the US. I also issued a warning for not carrying proof of insurance.
Unit 1 arranged for a private tow and had family members arrive on scene to drive her home.
This concludes my involvement in this case.
I certify (declare) under penalty of perjury under the laws of the State of Washington that the
foregoing is true and correct.
ELECTRONICALLY SIGNED BY J. ELFERING R13002 06/15/2025, 1625 HOURS, RENTON WA
PAGE 3 OF 4
REPORT NO. EG02115 CASE# 25-5219 DATE AND TIME 06/15/2514:49
OF COLLISION
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PAGE 4 OF 4