HomeMy WebLinkAbout25-5266 ("7—
STATE.w,-" .:.. TcN 1 27cRaFFi O EG02847
COLLISION REP F 1591971
CASE# 25-5266 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 I 2
3 M M D D Y Y Y Y TIME I2400) COUNTY# MILES CITY#
COAT sloN 06 - 16 - 2025 1624 17 a. e W 8 OF IN 8 1070 a
S
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
BLOCK
RENTON AVE EXT 8✓ .�
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ 1.= FEET e S e W B TAYLOR AVE N
0 1 29
MOTOR PEDAL- : DAM ETHRESHOLD MET PHONE
UNIT 01 VEHICLE CYCLE YES ,/No D:2533944315 0 1 30
6❑ LAST NAME SINGH FIRST NAME ANKOOL MIDDLE' 0 9 31
INITIAL
STREET I r I' 24615 64TH AVE S#A208 CITY KENT ST WA 21P 2=
NEW ADDRESS
7❑ COL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED a
INTERLOCK YES No INTERLOCKYES No YES Na
8❑ LDICENS STATE WA SEX'M MMDDVY 10 - 19 - 2003 1 2 32
9 ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 H U5 E7 CLASRS 1 NATURE OF INJURIES 2
s
10 1❑ LICn NSte PPB2607 STATE WA WIN, JTDKB22U540058481
11 0 0 PLATE#FTRAILER
STATE PLATE# STATE ROM To
1 2 ;-- TRLR TRLR. 3 7 33
12 0 0 VIN#' VIN#
FROM TO
VEH.YEAR 2004 MAKE TOYT MODEL pRIUS STYLE SD IVEHDAMIAGE TOWEED Ftj NO2fBLIN TOWED BY GOVT..VEHICLNO E 5 1 34
13❑ REGISTERED OWNER INFO OWNEDBYDRIVER II—1 VEHICLE cNO..II 1
SHADE 1N DAMAGED AREA ❑ 35
14❑ LIABILITY INSURANCE NSURANCE CO PROGRESSIVE 996519974 4
IN EFFECT 8 POLICY# STOP
Vtw CHARGE 5 ❑ 36
ecnu Y YES❑NO❑ CITATION# NONE 10 ftOTTOM
15❑ nomc 6
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT VEHICLE CYCLE OWNER YeMf No D:2534096952
16�
LAST NAME JONES FIRST NAME STEVEN MIDDLE q
INITIAL
17 STREET 11707 87TH AVE S CITY SEATTLE I ST', WA I ZIP 98178 37
NEW ADDRESS I ❑
18❑ CDL IGNITION REQUIRED IGNITION PRESEIJT MEDfCALTRANSPORTED ❑ 38
1NTERLOCKYEs ND INTERLOCK YES NO vEs NO
19❑ DRIVER'#
❑ ON DUTY STATUS AIRBAG 6 RESTR 4 EJECT 1 H�SET INJURY 1 NATURE OF INJURIES ❑ 40
21❑ LICENSE,CGG8424 TATf'WA v)N# JTDKARFP5H3055021
❑ 41
PLATE#
TRAILER TRAILER ❑22 PLATE# STATE PLATE STATE 42
23 TRLR RLR� 43
VIN#. '[N#,
EHCLEYS
TOWED BY GO HI 44
VEH.YEAR 2017 MAKE TDYT MODEL pRIUS STYLE $D DAMIAGE TOWED✓ ND BLIN YES NO
24
REGISTERED OWNER INFO ISABELLA HENSON 1170787TH AVES SEATTLE WA 98178 VEHICLE NO.2
SHADE IN DAMAGED AREA
LIABILITY INSURANCE INSURANCE CO GEICO 6058 56 7170 3 4
IN EFFECT &POLICY# t 4TOP 5
venue YES❑ N J
.1-1 CITATION# CHARGE tOBOTTQM
�ecns�v
25 OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
26
N.ODALOV/C 11628 WA0171300
PART A . PAGE 01 OF
9000-345-159(R 11(181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EG02847
COLLISION REPORT III III III III III 111
1591972 CASE# 25-5266
E NA ADDITIONAL PERSONS INVOLVED(PASSENGERS AND/OR WITNESSES ONLY)
M
(LAST,FIRST,MIDDLE INITIAL) MADDOCK ALWAYS
ADDRESS&PHONE#
11797 87TH AVE S SEATTLE WA 98178 2533506124 SEXi X MMODDYBvvY
PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET INJURY NATURE OF INJURIES
❑ 2 POS. 7 6 4 1 USE CLASS 1 ----�
:NAME
(LAST FIRST MIDDLE INITIAL) { SILVIS EMILIE
ADDRESS&PHONE#
11707 87TH AVE S SEATTLE WA 98178 2534094779 SEX' MM DD;Y
SEAT HELMET INJURY NATURE OF INJURIES
PASSENGER a WITNESS❑!UNIT# 2 POS. ' 3 AIRBAG 6 RESTR. 4 EJECT 1 USE CLASS 1 ----�
NAME MIDDLE INITIAL) UNKNOWN HECTOR
(LOST,FIRST,
ADDRESS&PHONE# 2068564158
SEX VD.O.B.
MMDDYYYY
PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET 9NJURY NATURECFINJURIES
❑ POS. 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.
N.ODALOVIC 06-16-25 07:32 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST.DET DATED PLACE SIGNED
APPROVED BY DATE
P.SUMMERS 8887 612112025 11:17:32 PM
BADGE OR ID# ; 11628 ORI# WA0171300 TIME POLICE DISPATCHED 4:29 Pry/ TIME POLICE ARRIVED i 4:37 PM
PART B 3000-345.160(R1Vt8) PAGE F2 --]OF F5
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EG02847
COLLISION REPORT III III III III III 111
1591972 CASE# 25-5266
E NA ADDITIONAL PERSONS INVOLVED(PASSENGERS AND/OR WITNESSES ONLY)
M
(LAST,FIRST,MIDDLE INITIAL) UNKNOWN VINNY
ADDRESS&PHONE#
j .
8082854815 SEX U MMDDDYBYYY
PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET INJURY NATURE OF INJURIES
❑ 0 POS. : USE CLASS ----�
:NAME
(LAST FIRST MIDDLE INITIAL)
ADDRESS&PHONE#
SEX MMDDYYYY D.O.B. -
PASSENGER❑WITNESS UNIT# : SEAT AIRBAG RESTR. EJECT HELMET INJURY: NATURE CFINJURIES
POS. USE CLASS ----�
:NAME
(LOST,FIRST,MIDDLE INITIAL)
ADDRESS&PHONE#
SEX/ MMDDYY D.O.B.
YY
PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET NJURY 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.
N.ODALOVIC 06-16-25 07:32 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST.DET DATED PLACE SIGNED
APPROVED BY DATE
P.SUMMERS 8887 612112025 11:17:32 PM
BADGE OR ID# ; 11628 ORI# WA0171300 TIME POLICE DISPATCHED 4:29 Pry/ TIME POLICE ARRIVED i 4:37 PM
PART B 3000-345.160(R1Vt8) PAGE 3�OF F5
TIM
REPORT NO. EG02847 CASE# 25-5266 OF COLLI ION 06/16/25 16:24
OF COLLISION
NARRATIVE
25-5266
Unless otherwise noted, the following occurred in the City of Renton, County of King, WA.
On 06-16-2025 at approximately 1629 hours I was dispatched to a two-vehicle collision at Renton
Ave Extension/Taylor Ave N. I arrived at approximately 1637 hours and met with the drivers.
Unit 1 was traveling eastbound on Renton Ave Extension when he says his brakes failed. Unit 2 was
traveling northbound on Taylor Ave N, with the right of way, and was struck by unit 1 in the
intersection. The damage on both vehicles is consistent with this account. Unit 1 was drivable, and
unit 2 was not drivable with airbag deployment. Unit 2 was towed by Gene Meyer Towing. No injuries
were reported. Unit 1 did have an "ABS" brake light on the dashboard which was photographed. Unit
1 driver completed a lap around the block and when he came back to the collision scene, he told me
that only half of his brake system was working. Unit 1 provided two witnesses for contact which were
listed in this report. No one was cited in this incident.
I provided both parties with the case number. Photographs of the scene were uploaded to
evidence.com.
During this incident it is likely my body-worn and/or in-car camera was recording audio and video.
This report is merely a summary of the incident and is not intended to be an exact transcription of the
entire investigation or what may have been captured with the recording system.
I declare under penalty of perjury under the laws of the State of Washington that the foregoing is true
and correct. Electronically signed by N. Odalovic#11628 on 06-16-2025 at 1930 hours in Renton,
WA.
PAGE 4 OF 5
REPORT NO. EG02847 CASE# 25-5266 DATE AND TIME 06/16/2516:24
OF COLLISION
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PAGE 5 OF 5