HomeMy WebLinkAbout25-5391 �oLcRaiTFFiN 0 7 27c REPORT NO. EG02849
"i ,one COLLISION REP F 1591971
CASE# 25-5391 2
INTERSTATE CITY STREET FIRE ❑
RESULTED
STOLEN
1 2 STATE ROUTE OTHER VFHICI F LOCAL AGENCY 4200 3[�
HIT&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 - 20 - 2025 1654 17 a. e W 8 OF IN 8 1070 3
S
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
NE 10TH ST BLOCK NO. 8✓ 2800 .�
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5 ,= FEET e S e W B NE SUNSET BLVD
❑ 11
0 1 29
MOTOR PEDAL- DAM E THRESHOLD MET PHONE
UNIT 01 VEHICLE CYCLE YEs NO �/ D:2067107328 1 6 30
6 LAST NAME FLORES CASTILLO FIRST NAME ENMA MIDDLE E 1 2 31
INITIAL
STREET F-1' 3030 NE 10TH ST APT 305 CITY RENTON WA
NEW ADDRESS S7 ZIP 980563158 z
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
INTERLOCK YEs No,/ INTERLOCKYEs NO YES NO,/
DRIVE STATE WA SEX'F MM flYY 09 - 26 - 1999 1 1 2 32
8❑ L
9 ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 H U5 E7 CLASS 1 NATURE OF INJURIES 2
LICENSte CMS0538 STATE WA WIN# 2HGFG12897H566471 3
10 1❑ PI ATF
11 3 0 PLATE# STATE TRAIPLATE# STATE ROM To
RA
TRLR TRLR. 3 7 33
12 3 0 vIN#' VIN#
FROM TO
VEH.YEAR 2007 MAKE HOND MODEL CIVIC STYLE CID IVEHDAMIAGE TOWEED Ftj NO2fBLIN TOWED BY GOVT..VEHICLNOFE 3 7 34
13❑ REGISTERED OWNER INFO ENMA FLORES CAST1LL03030 NE LOTH STAP7305 RENTON WA 98056 II—ll VEHICLE cNO..II 1
SHADE 1N DAMAGED AREA ❑ 35
14 LIABILITY INSURANCE❑ NSURANCE CO NONE 4
IN EFFECT &POLICY# STOP
VEHICLE CHARGE 5 ❑ 36
EGALI Y YES❑NO CITATION# 5A0395798 FOLLOW VEHICLE TOO CLOSELY,NO a BOTTOM
15❑ —HUH. <1 7 6
02 MOTOR PEDAL 'PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
� �� VEHICLE CYCLE OWNFR YES NO D:2068664083
16�
LAST NAME MUNOZ FIRST NAME ' JUAN MIDDLE D
INITIAL
17 STREET El 26285 238TH LN SE APT P302 CITY MAPLE VALLEY I ST', WA I ZIP 980385035 37
NEW ADDRESS I ❑
18❑ CDL IGNITION REQUIRED IGNITION pRESEIJT MEDfCALTRANSPORTED ❑ 38
W7ERLOCKvF No INTERLOCkCvEs ao ves No,�
19 DRIVER'# 05 O6 1992 � 39
20 ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 H U SET INJCLA S 1 NATURE OF INJURIES 40
21❑ LICENSE I CPW8977 TATf WA vIN# 5NMP2DGLXRH016042
❑ 41
PLATE#
TRAILER TRAILER ❑22 PLATE# STATE PLATE STATE 42
23 43
TRLR RLR
VIN#. '[N#,
VEH.YEAR 2024 MAKE HYUN MODEL $ApJTA STYLE $V DAMIAGE TOWED NOO✓ BLIN TOWED BY GO YES N HI 44
O
24 YES
REGISTERED OWNER INFO JUAN MUNOZ 26285238TH LN SE APT P302 MAPLE VALLEY WA 98038 VEHICLE NO.2
SHADE IN DAMAGAREA
LIABILITY INSURANCE INSURANCE CO GEICO 6042167574 E B
IN EFFECT &POLICY# t 4TOP
Venue ❑ „I�1 CITATION# CHARGE tOBOTTOM
LEGALLY YES N`'L-1
25 B
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
26
HANSEN HSU 12651 WA0171300
PART A . PAGE 01 OF
9000-345-159(R 11(181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EG02849
COLLISION REPORT III III III III III 111
1591972 CASE# 25-5391
E NA ADDITIONAL PERSONS INVOLVED(PASSENGERS AND/OR WITNESSES ONLY)
M
(LAST,FIRST,MIDDLE INITIAL) MUNOZ KELSEYJ
ADDRESS&PHONE# D.0
4600 DAVIS AVE S APT U105 RENTON WA 980556271 SEXi F M B.Y 02 - 13 - 1993
PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET INJURY NATURE OF INJURIES
❑ 2 POS. 3 2 4 1 USE CLASS i 1 ----�
:NAME
Lgsr FIRs7 MIDDLE INITIAL) GOMEZ ONTON JOSUE G
ADDRESS R PHONE# D O B
920 N 167TH ST APT 5 SHORELINE WA 981335330 SEX' M MMDDYYvr 05 - 19 _ 1994
SEAT HELMET INJURY NATURE OF INJURIES
PASSENGER a WITNESS❑!UNIT# 2 POS. ' 7 AIRBAG 1 RESTR. 4 EJECT 1 USE CLASS 1 ----�
: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
Units 1 and 2 both traveling westbound on NE 10th St, along the 2800 block, approaching the
intersection of NE Sunset Blvd. Unit 1 rear ends Unit 2 causing reportable non disabling rear end
damage to Unit 2 and non reportable non disabling front end damage to Unit 1. No injuries reported.
Unit 1 driver no insurance and NVOL w/lD. Unit 1 driver cited accordingly.
I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT.
HANSEN HSU 06-20-25 06:21 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST.DET DATED PLACE SIGNED
APPROVED BY DATE
P.SUMMERS 888 1 6/21/2025 11:17:22 PM
BADGE OR ID# 12651 ORI# WA0171300 TIME POLICE DISPATCHED 1 4:57 Pry/ TIME POLICE ARRIVED i 5:05 PM
PART B 8800-845.160(R1Vt8) PAGE 0 OF 37
REPORT NO. EG02849 CASE# 25-5391 DATE AND TIME 06/20/2516:54
OF COLLISION
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