HomeMy WebLinkAbout25-5361 �oLcRaiTFFiN 0 7 27c REPORT NO. EG03048
"i ,one COLLISION REP F 1591971
CASE 25-5361 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 z
3 M M D D Y Y Y Y TIME I2400) COUNTY# MILES CITY#
coAT sloN 06 - 19 - 2025 2000 17 a. S e W 8 IN
OF 8 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓
SOUTH GRADY WAY BLOCK NO.
8 100
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ 100 00 FEET e✓ S e W 8 RA/NJER AVE SOUTH
OF11
29
♦� MOTOR PEDAL- DAM ETHRESHOLD MET PHONE
UNIT 01 VEHICLE CYCLE YES NO D:2064872892 0 7 30
6❑ LAST NAME BANG FIRST NAME JASON MIDDLE' L 1 1 2 31
INITIAL
STREET E:1' 31723 48TH LN SW APT D
NEW ADDRESS CITY FEDERAL WAY S7 WA 21p 98023 z
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
INTERLOCKYEs No,/ INTERLOCK YEs No�/ vEs Na,/
8❑ LICENSE STATE OVA SEX'M MM flYY 05 - 16 - 1994 1 2 32
9 ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 H L E7 2 1 �� 1 NATURE OF INJURIES z
SS
ENSte CHT8312 srArE WA WIN# WAUR4AF59KA012002 3
10 1❑ PI
11 0 0 PLATE# STATE TRAIPLATE# STATE ROMRA
To
TRLR TRLR. 3 7 33
12 0 0 vIN#' VIN#
FROM TO
VT,VEHICLE
VEH,YEAR 2019 MAKE AUDI MODEL S5 STYLE SD VEHICLE TOWED TO BLIN TOWED BY GO g 9 34
13 DAMAGE YES NO ✓ YES❑ NO
REGISTERED OWNER INFO 1ASO1BA1G3172348THLN SWAPTD FEDERAL WAYWA 98023 D:2064872892 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
4 LIABILITY INSURANCE INSURANCE CO 3 4
14 PROGRESSIVE 959763658
IN EFFECT &POLICY# STOP _
VEHICLE YESCHARGE 5 ❑ 36
EGALI v [:]NO[:] CITATION# 10 ftOTTOM
15❑ sTAnomc 7 6
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT VEHICLE CYCLE OWNER YES NO ,/ D:2069138602
16�
LAST NAME TRUONG FIRST NAME JACKY MIDDLE
INITIAL
17 STREET El 8317 38TH AVE S CITY SEATTLE ST I WA ZIP 98118 37
NEW ADDRESS I I I ❑
18❑ CDL IGNITION REQUIRED IGNITION pRESEIJT MEDfCALTRANSPORTED ❑ 38
W7ERLOCKYEs No INTERLOCkCvEs no YES No,�
19 DRIVER'#
ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 HELMET 2 IINLJAU$Y 1 NATURE OF INJURIES 40
21❑ LICENSE I D95047G TATf WA vIN# 1FTER4LR1SLE04682
❑ 41
PLATE#
TRAILER TRAILER ❑22 PLATE# STATE PLATE STATE 42
23 43
TRLR RLR
VIN#. '[N#,
VEH.YEAR 2025 MAKE FORD MODEL RANGER STYLE PK DAMIAGE TOWED NOO✓ BLIN TOWED BY GO YES N HI 44
YES O
24
REGISTERED OWNER INFO OWNED BYDRIVER VEHICLE NO.2
SHADE IN DAMAGAREA
LIABILITY INSURANCE INSURANCE CO PROGRESSIVE 996991855 7 3
IN EFFECT &POLICY# t 4TOP
VEHICLE � CE] CITATION# CHARGE
25 tOBOTTQM
LEGALLY YES N J
s 7
7DADAM
S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
26
1254 WA0171300
PART A . PAGE 01 OF
9000-345-159(R 11(181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EG03048
COLLISION REPORT III III III III III 111
1591972 CASE# 25-5361
E NA ADDITIONAL PERSONS INVOLVED(PASSENGERS AND/OR WITNESSES ONLY)
M
(LAST,FIRST,MIDDLE INITIAL) SAEFONG NIKKI M
ADDRESS&PHONE#
8317 38TH AVE S SEATTLE WA 98118 SEXi F MMDDD B. 10 — 24 — 1999
PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET INJURY NATURE OF INJURIES
z ❑ 2 POS. 3 2 4 1 USE 1 2 CLASS 1 ----�
:NAME
(LAST FIFS7 MIDDLE INITIAL)
ADDRESS R PHONE#
SEX D.O.B. -
MMDDYYYY
PASSENGER❑WITNESS UNIT# : SEAT AIRBAG RESTR. EJECT HELMET INJURY: NA7URECFINJURIES
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
The following occurred in the City of Renton, County of King, State of Washington in the United
States of America. On 6-19-25 at approximately 2002hrs, I was traveling west on S Grady Way and
as I approached Rainier Ave South I got behind WA CHT8312 (vehicle 1), which was stopped in the
middle of traffic. I approached the driver, who was identified by a WA DL as Bang, Jason L. Bang
stated he had been in a traffic accident and the other vehicle had pulled into the KIA lot. The other
vehicle, WA D95047G, was driven by Truong, Jacky (vehicle 2)
Vehicle 2 had stopped for traffic facing west on S Grady Way. Vehicle 1 was behind vehicle 2 and
noticed that traffic had started moving; however, he did not notice that vehicle 2 had not started
moving and ran into the back of vehicle 2.
Both drivers were identified by WA DL's
I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT.
D.ADAM 06-20-25 01:03 AM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST.DET DATED PLACE SIGNED
APPROVED BY DATE
QUINT TIBEAU 7691 6/22/2025 9:18:32 PM
BADGE OR ID# 1254 ORI# WA0171300 TIME POLICE DISPATCHED 1 8:02 Pry/ TIME POLICE ARRIVED i 8:02 PM
PAIN B 30e0-345.160(R1Vt8) PAGE 0 OF F3
REPORT NO. EG03048 CASE# 25-5361 DATE AND TIME 06/19/25 20:00
OF COLLISION
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