HomeMy WebLinkAbout25-5321 IT si " II IIIII III IIIII II IIII IIIII I . 27c REPORT NO EG05325OLCERA
COLLISION REPORT 1591971
CASE# 25-5321 2
INTERSTATE CITY STREET FIRE ❑
RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VEHICLE LOCAL AGENCY. 4150 3
COUNTY RD NVOLVED CODING
PRIVATE WAY
2❑ TOTAL 1
TRIBAL 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 - 18 - 2025 1101 17 =.�� S W e OF ?070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION
BENSON DR S BLOCK NO. e 3600 .�
4a❑ MILE POST
❑ DISTANCE OF(REFERENCE OR CROSS STREET)
5 C------�.� FEET e S 8 w
0 1 29
MOTtlR PEDAL- DAM AG THRESHOLD MET PHONE
UNIT 01 VEHICLE CYCLE' YES ✓NO 0 1 30
6 LAST NAME UNKNOWN FIRST NAME MIDDLE 1 1 2 31
INITIAL
STREET
NEW ADDRESS CITY; W/LM/NGTON ST; ZIP 2
7 CDL : IGNITION REQUIRED
IGNITION PRESENT MEDICAL TRANSPORTED 3
INTERLOCKYEs No INTERLOCICYES NO[:] YES No
8 LCEENSE# STATE SEX U MMDDYY+ 1 2 32
9 ON DUTY STATUS AIRBAG 9 RESTR 9 EJECT ? HELM
USEET 9 CLASS 0 NATURE OF INJURIES 2
LICENSE, CPW0088 STATE WA VIN# 1FTRE14263HA65807 3
10[9� PI ATF#
11[-j- TRAILER STATE TRAILER ,STATE ROM TO
11 3 5 PLATE# PLATE#
TRLR TRLR 5 1 33
12 3 5 vIN# vIN#
FROM TO
VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN 7 v GOVT VEHICLE g 1 34
13 3 2003 FORD ECONO DAMAGE ves ✓ No� ��MEYERS Yes No�
REGISTERED OWNER INFO ISRAEL AVALOS RAMIREZ 28918186TH PL SE KENT WA 98042 D:2066505628 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
14❑ LIABILITY INSURANCE❑ NSURANCE CO 3 4
IN EFFECT &POLICY# 4TOP
ic CHARGE 5 36
Lemur yes❑NO❑ CITATION# HARE 7 0 80TTOM
15❑ sTnNowc s 7 e
III MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT VEHICLE CYCLE rtwNFR YES)/ NO D:9106603659
16�
LAST NAME NGUYEN FIRST NAME LYN MIDDLE' M
INITIAL
STREET ❑ 37
17 ?610 FORDHAM RD CITY WILMINGTON ST NC ZIP 284034904 g
NEW ADORE
SS '.
18❑ CDL ...; IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED' ❑ 38
INTERLOCKYES No INTERLOCKYEs NO ves No
19� DRIVER'S STATE NC SEX F D.o.e. 08 12 ?965 39
LICENSE# MMdDYY -
HELMET INJURY' NATURE OF INJURIES 40
20❑ ON DUTY STATUS' AIRBAG 9 RESTR 4 EJECT 1 6 ❑
USE CLASS HEAD PAIN/BLEEDING FROM LIP
21 LLCANS E BWY5736 TATE WA VIN# 4S4BSAFC3J3323867 41
22❑ [TILER TRAILER
PLATE# STATE PATE# STATE ❑ 42
23 TRLR kRLR 43
UIN#. 'IN#.
VEH.YEAR 2Q1$ MAKE SUBA MODEL OUTBAC STYLE VEHICLE TOWED TO BLIN TOWED BY GOV HI 44
24 DAMAGE ves�/ No GENE MEYERS ves No�/
REGISTERED OWNER INFO QUAN NGUYEN 13118158TH AVE SE RENTON WA 98059 D:2523319609 VEHICLE NO.2
SHADE IN DAMAGED AREA
2 3 4
LIABILITY INSURANCE INSURANCE CO STATE FARM 5275220EO247A
IN EFFECT &POLICY# t STOP
vemae YES❑ N J
,.I—I CITATION# CHARGE to BOTTOM
LE—LY
255 8
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
26
C.ARNOLD 12509 WA0171300
PAGE 01 OF
PART A 3000-345-159(R 11/18)
POLIICFETRAFFICN CORRECTION REPORT NO. EGO5325
COLLISION REPORT III III III III III 111
1591972 CASE# 25-5321
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.
C.ARNOLD 06-18-25 12:26 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST.DET DATED PLACE SIGNED
APPROVED BY DATE
6/30/2025 2:22:16 PM
C.JACOBS 1953
BADGE OR ID# 12509 ORI# ( WA0171300 TIME POLICE DISPATCHED'; 11:04 AM TIME POLICE ARRIVED 11:11 AM
PART B 3 Do-3mx-,ao(Rtrras) PAGE 27 OF 47
REPORT NO.` EG05325 CASE# 25-5321 O COLLI COLLISION TIME
OF 06/18/25 11:01
COLLI
NARRATIVE
CC 25-5321
On 6/18/2025 at1104 hours I was dispatched to a motor vehicle collision at 3600 block of Benson Dr
S in the City of Renton, King County, Washington.
Pre-Collision
Driver 2 stated that she was proceeding North in the 3600 block of Benson Dr S in the #1 lane.
Driver 1 fled the scene on foot and did not provide a statement.
Collision
Driver 2 stated that as she was proceeding straight ahead, Unit 1 approached from behind and the
front bumper of Unit 1 collided with the rear bumper of Unit 2.
Driver 1 fled the scene and Driver 2 was unable to provide a description of Driver 1. Driver 2 stated
that she didn't even see Driver 1. There were no witnesses present for comment.
Injuries
Driver 2 sustained minor injuries in the form of a cut on her lip and head pain.
Vehicle Disposition
Both vehicles were towed by Gene Meyers as Driver 2 was medically transported and Driver 1 fled
the scene.
Final Disposition
Driver 1 did commit the crime of hit and run attended because a driver of any vehicle involved in an
accident resulting in the injury to or death of any person or involving striking the body of a deceased
person shall immediately stop such vehicle at the scene of such accident or as close thereto as
possible but shall then forthwith return to, and in every event remain at, the scene of such accident
until he or she has fulfilled the requirements of subsection (3) of this section; every such stop shall be
made without obstructing traffic more than is necessary.
Driver 2 will NOT be able to identify Driver 1.
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 Officer C. Arnold #12509 at 12:21 on 6/18/2025 in the City of Renton, King
County, Washington.
PAGE 3 OF 4
REPORT NO. EG05325 CASE# 25-5321 DATE AND TIME i 06/18/25 11:01
OF COLLISION
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