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HomeMy WebLinkAbout25-5637 IT si " II IIIII III IIIII II IIII IIIII I . 27c REPORT NO EG05001OLCERA COLLISION REPORT 1591971 CASE# 25-5637 2 INTERSTATE CITY STREET FIRE ❑ RESULTED 1 STATE ROUTE OTHER STOLEN ❑ ❑ VEHICLE ❑ LOCALAGENCY 3 HIT&RUN ✓ C©DING COUNTY RD PRIVATE WAY INVOLVED 2 TOTAL#OF OBJECT 1 s 28 TRIBAL UNITS 03 STRUCK RESERVATION : 1 1 2 3� M M D D Y Y Y Y TIME(2400) COUNTY# MILES CITY# eaCL s on' 06 - 29 - 2025 1320 17 =.= S 8 W e OF IN e 1070 s 4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑ S CARR RD BLOCK NO. 4a❑ MILE POST e ❑ DISTANCE OF(REFERENCE OR CROSS STREET) 5 C------ 1.1 FEET e S 8 W e TALBOT RD S 0 1 29 MOTOR ✓ PEDAL- DAM AG THRESHOLD MET PHONE UNIT 01 VEHICLE ❑ CYCLE ❑ YES ✓NO O 3 30 6❑ LAST NAME UNKNOWN FIRST NAME MIDDLE t 1 2 31 INITIAL STREET ❑) CITY', ST ZIP 2 NEW ADDRESS 7 CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3 INTERLOCKYEs NO INTERLOCKVEs No YES NO 8❑ DCIENSE# STATE SEX U MMDDYY' —71— 1 2 32 9 ON DUTY STATUS' AIRBAG 9 RESTR 9 EJECT 1 HELM USEET 9 CLASSY 0 NATURE OF INJURIES 2 LICENSE, 3 1 O� PI ATF#' STATE V(N TRAILER STATE TRAILER STATE 11 0 0 PLATE# PLATE# FROM To TRLR TIN 7 3 33 12 0 Q VIN#' VIN# FROM TO VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BUN TOWED BY GOVT VEHICLE 7 5 13� SD DAMAGE YES�NO ✓� YES❑ NO✓ 34 REGISTERED OWNER INFO UNKNOWN VEHICLE NO. 1 SHADE IN DAMAGED AREA 11 35 14❑ LIABILITY INSURANCE❑ NSURANCE CO m IN EFFECT &POLICY# CHARGE t5 36 YES❑NO❑ CITATION# 15❑ STMDwc s 7 6 MOTOR ✓ PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE UNIT 02 VEHICLE CYCLE nWNFR YES�/ NO D:8133820486 16� LAST NAME SUMMERLIN FIRST NAME BROOKE MIDDLE E INITIAL 17 F1 STREET ❑ ❑ 400 S 46TH PL UNIT D CITY RENTON ST, yyq ZIP 98055 g 37 NEW ADDRESS 18❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICALTRANSPORTED: 38 INTERLOCKYES No�/ INTERLOCK YES N �/ YES NO✓ 19 DRIVER'S STATE WA SEX F I D-O.B. 03 16 1991 39 LICENSE# MMDDYY — 20❑ ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 HELMET 2 INJURY J7 NATURE OF INJURIES 40 USE CLASS SHOULDER PAIN 21 LICENSE I PLATE# BPP3655 rare WA vIN# 3W2B7AX8KM054168 41 22❑ [TILER TAILER PLATE# STATE PLATE# STATE 42 23 TRLR RLR 43 UIN#. 'IN# 44 VEH.YEAR ZQ1<J MAKE �/OLJ( MODEL TIGUANS STYLE VEHICLE TOWED TO BLIN TOWED BY GOV HI 24 DAMAGE YES NO�/ VES NO✓ REGISTERED OWNER INFO OWNEDBYDRIVER VEHICLE NO.2 SHADE IN DAMAGED AREA 2 3 4 LIABILITY INSURANCE INSURANCE CO ALLSTATE 987298170 IN EFFECT &POLICY# t STOP ­1— ❑ ,J—I CITATION# CHARGE to BOTTOM L,—LY YES N 6 25 OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# JAGENCY 26 BLAKE BOWIE 12105 WA0171300 PAGE 01 OF PART A 3000-345-189(R 11/18) STATE OF POLICETRAFFICN CORRECTION REPORT NO. EGO5001 COLLISION REPORT III III III III III 111 1591972 CASE# 25-5637 E NA ADDITIONAL PERSONS INVOLVED(PASSENGERS AND/OR WITNESSES ONLY) M (LAST,FIRST,MIDDLE INITIAL) SUMMERLIN IRIS ADDRESS&PHONE# SEXi F MMDDDYBYYY 09 — 25 — 2024 PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET NJURY NATURE OF INJURIES z �' 2 POS. 8 2 10 1 USE 2 GLASS 1 ----� :NAME (LAST EIFS7 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 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. BLAKE BOWIE 06-29-25 02:35 PM INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST.DET DATED PLAGE SIGNED APPROVED BY DATE D.SKELTON 9139 6/29/2025 4:09:58 PM BADGE OR ID# 12105 ORI# WA0171300 TIME POLICE DISPATCHED 1 1:25 PM TIME POLICE ARRIVED i 1:34 PM PAST B 3 Do-3mx—attar(t 1Mff) PAGE 2�OF F5 REPORT NO. EG05001 CASE# 25-5637 DATE OF COLLI r�510NN + 06/29/25 13:20 L1 NARRATIVE On 06-29-2025 at 1325 hours I was dispatched to the intersection of S Carr Rd /Talbot Rd S, in the City of Renton, County of King, State of Washington, for a reported hit and run that just occurred. While enroute, dispatch advised that three vehicles were involved and two of them parked in a near by parking lot while the third vehicle continued to drive east on Talbot Rd S. Upon arrival, Unit 3 was leaving the parking lot in his vehicle while Unit 2 was parked in the parking lot and her vehicle had damage down the drivers side of the vehicle. The driver of Unit 2 stated she was facing eastbound on S Carr Rd trying to turn southbound on Talbot Rd S. Before she could make the turn, she was hit on the drivers side by Unit 3. Unit 2 and Unit 3 both pulled into the parking lot to exchange information but Unit 1 continued to drive away eastbound on S Carr Rd. Unit 1 is described as a white sedan with a spoiler. She stated her shoulder was hurting but declined medical attention at this time. I provided her with my business card which contained the case number for her records. I contacted Unit 3 via the phone as Unit 2 provided me with his information. Unit 3 stated he was merging over into the turn lane from the middle lane then he was hit on the drivers side which pushed him into Unit 2. Unit 3 did not get a good look at Unit 1 but confirmed that the vehicle drove eastbound without stopping. Unit 3 did not complain of any injuries and does not have proof of insurance but states he does have insurance. I provided Unit 3 with the case number for his records. There is limited information on Unit 1 as they fled the scene of a collision without stopping or changing information with the other drivers involved. It is unknown who the driver of Unit 1 is. There are possible traffic cameras at the intersection that might give us more information on Unit 1. I certify (declare) under penalty of perjury under the laws of the State of Washington that the foregoing is true and correct. Electrically signed by Officer B. Bowie / 12105 on 06-29-2019 at 1434 hours in the City of Renton. PAGE 3 OF 5 SUPPLEMENTAL REPORT No. EG05001 POLICE TRAFFIC 1 1 8 27 µ ^'� COLLISION REPORT CASE# 25-5637 t113197 1 COMMERCIAL MOTOR CARRIER INTERSTATE INTRASTATE UNIT# USDOT ICC# VEHICLE TYPE CARGO BODY 3 TYPE 2 ❑ 1 28 CARRIER NAME 3 CARRIER L ADDRESS CITY ST ZIP 4 ❑ NAME # PLACARa GWVR NAME IF NO NUMBER SOURCE AXLES + 4a ❑ ADDITIONAL UNITS MOTOR PEDAL- PROPERTY DAMAGE THRESHOLD MET PHONE UNIT# 3 �✓ PEDESTRIAN v s No D:2067739577 5 VEHICLE —CYCLE OWNER 2 0 29 LAST NAME RUSHING FIRST NAME JONATHAN MIDDLE' A INITIAL STREET 30 ❑ NFW AnnRFS 10432 67TH AVE S CITY SEATTLE I ST WA ZiP g8178 6 CDL IGNITION REQUIRED +IGNITION PRESENT MECiICAL TANSPORTED 1 1 2 31 INTERLOCK YES NOZ :INTERLOCK YES NO L LICENSE DRIVER'S STATE SEX M .D-O.BY OS - 22 - 1978 ' 7 ON DUTY STATUS AIRBAG 2 RESTR. 4 EJECT 1 HELMET 2 INJURY 1 NATUREOFINJURIES USE CLASS 8 ❑ 1 32 LICENSE'CPY5988 TAT WA uiN JTHCL46F095004037 PLATE# 9 TRAILER TRAILER L PLATE# STATE PLATE# STATE 10 ❑ TRLR TRLR _VIN.# VIN.#. 11 0 0 VEH.YEAR2009 MAKE LEXS MODELLS 400 STYLE SD VEHICLE TOWE E T ABLIN TOWED BY GovT.VFHCI E FROM TO DAMAGE YES NO YES NO JONATHAN RUSHING 10432 67TH AVE S SEATTLE WA 98178 D:2067739577 7 rj 33 REGISTERED OWNER INFO. SHADE IN DAMAGED AREA 12 4 FROM TO LIABILITY INSURANCE❑ INSURANCE CO )TOP' IN EFFECT &POLICY# 1 -"_`--' 5 m 34 13 ❑ vEnic�E YES[] NO❑ CITATION# CHARGE 10 E#OTTOM ecauY sTnNoiNc MOTOR PEDAL_ ' 1:1PROPER' : DAMAGE THRESHOLD MET PHONE 35 14 ❑ UNIT# VEHICLE CYCLE PEDESTRIAN OWNER YEEF-1 NO 36 15 LAST NAME FIRST NAME INITIAL 16 ❑ STREET �' CITY ST ZIP NFW ADDRESS CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TAN SPORTED INTERLOCK YES NO INTERLOCK YES NO 'YES NO 17 5 37 LLIICENSE#RIVER'S —F SEX MMODW 18 ❑ HELMET 'INJURY NATURE OF INJURIES 38 ON DUTY STATUS AIRBAG RESTR. EJECT USE CLASS,: 19 ❑ LICENSE TAT VIN# 39 PLATE# 20 TRAILER' TRAILER 40 PLATE#, STATE PLATE# - STATE ❑ 21 ❑ ❑ 41 TRLR TRLR VIN# VIN#Y 42 22 VEH.YEAR MAKE I MODEL I STYLE VEHICLE TOWED DUET ABLIN TOWED BY GOVT.VEHICLE DAMAGE YES NO YES NO 23 REGISTERED OWNER INFO. SHADE IN DAMAC ED AREA 43 2 3 4 LIABILITY INSURANCE[-] INSURANCE CO IN EFFECT I &POLICY# 7c;Q S. 44 vewc�e ❑ ❑ CITATION# CHARGE 24 I..TF_ YES NO STIWDING 8 3 G 1 CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT. BLAKE BOWIE 06-29-25 02:35 PM 25 INVESTIGATING OFFICER'S SIGNATURE OFFICER'S PHONE UNIT OR DIST DET DATED: PLACE SIGNED 26 OR Ib# 12105 O#RI WA0171300 APSKELTON 6/229/2025 PAGE OF 3000-345-013(R 11/18) REPORT NO. EG05001 CASE# 25-5637 DATE AND TIME 06/29/2513:20 OF COLLISION> ' � A 1 �SYts � sa. Y r, e " z' $Y O PAGE 5 OF 5