HomeMy WebLinkAbout25-5329 IT si " II IIIII III IIIII II IIII IIIII I . 27c REPORT NO EG05326OLCERA
COLLISION REPORT 1591971
ASE# 25-5329 2
INTERSTATE CITY STREET FIRE ❑
RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VEHICLE LOCAL A`OENC'Y 4100 3
COUNTY RD INVOLVED CODING
PRIVATE WAY TOTAL 1
2❑ TRIBAL UNITS#OF 03 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 1622 17 =.= S 8 W e IN OF M 1070 a
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION
NE 3RD ST BLOCK NO. e 2500 .�
4a❑ MILE POST
❑ DISTANCE OF(REFERENCE OR CROSS STREET)
5 50 00 FEET e✓ S 8 W e EDMONDS AVE NE
0 1 29
MOTOR PEDAL- DAM AG THRESHOLD MET PHONE
UNIT 01 VEHICLE CYCLE' YES ✓NO D:2063836231 0 7 30
5 LAST NAME UNTI FIRST NAME CARMEN MIDDLE E 1 1 2 31
INITIAL
STREET 2300 BENSON RD S UNIT F3 CITY RENTON ST; WA ZIP 980558879 2
NEW ADDRESS
7 CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
INTERLOCKYEs NO 1/ INTERLOCKYEs N �/ YES D NOZ
8 DRIVER'CENS
STATE WA SEX F MMOCSYY' 05 — 14 — 1982 1 2 32
9 ON DUTY STATUS AIRBAG 6 RESTR 4 EJECT, 1 HELMET2 INJURY 7 NATURE ofNOFC 2
USE CLASg COMPLAINT OF CHEST PAIN
10 9 LI ENSE! ARM6581 STATE WA VN# JTDKN3DUXE0359131 3
TRAILER STATE TRAILER ,STATE
11 3 5 PLATE# PLATE# FROM To
TRLR TRLR 3 7 33
12 3 5 VIN# VN#
( FROM TO
VER YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN 7 v GOS VEHICLE 9 9 34
13 4 2014 TOYT PRIUS P4 DAMAGE YES ✓ONO � �MEYER TOWING YEV HNOF/I
REGISTERED OWNER INFO CARMEN UNTI 2300 BENSON RD S UNIT F3 RENTON WA 98055 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
14 LIABILITYINSURANCE NSURANCECO GRANGE INSURANCE510444002.W 3 4
IN EFFECT &POLICY# 4TOP _
srgNOLNG 5A0563856 CHARGE INATTENTIVE DRIVING o ooTrob 36
ves NO CITATION#
15
III MOTOR L � PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT VEHICLE CYCLE: OWNER YES 1/ NO D:4259028278
16�
LAST NAME LA FIRST NAME ANDY MIDDLE' D
INITIAL
17 F1 STREET ❑ 37 5131 NE 8TH CT UNIT 5131 CITY RENTON ST, WA ZIP 980594469 4
NEW ADDRESS
18❑ CDL IGNITION REQUIRE6 IGNITION PRESENT MEDICAL TRANSPORTED'. 38
INTERLOCKYEs ND fNTERLOCKYEs NO vEs No;�
19 DRIVER'S STATE WA SEX M I D.O.B. 01 27 2006 39
LICENSE# MMDDYY —
20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 HELMET 2 SE CLAY 1 NATURE OF INJURIES 40
SS
21 LICENSLATE E CHD5752 rarE WA vIN# WAUENAF40HN034359 41
22❑ PLATE# STATE PATE# STATE ❑ 42
23 TRLR kRLR 43
UIN#. 'IN#.
VEH.YEAR 2Q17 MAKE gUDI MODEL q4 STYLE P4 VEHICLE TOWED TO BLIN TOWED BY GOV HI 44
24 DAMAGE ves�/ No GENE MEYERS TOWING ves No
REGISTERED OWNER INFO CAM PHAM 5131 NE 8TH CT RENTON WA 98059 VEHICLE NO.2
SHADDAMAGEeOAREA
3
LIABILITY INSURANCE INSURANCECO STATE FARM 4810226E2647B
IN EFFECT &POLICY# 9TOP
veeiae ,J—I CITATION# CHARGE t060TTOM
LecnLLr YES N`[
25 '
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
26
D.NELSON 12421 WA0171300
PAGE 01 OF
PART A 3000-345-159(R 11/18)
POLIICFETRAFFICN CORRECTION REPORT NO. EGO5326
COLLISION REPORT III III III III III 111
1591972 CASE# 25-5329
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.
D.NELSON 06-18-25 05:25 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST.DET DATED PLACE SIGNED
APPROVED BY DATE
6/30/2025 2:39:47 PM
C.JACOBS 1953
BADGE OR ID# 12421 ORI# ( WA0171300 TIME POLICE DISPATCHED'; 4:25 Pry TIME POLICE ARRIVED 4:26 PM
PART B 3 Do-3mx-,ao(Rtrras) PAGE 27 OF 57
REPORT NO.` EG05326 CASE# 25-5329 O COLLI COLLISION TIME
OF 06/18/25 16:22
COLLI
NARRATIVE
25-5329 COLL
On 6/18/2025 at 1622 hours I was working as a uniformed patrol officer and driving a marked patrol
vehicle for the City of Renton. I was dispatched to a report of a three-vehicle collision near the
intersection of Edmonds Ave NE and NE 3rd St Renton/King/WA. A witness and an involved party
were both calling it in.
I located the collision in the #2 lane of NE 3rd St facing west, two vehicles were undrivable and the
third was able to move from the roadway.
I spoke with the driver of the 2014 Toyota Prius WA/ARM6581 (Unit 1), identified by her WADL as
Carmen E Unti DOB: 5/14/1982. Carmen said that she was driving west in the #2 lane of NE 3rd and
did not realize traffic in front of her was stopped, colliding with Unit 2. The Prius had extensive front-
end damage and there was a combination of airbags deployed inside the vehicle. Carmen said she
had slight pain in her chest from her seatbelt but was otherwise not injured. Gene Meyer Towing
removed the Prius from the scene.
The driver of the 2017 Audi A4 WA/CHD5752 (Unit 2), was identified by his WADL as Andy D La
DOB: 1/27/2006. Andy said that he was stopped for traffic in the #2 lane facing west on NE 3rd St
when he was struck by Unit 1. The Audi had damage to the front and rear bumpers and was not
drivable. There were no airbags deployed inside the vehicle and Andy said he was not injured. Gene
Meyer Towing removed the Audi from the scene.
The driver of the 2023 Toyota Rav4 WA/CGH0388 (Unit 3), identified by her WADL as Stephanie A
Nguyen DOB: 8/9/1993 advised she was also stopped for traffic in the #2 lane facing west when she
was struck by the Audi. The Rav4 had minimal damage to the middle of the rear bumper, no airbag
deployment, and Stephanie said she was not injured.
Based on both Units 2 and 3 stopped for traffic and Carmen's failure to stop I cited her for RMC10-12-
25 Inattentive Driving under Sector citation #5A0563856. This citation should be mailed to Carmen at
her DOL address.
I provided all involved with an exchange of information and cleared the scene.
Nothing further.
I certify under penalty of perjury under the laws of the State of Washington that the foregoing is true
and correct.
D. Nelson #191 6/18/2025 Renton WA
PAGE 3 OF 5
SUPPLEMENTAL REPORT NO. EG05326
POLICE TRAFFIC
1 1 8 27
COLLISION REPORT CASE#+ 25-5329
1 COMMERCIAL MOTOR CARRIER INTERSTATE INTRASTATE
UNIT# USDOT ICC# VEHICLE TYPE CARGO BODY
TYPE
2 ❑ 1 28
CARRIER
NAME
3 CARRIER L
ADDRESS
CITY ST ZIP
4 NAME # PLACARD
GWVR NO NUMBER
SOURCE' AXLES ' 1:1 + NAME IF
4a ❑ ADDITIONAL UNITS
'J ,µ MOTOR PEDAL- PROPERTY DAMAGE THRESHOLD MET PHONE
UNIT# 3 �✓ PEDESTRIAN �', YES NO
5 VEHICLE CYCLE OWNER ✓ D:2067956971
0 7 Zg
LAST NAME NGUYEN FIRST NAME STEPHANIE MIDDLE' A
INITIAL
STREET 30
NEW ADDRF. 566 ROSARIO AVE NE CITY RENTON ST WA ZIP 980594553
6 [2 1 2 31
CDL IGM710N REOU1REb 1GNi710N PRESENT MEDICAL
INTERLOCK YEs No�/ „INTERLOCK YEs NO I YES N...✓
G
DRIVER'S wq SEX F D.O.B OS
LICENSE MMDDvvY - 19 - 1993
ON DUTY STATUS: AIRBAG 2 RESTR. ¢ EJECT 1 HELMET 2 INJURY 1 NATUREGFINJURIES
USE CLASS
8 ❑ : ,. 1 32
LICENSE CGH0388 TAT WA VIN# 2T3P1RFV3PC331259
PLATE#
9 TRAILER TRAILER 2
PLATE#r STATE PLATE# STATE
10 ❑ TRLR TRLR
VIN.# VIN.#.
11 3 5 VEH.YEAR2023 MAKE TOYT MODELRA V4 STYLE P4 VEHICLE TOWE E T ABLIN TOWED BY GOVT.VFHICI F FROM TO
DAMAGE YES NO ✓ YES NO ✓
REGISTERED OWNER INFOMIKEY HUYNH 566 ROSARIO AVE NE RENTONWA98059 9 9 33
SHADE IN DAMAGED AREA
12 � 3 4
FROM TO
LIABILITY INSURANCE INSURANCE CO FIRST NATIONAL INSURANCE H2577889 GQO
IN EFFECT &POLICY# i m 34
13 vewcEe YES NO[jj CITATION# CHARGE
ecauv
sTANolmc ✓
MOTOR PEDAL_ ' 1:1PROPERTYEl DAMAGE THRESHOLD MET PHONE ❑ 35
14 ❑ UNIT# VEHICLE CYCLE PEDESTRIAN OWNER YES NO
15 LAST NAME FIRST NAME NIIT ALE
❑ 36
16 ❑ STREET CITY ST! ZIP
NEW ADDRESS"
CDL IGNITION RE(]UIRED IGNITION PRESENT MEDICALTANSPORTED
INTERLOCK YES NO INTERLOCK YEs NO YES NO.
17 4 37
LLIICENSE#RIVERS STATE I SEX MMDDYBYY - 1
18 ❑
HELMET I 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#+.
42
22 VEH.YEAR MAKE I MODEL I STYLE I VEHICLE TOWED DUE T SABLIN TOWED BY GOVT.VEHICLE
DAMAGE YES NO YES NO
23 REGISTERED OWNER INFO. SHADE IN DAMAGED AREA 43
2 3 4
LIABILITY INSURANCE INSURANCE CO
IN EFFECT I &POLICY# tK-99
5 44
vewcEe ❑ ❑ CITATION# CHARGE 24 IEGALLY VES NO3 3 6
I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT.
D.NELSON 06-18-25 05:25 PM
25 INVESTIGATING OFFICER'S SIGNATURE OFFICER'S PHONE UNIT OR DIST DET DATED: PLACE SIGNED
26 BADGE
R Ib E 12421 O#RI WA0171300 APJACOBS 6133012025
PAGE OF
3000-345-013(R 11l18)
REPORT NO. EG05326 CASE# 25-5329 DATE AND TIME i 06/18/25 16:22
OF COLLISION
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PAGE 5 OF 5