HomeMy WebLinkAbout25-5493 IT si " II IIIII III IIIII II IIII IIIII I . 27c REPORT NO EG06264OLCERA
COLLISION REPORT 1591971
CASE# 25-5493 2
INTERSTATE CITY STREET FIRE ❑RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VEHICLE ❑ LOCAL A`GENC'Y. 4100 3
COUNTY RD INVOLVED CODING
PRIVATE WAY TOTAL 1
2❑ 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 - 24 - 2025 1408 17 =.= S 8 W e IN OF M 1070 a
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION �✓ NON INTERSECTION ❑
BLOCK NO.
108TH AVE SE
4a❑ MILE POST
❑ DISTANCE OF(REFERENCE OR CROSS STREET)
5 �. FEET S 8 W e SE 180TH ST
0 1 29
MOTtlR PEDAL- DAMAG THRESHOLD MET PHON
UNIT 01 E
VEHICLE ❑ CYCLE' ❑ YES NO �/ D:2066028814 0 8 30
6 LAST NAME BARRAGAN FIRST NAME BERTHA MIDDLE 1 1 2 31
INITIAL
STREET ❑ 26310 186TH AVE SE
NEW ADDRESS CITY COVINGTON ST WA ZIP 980428424 2
7 CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
INTERLOCKYEs NO INTERLOCKYE, NO YEB N.Ll
8 LICIENS# STATE WA SEX F MDmo,YY' 03 - 27 - 1965 1 2 32
9 ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 N USEET INJURY
CLASS 1 NAruRE of INJURIES 2
3
10 P1 AT5 'ti�, BQX5461 STATE WA vN# 2T16URHE9FC427239
TRAILER STATE TRAILER STATE
11 3 5 PLATE# PLATE# FROM To
TRLR TRLR 5 1 33
12 0 o VIN# VIN#
FROM TO
VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT VEHICLE 9 9 34
13 3 2015 TOYT COROL DAMAGE YES NO YES❑ NO
REGISTERED OWNER INFO OWNEDBYDRIVER VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
14 LIABILITY INSURANCE NSURANCE CO pEMCO CA 0826182 3 4
IN EFFECT &POLICY# 4TOP VEHICLE
srgNOLNG ❑
NO 5A0512700 CHARGE FOLLOW VEHICLE TOO CLOSELY B o ooTrofi 36
YES CITATION#
15
III MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT VEHICLE CYCLE nWNFR YES NO �/ D:2062358977
16�
LAST NAME STIPAN FIRST NAME TANNER MIDDLEI
INITIAL
2 37
17 STREET ❑'❑ 6906 138TH AVE SE CITY KENT ST, WA ZIP 980428048
NEW AbORESS
18❑ CDL IGNITION REQUIREfl IGNITION PRESENT MEDIGALTRANSPORTED 38
INTERLOCKYEs ND INTERLOCK YES NO YEs NU'
19[ DRIVER'S STATE WA SEX M I D.O.B. I 11 28 2003 39
LICENSE# MMDDYY -
HELMET INJURY' NATURE OF INJURIES 40
20❑ ON DUTY STATUS' AIRBAG 2 RESTR 4 EJECT 1 USE CLASS 1 ❑
21 LICENSLATE E CRL0064 TATE WA vIN# JT8BD69S420172845 41
22❑ [TILER TRAILER
PLATE# STATE PATE# STATE ❑ 42
23 TRLR kRLR 43
UIN#. 'IN#.
VEH.YEAR 2QQ2 MAKE LEXS MODEL GS STYLE VEHICLE TOWED TO BLIN
TOWED BY GOV HI 44
24 DAMAGE YES NO YES NO
REGISTERED OWNER INFO OWNEDBYDRIVER VEHICLE NO.2
SHADE IN DAMAGED AREA
2 3 4
LIABILITY INSURANCE INSURANCE CO PROGRESSIVE 930 629 652
IN EFFECT &POLICY# t 9TOP
veeiae ,J—I CITATION# CHARGE tO BOTTOM
LecnLLY YES N`[_
25 s a
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. EG06264
COLLISION REPORT III III III III III 111
1591972 CASE# 25-5493
ADDITIONAL PERSONS INVOLVED(PASSENGERS AND/OR WITNESSES ONLY)
NAME LAW FAYE C
(LAST,FIRST MIDDLE INITIAL}
ADDRESS&PHONE#
8026 372ND PL SE SNOQUALMIE WA 980659308 4253950541 SEX' F MMooYYYv 11 - 14 - 2006
SEAT HELMET I INJURY NATURE OF INJURIES
PASSENGER F,-/1 WITNESS ,UNIT# 2 POS. 3 AIRBAG j 2 RESTR. 4 EJECT 1 USE CLASS ;7 COMPLAINT OF NECK PAIN
'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.M -T L----------�
MDDYYYY
PASSENGER WITNESS UNIT# PO
SEAT AIRBAG RESTR. EJECT HELMET INJURYSS rNATURE OF INJURIES
❑ QPOS. USE GLA — ----�
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 06-24-25 02:53 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST.DET DATED PLACE SIGNED
APPROVED BY DATE
C.JACOBS 1953 7/3/2025 9:05:38 AM
BADGE OR ID# 12509 ORI# ( WA0171300 TIME POLICE DISPATCHED'; 2:09 PM TIME POLICE ARRIVED 2:12 PM
PART B 3 Do-3mx-,ao(Rtrras) PAGE 27 OF 47
REPORT NO.` EG06264 CASE# 25-5493 O COLLI COLLISION TIME
OF 06/24/25 14:08
COLLI
NARRATIVE
CC 25-5493
On 6/24/2025 at 1409 hours I was dispatched to a motor vehicle collision at the intersection of 108th
Ave SE and SE 180th St in the City of Renton, King County, Washington.
Pre-Collision
Driver 2 stated that they were stopped at a red light facing South on 108th Ave SE at the intersection
of SE 180th St in the #2 lane.
Driver 1 stated that she was traveling North on 108th Ave SE in the #2 lane approaching SE 180th St.
Collision
Driver 2 stated that while stopped for the red light, the front bumper of Unit 1 collided with the rear
bumper of Unit 2.
Driver 1 stated that she had received a phone call that her father had a stroke while she was driving.
Driver 1 stated that when she heard this information, she released her foot from the brake causing
Unit 1 to roll forward and the front bumper of Unit 1 collided with the rear bumper of Unit 2.
Injuries
The only injuries reported were from the front seat passenger of Unit 2. This passenger had previous
injuries from a collision 3 weeks prior and the impact of this new collision caused stiffness in her neck
and may have exacerbated the pre-existing injuries. The passenger was not transported medically
and was already on her way to a doctors appointment. No other injuries reported.
Vehicle Disposition
Both vehicles were operable and driven from the scene.
Proximate Cause
I determined that Driver 1 is the proximate cause of this collision because the driver of a motor
vehicle shall not follow another vehicle more closely than is reasonable and prudent, having due
regard for the speed of such vehicles and the traffic upon and the condition of the highway and
because it is a traffic infraction to drive dangerously distracted which Driver 1 did because a person
who engages in any activity not related to the actual operation of a motor vehicle in a manner that
interferes with the safe operation of such motor vehicle on any highway. This was done because
Driver 1 admitted to being on the phone while driving and the contents of the statements made over
the phone affected her driving in such a way as to cause a collision.
Driver 1 was cited per RCW 46.61.145. 1 opted not to cite Driver 1 for RCW 46.61.673 to reduce
financial burden
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 14:44 on 6/24/2025 in the City of Renton, King
County, Washington.
PAGE 3 OF 4
REPORT NO. EG06264 CASE# 25-5493 DATE AND TIME i 06/24/25 14:08
OF COLLISION
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