HomeMy WebLinkAbout25-5884 )STATE
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Oc� RA EG08062
COLLISION REPRT 1591971
CASE# 25-5884 2
INTERSTATE CITY STREET FIRE ❑
RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VEHICLE LOCAL A`GENC'Y 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
coulsfoN' 07 - 07 - 2025 0802 17 =.= S 8 W e IN OF M 1070 a
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION
LK WASHINGTON BLVD N BLOCK NO, e 3600 .�
4a❑ MILE POST
❑ DISTANCE OF(REFERENCE OR CROSS STREET)
5 C------�.� FEET e S B W
0 2 29
MOTtlR PEDAL- DAMAG THRESHOLD MET PHONE
UNIT 01 VEHICLE CYCLE YES NO ✓ 30
6 LAST NAME UNKNOWN FIRST NAME MIDDLE 1 1 2 31
INITIAL
STREET F-1 CITY ST ZIP' 2
NEW ADDRESS
7 CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED. 3
INTERLOCKYEs NO INTERLOCKYEs No YES NO
LCEENSE# STATE SEX U MMDDYY'. —=— t 32
8❑ VERS
9 ON DUTY STATUS AIRBAG 9 RESTR 9 EJECT 1 HELM
USEET 9 CLASS 0 NATURE OF INJURIES 2
LICENSE, 3
1 O PI ATF# STATE V(N
TRAILER STATE TRAILER ,STATE
11 JPLATE# PLATE# FROM TO
TRLR TRLR 5 1 33
12 VIN# VIN#
FROM TO
VEH.YEAR MAKE MODEL STYLE TR VEHICLE TOWED TO BUN TOWEBBv GOVT VEHICLE 5 1 34
13 4 DAMAGE YES�NO� YES NO
REGISTERED OWNER INFO UNKNOWN VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
14 LIABILITY INSURANCE❑ INSURANCE CO 3
IN EFFECT &POLICY# 4TOP
ic CHARGE t S 36
Lemur yes[:]NO[:] CITATION# HARE 7 o BOTTOM
15❑ sTINowH B 7 e
MOTOR PEDAL-:. PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT 02 VEHICLE CYCLE' awNFR YES NO ,/ HO 2067158514
16�
LAST NAME WENDORF FIRST NAME JASON MIDDLE C
INITIAL
17 F1 STREET ❑' 11416 85TH AVE S CITY 37 SEATTLE ST, WA ZIP 981783901 g
NEW ADDRESS
18❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED ❑ 38
INTERLOCKYEs NO INTERLOCKYrS NO vEs No
19[ LICEENSE# STATE SEX M MMDDYY 07 26 1972 39
❑7 HELMET INJURY' NATURE OF INJURIES 40
20 ON DUTY STATUS' 1 AIRBAG' RESTR EJECT 2 USE 8 CLASS 6 FACIAL LACERATIONS/ROAD RASH/CONTUSIONS ❑
21 1
PLATE# rare vIN# 4� 41
22❑ [TILER AILER
I PLATE# STATE PATE# STATE ❑ 42
43
23=
RLR
VfN IN
UIN#. 'IN#.
VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN
TOWED BY GOV HI 44
24= DAMAGE YES NO YES NO
REGISTERED OWNER INFO VEHICLE NO.2
SHADE IN DAMAGED AREA
2 3 4
LIABILITY INSURANCE❑ INSURANCE CO
IN EFFECT &POLICY# 9TOP
vewae YES❑ N`,.[—I CITATION# CHARGE tO BOTTOM
VEHICLE
25 a a
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
26 C.ARNOLD 12509 WA0171300
4 4
PAGE 01 OF
PART A 3000-345-159(R 11/18)
POLIICFETRAFFICN CORRECTION REPORT NO. EG08062
COLLISION REPORT III III III III III 111
1591972 CASE# 25-5884
ADDITIONAL PERSONS INVOLVED(PASSENGERS AND/OR WITNESSES ONLY)
NAME MIDDLE INITIAL} SHEPHERD DOMINIQUEA
(LAST,FIRST,
ADDRESS&PHONE#
21615 64TH AVE S KENT WA 98032 2064188114 SEX' F MMoovvvv 02 - 16 - 1998
PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET INJURY NATURE OF INJURIES
�' POS. USE CLASS
'NAME
(LAST FIRS,MIDDLE INITIAL)
ADDRESS&PHONE#
' D.O.B.
SEX MMDD -F L----------�
YYYY
PASSENGER F]WITNESSD 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# SEAT AIRBAG RESTR. EJECT HELMET INJURY NATURE OF INJURIES
❑ Q POS. 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.
C.ARNOLD 07-07-25 01:03 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST.DET DATED PLACE SIGNED
APPROVED BY DATE
M.LEVERTON 2517 7/9/2025 7:30:05 AM
BADGE OR ID# 12509 ORI# ( WA0171300 TIME POLICE DISPATCHED'; 9:14 AM TIME POLICE ARRIVED 9:21 AM
PART B 3 Do-3mx-,ao(Rtlras) PAGE 27 OF 57
REPORT No.` EG08062 CASE# 25-5884 COLLI SICiN TIME OF 07/07/25 09:02
COLLI
NARRATIVE
25-5884
On 7/7/2025 at 0916 hours I was dispatched to a motor vehicle collision at the 3600 block of Lake
Washington Blvd N in the City of Renton, King County, Washington.
Pre-Collision
Bicyclist 1 stated that he was proceeding North on Lake Washington Blvd N in the designated bike
lane in the 3600 block. Bicyclist 1 stated that he was within the marked bike lane on the East side of
the roadway proceeding with the direction of traffic.
Driver 1 fled the scene and did not provide comment.
Witness 1 stated that she was behind Unit 1 and saw that Bicyclist 1 was in front of Unit 1.
Collision
Bicyclist 1 stated that as he was in the 3600 block, Unit 1 attempted to pass him. Bicyclist 1 stated
that while doing so, Unit 1 drifted into the bike lane and that the rear passenger side of Unit 1 collided
with Bicyclist 1, forcing him off of the roadway and to be ejected from his bicycle.
Witness 1 stated the same as Bicyclist 1. Neither Witness 1 nor Bicyclist 1 saw the driver of Unit 1
and would not be able to identify the suspect in this case.
Injuries
Bicyclist 1 sustained minor injuries in the form of facial lacerations and road rash. I also saw that
there was a noticeable bump of the left side of his forehead. Bicyclist 1 was evaluated at the scene
but refused medical transport. Bicyclist 1's wife responded to the scene and advised that they would
self-transport to a hospital later if they determined it was necessary.
Vehicle Disposition
Both vehicles were operable and did not require a tow.
Final Disposition
Driver 1 did commit the crime of hit and run attended (RCW 46.52.020) 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.
Subsection 3 states:
Unless otherwise provided in subsection (7) of this section the driver of any vehicle involved in an
accident resulting in injury to or death of any person, or involving striking the body of a deceased
person, or resulting in damage to any vehicle which is driven or attended by any person or damage to
other property shall give his or her name, address, insurance company, insurance policy number, and
vehicle license number and shall exhibit his or her vehicle driver's license to any person struck or
injured or the driver or any occupant of, or any person attending, any such vehicle collided with and
shall render to any person injured in such accident reasonable assistance, including the carrying or
the making of arrangements for the carrying of such person to a physician or hospital for medical
treatment if it is apparent that such treatment is necessary or if such carrying is requested by the
injured person or on his or her behalf. Under no circumstances shall the rendering of assistance or
other compliance with the provisions of this subsection be evidence of the liability of any driver for
such accident.
Driver 1 failed to satisfy the elements of this RCW.
Unit 1 is described as a white "Staples" Box Truck and was last seen traveling North on Lake
Washington Blvd N. Per a check of FLOCK, I was unable to locate a white "Staples" box truck in the
area of our FLOCK cameras around the time of the collision. These cameras were far from the
incident location. I called Staples customer support to search for further information reagarding driver
information for Unit 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 09:50 on 7/7/2025 in the City of Renton, King
PAGE 3 OF 5
REPORT No.` EG08062 CASE# 25-5884 O COLLI COLLISION TIME
OF 07/07/25 09:02
COLLI
NARRATIVE
County, Washington.
PAGE 4 OF 5
REPORT NO. EG08062 CASE# 25-5884 DATE AND TIME i 07/07/25 09:02
OF COLLISION
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