HomeMy WebLinkAbout25-5689 IT si " II IIIII III IIIII II IIII IIIII I . 27c REPORT NO EG08319OLCERA
COLLISION REPORT 1591971
❑ El
�A$E 25-5689 2 0 7
INTERSTATE CITY STREET ✓STATE ROUTE OTHER LOCALAGENCY 4250 3
CODIN6COUNTY RD PRIVATE WAY
2 TOTAL#OF OBJECT 1 1 8 28
TRIBAL UNITS 03 STRUCK
RESERVATION : 2
3� M M D D Y Y Y Y TIME(2400) COUNTY# MILES CITY#
eaCL s on' 06 - 30 - 2025 2315 17 =.= S 8 W e OF IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
S 4TH ST BLOCK NO.
4a❑
MILE POST e
❑ DISTANCE OF(REFERENCE OR CROSS STREET)
5 MILES 1.1 FEET e S 8 W e MAIN AVE S
0 2 29
MOTOR PEDAL- DAM AG TSHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE ❑ YES NHREO ✓ 0 1 30
6❑ LAST NAME UNKNOWN FIRST NAME UNKNOWN MIDDLE 1 2 31
INITIAL
STREET F�
NEW ADDRESS CITY', RENTON ST: ZIP: 2
7� +CDL IGN(TIUN REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED. 3
INTERLOCKYEs NO INTERLOCKYEs No YES NO
8❑ LCEENSE# SRVERSTTATE SEX M MMDDYY' -=- 1 2 32
9 ON DUTY STATUS' AIRBAG 9 RESTR 9 EJECT 9 HELM
USEET 9 CLASSY 0 NATURE OF INJURIES 2
10 PI ENSttEI D00278A STATE WA VIN# 1N6AA07F88N311764 3
TRAILER STATE TRAILER STATE
11 2 5 PLATE# PLATE# ROM To
TRLR TRLR 5 1 33
12 2 5 VIN#' VIN#
FROM TO
VEH.YEAR 2008 MAKE NISS MODEL TITAN STYLE TR VEHICLE TOWED[n TO ZBUN TOWED By GOVT VEHICLE g 1 34
DAMAGE YES II_II NO YESII_I) NO✓
13 REGISTERED OWNER INFO MARK SOLIVEN 8815 S 132ND ST RENTON WA 98057 VEHICLE NO. 1
SHADE IN DAMAGED AREA 35
14❑ LIABILITY INSURANCE❑ NSURANCE CO 3 4
IN EFFECT &POLICY#
vewcLe t S ❑ 36
ecnur yes❑NO❑ CITATION# CHARGE 7 0 80TTOM
15❑ STM ING s 7 e
MOTOR ✓ PEDAL- PEDESTRIAN1:1 PROPERTY DAM THR OLD MET PHONE
UNIT 02 VEHICLE CYCLE nWNFR YES�/ NO D:4256256670
16�
LAST NAME SANDOVAL-GARCIA FIRST NAME JUAN MIDDLE M
INITIAL
STREET ❑
17 ❑ 1820 PIERCE AVE NE CITY RENTON ST, WA ZIP 98056 37
NEW ADORE SS
18❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED ❑ 38
INTERLOCKYEs No INTERLOCK YES NO vEs NO
19 DRIVER'S STATE WA SEX M D.O.e. 09 - 12 1990 39
LICENSE# MMODYY —
:
20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 HELMET INJURY NATURE OF INJURIES 40 USE CLASS 1 ❑
21 LICENSE
PATE# BPY1981 TATE I WA VIN# 19XFC2F78JE200604 41
22❑ [TILER TAILER
PLATE# STATE PLATE# STATE 42
23 TRLR RLR 43
UIN#. 'IN#
VEH.YEAR 201$ MAKE HOND MODEL CIVIC STYLE SD VEHICLE TOWED TO BLIN
TOWED BY GOV HI 44
24 DAMAGE YES NO✓ NO✓
REGISTERED OWNER INFO OWNED BY DRIVER VEHICLE
N0.2
SHADE DEGE AREA
LIABILITY INSURANCE[Z INSURANCE CO SAFECO P5812857
IN EFFECT &POLICY# IU�o
L,—Le ❑ J—I CITATION# CHARGE
LEGALLY YES N
25 OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
26
N.ODALOV►C 11628 WA0171300
PAGE 01 OF
PART A 3000-348-189(R 11/18)
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EG08319
COLLISION REPORT III III III III III 111
1591972 CASE# 25-5689
E NA ADDITIONAL PERSONS INVOLVED(PASSENGERS AND/OR WITNESSES ONLY)
M
(LAST,FIRST,MIDDLE INITIAL) REED COOPER
ADDRESS&PHONE
RENTON 3179897795 SEXi M MMDoovBVyY 03 - 25 - 2001
PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET INJURY NATURE OF INJURIES
Q Q I 2 POS. 3 2 4 1 USE CLASS j 1 ----�
:NAME
(LAST EIFS7 MIDDLE INITIAL) { BAUER ALYSSA N
ADDRESS&PHONE#
MMDDY Y
RENTON 3179897795 SEX' U D C'e•YY 04
SEAT HELMET INJURY NATURE OF INJURIES
PASSENGER a WITNESS UNIT# 2 P1:11OB. 9 AIRBAG 2 RESTR. 4 EJECT 1 USE CJU:R 1 ----�
NAME MIDDLE INITIAL) BAUER JASPER O
(LAST,FIRST,
AQQREss&PHONE# RENTON SEX 03 _ 31 _ 2025
. U DA.B.
MM DDYYY
PASSENGER I
WITNESS UNIT# 2 SEAT 6 AIRBAG 2 RESTR. 4 EJECT 1 HELMET INJURY' 1 NATURECFINJURIES
a 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.
N.ODALOVIC 07-01-25 08:03 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST.DET DATED PLACE SIGNED
APPROVED BY DATE
HANSEN HSU 12651 711012025 12:27:20 AM
BADGE OR ID# j 11628 ORI# WA0171300 TIME POLICE DISPATCHED 11:21 PM TIME POLICE ARRIVED i 11:28 PM
PART B 3 Do-3mx-attar gt 1Mffp PAGE F2 --]OF F
REPORT NO. EG08319 CASE# 25-5689 DATE OF COLLI r�510NN + 06/30/25 23:15
L1
NARRATIVE
25-5689
Unless otherwise noted, the following occurred in the City of Renton, County of King, WA.
On 06-30-2025 at approximately 2321 hours I was dispatched to a collision that occurred at S 4th St/
Main Ave S.
Upon arrival, I only observed unit 2 on scene who was being evaluated by the Renton Fire Authority.
The driver of unit 2, Juan, stated that he was traveling north on Main Ave S driving at approximately
23 miles per hour in lane 1. Unit 2 came up behind Jose's vehicle and was flashing headlights behind
them. Unit 1 has some sort of intercom system and the occupants of unit 2 heard a male voice while
the vehicle was behind them, but they could not tell what he was saying. No one was able to visually
see the driver of unit 1. As the vehicles approached S 4th St, unit 1 tried to pass unit 2, but there was
a median in the roadway and subsequently side-swiped unit 2. Unit 2 followed unit 1 for a short
distance but then returned to the original collision scene. Unit 1 did not stop to exchange information
with unit 2. Unit 2 then collided with an unknown description semi-truck who also did not stay on
scene of the collision.
Unit 2 was drivable with no airbag deployment. There was an infant in the vehicle who was evaluated
but otherwise no occupants sustained any injuries.
I provided Jose with the case number. Photographs of unit 2 were uploaded to evidence.com. After
the incident, Jose uploaded two videos of the suspect vehicle to evidence.com which I reviewed.
Police went to the registered address for unit 1 but were unable to locate the vehicle.
During this incident it is likely my in-car camera and/or body-worn camera was recording audio and
video. This report is merely a summary of the incident and is not intended to be an exact transcription
of the entire investigation or what may have been captured with the recording system.
I declare under penalty of perjury under the laws of the State of Washington that the foregoing is true
and correct. Electronically signed by N. Odalovic#11628 on 07-01-2025 at 2000 hours in Renton,
WA.
PAGE 3 OF 5
SUPPLEMENTAL REPORT No. EG0831 9
POLICE TRAFFIC
1 1 7 27
µ ^'� COLLISION REPORT CASE# 25-5689
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
'J MOTOR PEDAL- PROPERTY DAMAGE THRESHOLD MET PHONE
5 ❑ UNIT 3 VEHICLE CYCLE ❑ PEDESTRIAN ❑ OWNER :❑ YES NO
0 1 29
LAST NAME UNKNOWN FIRST NAME MIDDLE'.
INITIAL
30
-CITY
RENTON ST ZiP
NFW ArinRFfi .
6 CDL GNITION PRESENT MEDICAL TANSPORTED 1 1 2 31
I O 1{iNiTION
INTERLOCK PREQUIRED ES ONO[:] YES NO I YES N
DRIVER'S I STATE I SEX U MMDQ 8 Y L
LICENSE'
7
OENSE STATUS AIRBAG 9 RESTR. 9 EJECT 1 HELMET 9 INJURY;O NATURE DF INJURIES
USE CLASS
8 ❑ 1 32
LICENSE TAT VIN.
PLATE#
9 TRAILER TRAILER L
PLATE# STATE PLATE STATE
0
10 TRLR TRLR
VIN.# VIN#.
11 0 0 VEH.YEAR MAKE UNKN MODEL SEMI STYLE VEHICLE TOWE E T ABLIN TOWED BY GOVT.VFHIOI F FROM TO
DAMAGE YES NO YES NO
REGISTERED OWNER INFO.UNKNOWN RENTON 5 1 33
12 � SHADE IN DAMAGED AREA
4 FROM TO
LIABILITY INSURANCE❑ INSURANCE CO TP
IN EFFECT &POLICY# 1cl)
__`-'_.5 m 34
13 vewc�e YES NO[jj CITATION# CHARGE
0TFOM
ecauv
sTnNoiNc
MOTOR PEDAL- ' 1:1PROPERTY DAMAGE THRESHOLD MET PHONE 35
14 ❑ UNIT# VEHICLE CYCLE PEDESTRIAN OWNER YES NO
36
15 LAST NAME FIRST NAME NIT AL
16 ❑ STREET �' CITY ST' ZIP
NEW ADDRESS
CDL IGNITION RE6UIRED IGNITION PRESENT MEDICAL TANSPORTED
INTERLOCK YES NO INTERLOCK YEs Net .YES NO
17 5 37
LLIICENSE# STATE SEX MD.r3D.6
18 ❑ ❑
HELMET 'INJURY NATURE OF INJURIES 38
ON DUTY STATUS AIRBAG RESTR. EJECT USE CLASS,:
19 ❑ ❑ 39
LICENSE TAT vIN#
PLATE#
20 TRAILER' TRAILER 40
PLATE#, STATE STATE PLATE# - ❑
21 ❑ [4 41
TRLR TRLR
VIN#�, VIN#Y
42
22 VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED DUE T ABLIN TOWED BY GOVT.VEHICLE
DAMAGE YES NO YES NO El
23 REGISTERED OWNER INFO. SHADE IN DAMACED AREA 43
2 3 4
LIABILITY INSURANCE INSURANCE CO
IN EFFECT I &POLICY# 7c;Q
S. 44
vewc�e ❑ ❑ CITATION# CHARGE
24 I..EG_ 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.
N.ODALOVIC 07-01-25 08:03 PM
25 INVESTIGATING OFFICER'S SIGNATURE OFFICER'S PHONE UNIT OR DIST DET DATED: PLACE SIGNED
26 BADGE OR ID# 11628 O#RI WA0171300 APPROVE
HSU D BY 7/11 OF
0/2025
PAGE �
3000-345-013(R 11/18)
REPORT NO. EG08319 CASE# 25-5689 DATE AND TIME 06/30/25 23:15
OF COLLISION
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PAGE 5 OF 5