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HomeMy WebLinkAbout25-4400 )STATE TFcN 5 6 27i 1 Oc� RA EG09906 COLLISION REPRT 1591971 CASE# 25-4400 2 INTERSTATE CITY STREET❑ FIRE ❑ RESULTED 1 STOLEN r STATE ROUTE ❑ OTHER ❑ VEHICLE � LOCAL A`GENO'Y 4100 3 L--� HIT&RUN ❑ CODING ❑ COUNTY RD PRIVATE WAY ❑✓ INVOLVED 2 2 TRIBAL UN TS#OF OBJECK 1 1 8 28 03ISTRUC OVER EMBANKMENT RESERVATION ". + 2 3� M M D D Y Y Y Y TIME(2400) COUNTY# MILES CITY# DATE OF'. N E cDLUSION' 05 - 19 - 2025 1432 17 =.[� S 8 W e OF IN e 1070 3 4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION BRONSON WAYNE MILE POST e 275 .� 4a❑ MILE POST ❑ DISTANCE OF(REFERENCE OR CROSS STREET) 5 C------�.� FEET e S B W 0 6 29 MOTtlR PEDAL- DAM AG THRESHOLD MET PHONE UNIT 01 VEHICLE CYCLE YES Vl NO D:5099899292 30 6 LAST NAME BONAUDI FIRST NAME KAREN MIDDLE R 1 1 2 31 INITIAL STREET 1:1 15205 140TH WAY SE APT D104 CITY RENTON ST WA ZIP 980587855 2 NEW ADDRESS 7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3 INTERLOCKYES NO INTERLOCKYES NO YES NO 8 DRIVE # STATE WA SEx F MMoCSYY' 09 - 05 - 1946 32 9 ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 N USEET 2 1 INJURY CLASS 1 NAruRE of INJURIES 2 10 LI ENSE' DP89851 STATE WA VIN# 5J6TF2H58DL005940 3 TRAILER STATE TRAILER ,STATE 11 0 0 PLATE# PLATE# FROM TO rRLR TRLR 3 7 33 12 VIN# VIN ( FROM TO VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED By GOVT VEHICLE 13 9 2013 HOND CROSST DAMAGE YES�No ✓� YEs_ 5 1 34 REGISTERED OWNER INFO KAREN BONAUDI 15205140TH WAY SEAPT D104 RENTON WA 98058 VEHICLE NO. 1 ❑ SHADE IN DAMAGED AREA 35 LIABILITY INSURANCE❑ INSURANCE CO 3 4 14 FARMERS INSURANCE 18795546 IN EFFECT &POLICY# 4TOP vEnic�E CHARGE 5 36 Lemur YES❑NO❑ CITATION# BOTTOM 15❑ sTnNowc Y e MOTOR PEDAL-:. PROPERTY DAM THR OLD MET PHONE UNIT ❑ ❑ PEDESTRIAN Q✓ D:2063315358 VEHICLE CYCLE' nWNFR YES f/ NO 16� LAST NAME MOHAMADAMIN FIRST NAME SHALLAW MIDDLE I A INITIAL 17 F1 STREET ❑' 1 371620 SE PETROVITSKY RD CITY RENTON ST, WA ZIP 980586637 NEW ADDRESS 1$ CDL IGNITION REQUIRED3 IGNITION PRESENT MEDICAL TRANSPORTED 38 INTEF�LOCKYEs No INTERLOC�CYEs No ves NO 19 DRIVER'S # STATE WA SEXI M MMDDYY 01 O6 1987 39 20 ON DUTY STATUS 3 AIRBAG' RESTR EJECT HELMET 2 INJURY' 7 NATURE OF INJURIES ❑ 40 USE CLASS POSSIBLE KNEE INJURY LICENSE ATE# TATE vIN# 41 21 P 22❑ [TILER AILER PLATE# STATE PATE# STATE ❑ 42 23 TRLR kRLR 43 UIN#. 'IN#. GOV H 44 VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY I 24 1 7 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 vemae ❑ ,.I—I CITATION# CHARGE tO BOTTOM ALLr YES N`LJ 25 a a OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY 26 C.CATALAN 12007 WA0171300 PART A PAGE 01 OF 3000-345-159(R 11/181 POLIICFETRAFFICN CORRECTION REPORT NO. EG09906 COLLISION REPORT III III III III III 111 1591972 CASE# 25-4400 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. C.CATALAN 05-20-25 02:35 PM INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST.DET DATED PLACE SIGNED APPROVED BY DATE C.JACOBS 1953 711512025 1:49:21 PM BADGE OR ID# 12007 ORI# ( WA0171300 TIME POLICE DISPATCHED'; 2:32 Pry TIME POLICE ARRIVED 2:32 PM PART B 3 Do-3mx-,ao(Rtrras) PAGE 27 OF 57 REPORT NO.` EG09906 CASE# 25-4400 O COLLI COLLISION TIME OF 05/19/25 14:32 COLLI NARRATIVE On May 19, 2025, at 1432 hours I flagged down by a passerby about a vehicle stuck in an embankment at Kaiser Permanente, 275 Bronson Way NE, in the city of Renton, county of King, and State of Washington. While searching for the collision, I located the vehicle on the northeast side of the property. The vehicle was as a Honda Crosstour bearing Washington plates DP89851. The driver, identified das Karen Bonaudi, was sitting inside her vehicle. I asked if she sustained any injuries, and she said no. Karen exited the vehicle and explained that she intended to park in a handicap stall belonging to Kaiser Permanente. As she aligned her vehicle into the stall, her foot slipped and from the brake onto the accelerator. Her vehicle rushed forward, ran over some shrubbery, and landed in between 2 handrails on a walkway. Her vehicle sustained severe damage to the front bumper and damaged the two handrails. While speaking with Karen, a security guard named Shallaw Mohamadamin, approached me and said he sustained an injury to his knee. Shallaw said he was walking northbound along the walkway when he heard a vehicle crashing through the bushes. He ran forward but was nicked by the vehicle or the metal handrail. He sustained a minor abrasion to his knee and refused any medical assistance. Based on the above statements, I determined that the Driver of Unit 1 (Karen) is the proximate cause for the collision due to inattention causing a collision. Due to the severe damage sustained by Karen's vehicle, it was towed away by Bankers Towing. An exchange of information was provided to all involved parties I certify (declare) under penalty of perjury under the laws of the State of Washington that the foregoing is true and correct. C. Catalan 06/02/2025 Renton PAGE 3 OF 5 SUPPLEMENTAL REPORT No. EG09906POLICE TRAFFIC 1 27 ... °`f COLLISION REPORT CASE# 25-4400 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 + NAME IF 4a ❑ ADDITIONAL UNITS MOTOR PEDAL- PROPERTY DAMAGE THRESHOLD MET PHONE }j� PEDESTRIAN �/ D:4252352800 5 UNIT vT 3 VEHICLE CI CYCLE C) C� OWNER YES NO 29 FIRST NAME MIDDLE' LAST NAME PERMANENTS KAISER INITIAL STREET 30 NEW ADDRFR 275 BRONSON WAY NE CITY RENTON ST WA ZJP 98058 6 ❑ PRESENT MEDICALTANSPORTED. 1 31 CDL IONITION REQUIREfl IGNi71ON INTERLOCK YES: NO {NTERLOCK YESL No I YES N . DRIVER'S STATE SEX U MDJO -�- LICENSE; 7 ON DUTY STATUS: AIRBAG RESTR. EJECT HELMET I INJURY NATUREOFINJURIES USE CLASS 8 ❑ #LICENSE VIN 1 32 PLATE# rAr 9 TRAILER TRAILER 2 PLATE# STATE PLATE# STATE 10 ❑ TRLR TRLR VIN.# VIN.R4 11 VEH.YEAR MAKE MODEL STYLE VEHICLE TO WE E T ABLIN TOWED BY GOVT.VFHICI F FROM TO DAMAGE YES NO YES NO REGISTERED OWNER INFO. m 33 12 � SHADE IN DAMAGED AREA LIABILITY INSURANCE❑ INSURANCE CO 4 FROM TO TO IN EFFECT &POLICY# 34 13 YES NO CITATION# CHARGE 10 8C)1`l OM ecauv DAMAGE THRESHOLD MET PHONE 35 sTnNoiNc MOTOR PEDAL- ' PROPERTY 1:1 14 ❑ UNIT# VEHICLE CYCLE PEDESTRIAN OWNER YES NO 15 LAST NAME FIRST NAME ❑INITMIDDL ALE 36 16 ❑ STREET CITY ST! ZIP NEW ADDRESS" GDL IGNITION REOUIRED IGNITION PRESENT MEl71CALTANSPORTED INTERLOCK YES NO INTERLOCK YES NO YES NO 17 37 LLIRIVERSICENSE# STATE I SEX M�Dfl 18 ❑ ❑ HELMET INJURY NATURE OF INJURIES 38 ON DUTY STATUS AIRBAG RESTR. EJECT USE CLASS 19 ❑ ❑ 39 LICENSE viN# PLATE# rAT 20 ❑ TRAILER TRAILER ❑ 40 PLATE#. STATE PLATE# STATE 21 ❑ TRLR TRLR 41 VIN#7 VIN#i 42 22 VEH.YEAR MAKE I MODEL I STYLE 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 &POLICY# t.K-99 5 44 vEHic�F ❑ ❑ CITATION# CHARGE 24 IEG_ VES NOSTIWDING3 3 6 I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT. C.CATALAN 05-20-25 02:35 PM 25 INVESTIGATING OFFICER'S SIGNATURE OFFICER'S PHONE UNIT OR DIST DET DATED: PLACE SIGNED 26 ORID# 12007 O#RI WA0171300 APJACOBS 7%15/2025 PAGE OFF 3000-345-013(R 11/18) REPORT NO. EG09906 CASE# 25-4400 DATE AND TIME i 05/19/25 14:32 OF COLLISION �a oll 02 v e Y 4 $q*'Xq a awwxtl m ! y. i f Z 4 � t t �y 1 �Y �Yk PAGE 5 OF 5