HomeMy WebLinkAbout25-5312 iiTGiNII IIIII III IIIII II IIII IIIII I . 27c REPORT NO EG11498oc� RA
COLLISION REPORT 1591971
ASE# ; 25-5312 2
INTERSTATE CITY STREET FIRE ❑
RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VEHICLE ❑ LOCAL AOENC'Y 4200 3
COUNTY RD ❑ NVOLVED CODING
PRIVATE WAY
2❑ TRIBAL TOTAL 1
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 - 18 - 2025 0814 17 =.= S 8 W E IN OF M 1070 a
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION �✓ NON INTERSECTION ❑
BLOCK NO.
BRONSON WAY
4a❑ MILE POST
❑ DISTANCE OF(REFERENCE OR CROSS STREET)
5 �. FEET e S 8 W e SUNSET BLVD N
0 1 29
MOTtlR PEDAL- DAMAG THRESHOLD MET PHON
UNIT 01 E
VEHICLE ❑ CYCLE ❑ YES No �/ D:5093365112 0 8 30
5 LAST NAME DANG FIRST NAME LONG MIDDLE T 1 2 31
INITIAL
STREET Z 4304 NE 17TH ST CITY RENTON I ST WA ZIP 98059 2
NEW ADDRESS
7 CDL IGNITIQN REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
INTERLOCKYES NO INTERLOCKYES N0 YES F NO
8❑ LICIENS# STATE WA SEX M MMor YY' 03 1 2 32
9[�] ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 N USEET INJURY
CLASS 1 NAruRE of INJURIES 2
10 LICENSE BUB4948 STATE WA VN# 5FNRL185X3B015695 3
TRAILER STATE TRAILER ,STATE
11 3 0 PLATE# PLATE# FROM TO
TRLR TRLR 7 3 33
1 0
( FROM TO
2 Q VIN# VIN#
VER YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED By GOVT VEHICLE 9 9 34
13 3 2003 HOND ODYSSE DAMAGE YES�NO� YES❑ NO
REGISTERED OWNER INFO OWNEDBYDRIVER VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
14❑ LIABILITY INSURANCE❑ NSURANCE CO 3 4
IN EFFECT &POLICY# 4TOP 5
vEnicLe CHARGE
srnc rroiN Yes❑NO❑ CITATION# SA0512682,5A0512682 NEGLIGENT DRIVING 2ND DEGREE, B �o eoTrofi 1 36
15
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT VEHICLE ❑ CYCLE' ❑ ❑ nWNFR D:4256335695
16�
LAST NAME SMITH FIRST NAME LACY MIDDLE' D
INITIAL
STREET ❑
17 ' 1❑ 055 S GRADY WAY CITY RENTON ST, WA ZIP 98057 37
NEW ADDRESS
18❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED'. 38
INTERLOCKYES No jNTERLOXYEs 11--hl vES Nol
19 DRIVER'S STATE WA SEXI F D.O.B. 08 21 1990 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 66290D rarE WA vIN# 1GNLCDEC7JR296296 41
22❑ PLATE# STATE PATE# STATE ❑ 42
23 TRLR kRLR 43
UIN#. 'IN#.
VEH.YEAR 201$ MAKE CHEV MODEL TAHOE STYLE VEHICLE TOWED TO BLIN
TOWED BY GOV HI 44
24 DAMAGE YES NO YES NO
REGISTERED OWNER INFO CITYOFRENTON35S5NE2NDST RENTONWA98056 VEHICLE NO.2
SHADE IN DAMAGED AREA
2 3 4
LIABILITY INSURANCE INSURANCECO CITY OF RENTON SELF INSURED
IN EFFECT &POLICY# t 9TOP
veeiae ,J—I CITATION# CHARGE tO BOTTOM
LecnLLY YES N`.LJ
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. EG11498
COLLISION REPORT III III III III III 111
1591972 CASE# 25-5312
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.ARNOLD 06-18-25 09:12 AM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST.DET DATED PLACE SIGNED
APPROVED BY DATE
M.LEVERTON 2517 7/21/2025 8:33:00 AM
BADGE OR ID# 12509 ORI# ( WA0171300 TIME POLICE DISPATCHED'; 8:14 AM TIME POLICE ARRIVED 8:14 AM
PART B 3oDo-345-,ao(Rtlras) PAGE 27 OF 47
REPORT No.` EG11498 CASE# 25-5312 O COLLI COLLISION TIME
OF 06/18/25 08:14
COLLI
NARRATIVE
CC 25-5312
On 6/18/2025 at 0814 hours I was dispatched to a motor vehicle collision at intersection of Bronson
Way N and Sunset Blvd N in the City of Renton, King County, Washington.
Pre-Collision
Driver 2 stated that she was stopped at a red light in the #3 lane of Bronson Way N preparing to
perform a lefthand turn to proceed North on Sunset Blvd N.
Driver 1 stated that he was behind Unit 2 in the #3 lane of Bronson Way N preparing to perform a
lefthand turn to proceed North on Sunset Blvd N.
Collision
Driver 2 stated that while stopped, Unit 1 moved forward and the front bumper of Unit 1 collided with
the rear bumper of Unit 2.
Driver 1 stated that he had just worked a 12 hour shift and was very sleepy. Driver 1 stated that he
closed his eyes and must have fallen asleep. Driver 1 stated that he was awoken when the front
bumper of Unit 1 collided with the rear bumper of Unit 2.
Driver 1 informed me that he does not have insurance.
Injuries
No injuries reported.
Vehicle Disposition
Both vehicles were operational.
Proximate Cause
I determined that Driver 1 is the proximate cause of this collision because under circumstances not
constituting negligent driving in the first degree, he operates a motor vehicle in a manner that is both
negligent and endangers or is likely to endanger any person or property. Driver 1 did this by operating
a vehicle when he knew that he was too tired to safely operate a vehicle upon a public roadway.
Driver 1 was cited per RCW 46.61.525 and RCW 46.30.020.
1 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 09:06 on 6/18/2025 in the City of Renton, King
County, Washington.
PAGE 3 OF 4
REPORT NO. EG11498 CASE# 25-5312 DATE AND TIME i 06/18/25 08:14
OF COLLISION
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