HomeMy WebLinkAbout25-6462 iiTGiNII IIIII III IIIII II IIII IIIII I . 27c REPORT NO EG13512oc� RA
COLLISION REPORT 1591971
CASE# 25-6462 2
INTERSTATE CITY STREET FIRE ❑
RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VEHICLE ❑ LOCAL AGENC'Y 4100 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
COLLISION'. 07 - 27 - 2025 2313 17 =.= S 8 W E IN OF M 1070 a
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION �✓ NON INTERSECTION ❑
PARKAVEN BLOCK NO. e 300 .�
4a❑ MILE POST
❑ DISTANCE OF(REFERENCE OR CROSS STREET)
5 �. FEET e S 8 W e N 3RD ST
0 1 29
MOTtlR ✓ PEDAL- DAM AG THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE ❑ vEs Vl No D:2063273155 0 1 30
6❑ LAST NAME JACKSON FIRST NAME JHANA MIDDLE 1 2 31
INITIAL
STREET ❑ 3151 NE 16TH ST APT 329 CITY RENTON ST WA ZIP 98056 2
NEW ADDRESS
7 CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED'. 3
INTERLOCKYES ✓No INTERLOCKYEs NO✓ YES NO✓
8� LICIENS# STATE WA SEX F MMo YY' 04 - 23 - 1977 1 2 32
9� ON DUTY STATUS AIRBAG 6 RESTR 4 EJECT 1 N USEET 2 1 INJURY
CLASS 1 NAruRE of INJURIES 2
LICENSE, CJL4125 STATE WA VN# 1LNHL9FT6AG607945 3
10 PI ATP rt
TRAILER STATE TRAILER ,STATE
11 0 0 PLATE# PLATE# ROM TO
TRLR TRLR 7 3 33
1 3
( FROM TO
2 Q VIN# VIN#
VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED By GOVT VEHICLE
13 4 2010 LINC CRM SD DAMAGE YES�No ✓� Yes❑ No✓ 1 5 34
REGISTERED OWNER INFO OWNEDBYDRIVER VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
LIABILITY INSURANCE❑ INSURANCE CO 2 3 4
14 GENERAL 53-WA 6341339
IN EFFECT &POLICY# 4TOP
VEHICLE CHARGE I 5 36
Lemur YES❑NO❑ CITATION# 7 0 80TTOM
15❑ EIA o c
rL� MOTOR ✓ PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT VEHICLE ❑ CYCLE' ❑ ❑ OWNER D:2534066743
16�
LAST NAME ALVAREZ FIRST NAME CHRISTIAN MIDDLE I D
INITIAL
STREET ❑
17 ❑ 430 MILL AVE S APT 1S CITY RENTON ST, WA ZIP 98057 4 37
NEW ADDRESS
18❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDIGALTRANSPORTED^ 38
INTERLOCK YEs No INTERLOCK YES No✓ vEs NO
19 DRIVER'S STATE WA SEX U D•O•B 03 15 1992 39
LICENSE# MMDDYY —
20❑ ON DUTY❑ STATUS AIRBAG 6 RESTR 4 EJECT 1 HELMET 2 INJURY' 6 11 NATURE OF INJURIES 40
USE CLASS HAND PAIN
21 LICENS BTZ4360 TATE WA VIN# 1VWAT7A31FC107785 41
LATE#
22❑ [TILER TRAILER
PLATE# STATE PATE# STATE ❑ 42
23 TRLR kRLR 43
UIN#. 'IN#.
VEH.YEAR 2015 MAKE VOLJ( MODEL pASSAT STYLE $D VEHICLE TOWED TO BLIN
TOWED BY GOV HI 44
24 DAMAGE YES NO YES NO✓
REGISTERED OWNER INFO OWNEDBYDRIVER VEHICLE NO,2
SHADEDAMAGEDAREA
3 4
LIABILITY INSURANCE❑ INSURANCE CO PROGRESSIVE 999891497
IN EFFECT &POLICY# 9TOP
veeiCLe ❑ ,J—I CITATION# CHARGE 1060TTOM
LecnLLr YES N`[
25 e
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
26
JASON TURNER 12650 WA0171300
PAGE 01 OF
PART A 3000-345-159(R 11/18)
POLIICFETRAFFICN CORRECTION REPORT NO. EG13512
COLLISION REPORT III III III III III 111
1591972 CASE# 25-6462
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.
JASON TURNER 07-28-25 12:34 AM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST.DET DATED PLACE SIGNED
APPROVED BY DATE
CASEY PROCTER 12123 7/28/2025 2:45:40 AM
BADGE OR ID# 12650 ORI# ( WA0171300 TIME POLICE DISPATCHED'; 11:13 PM TIME POLICE ARRIVED 11:17 PM
PART B 3 Do-345-,ao(Burls) PAGE 27 OF 47
REPORT NO.` EG13512 CASE# 25-6462 O COLLI COLLISION TIME
OF 07/27/25 23:13
COLLI
NARRATIVE
Unit 1 reported that they were driving eastbound on N 3rd ST approaching a green light at Park Ave
N. Unit 1 was driving in the number 2 lane. Unit 1 proceeded through the intersection, Unit 2 ran a
redlight and struck the passenger side of Unit 1's vehicle. Unit 1 reported no injuries. Unit 1's vehicle
had a combination of airbag deployment and significant damage to the passenger side. The vehicle
was still driveable, Unit 1 drove the vehicle after officers advised not to due to no airbags in the car.
Unit 2 reported that they were driving southbound on Park Ave N approaching a green light at N 3rd
ST when Unit 1 suddenly pulled into the middle of the intersection from lane 2 of N 3rd ST. Unit 2
attempted to swerve away but struck the passenger side of Unit 1. Unit 2 complained of pain to his
hands and was evaluated by Renton Fire and not transported. Unit 2 had a combination of airbags
deploy. Unit 2 had a ignition interlock device in his vehicle and no signs of impairment. Unit 2 was
towed due to no longer being driveable.
At this time I can not develop proximate cause as both drivers provided conflicting accounts with no
witnesses on scene.
I declare under penalty of perjury under the laws of the State of Washington that the foregoing is true
and correct. Electronically signed by J. Turner 12650 on 07/28/2025 at 0026 hours.
PAGE 3 OF 4
REPORT NO. EG 13512 CASE# 25-6462 DATE AND TIME i 07/27/25 23:13
OF COLLISION
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