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HomeMy WebLinkAbout25-6230 iiTGiNII IIIII III IIIII II IIII IIIII I . 27c REPORT NO EG16643oc� RA COLLISION REPORT 1591971 ASE# 25-6230 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 coulsloN' 07 - 19 - 2025 2127 17 =.= S 8 W e IN OF M 1070 a 4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION �✓ NON INTERSECTION ❑ BLOCK NO. NE SUNSET BLVD 4a❑ MILE POST ❑ DISTANCE OF(REFERENCE OR CROSS STREET) 5 �. FEET H S 8 W e EDMONDS AVE NE 0 1 29 MOTtlR ✓ PEDAL- DAM AG THRESHOLD MET PHONE UNIT 01 VEHICLE ❑ CYCLE ❑ YEs Vl No D:2532261523 0 6 30 5 LAST NAME GOVORUSHKIN FIRST NAME YEVGENIY MIDDLE 1 1 2 31 INITIAL STREET ❑ 1709 SHELTON AVE NE CITY RENTON ST I WA ZIP 980563359 2 NEW ADDRESS 7 CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED. 3 INTERLOCKYEs NO✓ INTERLOCKYEs Na✓ YES D NOZ 8 LICIENSE# STATE WA SEX M MMDO orYY' 05 1 2 32 9 ON DUTY STATUS AIRBAG 6 RESTR 4 EJECT, 1 HELMET 2 INJURY 7 NATUREof IN HELMET 2 USE ,CLASS PAIN/N LEFT ARM 10 1 LICENSuE! BUC8575 STATE WA VN# 2T1BURHE2HC794342 3PI ATr � TRAILER STATE TRAILER STATE 11 3 5 PLATE# PLATE# FROM To TRLR TRLR 3 7 33 12 0 0 VIN# VIN# '.....: FROM TO VER YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN 7 Y GOS VEHICLE 3 7 34 13 4 2017 TOYT COROL SD DAMAGE ves ✓ No � �MEYERS Yes❑ No✓ REGISTERED OWNER INFO YEVGENIY GOVORUSHKIN 1709 SHELTON AVE NE RENTON WA 98056 VEHICLE NO. 1 ❑ SHADE IN DAMAGED AREA 35 LIABILITY INSURANCE❑ INSURANCE CO 4 14 ✓ PROGRESSIVE 71588367 IN EFFECT &POLICY# 9TOP vEnic�E 5 36 LEGALLY YES[:]NO[:] CITATION# CHARGE 7 o BOTTOM 15❑ STANDING I a MOTCYR ✓ PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE UNIT 02 VEHICLE ❑ CYCLE' ❑ ❑ nWNFR YEs No �/ D:2068590556 16� LAST NAME SEMA FIRST NAME ABERASH MIDDLE K INITIAL 17 F1 STREET ❑❑ 3810 S 158TH ST APT C7 CITY TUKWILA ST, WA ZIP 981882670 4 37 NEW ADDRESS 18❑ CDL IGNITION REQUIRED IGNTION PRESENT MEDICALTRANui"PQRTED 38 INTERLOCKYEs No✓ jNTERLOGKYEs No✓ rEs No;✓ 19 DRIVER'S STATE WA SEX F I D-O... 07 23 1985 39 LICENSE# MMDDYY - 20❑ ON DUTY STATUS AIRBAG 1 RESTR 4 EJECT 1 HELM USE ET 2 INJURY 1 NATURE OF INJURIES 40 21 LICENSEPLATE# BEE0782 TATE WA VIN# JTEES42A182070051 41 22❑ PLATE# STATE PATE# STATE ❑ 42 23 TRLR kRLR 43 UIN#. 'IN#. VEH.YEAR 200$ MAKE TOYT MODEL HIGHlAN STYLE UTVEHICLE TOWED TO BLIN TOWED BY GOV HI 44 24 DAMAGE YES NO✓ YES NO✓ REGISTERED OWNER INFO MERID BOGER IIIWS 158TH STAPT C7 TUKWILA WA 98188 VEHICLE NO.2 SHADE IN DAMAGAREA 2 3 LIABILITY INSURANCE✓ INSURANCE CO PROGRESSIVE 923776847 IN EFFECT &POLICY# t 9TOP LVEHICLE EIAILY YES❑ N CL J CITATION# CHARGE tO BOTTOM LEGALL 25 OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY J 26 KEVIN PETERSON 12808 WA0171300 PAGE 01 OF PART A 3000-345-159(R 11/18) POLIICFETRAFFICN CORRECTION REPORT NO. EG16643 COLLISION REPORT III III III III III 111 1591972 CASE# 25-6230 ADDITIONAL PERSONS INVOLVED(PASSENGERS AND/OR WITNESSES ONLY) NAME BOGER MERID A (LAST,FIRST MIDDLE INITIAL) ADDRESS&PHONE# D O 3810 S 158TH ST APT C7 TUKWILA WA 981882670 SEX' M MMooYYYv 01 - 05 - 1966 PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET INJURY NATURE OF INJURIES E j 2 POS. 3 2 4 1 USE 2 OLASS 1 ��---� 'NAME LAsr F RST,MIDDLE INITIAL) MERID ELLIOTT A ADDRESS&PHONE# D C,B 3810 S 158TH ST APT C7 TUKWILA WA 98188 SEX' M MMDDVVYv 11 _ 02 _ 2015 SEAT HELMET INJURY NATURE OF INJURIES PASSENGER �WITNESS UNIT# i 2 POS. 7 AIRBAG 2 RESTR. 4 EJECT 1 USE 2 CLASS 1 ----� NAME MIDDLE INITIAL) MERID HARRY ',(LAST,FIRST, AODREss a PHONE# 3810 S 158TH ST APT C7 TUKWILA WA 98188 D.O.B. M 08 SEX _ 21 _ 2017 MMDDVYYY PASSENGER Z WITNESS UNIT# 2 SEAT 9 AIRBAG 2 RESTR. 4 EJECT 1 HELMET 2 INJURY 1 NATURE OF INJURIES Q POS. USE CASS 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. KEVIN PETERSON 07-21-25 02:08 AM INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST.DET DATED PLACE SIGNED APPROVED BY DATE J.CHRISTIANSEN 10437 8/6/2025 8:18:39 PM BADGE OR ID# 12808 ORI# ( WA0171300 TIME POLICE DISPATCHED'; 9:48 PM TIME POLICE ARRIVED 9:48 Pm PART B 3aaa-345-,ao(R11r1s) PAGE 27OF 57 POLIICFETRAFFICN CORRECTION REPORT NO. EG16643 COLLISION REPORT III III III III III 111 1591972 CASE# 25-6230 ADDITIONAL PERSONS INVOLVED(PASSENGERS AND/OR WITNESSES ONLY) NAME MERID EPHRATA (LAST,FIRST MIDDLE INITIAL} ADDRESS&PHONE# 3810 S 158TH ST APT C7 TUKWILA WA 98188 SEX' F MMooYYYv 07 — 11 — 2019 PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET LASS NATURE OF INJURIES E', 2 POS. 10 2 4 1 USE 2 CLASS 1 'NAME (LAST FIRST,MIDDLE INITIAL) MERID ARON ADDRESS&PHONE# D O B 3810 S 158TH ST APT C7 TUKWILA WA 98188 SEX' M MMDDYVYv 10 _ O6 _ 2022 SEAT HELMET INJURY NATURE OF INJURIES PASSENGER WITNESS UNIT# i 2 PCS 10 AIRBAG 2 RESTR. 10 EJECT 1 USE 2 CLASS 1 '.NAME (LAST,FIRST,MIDDLE INITIAL) ADDRESS&PHONE# SEX' D.O.B.M _� 1I MDDYYYY PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR, EJECT HELMET INJURY NATURE OF INJURE ❑ Q POS. 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. KEVIN PETERSON 07-21-25 02:08 AM INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST.DET DATED PLACE SIGNED APPROVED BY DATE J.CHRISTIANSEN 10437 8/6/2025 8:18:39 PM BADGE OR ID# 12808 ORI# ( WA0171300 TIME POLICE DISPATCHED'; 9:48 PM TIME POLICE ARRIVED 9:48 Pm PART B 3 Do-3mx-,ao(Rtrras) PAGE 37 OF 57 REPORT NO.` EG16643 CASE# 25-6230 O COLLI COLLISION TIME OF 07/19/25 21:27 COLLI NARRATIVE I was dispatched to a collision on 07/19/25 at 2148 hours I was dispatched to a collision at NE Sunset Blvd and Edmonds Ave NE, in city Renton, King County WA. Unit 1 BUC8575 Driver: Yevgeniy V. Govorushkin (DOB 05/11/1988) Unit 2 BEE0782 Driver: Aberash K Sema (DOB 07/23/1985) 1 contacted both parties Unit 1 stated that he was traveling in lane two traveling West on NE Sunset Blvd when approaching the Edmonds intersection, the light turned yellow. Unit 2 then stopped for the light and unit 1 did not have enough time to stop and hit unit 2. Unit 1 stated he thought unit 2 was going to go through the intersection on the yellow. Unit 2 was traveling West on NE Sunset Blvd when approaching the intersection of Edmonds Ave NE, the light turned yellow and Unit 2 stopped for the light. Unit 1 then hit the back of unit 2 while they were sitting at the light. Unit 1 was seen by Renton Fire for airbag deployment and pain to left arm. All personal in unit 2 stated no injuries and did not want to see medics. I certify (declare) under penalty of perjury under the laws of the State of Washington that the foregoing is true and correct. Electronically signed: Officer Kevin L. Peterson Date and Place: 07/20/2025, 0207 hours at Renton, WA **** AUTO-POPULATED SECTION **** THE FOLLOWING ARE DESCRIPTIONS ENTERED FOR ITEMS SELECTED AS "OTHER": Motor Vehicle Unit 2 Seat Position (Passenger EPHRATA MERID): CENTER ROW DRIVER SIDE Seat Position (Passenger ARON MERID): CENTER ROW PASSENGER SIDE **** END OF AUTO-POPULATED SECTION **** PAGE 4 OF 5 REPORT NO. EG16643 CASE# 25-6230 DATE AND TIME i 07/19/25 21:27 OF COLLISION a ^ w Vf y Y { A i y �t+wsu r au �, a a � 1 h" M� 'N• � q�. �t t S 4 PAGE 5 OF 5