HomeMy WebLinkAbout25-6829 ("7—
STATE.w,-" .:.. TFFiN27CERAc REPORT NO. EG16729
,one COLLISION REP F 1591971
CASE# 25-6829 2
INTERSTATE CITY STREET FIRE ❑
RESULTED
STOLEN
1 2 STATE ROUTE ❑ OTHER ❑ VFHICI F ❑ LOCAL AGENCY 4200 3[�
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 TRIBAL UN 75 TOTAL#OF STRUCK OBJECT 11 8 2$
RESERVATION 2
3 M M D D Y Y Y Y TIME I2400) COUNTY# MILES CITY#
coAT sloN 08 - O6 - 2025 0646 17 ❑. e W❑ OF IN 8 1070 a
S
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓
NE3RDST BLOCK NO. 8✓ 300 .�
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ 50 00 FMILES N EET e✓ S ❑ E ❑ SUNSET BLV N
1 91
29
MOTOR PEDAL- DAM ETHRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE; ❑ Yes ,/No D:2063043994 0 1 30
6❑ LAST NAME KAUA FIRST NAME NICOLE MIDDLE' 0 4 31
INITIAL
STREET E:1' 1933 SW 322ND PL#297 CITY FEDERAL WAY WA
NEW ADDRESS S7 ZIP 98023 z
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED a
INTERLOCK YEs No INTERLOCKVES NO YES NO
LDRIVE STATE WA SEX'F MM flYY 08 - 06 - 2025 1 2 32
$❑
9 ON DUTY❑ STATUS AIRBAG 2 1 USE RESTR 9 EJECT 1 H L ET ��SRY 1 NATURE OF INJURIES 2
LICTNSE BTN2940 srnrF WA WIN#' 1FMDU74W42UD58674
10 9❑ 3�
11 0 0 PLATE# STATE TRAIPLATE# STATE ROM To
RA
TRLR TRLR. 7 3 33
12 0 0 vIN#' VIN#
FROM TO
13 p VEH.YEAR2002 MAKE FORD MODEL EXPLOR STYLE UT VEHICLE TOWED 2NODi�ABLIN tIHNK RS GOVT.VEHIICL✓ 3 7 34
❑ DAMAGE II1I._IIII tlAlVt(t ccJllu—'II
REGISTERED OWNER INFO JORGE ROMERO MONTERO,1933SW322ND PL#297 FEDERAL WAY WA 98023 D:9999999999 VEHICLE NO. 1 ❑
SHADE 1N DAMAGED AREA 35
14� LIABILITY INSURANCE❑ INSURANCE CO NONE NONE
IN EFFECT &POLICY# I STOP _ 5
VEHICLE CHARGE 10 ftOITOM ❑ 36
e�AU YES❑No❑ CITATION# 5A0610520,5A0610520, OP MOT VEH W/OUT INSURANCE,NO
15❑ sranowc a e
MOTOR � PEDAL- PROPERTY THR OLD MET PHONE
UNIT 02 t�J ❑ PEDESTRIAN ❑ [:][AM D:3605000896
VEHICLE CYCLE OWNER ES NO
16� '
LAST NAME MORENO CASTILLO FIRST NAME DAVID MIDDLE'
INITIAL
17❑ STREET El 1729 WHITMAN AVE NE CITY RENTON ST', WA ZIP 98059 37
NEW ADDRESS : ❑
1$❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICALTRANSPORTED ❑ 3$
1NTERLOCKvEs NO INTERLOCK YES NO YES NO
19❑ DRIVER'#
❑ ON DUTY STATUS AIRBAG 2 RESTR 9 EJECT 1 H�SET CLASS 1 NATURE OF INJURIES ❑ 40
21❑ LICENSE I C28373W rAre WA vIN# 1FTYR44E19PA38427
❑ 41
PLATE#
TRAILER TRAILER ❑22� PLATE# STATE PLATE STATE 42
23 43
TRLR RLR
VIN#. '[N#,
44
VEH.YEAR 2009 MAKE FORD MODEL RANGER STYLE DAMIAGE ✓TOWED NOO BLIN TOWED BY GO BANKERS YES N HI O
Ct
24
REGISTERED OWNER INFO OWNED BY DRIVER VEHICLE NO.2
SHADE IN DAMAGED AREA
LIABILITY INSURANCE INSURANCE CO COUNTRY FINANCIAL P46A4884980 E 3 4
IN EFFECT &POLICY# I 4TOP 5
Venue LEGALLY ❑ „I�1 CITATION# CHARGE tOBOTTOM
YES N`'L-1
25 OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# JAGENCY
26
SULIASI TAMAIVENA 12788 WA0171300
PART A . PAGE 01 OF
9000-345-159(R 11(181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EG16729
COLLISION REPORT III III III III III 111
1591972 CASE# 25-6829
ADDITIONAL PERSONS INVOLVED(PASSENGERS AND/OR WITNESSES ONLY)
'.NAME
(LAST,FIRST,MIDDLE INITIAL)
ADDRESS&PHONE#
SEXi D.O.B. -
MMDDYYYY
PASSENGER❑WITNESS❑;UNIT# SEAT AIRBAG RESTR. EJECT HELMET INJURY NATURECFINJURIES
POS. ' USE CLASS 1 ----�
:NAME
(LAST FIRST MIDDLE INITIAL)
ADDRESS&PHONE#
SEX D.O.B. -
MMDDYYYY
PASSENGER❑WITNESS UNIT# : SEAT AIRBAG RESTR. EJECT HELMET INJURY: NATURECFINJURIES
POS. USE CLASS ----�
:NAME
(LOST,FIRST,MIDDLE INITIAL)
ADDRESS&PHONE#
SEX MMDDYY D.O.B.
YY
PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET NJU S' NATURE OF INJURIES
❑ ❑ POS. I 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.
SULIASI TAMAIVENA 08-06-25 09:54 AM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST.DET DATED PLAGE SIGNED
APPROVED BY DATE
S.WOODWARD 11528 1 81712025 4:49:52 AM
BADGE OR ID# 12788 ORI# WA0171300 TIME POLICE DISPATCHED 6:47 AM TIME POLICE ARRIVED i 6:55 AM
PART B 3000-345.160(R1Vt8) PAGE F2 --]OF 47
TIM
REPORT NO. EG16729 CASE# 25-6829 OF COLLI ION 08/06/25 06:46
OF COLLISION
NARRATIVE
On 08/06/2025, at approximately 0647 hours, I was dispatched to an unknown accident at NE 3RD
ST/SUNSET BLVD N, in the City of Renton, while I was employed as a uniformed Patrol officer for
the City of Renton, County of King, State of Washington. Dispatch advised that one of the vehicles
was driving in the wrong direction and had hit another car.
Unit#1 was traveling eastbound on NE 3rd ST in lane #1 (lane #1 being the nearest to the curb and
right turn lane, but ends in 50 ft). The driver advised that she had just turned right onto NE 3rd ST and
was trying to drive uphill, where she stated that the tires of the vehicle (unknown which tire) had spun
out, causing her vehicle to cross into the oncoming traffic and hit Unit#2's vehicle. The vehicle
sustained damage to the right side, specifically the front right fender, front right tire, and rear right
fender. The vehicle was not drivable.
Unit#2 was traveling westbound on NE 3rd St in lane #4 (lane #1 being nearest to the curb). The
driver stated he was in the left turning lane when he saw Unit#1's vehicle spin out and hit his vehicle.
His vehicle sustained heavy damage on its left side, specifically affecting the bumper/fender, driver's
tires, and left rear bumper/fender. The vehicle was unable to drive.
Both vehicles were towed by Bankers. Photos were taken and uploaded as evidence. An information
exchange form was given to both parties.
I conducted nystagmus on Unit#1, and she did not show any signs of being impaired. However, she
received multiple tickets for driving without a valid license, without insurance, without providing
registration, and with expired tabs (2023). She was notified about this ticket and was told that they
would be mailed to her address.
This concludes my report.
My Axon camera was on for this call.
I certify (declare) under penalty of perjury under the laws of the State of Washington that the
foregoing is true and correct. This report was electronically signed by Officer S. Tamaivena #12788,
August 6th, 2025, at 0950, Renton, WA.
**** AUTO-POPULATED SECTION ****
THE FOLLOWING ARE DESCRIPTIONS ENTERED FOR ITEMS SELECTED AS "OTHER":
Motor Vehicle Unit 1
Action Code: TIRE SPINNED OUT
**** END OF AUTO-POPULATED SECTION ****
PAGE 3 OF 4
REPORT NO. EG 16729 CASE# 25-6829 DATE AND TIME 08/06/25 06:46
OF COLLISION
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