HomeMy WebLinkAbout25-6861 ("7—
STATE.w,-" .:.. TFFiN27CERAc REPORT NO. EG16958 570
00LLISION REP F 1591971
FIRE CASE# 25-6861 2 0 5
INTERSTATE CITY STREET RESULTED
STOLEN
1 1 STATE ROUTE OTHER VFHICI F LOCAL AGENCY 4200 3[�
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 TRIBAL TOTAL UN 75#OF02 OBJECT
STRUCK 1 8 2$
RESERVATION ", 2
3 M M D D Y Y Y Y TIME I2400) COUNTY# MILES CITY#
coAT sloN 08 - 07 - 2025 0654 17 a. e W 8 OF IN 8 1070 3
S
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓
MAINAVES BLOCK NO. 8✓ 300 .�
4a❑ MILEPOST
❑ DISTANCE OF(REFERENCE OR CROSS STREET)
5 �. FEET e S e W B
OF 4 29
MOTOR PEDAL- DAM ETHRESHOLD MET PHONE
����0� VEHICLE CYCLE Yes ,/No D:3603886494 0 1 30
6 LAST NAME KIVUVA FIRST NAME DORCAS MIDDLE N 1 1 2 31
INITIAL
STREET E:1' 1800 S 330TH ST APT A101 CITY FEDERAL WAY WA
NEW ADDRESS S7 ZIP 980039401 z
7❑ COL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
INTERLOCK YES LINOZINTERLOCK YES No W YES NOW
8❑ LDICENS STATE WA SEX'F MM flYY 09 - 20 - 1971 1 2 32
9 F] ON DUTY STATUS' AIRBAG 2 RESTR 4 EJECT 1 H U5 E7 CLASRS 1 NATURE OF INJURIES 2
LICENSE CKU1879 srArE WA WIN# SALCR2BG6HH666102 3
10 9❑ PI ATF it
RAILER TRAILER
11 2 5 PLATE# STATE PLATE# STATE FROM To
TRLR TRLR. 1 3 33
12 2 5 VIN#' VIN#
FROM TO
13 4 VEH.YEAR2017 MAKE LNDR MODEL DISCOV STYLE UT VEHICLDAMAGETOWEEDFtl T02fBLIN TOWED BY GOVT.VEHIICLNOF✓ 5 1 34
❑ REGISTERED OWNER INFO OWNEDBYDRIVER IIIL—llll VEHICLE ccNJll OO..'II 1
SHADE 1N DAMAGED AREA ❑ 35
4 LIABILITY INSURANCE INSURANCE CO 3 4
14 PROGRESSIVE 960033947
IN EFFECT &POLICY# STOP _
VtwCLL CHARGE i 5 ❑ 36
ecnu v YES❑NO❑ CITATION# 10 ftOTTOM
15❑ sranomc a 7 6
MOTOR PEDAL: PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT VEHICLE CYCLE' OWNER YES NO D:7867212949
16�
LAST NAME VENANCIO FIRST NAME S—NE MIDDLE D
INITIAL
17 STREET El 11752 SE 191ST ST CITY RENTON I ST WA ZIP 980587202 37
NEW ADDRESS I I I ❑
18❑ CDL IGNITION REQUIRED IGNITION pRESEIJT MEDfCALTRANSPORTED ❑ 38
W7ERLOCKvEs ND INTERLOCkCvEs no ves No,�
19 DRIVER'#
ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 H U SET INJURY 1 NAruRE of INJURIES 40
CLASS
21❑ LICENSE,CN64690 TATf WA vIN# JTDBT1230Y0034996
❑ 41
PLATE#
TRAILER TRAILER ❑22 PLATE# STATE PLATE STATE 42
23 43
TRLR RLR
VIN#. '[N#,
VEH.YEAR 2000 MAKE TQYT MODEL ECHO STYLE DAMIAGE TOWED NOO✓ BLIN TOWED BY GO YES N HI 44
YES O
24
REGISTERED OWNER INFO OWNED BYDRIVER VEHICLE NO.2
SHAD DAMAGED AREA
LIABILITY INSURANCE INSURANCE CO FOREMOST G01675970200 3 4
IN EFFECT &POLICY# 4TOP
- 5
venue YES❑ N.1-1 CITATION CHARGE
25 tO eOTTQM
�ecns�v J e
OFFICER'S NAME(PRINT)
26 OFFICER PHONE BADGE OR ID# AGENCY
J.WISNIEWSKI 12598 TWA0171300
PART A . PAGE 01 OF
9000-345-159(R 11(181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EG16958
COLLISION REPORT III III III III III 111
1591972 CASE# 25-6861
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 NJURY NATURE OF INJURIES
❑ ❑ POS. I USE CLASS
NARRATIVE
On Thursday, August 7, 2025, at 0654 hours, I was on routine patrol when I came upon a two-vehicle
collision in the area of the the 300 block Main Ave South.
The following occurred within the City of Renton, King County; Unit 1 - WA/ CKU18798 was being
driven by Dorcas Kivuva and headed south on Main Ave S in the 300 block and turned left into across
the double yellow line. Unit 2 - WA/CNB4690 was being driven by Simone Da Silva Venancio and
was traveling north in lane #2, closest to the curb, on Main Ave in the 300 block.
Dorcas stated she was driving south and quickly tried to turn left in front of Unit 2 into the parking lot
for the business center. The passenger side fender collided with the front bumper of Unit 2.
Simone stated she was traveling north, then all of a sudden Unit 1 quickly turned in front of her.
Simone stated she tried to stop and avoid the collision, when she was struck by Unit 1.
Based on both statements, it appears that Unit 1 was responsible for the collision. Neither vehicle
needed to be towed.
I declare under penalty of perjury under the laws of the State of Washington that the foregoing is true
and correct.
Electronically signed by Officer J. Wisniewski/#204 on 08/07/25 at 0725 in Renton, WA
I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT.
J.WISNIEWSKI 08-07-25 07:37 AM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST.DET DATED PLACE SIGNED
APPROVED BY DATE
J.CHRISTIANSEN 10437 8/7/2025 5:27:24 PM
BADGE OR ID# 12598 ORI# WA0171300 TIME POLICE DISPATCHED 1 6:54 AM TIME POLICE ARRIVED i 6:54 AM
PART B 3000-345.160(R1Vt8) PAGE F2 _-]OF F3
REPORT NO. EG 16958 CASE# 25-6861 DATE AND TIME 08/07/25 06:54
OF COLLISION
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