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Home My WebLink About25-7258 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 1 27c COLLISION REP FIT 1591971 CASE 25-7258 z INTERSTATE ❑ CITY STREET ❑ FIRE ❑RESULTED 1 STOLEN STATE ROUTE ❑ OTHER ❑ VFHICI F ❑ LOCAL AGENC 4200 3 HIT&RUN CODING COUNTY RD PRIVATE WAY INVOLVED 2 TOTAL#OF OBJECT 2$ i TRIBAL ': UNITS 03 STRUCK BUILDING RESERVATION z 3❑ DATE of M M D D Y Y Y Y TIME(2400) COUNTY# MILES N E IN CITY# ❑ cawsloN 08 - 2O - 2025 0708 17 ❑.❑ S 8 W e IN e 1070 3 4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓ SE PETROVITSKY RD BLOCK NO. e✓ 11002 4a❑ MILEPOST DISTANCE OF(REFERENCE OR CROSS STREET) 5 1❑ 500 00 FMILES EET e S ❑ W e 108THAVESE OF,1 29 MOTOR PEDAL- DAMETHRESHOLD MET PHONE NIT 01 VEHICLE ❑ CYCLE. El AG NO D:2539707049 30 6 LAST NAME RODFOR FORERO FIRST NAME JUAN MIDDLE S 1 1 2 31 INITIAL STREET ❑I 35015 4TH AVE S CITY ROY ST WA 2jp, 985809302 z NEW ADDRESS 7 CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3 ❑ iNTERLOCKYEs NO 1/ INTERLOCKYEs NO Z YEs No�/ $❑ LRIIVER # STATE WA SEX'M MMDDYY' 09 — 29 — 1996 32 9 ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 HELMET 2 CLASS 1 NATURE OF INJURIES z❑ 3 LICENSE CNZ3166 sTArI WAvrN# 5XXGR4A66DG092346 10❑ PI ATF# TRAILER STATE TRAILER STATE 11 0 0 PLATE# PLATE# FROM TO TRLR. TRLR 3 7 33 12❑ vIN#' VIN# 2013 KIA OPTIMA OIIF nIG FROM 34 VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED ILJ TO❑BLIN TOWED BY GOVT.VEHICLE 131 DAMAGE YES NO 1I YES[:] NO✓ REGISTERED OWNER INFO SANTIAGO TAPIAS FORERO 12110 GOLDEN GIVEN RD E TACOMA WA 98445 VEHICLE NO. 1 ❑ SHADE IN DAMAGED AREA 35 14❑ UABILI INSURANCE❑ INSURANCE CO GEICO 6176097324 3 4 IN EFFECT &POLICY# 9TOP vEHICE CHARGE 5 36 L-"" YES❑NO❑ CITATION# 10 BOTTOM 15❑ STANDING 6 MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE UNIT VEHICLE ❑ CYCLE ❑ ❑ OWNFR ❑ YES 1/ NO D:4255621200 16❑ LAST NAME KIPPER FIRST NAME JULIE MIDDLE INITIAL 17❑ STREET ❑', 11002 SE PETROVITSKY RD CITY' RENTON ST WA ZIP 98056 37 NEW ADDRESS ❑ 18� CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL t—T�RANSPORTED 38 INTERLOCKYES�NOR INTERLOCK YEs I I No� YES t l NO❑ 19 LLIICENS # STATE SEX U MMDDYY 39 HELMET INJURY NATURE OF INJURIES 40 20❑ ON DUTY STATUS' AIRBAG RESTR EJECT USE CLASS ❑ ❑21❑ LICENSE TArE VIN# 41 PLATE# 42 22❑ PLATE# STATE PLATE# STATE 23❑ 43 TRLR RLR UIN#. 'IN#. VEH YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY Gov HI 44 L4❑ DAMAGE YES NO YES NO REGISTERED OWNER INFO VEHICLE NO.2 SHADE IN DAMAGED AREA 2 3 4 LIABILITY INSURANCE❑ INSURANCE #E CO IN EFFECT &PO I 9TOP 5 vE""LE ❑ ,J� CITATION# CHARGE i o BOTTOM LEGALLY YES N J 25 s e =ON NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY 26 12421 WA0171300 PAGE 01 OF PART A 3000-345-159 fR 11/181 STATE OF POLICETRAFFICN CORRECTION REPORT No. EG23365 COLLISION REPORT III III III III III 111 1591972 CASE# 25-7258 ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY) NAME (LAST FIRST,MIDDLE INITIAL) ADDRESS&PHONE# SEX D.O.B. - - MMDDYYYY. PASSENGER❑WITNESS UNIT# SEAT AIRBAG RESTR. EJECT ' HELMET INJURY NATURE OF INJURIES POS. USE CLASS NAME '(LAST,FIRST MIDDLE INITIAL) ADDRESS&PHONE# D D B SEX MMDDYYYY PASSENGER ❑WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET INJURY NATURE OF INJURIES POS. USE CLASS NAME (LAST FIRST MIDDLE INITIAL) AppRESS R PHONE# SEX D.O.B. MMDDYYYY. - PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET NJURY NATURE OF INJURIES ❑ ❑ POS. USE CLASS ----� NARRATIVE' 25-7258 ACC On 8/20/2025 1 was working as a uniformed patrol officer and driving a marked patrol vehicle for the City of Renton. I was dispatched to a report of a single vehicle collision in the parking lot of 11002 SE Petrovitsky Rd Renton/King/WA. A property owner was calling to advise that a vehicle had struck her garage. I arrived on scene and located the black 2013 Kia Optima WA/CNZ3166 still on scene. The driver was identified by his WADL as Juan S Rodfor Forero DOB: 9/29/1996. Juan said that he was driving west through the parking lot and stopped to deliver a package. He said he believed he put it in park but when he came back, he saw his vehicle rolling. The front driver side bumper of the Kia stuck the support column of a garage directly across from the H building. The Kia was drivable and able to leave the scene. The property owner, identified by her WADL as Laura A Botz DOB: 7/14/1987, advised she came outside after hearing he crash. She said that her garage door was damaged along with the support column. I provided both parties with an exchange of information and cleared the scene. Nothing further. I certify under penalty of perjury under the laws of the State of Washington that the foregoing is true and correct. D. Nelson #191 8/20/2025 Renton WA I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT. D.NELSON 08-21-25 04:53 PM INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED APPROVED BY DATE C.JACOBS 1953 1 812812025 1:20:21 PM BADGE OR ID# 12421 ORI# WA0171300 TIME POLICE DISPATCHED 7:09 AM TIME POLICE ARRIVED';7:16 AM PART B PAGE IT]OF 4� SUPPLEMENTAL REPORT NO. EG23365 r` POLICE TRAFFIC 1 27 COLLISION REPORT CASE# 25-7258 1 COMMERCIAL MOTOR CARRIER INTERSTATE INTRASTATE G UNIT'# USDOT ICC# VEHICLE TYPE CARGO BODY ;TYPE ❑ 1 28 2 CARRIER NAME 3 CARRIER L ADDRESS ` CITY ST' ZIP—1 I ' 4 ❑ NAME # PLACARD: :❑ GI PLACARD IF NO NUMBER SOURCE AXLES + 4a ❑ ADDITIONAL UNITS MOTOR PEDAL- PROPERTY DAMAGE THRESHOLD MET PHONE 5 � UNIT# 3 VEHICLE I_J CYCLE _) PEDESTRIAN � OWNER �'.. YES NO D:2068523717 MIDDLE.. 29 LAST NAME BOTZ FIRST NAME LAURA INITIAL A STREET 30 NEW AnnRFrtP 11002 SE PETROVITSKY RD,UNIT CITY RENTON ST WA ZIP 1 98055 6 CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TANSPORTED 1 31 INTERLOCK YEs No zERLOCK YES E]Na� YEs N L DRIVER'S STATE I SEX F M�DDYBYv 07 - 14 - 1987 LICENSE 7 F-1 ON DUTY STATUS AIRBAG RESTR. EJECT HELMET INJURY NATURE OF INJURIES USE cLASS 8 ❑ ' 1 32 LICENSE+ rar VIN.# PLATE# 9 TRAILER TRAILER PLATE# STATE PLATE# STATE 10 ❑ TRLR TRLR VIN.#. VIN.#. 11 VEH.YEAR MAKE MODEL STYLE VEHICLE TOWS T SABLIN TOWED BY anvi vEHIG E FROM TO DAMAGE Y E ES NO YES NO REGISTERED OWNER INFO. m 33 12 SHADE IN DAMAGED AREA FROM TO LIABILITY INSURANCE❑ INSURANCE CO IN EFFECT &POLICY# tGQ VEHICLE 34 13 ❑ LEGALLY YES[:] NO❑ CITATION# CHARGE STANDING S} 8 7 6 14 ❑ UNIT Tr Vd 1 RE O CYDCLE � OWNER YES AGE NOHRESHOLD MET PHONE El 35 PEDESTRIAN 15 LAST NAME FIRST NAME MIDDLE': INITIAL36 STREET"[-] ❑ 16 NEn+AnnREs.�' CITY'. ST ZIP CDL IGNITION REdUiRED IGNITtGN PRESENT MEDICALTANSPORTED INTERLOCK YES No INTERLOCK YEs NO YEs NO El 17 37 LICENSE# STATE SEX MMDDDYBYY 18 ❑ ON DUTY� STATUS AIRBAG RESTR. ; EJECT HELMET INJURY NATURE of INJURIES 38 USE (CLASS 19 ❑ vIN# 39 LICENSE PLATE# rnr 20 ❑ TRAILER' TRAILER ❑ 40 PLATE# STATE PLATE# STATE 21 ❑ TRLR TRLR 41 VIN# YIN#i 42 22 VEH.YEAR MAKE I MODEL STYLE I VEHICLE TO DUET SABLIN TOWED BY GOVT.VEHICLE DAMAGE YES NO YES NO 23 REGISTERED OWNER INFO SHADE IN DAMAGED 3 a 4 AREA F 43 z LIABILITY INSURANCE INSURANCE CO ' VE EFFECT &POLICY# i 970P - 4 E:l 44 24 VEHICLE YES❑ NO❑ CITATION# CHARGE iq 60TiOM C=DLv STANDING 8 7 6 1 CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT. D.NELSON 08-21-25 04:53 PM 25 INVESTIGATING OFFICER'S SIGNATURE OFFICER'S PHONE UNIT OR DIST DET DATED: PLACE SIGNED APPROVED BY DATE 26 ORRID# 12421 O#I',WA0171300 JACOBS 8/28/2025 PAGE F OF 4 3000-345-013(R 11118) REPORT NO. EG23365 CASE# 25-7258 DATE AND TIME 08/20/25 07:08 OF COLLISION Y h 4r � I f tt 4` I a yG4 1,�fl tR C F +d 4 I t PAGE 4 OF 4