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HomeMy WebLinkAbout25-7040 IT si " II IIIII III IIIII II IIII IIIII I . 27c REPORT NO EG22660OLCERA COLLISION REPORT 1591971 INTERSTATE CITY STREET FIRE I CASE# 25-7040 2 RESULTEDSTOLENSTATE ROUTE OTHER VEHICLE LdCAI-AGENCY 4200 3 HIT&RUN CODING COUNTY RD PRIVATE WAY INVOLVED 2 TOTAL#OF OBJECT 1 s 28 TRIBAL UNITS 02 STRUCK RESERVATION : 1 1 2 3� M M D D Y Y Y Y TIME(2400) COUNTY# MILES CITY# eaCLson' 08 - 13 - 2025 0909 17 =.= S 8 W e IN e 1070 s 4�] ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓ SUNSET BLVD N BLOCK NO. e 600 .� 4a� MILE POST ❑ DISTANCE OF(REFERENCE OR CROSS STREET) 5 20 00 FEET e✓ S 8✓ W e BRONSON WAY NE 0 1 29 MOTOR PEDAL- DAMAG THRESHOLD MET PHONE UNIT 01 VEHICLE ❑ CYCLE ❑ YES No �/ D:2065369315 0 1 30 5 LAST NAME ROJAS AMBRIZ FIRST NAME MICHELLE MIDDLE E 1 1 2 31 INITIAL STREET ;❑ 642BLAINEAVENE CITY; RENTON ST, WA Zip; 980563669 2� NEW ADDRESS 7 CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED' 3 INTERLOCKYES NO✓ INTERLOCK YEs N©✓ YEs NO�/ 8 DRIVER # STATE WA SEXI F MMDDYY' 07 — 24 — 2006 1 2 32 9 ON DUTY STATUS' AIRBAG 2 RESTR 4 EJECT 1 HELMET 2 CLASSY 1 [NATURE of INJURIES 2 LICENSE, CPV8825 STATE WA VIN# 1N4AL2APXCC122277 3 10 Fq I PI ATP tI TRAILER 11 3 0 STATE TRAILER STATE PLATE# PLATE# ROM To TRLR zRLR 1 1 5 33 12 3 0 VIN#' vIN# FROM TO VEH.YEAR 2012 MAKE NISS MODEL ALA-IMA STYLE VEHICLE TOWED[n TO ZBLIN TOWEDBY GOVT VEHICLE 1 $ 34 13� DAMAGE YES II_II NO YESII_I) NO✓ REGISTERED OWNER INFO MICHELLE ROJAS AMBRIZ 642 BLAINE AVE NE RENTON WA 98056 VEHICLE NO. 1 SHADE IN DAMAGED AREA 35 14❑ LIABILITY INSURANCE❑ INSURANCE CO 3 4 IN EFFECT &POLICY# 4TOP V""' CHARGE 5 36 LEGALLY YES❑NO❑ CITATION# 7 0 80TTOM 15❑ STANDING 7 e MOTOR ✓ PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE UNIT 02 VEHICLE CYCLE nWNFR YES NO �/ D:9173304798 16� LAST NAME ✓OA FIRST NAME SOPHIA MIDDLE I N INITIAL 17 STREET ❑ 37 NEW ADORE SS❑ 2027 CAMAS AVE NE CITY RENTON ST, WA ZIP 980562780 1$❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED ❑ 38 INTERLOCKYEs NO✓ (NTERLOCI£YES xz ✓ YES NO✓ 19 DRIVER'S MMDiYY - HELMET INJURY: NATURE OF INJURIES 40 20❑ ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 USE 2 CLASS 1 ❑ 21 LICENSE LATE# CGY3675 rare WA vIN# USE 41 22❑ [TILER TAILER PLATE# STATE PLATE# STATE 42 23 TRLR RLR 43 UIN#. 'IN# VEH.YEAR 2023 MAKE JyJSs MODEL LEAF S/ STYLE VEHICLE TOWED TO BLIN TOWED BY GOV HI 44 24 DAMAGE YES NO✓ NO✓ REGISTERED OWNER INFO OWNED BY DRIVER VEHICLE N0.2 SHADE IN DAMAGEAREA 2 3 LIABILITY NSURANCE✓I INSURANCE CO GEICO4539504441 IN EFFECT &POLICY# I STOP LY—ve ❑ ,J—I CITATION# CHARGE to BOTTOM EEGnE YES N`[ 25 OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY J 26 D.NELSON 12421 WA0171300 PAGE 01 OF PART A 3000-348-189(R 11/18) STATE OF POLICETRAFFICN CORRECTION REPORT NO. EG22660 COLLISION REPORT III III III III III 111 1591972 CASE# 25-7040 E NA ADDITIONAL PERSONS INVOLVED(PASSENGERS AND/OR WITNESSES ONLY) M (LAST,FIRST,MIDDLE INITIAL) YU EVELYN V ADDRESS&PHONE# D� 2027 CAMAS AVE NE RENTON WA 98056 9173304441 SEXi F MMDDYYYY B. 08 — 29 — 2016 PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET INJURY NATURE OF INJURIES 2 POS. 9 2 4 1 USE 2 CLASS i 1 ----� :NAME (LAST FIRST MIDDLE INITIAL) ADDRESS R PHONE# SEX — MMDDYYYY PASSENGER❑WITNESS UNIT# : SEAT AIRBAG RESTR. EJECT HELMET NJURYURECFINJURIES POS. USE CLA : NAT SS ----� :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 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. D.NELSON 08-14-25 03:01 PM INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST.DET DATED PLACE SIGNED APPROVED BY DATE C.JACOBS 1953 8/26/2025 3:21:08 PM BADGE OR ID# 12421 ORI# WA0171300 TIME POLICE DISPATCHED 9:12 AM TIME POLICE ARRIVED i 9:22 AM PAST B 3 Do-3mx—attar(t 1Mff) PAGE 2�OF 4 REPORT NO. EG22660 CASE# 25-7040 GATE OF COLLI r�510NN + 08/13/25 09:09 L1 NARRATIVE 25-7040 ACC On 8/13/2025 1 was working as a uniformed patrol officer and driving a marked patrol vehicle for the City of Renton. 1 was dispatched to a report of a two-vehicle collision near the intersection of Sunset Blvd N and Bronson Way NE Renton/King/WA. An involved party was calling to report that there were no injuries, and both vehicles had pulled off to the side of the roadway. I arrived on scene and located both vehicles on the side of the roadway. The driver of a 2012 Nissan Altima WA/CPV8825 was identified by her WADL as Michelle Rojas Ambriz DOB: 7/24/2006. Michelle said that she was driving south on Sunset Blvd when the vehicle in front of her slowed down to get out of the way for two vehicles going the wrong way. She said that two vehicles were going north in the southbound lanes of Sunset Blvd. In this area of Sunset Blvd, the roadway is divided by a concrete barrier, there is one lane going northbound after the 1405 on/off ramps. The southbound lanes split to a right turn lane and southbound lane. This area is also a work zone since the overpass is being worked on, the area has numerous signs and cones designating it as such. Michelle said that she moved to avoid the two vehicles and collided with the back of the vehicle in front of her, the blue Nissan Leaf. Michelle said she was not injured and did not require any aid. There was damage to the front bumper of the Altima. The driver of the blue 2023 Nissan Leaf WA/CGY3675 was identified by her WADL as Sophia N Jao DOB: 2/15/1984. Sophia said she was driving south on Sunset Blvd when two vehicles that were driving north in the southbound lanes came around the corner. She said that she slowed down and moved right and that was when the Altima collided with her. Sophia was only able to say one of the vehicles may have been a Tesla. There was damage to the rear bumper of the Leaf, Sophia said she had a mild headache but did not require aid. Her passenger, Evelyn V Yu DOB: 8/29/2016, was not injured. Both vehicles were drivable and able to leave the scene. Michelle was not able to provide me with proof of insurance on scene, 1 provided her my business card and told her to email me proof of insurance and 1 would add it to the report. Michelle called the next day and advised she did not have any insurance as it had expired several months prior. I provided both Michelle and Sophia 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 8/13/2025 Renton WA PAGE 3 OF 4 REPORT NO. EG22660 CASE# 25-7040 DATE AND TIME 08/13/2509:09 OF COLLISION t u S r' f k � y a �x a � tiS i PAGE 4 OF 4