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HomeMy WebLinkAbout25-7063 IT si " II IIIII III IIIII II IIII IIIII I . 27c REPORT NO EG22661OLCERA COLLISION REPORT 1591971 CASE# 25-7063 2 INTERSTATE CITY STREET FIRE I RESULTEDSTOLENSTATE ROUTE OTHER VEHICLE LdCAI-AGENCY 4100 3 HIT&RUN CODING COUNTY RD PRIVATE WAY ❑ INVOLVED 2 TOTAL#OF OBJECT 1 8 28 TRIBAL UNITS 02 STRUCK RESERVATION : 1 1 2 3� M M D D Y Y Y Y TIME(2400) COUNTY# MILES CITY# eaCL s on' 08 - 13 - 2025 1656 17 =.= S 8 W e OF IN e 1070 s 4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑ BLOCK NO. e .� 4a SE CARR RD MILE POST ❑ ❑ DISTANCE OF(REFERENCE OR CROSS STREET) 5 1. FEET e S 8 W e 103RD AVE SE 1 9 29 MOTOR PEDAL- DAM AG THRESHOLD MET PHONE UNIT 01 VEHICLE ❑ CYCLE ❑ YEs Vl No D:2063534579 0 4 30 6 LAST NAME HAGEN FIRST NAME JAMES MIDDLE T 1 1 2 31 INITIAL STREET ❑ 12233 16TH AVE S CITY; BURIEN ST I WA ZIP; 981682272 2 NEW ADDRESS 7 CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3 INTERLOCKYEs NO INTERLOCKVEs N© vEs No 8 DRIVER #F STATE WA SEXI M MMDDYY' 12 — 26 — 1987 1 2 32 9 ON DUTY❑ STATUS' AIRBAG 1 RESTR 13 EJECT 2 HELMETS INJURY 7 NATURE A INJURIES 2 USE ,CLASS ROAD RASH ON RIGHT LEG AND LEFT WRIST 10 LI AETNES�E 7J9558 STATE WA VIN#, JKBZXNA167A020786 3 TRAI STATE TRAILER LE STATE 11 3 5 PLATE# PLATE# FROM To TRLR TRLR. 7 3 33 12 3 5 VIN# vIN# FROM TO 13 4 VERYEAR2007 MAKE KAWK MODEL ZX1400 STYLE VEHICLE TOYED NO�iS46LIN T�yYEp.QYrETOW GOES❑ENICILF O J 7 1 34 DAMAGE IIII._IIII FFCC�/VVAA REGISTERED OWNER INFO OWNEDBYDRIVER VEHICLE NO. 1 SHADE IN DAMAGED AREA 35 14 LIABILITY INSURANCE❑ NSURANCE CO IN EFFECT &POLICY# GTOP LEA L ❑ ❑ 5A0625711 CHARGE DRIVING ON LEFT CENTER OF aorrom ❑ 36 Yes NO CITATION# 15❑ STM ING MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE UNIT VEHICLE ❑ CYCLE ❑ ❑ nWNRR D:3603337255 16� LAST NAME WANDYAKA FIRST NAME MICHEAL MIDDLE' K INITIAL 17 F1 STREET ❑❑ 37 30233 56TH AVE NW CITY STANWOOD ST, WA ZIP 982927127 NEW ADDRESS 18 —1CDL IGNITION REQUIREO IGNITION PRESENT MEDICAL TRANSPORTED 38 INTERLOCKYES ND INTERLOCK YES NO ves NO 19 DRIVER'S STATE WA SEX M D.O.B. 11 02 1995 39 LICENSE# MMDCYYY — HELMET INJURY: NATURE OF INJURIES 4Q 20❑ ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 USE CLASS 1 ❑ 21 LICENSEPLATE# CLD7912 rare WA VIN# KM8J3CA49JU727318 41 22❑ STATE PLAAILER TE# STATE 42 PLATE# 23 TRLR RLR 43 UIN#. 'IN# VEH.YEAR 201$ MAKE HYUN MODEL T(JCSON STYLE VEHICLE TOWED TO BLIN TOWED BY GO HI 44 24� DAMAGE YES NO� YES NO REGISTERED OWNER INFO SHARDONNAE SPENCER 121112TH ST SWAPT E303 EVERETT WA 98204 VEHICLE NO.2 SHADE IN DAMAGED AREA 2 3 4 LIABILITY INSURANCE INSURANCE CO USAA GIC 0600939787101 IN EFFECT &POLICY# t STOP vewaE ❑ CITATION11 CHARGE 25 to BOTTOM EEGnEEY YES N a OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY 26 C.ARNOLD 12509 WA0171300 PAGE 01 OF PART A 3000-348-189(R 11/18) STATE OF POLICETRAFFICN CORRECTION REPORT NO. EG22661 COLLISION REPORT III III III III III 111 1591972 CASE# 25-7063 ADDITIONAL PERSONS INVOLVED(PASSENGERS AND/OR WITNESSES ONLY) '.NAME (LAST,FIRST,MIDDLE INITIAL) ADDRESS&PHONE SEXi D.O.B. — MMDDYYYY PASSENGERQ WITNESS� UNIT SEAT AIRBAG RESTR. EJECT ; HELMET INJURY NATURE OF INJURIES 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 PC& 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. C.ARNOLD 08-13-25 05:42 PM INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST.DET DATED PLACE SIGNED APPROVED BY DATE C.JACOBS 1953 8/26/2025 3:15:59 PM BADGE OR ID# 12509 ORI# WA0171300 TIME POLICE DISPATCHED 1 4:57 Pry] TIME POLICE ARRIVED i 4:58 PM PAST B 3 Do-3mx—attar(t 1Mff) PAGE 2�OF 4 REPORT NO. EG22661 CASE# 25-7063 OATS OF COLLI r�510NN + 08/13/25 16:56 L1 NARRATIVE CC 25-7063 On 8/13/2025 at 1656 hours I was dispatched to a motor vehicle collision at the intersection of SE Carr Rd and 103rd Ave SE in the City of Renton, King County, Washington. Pre-Collision Driver 2 stated that he was in the #2 lane of SE Carr Rd at 103rd Ave SE facing East and preparing to perform a lefthand turn. Driver 1 stated that he was in the #2 lane of SE Carr Rd approaching 103rd Ave SE. Collision Driver 2 stated that as he began his lefthand turn, Unit 1 approached from behind him in the oncoming lane of travel which is the #2 lane of Westbound SE Carr Rd and proceeding East. Driver 2 stated that he did not see Unit 1 and that the front end of Unit 1 collided with the rear drivers side quarter panel of Unit 2. Driver 1 stated that he was going around traffic in the oncoming lanes of travel at the intersection of SE Carr Rd and 103rd Ave SE. Driver 1 stated that he knew he was wrong. Driver 1 stated that he did not have time to react and as Unit 2 began its lefthand turn, the front end of Unit 1 collided with the rear drivers side quarter panel of Unit 2. Driver 1 was then ejected from Unit 1 and landed in the roadway. Injuries Driver 1 sustained minor road rash but refused treatment at the scene. Vehicle Disposition Unit 1 was rendered inoperable and was towed from the scene by a private tow. Proximate Cause I determined that Driver 1 is the proximate cause of this collision because no vehicle shall be driven on the left side of the roadway under the following conditions: When approaching within one hundred feet of or traversing any intersection or railroad grade crossing When approaching or upon the crest of a grade or a curve in the highway where the driver's view is obstructed within such distance as to create a hazard in the event other traffic might approach from the opposite direction Driver 1 was cited per RCW 46.61.125 1 certify (declare) under penalty of perjury under the laws of the State of Washington that the foregoing is true and correct. Electronically signed by Officer C. Arnold #12509 at 17:30 on 8/13/2025 in the City of Renton, King County, Washington. **** AUTO-POPULATED SECTION **** THE FOLLOWING ARE DESCRIPTIONS ENTERED FOR ITEMS SELECTED AS "OTHER": Motor Vehicle Unit 1 Action Code: OVERTAKING ON WRONG SIDE OF ROADWAY **** END OF AUTO-POPULATED SECTION **** PAGE 3 OF 4 REPORT NO. EG22661 CASE# 25-7063 DATE AND TIME 08/13/2516:56 OF COLLISION �L L r{k L , E 0 3 iY S lg } w Y L i S 1 f r tp�, PAGE 4 OF 4