HomeMy WebLinkAbout25-7297 IT si " II IIIII III IIIII II IIII IIIII I . 27c REPORT NO EG23399OLCERA
COLLISION REPORT 1591971
INTERSTATE CITY STREET FIRE I
CASE# 25-7297 2
RESULTEDSTOLENSTATE ROUTE OTHER VEHICLE LOCALANG 4100 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#
DATE OF N E IN eDLLISION' 08 - 21 - 2025 1119 17 =.= S 8 W E OF M 1070 a
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓
SW 43RD ST BLOCK NO. e 1508 .�
4a❑ MILE POST
❑ DISTANCE OF(REFERENCE OR CROSS STREET)
5 MILES 1.1 FEET B S B W e
0 1 29
MOTOR ✓ PEDAL- DAM AG THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE ❑ YEs Vl No D:2062146564 0 1 30
5 LAST NAME THORELL FIRST NAME JAN MIDDLE D 1 1 2 31
INITIAL
STREET ❑ 24442 24TH AVE S CITY; DES MOINES ST I WA ZIP 981984052 2
NEW ADDRESS
7 CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
INTERLOCKYES NO INTERLOCK VEs Na YES F NO
8 DRIVERCENSE# STATE WA SEXI M MMDDYY' 05 - 11 - 1972 1 2 32
9 ON DUTY STATUS' AIRBAG 6 RESTR 4 EJECT ', ) HELMET 2 INJURY 6 NATURE OF INJURIES 2
USE ,CLASS LOW SUGER,DIABETIC,POSSIBLE HEAD INJ
LICENSE, C31503Y STATE WA VIN# 1FTBR1Y85LKB13983 3
10 Fq I as ATP tt
TRAILER STATE TRAILER STATE
11 3 5 PLATE# PLATE# ROM To
TRLR TRLR 7 1 3 33
12 3 5 VIN# vIN#
FROM TO
13 2 VEH.YEAR2020 MAKE FORD MODEL TRANS, STYLE VEHICLE TOYED NO�iS46LIN Tl� {J RSTOWING GCS❑VT EHICLE
No� 3 7 34
DAMAGE IIII._IIII
REGISTERED OWNER INFO BLUE ORIGIN LLC 2121876TH AVES KENT WA 98032 VEHICLE NO. 1
SHADE IN DAMAGED AREA 35
2 LIABILITY INSURANCE INSURANCE CO 14 STAR INDEMNITY 1000639306241
IN EFFECT &POLICY#VEn" CHARGE 36
Lec LY YES❑NO❑ CITATION# <14,
15 STMDING
UN# MOTOR PEDAL- ❑ PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
1 T 02 VEHT,O,E CYCLE nWNFR
16�
LAST NAME IZAK FIRST NAME MICHAEL MIDDLE' R
INITIAL
17 F1 STREET ❑
❑ 16054 SE 172ND ST CITY RENTON ST, WA ZIP 98058 37
NEW ADDRESS
18❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICALTRAN3PORTED. ❑ 38
INTERLOCKYES NO INTERLOCK YES N YES NO
19 DRIVER'S STATE WA SEX M D.O.e. 04 06 1986 39
LICENSE# MMDDYY
20❑ ON DUTY❑ STATUS AIRBAG 6 RESTR 4 EJECT 1 HELMET 2 INJURY 5 NATURE OF INJURIES ❑ 40
USE CLASS BROKEN TIBIA
21 LICENSE I PATE# C5987ON rare WA vIN# NMOLE7E73J1370879 41
22❑ PLATE# STATE PLATE# STATE 42
23 TRLR RLR 43
UIN#. 'IN#
TOWED BY GOV HI 44
VEH.YEAR 2018 MAKE FORD MODEL TRANSIT STYLE VN DAMIAGE TOWED✓ No BLIN BANKERS TOWING
24
REGISTERED OWNER INFO CERTIFIED CALIBRATION SER LLC 917INDUSTRY DR TUKWILA WA 98t88 VEHICLE N0.2
SHADFY DAMAGED AREA
3 4
LIABILITY INSURANCE❑ INSURANCE CO
IN EFFECT &POLICY# Q
1-1— YES❑ N,JI CITATION11 CHARGEtO25
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
J
26
C.CATALAN 12007 WA0171300
PART A PAGE 01 OF
3000-345-189(R 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EG23399
COLLISION REPORT III III III III III 111
1591972 CASE# 25-7297
E NA ADDITIONAL PERSONS INVOLVED(PASSENGERS AND/OR WITNESSES ONLY)
M
(LAST,FIRST,MIDDLE INITIAL) CIMINO ALEXANDER G
ADDRESS&PHONE#
MONROE MONROE WA 98272 4256590086 SEXi M MMDDD BYYY 04 — 02 — 2005
PASSENGER WITNESS UNIT# SEAT I AIRBAG RESTR. EJECT HELMET INJURY NATURE OF INJURIES
1:1z; POS. USE CLASS ---�
:NAME
Lnsr EIRST,MIDDLE INITIAL) ABREGO EMILIO J
ADDRESS R PHONE#
RENTON RENTON WA 2063477661 SEX M MMDDYYYY D.O.B. 03 - 16 _ 2004
PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET INJURY NATURE OF INJURIES
❑ �✓ POS. USE INJURY ---�
LASS
:NAME
(LOST,FIRST,MIDDLE INITIAL)
ADDRESS&PHONE#
MMDDYY
SEX/ 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.
C.CATALAN 08-26-25 05:39 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST.DET DATED PLAGE SIGNED
APPROVED BY DATE
C.JACOBS 1953 812812025 2:24:09 PM
BADGE OR ID# 12007 ORI# WA0171300 TIME POLICE DISPATCHED 11:21 AM TIME POLICE ARRIVED i 11:29 AM
PAST B 3 Do-3mx—attar(t 1Mff) PAGE 2�OF 4
REPORT NO.` EG23399 CASE# 25-7297 O OF COLL1COLLI 510N TIME 08/21/25 11:19
NARRATIVE
On August 21, 2025, at approximately 1530 hours, I was dispatched to a two-vehicle collision with
reports of injury at 1508 SW 43rd St, within the City Limits of Renton, County of King, State of
Washington.
Upon my arrival, I observed heavy mechanism to the involved vehicles with airbag deployment as
well as both of the involved parties complaining of pain. The Renton Regional Fire Authority (RRFA)
responded to the scene for evaluation, and they advised that the driver of Unit#1 was diabetic, and
his blood sugar was "32." They suspected that his medical status was one of the contributing factors
to the collision.
Two independent witnesses approached me and had the following:
Witness, Alexander G. Cimino explained he was traveling from Tukwila to Renton. During that time,
he was traveling directly behind Unit#1. Alexander observed Unit #1 driving erratically because he
was unable to maintain his lane This led them to call 911 believing that the driver was under the
influence or was having a medical issue. He attempted to direct police to their location, but as they
entered Renton from West Valley Hwy on SW 43rd St, he observed Unit#1 strike Unit#2 head on.
Unit#1 was traveling eastbound on SW 43rd St in lane 2 of 2. Unit#1 then veered left, crossed the
center turn lane, and struck Unit#2 which was traveling westbound in lane 2 of 2. Both vehicles came
to a rest at
Another witness, identified as Emilio J. Abrego, stated he was following Unit#2 westbound on SW
43rd St. While they approached the 1000 block of SW 43rd St, Unit#1 crossed the center turn lane
and struck Unit#2 head on. Emilio had in car video footage, which I saw and confirmed. That video
was uploaded by Officer Nelson.
The driver of Unit#1 was identified as Jan Thorell. He was transported to Valley Medical Center.
The driver of Unit#2 was identified as Michael R. Izak and he was transported to Harborview Medical
Center. Medics suspected he sustained two broken tibias.
Both vehicles were impounded by Bankers Towing and 1 was unable to speak with the two involved
drivers due to the severity
Based on the information above, I determined that the Driver of Unit#1 (Jan Thorell) is the proximate
cause for the collision for failing to take care of himself causing a collision.
I certify (declare) under penalty of perjury under the laws of the State of Washington that the
foregoing is true and correct.
C. Catalan 08/26/2025 Renton
PAGE 3 OF 4
REPORT NO. EG23399 CASE# 25-7297 DATE AND TIME 08/21/25 11:19
OF COLLISION
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