HomeMy WebLinkAbout25-7141 IT si " II IIIII III IIIII II IIII IIIII I . 27c REPORT NO EG25413OLCERA
COLLISION REPORT 1591971
CASE# 25-7141 2
INTERSTATE CITY STREET❑ FIRE ❑
RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VEHICLE ❑ LOCALAGENCY 4150 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY ❑✓ INVOLVED
2� TOTAL#OF OBJECT 1 1 s 28
TRIBAL UNITS 02 STRUCK
RESERVATION : 2
3� M M D D Y Y Y Y TIME(2400) COUNTY# MILES CITY#
DATE OF N E
eDl�ls[oN' 08 - 15 - 2025 1843 17 =.�� S WE IN
OF 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓
BLOCK NO. e .�
4a
200 S 3RD ST MILE POST
❑
❑ DISTANCE OF(REFERENCE OR CROSS STREET)
5 2001.1 00 FEET e✓ S 8 W e S 2ND ST
0 4 29
MOTOR PEDAL- DAM AG TSHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE ❑ YES NHREO ✓ 30
6 LAST NAME UNKNOWN FIRST NAME MIDDLE t 1 2 31
INITIAL
STREET
NEW ADDRESS CITY I $EATTLE ST: ZIP: 2
7 CDL IGN(TIUN REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
INTERLOCK YEs NO✓ INTERLOCKYEs NO✓ YEs NOW
8❑ LCEENSE# SRVERSTTATE SEX U MMDDYY' —�— 32
9 ON DUTY STATUS' AIRBAG 9 RESTR 9 EJECT 9 N USE ET 9 CLASSY 0 NAruRE of INJURIES 2
LICENSE, CNR5503 STATE WA VIN# 3KPF24AD7RE813837 3
10 Fq I as ATP tt
TRAILER STATE TRAILER STATE
11 0 0 PLATE# PLATE# ROM To
TRLR rRLR 7 1 33
12 VIN#' VIN#
FROM TO
VEH.YEAR ZO24 MAKE KIA MODEL FORTE STYLE $D VEHICLE TOWED[n TO ZBLIN TOWEDBY GOVT VEHICLE 3 7 34
13� DAMAGE YES II_II NO YESII_I) NO✓
REGISTERED OWNER INFO DEANDRA BEN 13445 MARTIN LUTHER KING JR WUIVITS308 SEATTLE WA 98178 VEHICLE NO. 1
SHADE IN DAMAGED AREA 35
A LIABILITY INSURANCE NSURANCE CO 4
14 ❑ UNKNOWN UNKNOWN
IN EFFECT &POLICY# 9TOP
vEnicLE CHARGE 5 36
Lemur yes❑NO❑ CITATION# t a 80TTOM
15❑ STANDING I s 7 e
MOTOR PEDAL-:. PROPERTY DAM THR OLD MET PHONE
�' PEDESTRIAN Q✓ D:6169008803
VEHICLE CYCLE OWNER
YES✓ NO
16�
LAST NAME MABIE FIRST NAME ELEANOR MIDDLE R
INITIAL
STREET �/ ❑
17 ❑ 13233 SE 43RD PL CITY BELLEVUE ST, WA ZIP 98006 g 37
NEW ADDRESS :
18❑ IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED' 38
CDL INTERLOCKYES NO INTERLOCK YES 0No YES NO
19 DRIVERS STATE WA SEX M I D.O.s, 01 14 2005 � 39
LICENSE# MMDDYY —
6 HELMET INJURY NATURE OF INJURIES 3 40
20❑ ON DUTY STATUS 3 AIRBAG RESTR EJECT USE 2 CLASS 7 PAIN SHOULDER KNEE ANKLE RIGHT SIDELICENSE
❑
21 PLATE# VIN# 41
TArE
22❑ [TILER TAILER
PLATE# STATE PLATE# STATE 42
23 TRLR RLR 43
UIN#. 'IN#
VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN
TOWED BY GOV HI 44
24 1 7 DAMAGE YES NO YES NO
REGISTERED OWNER INFO VEHICLE NO.2
SHADE IN DAMAGED AREA
2 3 4
LIABILITY INSURANCE❑ INSURANCE CO
IN EFFECT &POLICY# 9TOP
vemae ❑ ,.I—I CITATION# CHARGE to BOTTOM
EEGnEEY YES NC
25 a s
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
26
KEVIN PETERSON 12808 WA0171300
PAGE 01 OF
PART A 3000-348-189(R 11/18)
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EG25413
COLLISION REPORT III III III III III 111
1591972 CASE# 25-7141
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 NJURY 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
POS. I USE CLASS
NARRATIVE
I was dispatched to a pedestrian hit and run collision on 08/16/25 at 200 S 3rd St, in city Renton, King
County WA.
Unit 1 CNR5503 Owner: Deandra Ben (DOB 08/13/1985)
Unit 2 Pedestrian: Eleanor R. Mabie (DOB 01/14/2005)
Upon arriving, I meet with the Mabie who told me that she was coming out of Little Ceaser's and
going back to her car. When she saw a black car approaching and it stopped in the parking lot, and
she said that the driver and her saw one another. She then went to cross the street and when doing
so the driver accelerated hit her and left. She stated that she had pain in her right shoulder right knee
and right ankle but did not want to go to hospital.
Upon reviewing the video at Safeway, you can see Unit 1 hit Mabie but then stops and speaks to her
for about 1 min prior to leaving. I called back Mabie, and she told me that she had forgotten but that
the lady stopped and asked if she was ok. She said no you hit me asked her for her insurance and
then Unit 1 drove away.
Mabie stated she could identify the driver if she saw her again.
Fire came to the scene and evaluated Mabie on scene and left.
Video and picture of Unit 1 license plate was uploaded to evidence.
I certify (declare) under penalty of perjury under the laws of the State of Washington that the
foregoing is true and correct.
Electronically signed: Officer Kevin L. Peterson Date and Place: 08/16/2025, 0044 hours at Renton,
WA
I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT.
KEVIN PETERSON 08-16-25 12:46 AM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST.DET DATED PLACE SIGNED
APPROVED BY DATE
P.SUMMERS 8887 91412025 2:40:00 PM
BADGE OR ID# 12808 ORI# WA0171300 TIME POLICE DISPATCHED 1 6:47 PM TIME POLICE ARRIVED i 6:51 PM
PAST B 3 Da-3mx—attar(txIMR) PAGE 2�OF F3
REPORT NO. EG25413 CASE# 25-7141 DATE AND TIME 08/15/2518:43
OF COLLISION
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