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HomeMy WebLinkAbout25-7794 iiTFiNII IIIII III IIIII II IIII IIIII I . 27c REPORT NO EG29024oc� RA COLLISION REPORT 1591971 CASE# 25-7794 2 INTERSTATE CITY STREET FIRE I RESULTEDSTOLENSTATE ROUTE OTHER VEHICLE LOCAI-AGENCY 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# eaCL s on' 09 - IN 07 - 2025 0913 17 �.[� S 8 W e OF e 1070 3 4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓ SUNSET BLVD N BLOCK NO. e 400 .� 4a❑ MILE POST ❑ DISTANCE OF(REFERENCE OR CROSS STREET) 5 700 00-] MILES N FEET e✓ S 8✓ W e N 3RD ST 2 0 29 MOTOR PEDAL- DAM AG THRESHOLD MET PHONE UNIT 01 VEHICLE ❑ CYCLE ❑ YEs Vl No D:4254638581 0 6 30 6 LAST NAME JENKINS FIRST NAME RILEY MIDDLE A 1 1 2 31 INITIAL STREET ❑ 1504 JONES AVE NE CITY; RENTON ST I WA ZIp; 98056 2 NEW ADDRESS 7 +CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED: 3 INTERLOCK YES NOW INTERLOCKVEs Na�/ YES F NOF,/ 8 DCIENSE# STATE WA SEXI M MMDDYY' 04 — 08 — 2001 1 2 32 -NJUR 9 ON DUTY STATUS' AIRBAG 2 RESTR 4 EJECT 1 N USEET 2 CLASSY 1 [NATURE of INJURIES 2 10 PI ENSrtEI BSG3912 STATE WA VIN# JMIBK143541116095 3 TRAILER STATE TRAILER STATE 11 3 0 PLATE# PLATE# FROM To TRLR zRLR 1 1 5 33 12 3 0 VIN#' vIN# FROM TO VEH.YEAR 2004 MAKE MAZD MODEL 3S5D STYLE P4 VEHICLE TOWED,DLt�TOBLIN TOWED By GOVT VEHICLE 1 5 34 13 DAMAGE YES II_II NO `/ YESII_] NO REGISTERED OWNER INFO RILEY JENKINS 1504 JONES AVE NE RENTON WA 98056 D:4254638581 VEHICLE NO. 1 SHADE IN DAMAGED AREA 35 4 LIABILITY INSURANCE INSURANCE CO 2 3 4 14 ALLSTATE 817979945 IN EFFECT &POLICY# 4TOP V"" CHARGE t S 36 Lec , YES❑NO❑ CITATION# 70 BOTTOM 15❑ STANDING 7 e MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE UNIT 02 VEHICLE CYCLE nWNFR D:5129991819 16� LAST NAME LAZCANO FIRST NAME HAILEY MIDDLE M INITIAL STREET ❑ 17 ❑ 623 GLENNWOOD CT NE CITY RENTON ST, WA ZIP 98056 q 37 NEW ADORE SS 18❑ I CK GNITION REQUIRED IGNITION : PRESENT MEDICAL TRANSPORTED. 38 CDL INTERLOCKYES NO INTERLO YES No FcDL YES NO 19 DRIVER'S ' MMDDYY — 20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 HELMET 2 INJURY 7 NATURE OF INJURIES 40 USE CLASS BACK PAIN 21 LICENSLATE E CMA1449 rarE WA vIN# 4S4BSETCXH3206227 41 22❑ PLATE# STATE[TILER I PLATE# STATE 42 23 TRLR RLR 43 UIN#. 'IN# VEH.YEAR 2017 MAKE $(JB,G MODEL O(iTB,gC STYLE p4 VEHICLE TOWED TO BLIN TOWED BY GOV HI 44 24 DAMAGE YES NO VES NO REGISTERED OWNER INFO HAILEY LAZCANO 623 GLENNWOOD CT NE RENTON WA 98056 D:5129991819 VEHICLE NO.2 SHADE IN DAMAGEAREA 2 3 LIABILITY INSURANCE❑ INSURANCE CO NO INSURANCE IN EFFECT &POLICY# 9TOP vew1— ❑ ,J—I CITATION11 CHARGE to BOTTOM LEGALLY YES N 25 a s OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY 26 RAYMOND WATSON 13127 WA0171300 PAGE 01 OF PART A 3000-345-189(R 11/18) STATE OF POLICETRAFFICN CORRECTION REPORT NO. EG29024 COLLISION REPORT III III III III III 111 1591972 CASE# 25-7794 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 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. RAYMOND WATSON 09-10-25 01:32 PM INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST.DET DATED PLAGE SIGNED APPROVED BY E DAT J.TRADER 4553 911812025 6:59:37 AM BADGE OR ID# 13127 ORI#s WA0171300 TIME POLICE DISPATCHED 9:14 AM TIME POLICE ARRIVED i 9:17 AM PAST B 3 Do-3mx—attar(t 1Mff) PAGE 2�OF 4 REPORT NO. EG29024 CASE# 25-7794 DATE OF COLLI r�510NN + 09/07/25 09:13 L1 NARRATIVE 25-7661 This report is a summary of events that occurred and is not an exact sequencing of events. Statements have been paraphrased and summarized. On 09/07/2025 at approximately 0914 hours, myself, Officer R. Watson, was dispatched to an accident with injuries, at Miller Paint, 350 Sunset BLVD N, within the City Limits of Renton, County of King, State of Washington. Dispatch notes stated that it was a 2-vehicle collision with injuries and that the vehicles had moved to the parking lot. I arrived on scene and observed two vehicles in the parking lot. Unit#1 driven by Riley A. Jenkins (04/08/2001) verified by WADOL photo, stated he was driving a Blue 2004 Mazda 3S5D, WA plate #BSG3912. He said that he was traveling south bound on Sunset BLVD N, when he attempted to merge into lane number 3, after the Houser Way Bypass. When he attempted to merge, he said that unit#2 must have pushed on the brakes and he collided with her. Riley declined aid and said he had no injuries. When I asked for his license, registration and insurance for the exchange of information he was able to provide me with the proper documentation. Unit#1 had moderate front left side damage but was able to be driven from the scene. There was no airbag deployment on unit#1. Riley's father brought up that there was an unsecured dog in the vehicle and wanted it included in the report. Unit#2 driven by Hailey M. Lazcano (DOB 10/05/1993) verified by WADOL photo, stated she was driving a Maroon 2017 Subaru Outback, WA plate #CMA1449. She said she was coming out of the Houser Way Bypass traveling southbound in the number 3 lane, when unit#2 collided with her vehicle. Hailey requested to be seen by medics because of a previous back injury and was assessed by Renton Fire Department medics on scene. When I asked for her license, registration and insurance for the exchange of information she was unable to provide me with her insurance. Hailey said she did not have current insurance on her vehicle. Unit#2 had moderate damage to the passenger side of her vehicle but was able to be driven from the scene. There was no air bag deployment on unit#2. An exchange of information was completed and provided to each party. Pictures were taken of each vehicle and uploaded to evidence.com. I certify (or declare) under penalty of perjury under the laws of the State of Washington that the foregoing is true and correct. Electronically signed by Officer R. Watson #13127 09/10/2025 1332 hours, Renton, King County, WA. PAGE 3 OF 4 REPORT NO. EG29024 CASE# 25-7794 DATE AND TIME 09/07/2509:13 OF COLLISION a t t, �a 1 � ll PAGE 4 OF 4