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
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