Loading...
HomeMy WebLinkAbout25-8406 IT si " II IIIII III IIIII II IIII IIIII I . 27c REPORT NO EG32786OLCERA COLLISION REPORT 1591971 CASE# 25-8406 2 INTERSTATE CITY STREET El STATE ROUTE OTHER LOCAI-A`NG 4250 3 C©DINGCOUNTY RD PRIVATE WAY 2 TOTAL#OF OBJECT 1 1 8 28 TRIBAL UNITS 04 STRUCK RESERVATION : 2 3� M M D D Y Y Y Y TIME(2400) COUNTY# MILES CITY# eDCL s o v' 09 - 28 - 2025 2127 17 =.= S 8 W e OF IN e 1070 3 4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION �✓ NE 7TH ST BLOCK NO. e 3028 .� 4a❑ MILE POST DISTANCE OF(REFERENCE OR CROSS STREET) 5❑ 200 00 FEET e✓ S 8 E e KIRKLAND AVE NE 0 1 29 MOTOR ✓ PEDAL- F DAM AG THRESHOLD MET PHONE UNIT 01 VEHICLE CYCLE YES ✓NO 1 4 30 5 LAST NAME UNKNOWN FIRST NAME MIDDLE t 1 2 31 INITIAL STREET F� CITY', ST ZIP 2 NEW ADDRESS 7� +CDL IGN(TIUN REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3 INTERLOCKYEs NOW] INTERLOCKY NO�/ YES NOZ 8❑ LCEENSE# SRVERSTTATE SEX U MMDDYY' —�— 32 9 ON DUTY STATUS' AIRBAG 9 RESTR 9 EJECT 1 HELM USEET 9 CLASSY 0 NATURE OF INJURIES 2 LICENSE, UNKNOWN 3 10 F1 PI ATP# STATE V(N 11[-j—] TRAILER STATE TRAILER STATE 11 3 5 PLATE# PLATE# 11ROM To TRLR TRLR. 3 7 33 12 0 0 VIN#' vIN# FROM TO VEH.YEAR MAKE TOYT MODEL CAMRY STYLE P4 VEHICLE TOWED fnTOZBUN TOWED By GOVT VEHICLE m 34 13 DAMAGE YES II_II NO `/ YESII_I) NO REGISTERED OWNER INFO UNKNOWN UNKNOWN VEHICLE NO. 1 ❑ SHADE IN DAMAGED AREA 35 14 LIABILITY INSURANCE❑ NSURANCE CO UNKNOWN IN EFFECT &POLICY#VEn" CHARGE 36 Lemur YES❑NO❑ CITATION# <14, 15 STANDING UN# MOTOR PEDAL- ❑ PEDESTRIAN1:1 PROPERTY DAM THR OLD MET PHONE 1 VEHiC1.E CYCLE nWNFR YES�/ NO 16❑ LAST NAME NONE FIRST NAME MIDDLE' INITIAL 17❑ STREET F-1 CITY, RENTON ST ZIP 37 NEW ADDRESS 18❑ IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED'. 38 CDL INTERLOCKYES NO INTERLOCK YES NO vEs NO: 19 DRIVER'S # STATE SEX U MMDDYY -= � 39 HELMET INJURY NATURE OF INJURIES 40 20❑ ON DUTY STATUS AIRBAG g RESTR g EJECT 1 USE 9 CLASS 0 ❑ 21 LICENSED796486 TATE I WA VIN# 1FTRX17L4XNC18657 41 22❑ [TILER TAILER PLATE# STATE PLATE# STATE 42 23 TRLR RLR 43 UIN#. 'IN# VEH.YEAR 1999 MAKE FORD MODEL F150 STYLE PK VEHICLE TOWED TO BLIN TOWED BY GOV HI 44 24� DAMAGE YES NO� VES NO REGISTERED OWNER INFO MARSHALL HOLDING-HOWELL 3028 NE 7TH ST RENTONWA 98056 VEHICLE NO.2 SHADE DAMAGEAREA 3 LIABILITY INSURANCE INSURANCE CO NATIONAL GENERAL 2028942941 IN EFFECT &POLICY# 9TOP 25 LE —LY YES v ❑ NIL] CITATION11 CHARGE t080TTOM GnEE ' 7OFFCE 'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY 26 FERNANDES 12848 WA0171300 PART A PAGE 01 OF 3000-345-189(R 11/181 STATE OF POLICETRAFFICN CORRECTION REPORT NO. EG32786 COLLISION REPORT III III III III III 111 1591972 CASE# 25-8406 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 GLASS 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 Vehicle 1 was driving westbound on NE 7TH ST in the 3000 block when it struck the back bumper of vehicle 2, which was parked on the northside of the road. Vehicle 3 was parked directly in front of vehicle 2, and vehicle 4 was parked directly in front of vehicle 3. When vehicle 1 struck vehicle 2, the impact caused vehicle 2 to lurch forward and strike vehicle 3, which then lurched forward and struck vehicle 4. Vehicle 1 then drove away without exchanging information, and the vehicle and driver were not identified. Vehicle 2 and 3 had damage to the front and rear bumpers, and vehicle 4 had damage to the rear bumper. I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT. MARIA FERNANDES 09-29-25 12:24 AM INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST.DET DATED PLACE SIGNED APPROVED BY DATE J.CHRISTIANSEN 10437 9/29/2025 8:48:05 PM BADGE OR ID# 12848 ORI# WA0171300 TIME POLICE DISPATCHED 1 9:29 PM TIME POLICE ARRIVED i 9:33 PM PART B 3 Da-3mx—attar(t 1Mff) PAGE 2�OF 4 SUPPLEMENTAL REPORT No. EG32786 POLICE TRAFFIC 1 1 8 27 COLLISION REPORT CASE# 25-8406 t113197 1 COMMERCIAL MOTOR CARRIER INTERSTATE INTRASTATE UNIT# USDOT ICC# VEHICLE TYPE CARGO BODY TYPE 2 ❑ 1 1 $ 28 CARRIER NAME 3 CARRIER L ADDRESS CITY ST ZIP 4 ❑ NAME # PLACARD GWVR NAME IF NO NUMBER SOURCE AXLES + 4a ❑ ADDITIONAL UNITS 'J MOTOR PEDAL- PROPERTY DAMAGE THRESHOLD MET PHONE 5 ❑ UNIT 3 VEHICLE CYCLE ❑ PEDESTRIAN :.. OWNER '.� YES NO 1 4 29 LAST NAME NONE FIRST NAME MIDDLE'. INITIAL 1 4 30 STREET CITY ST ZiP ❑ NEW ArmRFs RENTON 6 1 CDL IGNITION REQUIRED +IGNITION PRESENT MEDICALTANSPORTED' 1 31 INTERLOCK YES O NO�/ ;INTERLOCK YES NO Z/ I YEs N. DRIVER'S I STATE I SEX,U MMD —C� I LICENSE' 7 ONDUTYqSTATUS AIRBAG 9 RESTR. 9 EJECT 1 HELMET 9 INJURY 0 NATURE OF INJURIES USE CLASS 8 ❑ 1 32 LICENSE',CBG9573 TAT WA uIN 1FAFP34N77W288724 PLATE# 9 TRAILER I I TRAILER L PLATE# STATE PLATE# STATE 0 10 ❑ TRLR TRLR VIN.# VIN#. 11 0 0 VEH.YEAR2007 MAKE FORD MODELFOCUS STYLE SO VEHICLE TOWE E T ABLIN TOWED BY GOVT.VFHICI F FROM TO DAMAGE YES NO ✓ YES NO CARYNN HOLDING-HOWELL 3028 NE 7TH ST RENTON WA 98056 m 33 REGISTERED OWNER INFO. SHADE IN DAMAGED AREA. 12 FROM TO LIABILITY INSURANCE[] INSURANCE CO }Zt)P L.EFFECT &POLICY# _____ m 34 13 vEnICEE YES❑ NO❑ CITATION# CHARGE p 80TTOM EGALLY ST 4 MOTOR Z PEDAL- PROPERTY DAMAGE THRESHOLD MET PHONE 35 14 ❑ UN UNIT# VEHICLE CYCLE PEDESTRIAN1:1 OWNER YES NO 15 ❑ 36 LAST NAME NONE FIRST NAME NIT AL 16 ❑ STREET �' CITY RENTON ST ZIP NEW ADDRFsS CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TANSPORTED 17 ❑ INTERLODK YES NO .INTERLOCK YES NO 'YES rv0: ❑ 5 37 DRIVER'S STATE SEX U D.O.B _ j LICENSE# MMOD 18 ❑ w g 1 HELMET 9 =JURY 0 NATURE OF INJURIES 38 ON DUTY STATUS AIRBAG RESTR. 9 EJECT USE CLASS 19 ❑ LICENSE' CE 65 WA ❑ PLATE# Y52 TAT vIN# JNKCP11A82T505208 39 20 TRAILER' TRAILER 40 PLATE# STATE PLATE# - STATE ❑ 21 ❑ ❑ 41 TRLR TRLR VIN# VIN#Y 42 22 VEH.YEA MAKEMAKE INFI MODEL G2O STYLE SD VEHICLE TOWED DUET ABLIN TOWED BY GOVT.VEHICLE 4 DAMAGE YES NO YES NO IV 23 REGISTERED OWNER INFO.MARSHALL HOLDING-HOWELL 3028 NE 7TH ST RENTON WA 98056 SHADE IN DAMAC ED AREA 43 2 LIABILITY INSURANCE INSURANCE CO IN EFFECT &POLICY# j;g() 4,4,vewcEe ❑ ❑ CITATION# CHARGE 24 I..EGALLY YES NO STIWDING 3� 3 1 CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT. MARIA FERNANDES 09-29-25 12:24 AM 25 INVESTIGATING OFFICER'S SIGNATURE OFFICER'S PHONE UNIT OR DIST DET DATED: PLACE SIGNED BADGE ORI AP /226 ORID# 12848 # WA0171300 APPROVED 929/2025 PAGE[3 OFF4 3000-345-013(R 11/18) REPORT NO. EG32786 CASE# 25-8406 DATE AND TIME 09/28/25 21:27 OF COLLISION �4 wig t Y \: It � r '.a k x. i } X } PAGE 4 OF 4