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HomeMy WebLinkAbout25-8072 iiTFiNII IIIII III IIIII II IIII IIIII I . 27c REPORT NO EG33428oc� RA COLLISION REPORT 1591971 INTERSTATE CITY STREET FIRE I CASE# 25-8072 2 RESULTEDSTOLENSTATE ROUTE OTHER VEHICLE LOCALANG 4200 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 - 16 - 2025 1807 17 =.= S 8 W e OF e 1070 s 4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑ BLOCK NO. e .� 4a MAINAVES MILE POST ❑ ❑ DISTANCE OF(REFERENCE OR CROSS STREET) 5 MILES 1.1 FEET e S 8 W e S 3RD ST 0 3 29 MOTOR ✓ PEDAL- DAM AG THRESHOLD MET PHONE UNIT 01 VEHICLE ❑ CYCLE ❑ YEs Vl No D:2067302214 0 3 30 5 LAST NAME CRUZ CARDONA FIRST NAME KENIA MIDDLE E 1 1 2 31 INITIAL STREET ] 149 SW 160TH ST APT 11 CITY; BURIEN ST WA ZIP; 98166 2 NEW ADDRESS 7 CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3 INTERLOCKYEs No�/ INTERLOCKYEs N �/ YES ND�/ 8 DRIVER # STATE WA SEXI F MMDDYY' 04 — 28 — 1999 t 1 2 32 -NJUR 9 ON DUTY STATUS' AIRBAG 2 RESTR 4 EJECT 1 HELMET 2 CLASSY',1 [NATURE of INJURIES 2 LICENSE, CLE6313 STATE WA VIN#; JTDKN3DU8B1442921 3 10 Fl I PI ATP rt TRAILER STATE TRAILER STATE 11 2 5 PLATE# PLATE# FROM To TRLR zRLR 5 3 33 12 2 5 TRLR vIN# FROM TO VEH.YEAR 2011 MAKE TOY. MODEL PRIUS STYLE P4 VEHICLE TOWED TO BLIN TOWED BY GOVT VEHICLE g 3 34 13 DAMAGE YES NO YES❑ NO REGISTERED OWNER INFO KENIA CRUZ CARDONA 149 SW 160TH STAPT 11 BURIEN WA 98166 D:2067302214 VEHICLE NO. 1 SHADE IN DAMAGED AREA 35 2 3 4 4 LIABILITY INSURANCE INSURANCE CO 14 ❑ NO INSURANCE IN EFFECT &POLICY# 4TOP CHARGE t S 36 VEHICLE Lemur yes❑NO❑ CITATION# 7 0 80TTOM 15❑ sTnNowc MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE UNIT VEHICLE CYCLE nWNRR YEs No �/ D:2065103928 N:2067473916 16� LAST NAME JOHNSON FIRST NAME DENNIS MIDDLE INITIAL 17 F1 STREET ❑ ❑ 430 MINOR AVE N 505 CITY BURIEN ST, WA ZIP 98056 4 37 NEW ADDRESS 18❑ CDL IGNITION RfC3UIRED IGNITION : PRESENT MEDICAL TRANSPORTED' 38 INTERLOCK YEs NO INTERLOCK YES No V YEs NO 19 DRIVERS ' STATE WA SEX M D.©.e. 03 05 1950 � 39 LICENSE# MMDDYY — 20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 1HELM USEET 2 CLASSY 1 NATURE OF INJURIES 40 21 PLATE# BHT4805 rare WA vIN# WA1AY74L59DO09917 41 22❑ PLATE# STATE[TILER I PLATE# STATE 42 23 TRLR r RLR 43 UIN#. 'IN# VEH.YEAR 2009 MAKE gUDI MODEL Q7 STYLE $V VEHICLE TOWED TO BLIN TOWED BY GOV HI 44 24 DAMAGE YES NO VES NO REGISTERED OWNER INFO DENNIS JOHNSON 430 MINOR AVE N 505 BURIEN WA 98056 D:2065103928 N:2067473916 VEHICLE NO.2 SHADFY DAMAGE,D,AREA 3 �d LIABILITY INSURANCE INSURANCE CO PROGRESSIVE IN EFFECT &POLICY# 9TOP veHiaE ❑ ,J—I CITATION 11 CHARGE t080TTOM L'EGn�LY YES N 25 a e 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. EG33428 COLLISION REPORT III III III III III 111 1591972 CASE# 25-8072 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 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 09-21-25 07:03 PM INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST.DET DATED PLAGE SIGNED APPROVED BY DATE J.TRADER 4553 1 912512025 9:03:18 AM BADGE OR ID# 13127 ORI# WA0171300 TIME POLICE DISPATCHED 1 6:07 PM TIME POLICE ARRIVED i 6:07 PM PAST B 3 Do-3mx—attar(t 1Mff) PAGE 2�OF 4 REPORT NO. EG33428 CASE# 25-8072 DATE OF COLLI r�510NN + 09/16/25 18:07 L1 NARRATIVE 25-8072 This report is a summary of events that occurred and is not an exact sequencing of events. Statements have been paraphrased and summarized. On 09/16/2025 at approximately 1807 hours, myself, Officer R. Watson, was dispatched to an accident with unknown details, at the intersection of S 3rd ST and Main AVE S, within the City Limits of Renton, County of King, State of Washington. Dispatch notes stated that another officer had arrived on scene but had not seen the collision. When I arrived on scene, I observed two vehicles stopped in the turn lanes of north bound Main AVE S onto east bound S 3rd ST. Unit#1 driven by Kenia E. CRUZ-CARDONA (DOB 04/28/1999) verified by WADOL photo, stated she was driving a Gray 2011 Toyota Prius, WA plate #CLE6313. She said she was traveling north bound on Main AVE S in the number 1 lane, turning onto S 3rd ST headed east bound. She attempted to change lanes during the lane and collided with unit#2. Kenia said she had no injuries and declined aid. When I asked for her license, registration and insurance for the exchange of information she said she did not have insurance on her vehicle but provided her license and registration. Unit#1 had minor damage to the left side driver's side door and left rear panel. Unit#1 was able to be driven from the scene. There was no airbag deployment on unit#1. Unit#2 driven by Dennis Johnson (DOB 03/05/1950) verified by WADOL photo, stated he was driving a Gray 2009 Audi Q7, WA plate # BHT4805. He said he was traveling north bound on Main AVE S in the number 2 lane, turning onto S 3rd ST headed east bound. He said while he was turning, unit#1 turned into his vehicle making contact. Dennis said he had no injuries and declined aid. When I asked for his license, registration and insurance for the exchange of information he was unable to provide me with his insurance but said it was current and through Progressive. Unit#2 had minor damage to the passenger side of the vehicle, and it 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 09/21/2025 1213 hours, Renton, King County, WA. PAGE 3 OF 4 REPORT NO. EG33428 CASE# 25-8072 DATE AND TIME 09/16/2518:07 OF COLLISION f �t. 71 ti; F t t4 1 p 4 x� as � s 4 �t t t a; PAGE 4 OF 4