HomeMy WebLinkAbout25-8443 iiTFiNII IIIII III IIIII II IIII IIIII I . 27c REPORT NO EG33429oc� RA
COLLISION REPORT 1591971
CASE# 25-8443 2
INTERSTATE CITY STREET FIRE I
RESULTED STOLENSTATE ROUTE OTHER VEHICLE LOCALANG 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#
DATE OF N E
eDL�ISION' 09 - 29 - 2025 1346 17 =.�� S W OF 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓
NE SUNSET BLVD BLOCK ST e 4300 .=
4a❑ MILE POST
❑ DISTANCE OF(REFERENCE OR CROSS STREET)
5 10 00 FEET e✓ S 8 E e WHITMAN CT NE
OF 4 29
MOTOR ✓ PEDAL- DAM AG THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE ❑ YEs Vl No D:4254964345 0 1 30
6 LAST NAME VA CA PEREZ FIRST NAME CRISTIAN MIDDLE t 1 2 31
INITIAL
STREET ❑ 4300 NE SUNSET BLVD J6 CITY; RENTON ST I WA ZIp; 98059 2
NEW ADDRESS
7 CDL III GN(TIUN REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
INTERLOCKYEs NO✓ INTERLOCKYEs NO✓ YES ✓ NO
8 DRIVER # STATE WA SEXI F MMDDYY' 12 - 28 - 1987 1 2 32
9 ON DUTY STATUS' AIRBAG 2 RESTR 4 EJECT 1 HELMET 2 INJURY 6 NATURE of INJURIES 2
USE CLASS COMPLAINT OF HEAD PAW
LICENSE, CLW4376 STATE WA VIN# 5N1AT2MV5GC734604 3
10 Fq I PI ATP tt
TRAILER STATE TRAILER STATE
11 3 5 PLATE# PLATE# ROM To
TRLR zRLR. 1 3 33
12 3 5 VIN# vIN#
FROM TO
13 4 VEH.YEAR2016 MAKE NISS MODEL ROGUE STYLE UT VEHICLE TOYED NO�iS46LIN T�VyED.6LRS �ESEENp $ 7 34
DAMAGE IIII._IIII HHttVVii((tt I_I
REGISTERED OWNER INFO OWNED BY DRIVER VEHICLE R 1
SHADE IN DAMAGED AREA 35
4 LIABILITY INSURANCE INSURANCE CO 4
14 PROGRESSIVE 994577931
IN EFFECT &POLICY# 9TOP
VEn" CHARGE 5 36
Lec Lr YES❑NO❑ CITATION# t a BOTTOM
15❑ STMDING 7 e
MOTCYR ✓ PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT 02 VEHICLE CYCLE nWNRR YEs✓ No D:4254952222 N:4254952896
16�
LAST NAME GRAY FIRST NAME ANDREW MIDDLE' C
INITIAL
17 F1 STREET ❑
❑ 18031 SE 147TH ST CITY RENTON ST, WA ZIP 98059 4 37
NEW ADDRESS
18❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICALTRANSPORTED. 38
INTERLOCKYES NO✓ INTERLOCK YES NO✓ YES NO✓
19 DRIVER'S '
MMDDYYj I —
20❑ ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 HELMET 2 INJURY 7 NATURE OF INJURIES 40
USE CLASS COMPLAINT OF BACK PAIN
21 ILICENSE PATE# BHH0179 rare WA vIN# 4S4BSENC2J3218200 41
22❑ PLATE# STATE PLATE# STATE 42
23 TRLR RLR 43
UIN#. 'IN#
VEH.YEAR 201$ MAKE $Ugq MODEL OUTBAC STYLE I-IB VEHICLE TOWED TO BLIN
TOWED BY GOV HI 44
24 DAMAGE YES NO✓ NO✓
REGISTERED OWNER INFO OWNED BY DRIVER VEHICLE
NQ.2
SHADFY DAMAGED AREA
3 4
LIABILITY INSURANCE[Z INSURANCE CO PROGRESSIVE 939109419
IN EFFECT &POLICY#Y 1—,—LY YES❑ N,JI CITATION# CHARGE UR
`.L J25
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
26
T.NELSON 12327 WA0171300
PAGE 01 OF
PART A 3000-348-189(R 11/18)
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EG33429
COLLISION REPORT III III III III III 111
1591972 CASE# 25-8443
E NA ADDITIONAL PERSONS INVOLVED(PASSENGERS AND/OR WITNESSES ONLY)
M
(LAST,FIRST,MIDDLE INITIAL) REYNOLDS LINDA L
ADDRESS&PHONE#
18031 SE 147TH ST RENTON WA 98059 SEXi F MMDDD B. 07 — 07 — 1949
PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET INJURY NATURE OF INJURIES
❑ 2 POS. 3 2 4 1 USE 1 2 GLASS j 1 ----�
:NAME
Lnsr EIRST,MIDDLE INITIAL) ALEN CHRIS
ADDRESS R PHONE#
5037500873 SEX' U .MD D evr C-------�
PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET NJURY NATURE OF INJURIES
❑ �✓ POS. USE INJURY ---�
LASS
:NAME
(LOST,FIRST,MIDDLE INITIAL)
ADDRESS&PHONE#
SEX/ D.O.B. —
MMDDYYYY
PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET NJURY NATURE OF INJURIES
POS. I USE GLASS
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.
T.NELSON 09-29-25 03:35 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST.DET DATED PLAGE SIGNED
APPROVED BY DATE
J.TRADER 4553 913012025 1:17:34 PM
BADGE OR ID# 12327 ORI#s WA0171300 TIME POLICE DISPATCHED 1 1:52 PM TIME POLICE ARRIVED i 1:57 PM
PAST B 3 Do-3mx—attar(t 1Mff) PAGE 2�OF 4
REPORT NO. EG33429 CASE# 25-8443 DATE OF COLLI r�510NN + 09/29/25 13:46
L1
NARRATIVE
25-8443
Unless otherwise noted, the following occurred in the City of Renton, County of King, WA.
responded to an injury collision in the 4300 block of NE Sunset Blvd. Dispatch advised: "NOW,
2MVA.. OTHER DRIVER FAINTED.. NB .."
I arrived with Renton Fire Authority (RFA) already on scene. I observed unit 1 and unit 2 blocking the
westbound lanes of NE Sunset BLVD. Both unit 1 and unit 2 had significant front-end damage. I
observed the driver of unit 1, Vaca Perez, lying on her back in the roadway being treated by RFA. I
did not observe any injuries to Vaca Perez, but I gathered that she was experiencing head pain. Vaca
Perez was conscious but was very overwhelmed and therefore unable to provide her account of the
collision. I gathered the following from the occupants of unit 2, Gray and Reynolds, and a witness,
Allen:
Unit 1 was attempting to make a left turn out of Spring Tree Condos, 4308 NE Sunset Blvd. Unit 2
was travelling westbound on NE Sunset Blvd in lane 2 when unit 1 pulled out in front of unit 2 and unit
2 was unable to stop in time causing the front end of unit 2 to strike the front driver side of unit 1.
My observations of the damage was consistent with what was relayed to me.
Unit 1 was inoperable and was towed.
Vaca Perez was transported to Valley Medical Center (VMC) for further evaluation.
provided the involved parties with an exchange of information.
Based on the aforementioned information, I believe that unit 1's failure to yield the right of way to unit
2 is the proximate cause of the collision.
I declare under penalty of perjury under the laws of the State of Washington that the foregoing is true
and correct.
Electronically signed by T. Nelson 12327 on 09-29-2025 at 1528 hours in Renton, WA.
PAGE 3 OF 4
REPORT NO. EG33429 CASE# 25-8443 DATE AND TIME 09/29/2513:46
OF COLLISION
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