HomeMy WebLinkAbout25-8384 IT �i " II IIIII III IIIII II IIII IIIII I . 27c REPORT NO EG33596OLCERA
COLLISION REPORT 1591971
CASE# 25-8384 2
INTERSTATE CITY STREET FIRE ❑
RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VEHICLE ❑ LOCAI-A`NG 4200 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
87
2❑ TRIBAL i UNITS#OF 02 SOTRUCK METAL SIGN POST 28
i RESERVATION : 2
3� M M D D Y Y Y Y TIME(2400) COUNTY# MILES CITY#
eaCLsov' 09 - 27 - 2025 1848 17 =.= S 8 W e IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
SW 16TH ST BLOCK NO. e 800 .�
4a❑ MILE POST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ MILES�. FEET e S 8 E e RAYMOND AVE SW
0 1 29
MOTOR ✓ PEDAL- DAM AG THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE ❑ YES ✓NO 30
5❑ LAST NAME GRACA FIRST NAME NATALIA MIDDLE ISt 1 2 31
INITIAL
STREET ] 12548 LAKE CITY WAY NE APT A230 CITY; SEATTLE ST WA ZIP; 98125 2
NEW ADDRESS
7� +CDL IGN(TIUN REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
INTERLOCKYES NO%/ INTERLOCKYEs NO�/ YEs NO�/
8❑ DRIVER # STATE WA SEXI F MMDDYY' 12 - 11 - 1985 32
9 ON DUTY STATUS' AIRBAG 2 RESTR 4 EJECT 1 HELMET
2 CLASSY 1 [NATURE of INJURIES 2
LICENSE, CPN1039 STATE WA VIN#; JM3TB3DV1D0400788 3
10 F1 as ATP tt
TRAILER STATE TRAILER STATE
11 3 5 PLATE# PLATE# ROM T.
7
TRLR TRLR. 3 7 33
12 VIN#' VIN#
FROM TO
VEH.YEAR ZOI3 MAKE MAID MODEL CX9 STYLE SV VEHICLE TOWED[n TO ZBE TOWEDBY GOVT VEHICLE m 34
13� DAMAGE YES II_II NO YESII_I) NO✓
REGISTERED OWNER INFO NATALIA GRACA 12548 LAKE CITY WAY IVEAPTA230 SEATTLE WA 98125 VEHICLE NO. 1
SHADE IN DAMAGED AREA 35
14❑ LIABILITY INSURANCE� INSURANCE CO STATE FARM 57043240347001
IN EFFECT &POLICY#
VEn" CHARGE 5 36
Lemur YES❑NO❑ CITATION# <14,
15❑ STANDING
MOTOR PEDAL PROPERTY DAM THR OLD MET PHONE
UNIT 02 ❑ PEDESTRIAN ✓ D:4254306500
VEHICLE CYCLE OWNERYES NO ✓
16❑
LAST NAME CITY OF RENTON FIRST NAME MIDDLE
INITIAL
17 F1 STREET ❑
❑ 1055 S GRADY WAY CITY RENTON ST, WA ZIP 98055 37
NEW ADDRESS
18❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED': ❑ 38
INTERLOCKYEs X YESFJxz YES NO
19[ DRIVER'S
# STATE SEXj U MD DO.B. -=_E:= 39
HELMET INJURY NATURE OF INJURIES 4Q
20❑ ON DUTY STATUS AIRBAG RESTR EJECT USE CLASSLICENSE
❑
21 PLATE# T-1- VIN# 41
22❑ [TILER TAILER
PLATE# STATE PLATE# STATE 42
23 TRLR RLR 43
UIN#. 'IN#
VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN
TOWED BY GOV HI 44
24 DAMAGE YES NO YES NO
REGISTERED OWNER INFO VEHICLE NO.2
SHADE IN DAMAGED AREA
2 3 4
LIABILITY INSURANCE❑ INSURANCE CO
IN EFFECT &POLICY# 9TOP
vemae ❑ ,.I—I CITATION# CHARGE to BOTTOM
EEGnEEY YES NC
25 a s
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
26
NICHOLAS SWAN 12965 WA0171300
PART A PAGE 01 OF
3000-345-189(R 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EG33596
COLLISION REPORT III III III III III 111
1591972 CASE# 25-8384
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
PC& 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.
NICHOLAS SWAN 09-27-25 10:20 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST.DET DATED PLACE SIGNED
APPROVED BY DATE
QUINT TIBEAU 7691 101112025 11:18:21 PM
BADGE OR ID# 12965 ORI# WA0171300 TIME POLICE DISPATCHED; 7:05 PM TIME POLICE ARRIVED i 7:14 PM
PAST B a Do-3mx—attar(t 1Mff) PAGE 2�OF 4
REPORT NO. EG33596 CASE# 25-8384 OATS OF COLLI r�510NN + 09/27/25 18:48
L1
NARRATIVE
#25-8384
Unless otherwise noted, all events took place in the City of Renton, in the County of King, in the State
of Washington.
This incident was captured on my body worn video camera and in-car cameras. This report is a
summary of events that occurred and is not an exact sequencing of events.
On 09/27/2025 at approximately 1905 hours I was dispatched SW 16th St and Raymond Ave SW in
the city of Renton, King County, WA, for a single vehicle collision with a sign where there were no
injuries.
Unit#1 was a grey 2013 Mazda CX9 with WA LIC: CPN1039 (VIN: JM3TB3DV1 D0400788)
I arrived on scene and the vehicle had moved out of the road and into a nearby parking lot. The driver
stated she was okay and had no injuries.
Driver 1 of Unit 1 stated she was driving west bound on SW 16th St. She approached the round
about, but did not realize there was a round about, and went straight over it. As she did this, it caused
her to accelerate and not have full control of her vehicle where she hit a street sign on the west side
of the round about. Driver 1 stated she was not going very fast, she believed she was driving
approximately 15mph.
Driver 1 was able to drive the vehicle away from the scene on her own.
I took pictures of the vehicles and uploaded them to Axon Evidence.
Officer Smith completed a City of Renton Origami report for the damaged street sign.
At the conclusion of my investigation, I determined that the proximate cause of the collision is due to
Unit 1 not paying full attention to the road and obstacles in front of them. By not paying attention, she
drove over a round about rather than around it and then hit a sign on the opposite side.
If the driver of Unit 1 would have seen the round about, this accident would not have happened.
This concludes my report.
I certify (declare) under penalty of perjury under the laws of the State of Washington that the
foregoing is true and correct.
Electronically signed by Officer N. Swan #12965 on 09/27/2025 at 1958 hours in the City of Renton.
**** AUTO-POPULATED SECTION ****
THE FOLLOWING ARE DESCRIPTIONS ENTERED FOR ITEMS SELECTED AS "OTHER":
Motor Vehicle Unit 1
Traffic Control: ROUND ABOUT
**** END OF AUTO-POPULATED SECTION ****
PAGE 3 OF 4
REPORT NO. EG33596 CASE# 25-8384 DATE AND TIME 09/27/2518:48
OF COLLISION
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