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HomeMy WebLinkAbout25-8176 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 6 27c COLLISION REP FIT 1591971 CASE 25-8176 z INTERSTATE ❑ CITY STREET FIRE ❑RESULTED 1 STOLEN STATE ROUTE ❑ OTHER ❑ VFHIC;I F ❑ LOCAL AOENC 4900 3 HIT&RUN CODING COUNTY RD PRIVATE WAY INVOLVED 2❑ TOTAL#TRIBAL OF 02 OBJECT 1 1 8 28 UNITS RESERVATION I STRUCK z 3 DATE OF M M D D Y Y Y Y TIME(2400) COUNTY# MILES N E IN CITY# cowsloN 09 - 1-- 2025 0816 17 ❑.= S IN 1070 3 4❑ oN (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑ LOGAN AVE N BLOCK NO. e✓ --- ----� ❑ 4a❑ MILEPOST DISTANCE OF(REFERENCE OR CROSS STREET) 5❑ ❑ FEET e S ❑ W e N 3RD ST OF,1 29 MOTOR ✓ PEDAL- DAMAGE THRESHOLD MET PHONE UNITS VEHICLE ❑ CYCLE ❑ YEs �/No D:2063691534 0 4 30 6 LAST NAME FERNANDEZ FIRSTNAME MARCO MIDDLE H 1 0 1 31 INITIAL STREET ❑ 5726 S BANGOR ST CITY SEATTLE ST WA 2jp, 98178 z NEW ADDRESS 7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3 INTERLOCK YES[:]NO 1/ INTERLOCKYEs NO�/ YES R No�/ 8❑ LDRIVER # STATE WA SEX'M MID LOB 09 — 26 — 2001 1 2 32 9❑ ON DUTY❑ STATUS AIRBAG 2 RESTR 2 EJECT 1 HELMETU E 2 CLASS 1 NATURE OF INJURIES z❑ 3 10❑ P1 aT�S� AXP6285 sTATI WAurN# JTHCF5C29C5055462 TRAILER STATE TRAILER STATE 11 3 5 PLATE# PLATE# FROM TO TRLR. TRLR. 5 1 33 12 3 5 VIN#' VIN# FROM TO ❑ VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TR Y GOVT.VEHICLE 7 1 34 13 2 2012 LEXS IS P4 DAMAGE YES NO �MEYER YES❑ No✓ REGISTEREDOWNERINFO MARCO FERNANDEZ 5726 S BANGOR ST SEATTLE WA98178 D:2063691534 VEHICLE NO. 1 ❑ SHADE IN DAMAGED AREA 35 14 rI LIABILITY INSURANCE U INSURANCE CO STATE FARM 5683658DO947 4 IN EFFECT &POLICV# TOPVEHICLE CHARGE36 LEGALLv YES❑NO CITATION# <1�3 OTTOM 15❑ STANDING 7 6 MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE UNIT 02 VEHICLE ❑ CYCLE ❑ ❑ : PROPOWNFR ❑ YES 1/ No D:4259415035 16 a LAST NAME CORNER FIRST NAME DIANE MIDDLE IR INITIAL 17 STREET❑ NEW ADOREss❑' 305 CHELAN AVE SE CITY RENTON ST WA ZIP 98059 37 18❑ CDL IGNITION REQUIRED IGNITION PtR—E—S1ENT MEDICAL—T�RANSPORTED � 38 INTERLOCKYES�NO INTERLOCK YEs I I NOF vEs t l NOF,/ 19 DRIVER'S STATE WA ]SEX IF D.C.B. 10 _ 27 1959 39 LICENSE# MMDDYY 20❑ ON DUTY STATUS AIRBAG 6 RESTR 2 EJECT 1 HEIMET 2 INJURY 7 NATURE OF INJURIES ❑ 40 USE CLASS BACK PAIN ❑LICENSE 21❑ PLA E# CNG6842 TATE 41 WA VIN# KNDJN2A29E7079538 1 42 22❑ PLATE# STATE PLATE# STATE 23❑ UIN#. 43 TRLR RLR 'IN#. VEH YEAR 2014 MAKE KIA MODEL SOUL STYLE P4 VEHICLE TOWED TO BLIN TOWEDBY GOV HI �44 24❑ DAMAGE YES NO GENE MEYER YES NO REGISTERED OWNER INFO DIANE CORNER 305 CHELAN AVE SE RENTON WA 98059 D:4259415035 VEHICLE NO.2 SHADE IN DAG�AGELIAREA z add LIABILITY INSURANCE INSU&PORGY#E CO AARP 55PHG326834IN 1 9TOP 5 VEHICLE ❑ ,.I—I CITATION# CHARGE i o BOTTOM LEGALLY YES N`LJ 25 s e OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# JAGENCY 26 RAYMOND WATSON 13127 WA0171300 PAGE 01 OF PART A 3000-345-159 OR 11/181 STATE OF POLICETRAFFICN CORRECTION REPORT NO. EG35602 COLLISION REPORT III III III III III 111 1591972 CASE# 25-8176 ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY) NAME MIDDLE INITIAL) MENDOZA DOMINGO AISJIANA M (LAST FIRST, ADDRESS&PHONE# D O.B. 11436 SE 208TH ST SPC 49 KENT WA 98031 2066180247 SEX F MMDDYyYv 01 - 26 - 2001 PASSENGER Z WITNESS UNIT# POST 3 AIRBAG 2 RESTR. 2 EJECT ? HELMET INJURY NATURE OF INJURIES USE 2 CLASS 11 NAME (LAST,FIRST,MIDDLE INITIAL) ADDRESS&PHONE# D O B SEX' MMDDYYYY PASSENGER ❑WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET NJURY NATURE OF INJURIES POS. USE CLASS NAME (LAST FIR57 MIDDLE INITIAL) AppRESS&PHONE# SEX D.O.B. MMDDYYYY. - PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET NJURY NATURE OF INJURIES ❑ ❑ POS. 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 10-03-25 06:55 AM INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED APPROVED BY DATE J.TRADER 4553 1 101812025 11:13:18 AM BADGE OR ID# 13127 OR]# WA0171300 TIME POLICE DISPATCHED; 8:16 AM TIME POLICE ARRIVED',8:16 AM PART PAGE IT]OF 4� REPORT NO. EG35602 CASE# 25-8176 FC LNaoy L isI©�ON O 09/20/25 08:16 F cu NARRATIVE 25-8176 This report is a summary of events that occurred and is not an exact sequencing of events. Statements have been paraphrased and summarized. On 09/20/2025 at approximately 0816 hours, myself, Officer R. Watson, was dispatched to an accident with injuries, at the intersection of N 3rd ST and Logan AVE N, within the City Limits of Renton, County of King, State of Washington. Dispatch notes stated that there was a 2-vehicle collision blocking N 3rd ST. When I arrived on scene, I observed One vehicle facing north bound on Logan with significant damage and a second vehicle facing west bound on N 3rd ST. Unit#1 driven by Marco H. Fernandez (DOB 09/26/2001) verified by WADOL photo, stated he was driving a Gray 2012 Lexus IS, WA plate #AXP6285. A passenger, Aisjiana M. Mendiza-Domingo (DOB 01/26/2001) verified by WADOL photo, was sitting in front right seat. Marco said he was traveling north bound on Logan AVE N but did not recall how he collided with Unit#2. Aisjiana said she recalled Marco pressing on the brakes, but they did not stop the vehicle, and they collided with unit#2. Both occupants of unit#1 said they had no injuries and declined aid. When I asked for Marco's license, registration and insurance for the exchange of information he was able to provide all documentation. Unit#1 had significant front-end damage. Unit#1 was towed from the scene by Gene Meyer Towing. There was no airbag deployment on unit#1. Unit#2 driven by Diane R. Corner (DOB 10/27/1959) verified by WADOL photo, stated she was driving a Gray 2014 Kia Soul, WA plate #CNG6842. There were no other occupants in the vehicle. She stated she was coming out of the Renton Memorial Stadium parking lot east bound, turning north bound onto Logan AVE N when unit#1 ran a redlight and collided with her vehicle. She said she had back pain, was assessed by Renton Fire Department on scene but declined further treatment and left the scene with a friend. When I asked for Diane's license, registration and insurance for the exchange of information she was able to provide all documentation. Unit#2 had significant right-side damage. Unit#2 was towed from the scene by Gene Meyer Towing. There was a combination of airbag deployments 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 10/03/2025 0648 hours, Renton, King County, WA. PAGE 3 OF 4 REPORT NO. EG35602 CASE# 25-8176 DATE AND TIME 09/20/25 08:16 OF COLLISION p, 1� t k � T s c a >v 4:1y PAGE 4 OF 4