HomeMy WebLinkAbout25-7655 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 0 27c
COLLISION REP FIT 1591971
CASE 25-7655 z
INTERSTATE ❑ CITY STREET FIRE ❑RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHIr.I F ❑ LOCAL AOENC 4200 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 1 TOTAL#OF OBJECT 1 1 8 28
TRIBAL UNITS OZ STRUCK
RESERVATION
z
3❑ DATE of M M D D Y Y Y Y TIME(2400) COUNTY# MILES N E IN CITY# ❑
cowsloN 09 - 1-- 2025 1522 17 ❑.= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
SUNSET BLVD N BLOCK NO. e✓ ❑
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ ❑ FEET e S ❑ VV a BRONSON WAYN
0 8 29
MOTOR PEDAL- DAM THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El YES NO �/ D:2068599855 0 7 30
6� LAST NAME CRUZ FIRSTNAME ANYSSA MIDDLE L 1 1 2 31
INITIAL
STREET ❑, 1225 183RD ST SE APT M102 CITY BOTHELL ST WA ZjP, 980127549 z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED I IGNITION PRESENT MEDICAL TRANSPORTED 3
iNTERLOCKYEs NO INTERLOCKYEs NO YES NO
8❑ LRIIVER #
ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 H USEET ICNLJAURY 1 NATURE OF INJURIES z❑
3
10 1❑ P1 ATE 14 CDM0266 STATE WA u N# KNDJF722787535078
TRAILER STATE TRAILER STATE
11 3 5 PLATE# PLATE# FROM To
TRLR. RLR 1 7 33
12 0 0 VIN#j VIN#
:: FROM TO
VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE J 9 34
13 3 2008 KIA SPORTA DAMAGE YES NO YES[:] No✓
REGISTERED OWNER INFO OWNEDBYDRIVER VEHICLE NO. 1
SHADE IN DAMAGED AREA ❑ 35
14 LIABILI INSURANCE INSURANCE CO PROGRESSIVE 997546240 3 4
IN EFFECT &POLICY# 9TOP
15❑ LE
vEGALLv HIa.E 5 36
res�No D CITATION# 5A0625733 CHARGE FOLLOW VEHICLE TOO CLOSELY 10 aorrom
STANDING 8 7 6
MOTOR PEDAL PROPERTY DAM THR OLD M PHONE
UNIT�2 ❑✓ ❑ PEDESTRIAN ❑ ❑ D:4259194006
VEHICLE CYCLE OWNER YES NO V
ET
16 a
LAST NAME DELA CRUZ FIRST NAME VENETIA MIDDLE I C
INITIAL
17❑ STREET ❑', 13604 SE 170TH ST CITY' RENTON ST WA ZIP 980587040 37
NEW ADDRESS ❑
18� CDL IGNITION REQUIRED IGNITION PRESENT MEDICALTRANSPORTED ❑ 38
INTERLOCKYES�NOR INTERLOCK YEs❑NOF YES❑No❑
19 LICENSE# STATE WA SEX F M .C.B. 10 _ 28 _ 1985 39
WELMET INJURY1 NATURE OF INJURIES 40
20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 USE CLASS ❑
21❑ LICENSE BOF5658 TATe WA vIN1 7FARW2H58KE034603
❑ 41
PLATE#
42
22❑ PIR ILER LATE# STATE PLATE# STATE
23❑ VIN#. 43
TRLR RLR
'IN#.
VEH YEAR 2019 MAKE HOND MODEL CR-V STYLE VEHICLETOWED TO BLIN TOWEDBY GOV HI 44
24❑ DAMAGE YES NO YES NO
REGISTERED OWNER INFO ISRAEL DE LA CRUZ 13604 SE 170TH ST RENTON WA 98058 VEHICLE NO.2
SHADE IN DAMAGED AREA
2 3 4
LIABILITY
INSURANCE INSU&PORGY#E CO USAA 01727886OUIN 1 GD
LEGAL25
LY YES N�
❑ s e
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
J
26
C.ARNOLD 12509 WA0171300
PART A PAGE 01 OF C7
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EG36338
COLLISION REPORT III III III III III 111
1591972 CASE# 25-7655
ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY)
NAME
(LAST FIRST,MIDDLE INITIAL)_
ADDRESS&PHONE#
SEX D.O.B. - -
MMDDYYYY.
PASSENGER❑WITNESS UNIT# SEAT AIRBAG RESTR. EJECT ' HELMET INJURY NATURE OF INJURIES
PM USE CLASS
NAME
'(LAST,FIRST MIDDLE INITIAL)
ADDRESS&PHONE# D D B
SEX MMDDYYYY
PASSENGER ❑WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET INJURY NATURE OF INJURIES
POS. USE CLASS
NAME
(LAST FIR57 MIDDLE INITIAL)
AppRESS R 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.
C.ARNOLD 09-02-25 04:05 PM
NVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
C.JACOBS 1953 10/10/2025 1:25:40 PM
BADGE OR ID# 12509 ORI# WA0171300 TIME POLICE DISPATCHED 3:25 PM TIME POLICE ARRIVED',3:35 PM
PART I PAGE IT]OF 4�
REPORT NO. EG36338 CASE# 25-7655 OF COLLISION
09/02/25 15:22
OF CbLLI510N
NARRATIVE
CC 25-7655
On 9/2/2025 at 1525 hours I was dispatched to a motor vehicle collision at Sunset Blvd N and
Bronson Way N in the City of Renton, King County, Washington.
Pre-Collision
Driver 2 stated that she was stopped for traffic facing West on the double righthand turn #1 lane of
Sunset Blvd N.
Driver 1 stated that she was behind Unit 2 in the #1 lane of the double righthand turn of Sunset Blvd
N facing West.
Collision
Driver 2 stated that as she was stopped for traffic, Unit 1 began moving behind her and the front
bumper of Unit 1 collided with the rear bumper of Unit 2.
Driver 1 stated that the light turned green and did not see that Unit 2 had not moved yet. Driver 1
stated that she began moving forward and the front bumper of Unit 1 collided with the rear bumper of
Unit 2.
Injuries
None reported.
Vehicle Disposition
Both vehicles were operational.
Proximate Cause
I determined that Driver 1 is the proximate cause of this collision because the driver of a motor
vehicle shall not follow another vehicle more closely than is reasonable and prudent, having due
regard for the speed of such vehicles and the traffic upon and the condition of the highway.
Driver 1 was cited per RCW 46.61.145
1 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 C. Arnold #12509 at 15:58 on 9/2/2025 in the City of Renton, King
County, Washington.
PAGE 3 OF 4
REPORT NO. EG36338 CASE# ' 25-7655 DATE AND TIME 09/02/25 15:22
OF COLLISION
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