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HomeMy WebLinkAbout25-8510 a POLICETRAFFic" II I f I) 11I1ll(111(111l If( f 11 REPORT NO. EG33739 170 27 COLLISION REP FIT 1591971 CASE 25-8510 z INTERSTATE ❑ CITY STREET FIRE ❑RESULTED 1 STOLEN STATE ROUTE ❑ OTHER ❑ VFHIl.I F ❑ LOCAL AOENC 4Y00 3 HIT 8 RUN CODING COUNTY RD PRIVATE WAY INVOLVED 2❑ TRIBAL 02 TOTAL#OF 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 10 - 01 - 2025 1022 17 ❑.❑ S H W H OF 1070 3 4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓ MAPLE VALLEY HWY BLOCK NO. e✓ 1800 4a❑ MILEPOST DISTANCE OF(REFERENCE OR CROSS STREET) 5❑ ❑ FEET e S ❑ W e 2 0 29 UNIT MOTORVEHICL Z PEAL-CYCLE El AZGE NO THRESHOLD MET PHONE () 1 30 6 LAST NAME DELOS SANTOS FIRSTNAME JOSIE MIDDLE M 1 1 2 31 INITIAL STREET ❑, 14300 SE 171ST WAY APT M12 CITY RENTON ST WA Zjp, 980588734 z NEW ADDRESS 7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3 iNTERLOCKYEs NO INTERLOCKYEs NO YES R NO 8❑ LDRIVER # STATE WA SEX'F MID .O B 06 — 07 — 1979 1 2 32 9 ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 H U SE ICNLJAUSSY 1 NATURE OF INJURIES z❑ 3 10 9❑ P1 aT�S� BTY4256 sTArI WAurN# 3CZRU6H11LM720740 TRAILER STATE TRAILER STATE 11 4 0 PLATE# PLATE# FROM TO TRLR. TRLR 3 7 33 12 4 0 VIN#' VIN# >; FROM TO VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE 3 7 34 13 2020 HOND HR-V DAMAGE YES NO YES[:] NO✓ REGISTEREDOWNERINFO JOSIE DELOS SANTOS 14300 SE 171ST WAYAPTM12 RENTON WA 98058 VEHICLE NO. 1 ❑ SHADE IN DAMAGED AREA 35 14 rI LIABILITY INSURANCE U INSURANCE CO SAME. IN EFFECT &POLICY# 9TOP veHICE CHARGE 36 LE�ALLv YES No CITATION# 5A0608002 IMPROPER LANE USAGE o BOTTOM 15❑ NDING 8 6 MOTOR PEDAL- PROPERTY DAM THR OLD MET PHONE UNIT 02 VEHICLE CYCLE ❑ PEDESTRIAN ❑ OWNER ❑ YES 1/ NO 16 a LAST NAME LAED FIRST NAME RODOLFO MIDDLE I E INITIAL 17❑ STREET ❑', 5232 S AVON ST CITY' SEATTLE ST Wq ZIP 981782815 37 NEW ADDRESS ❑ 18� CDL IGNITION REQUIRED IGNITION PR—E-1SENT MEDICAL TRANSPORTED 38 INTERLOCKYES�NOR INTERLOCK YEs It I NOF YES t t— l NO❑ 19 DRIVER # INJURY NATURE OF INJURIES 40 20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 USE CLASS 1 ❑ 21❑ LICENSE CAY7659 TAre WA VIN1i JN1E631P9NU140659 ❑ 41 PLATE# El 42 22 R TILER❑ PLATILER E# STATE PLATE# STATE 23❑ 43 TRLR RLR VIN#. IN#. VEH YEAR 1992 MAKE NIS6 MODEL SENTRA STYLE VEHICLE TOWED TO BLIN TOWEDBY GOV HI �44 24❑ DAMAGE YES✓ NO BANKERS YES NO REGISTERED OWNER INFO RODOLFO LAED 5232 S AVON ST SEATTLE WA 981782815 VEHICLE NO.2 SHADEJN DAMAGEDAREA 4� 3 4 LIABILITY INSURANCE INSU PORGY#E CO ALLSTATE 087 692 050IN STOP 5 VE""LE ❑ ,J� CITATION# CHARGE U­A­ IES oBOTTOM N`LJ 6 25 OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY J 26 M.LEVERTON 2517 WA0171300 PART A PAGE 01 OF C7 3000-345-159 OR 11/181 STATE OF POLICETRAFFICN CORRECTION REPORT NO. EG33739 COLLISION REPORT III III III III III 111 1591972 CASE# 25-8510 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 POS. 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 FIRST 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. M.LEVERTON 10-01-25 11:25 AM INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED APPROVED BY E DAT RAYMOND GORAJEWSKI 12399 101212025 8:40:38 AM BADGE OR ID# 2517 ORI# WA0171300 TIME POLICE DISPATCHED 40:22 AM TIME POLICE ARRIVED 10:28 AM PART B PAGE IT]OF 4� REPORT NO. EG33739 CASE# 25-8510 F LNa O 10/01/25 10:22 F coy�isI©�ON u NARRATIVE unit 1 lane 2 changed to lane 1 struck unit 2 CC Within the city limits of Renton/King/WA I responded to a 2 vehicle crash near the 1800 block of Maple Valley Hwy. I contacted both drivers at the 1400 block of Bronson Way N in a parking lot. As unit 1 stated to tell me her version of the events leading up to the collision unit 2 blurted out, "She cut me off." Unit 1 told me she was westbound on Maple Valley Hwy and pointed to a vehicle to locate her approximate location. Unit 1 told me traffic was backing up so she decided to get over one lane to the right. She said it was clear to change lanes, however, she said she identified unit 2 as a ways back but driving very fast. She told me he was so far back she could change lanes. Unit 1 said unit 2 hit her vehicle. She did not complain of injury and damages did not require a tow truck. While unit 1 told me her version unit 2 remained quiet but was nodding and shaking his head reference portions of unit 1 statements. Unit 2 told me he was not speeding he was going about 35 in a 40 mph zone. He said he never changes lanes and unit 1 changes lanes into his path where they contacted. Unit 2 did not complain of injury and although damages required a tow truck and I had requested one, he made a call for his own assistance. I cited unit 1 Ref RCW 46.61.140 Improper lane change/lane use 2 vehicle collision via complaint. I certify (declare) under penalty of perjury under the laws of the State of Washington that the foregoing is true and correct. M.Leverton/2517 City of Renton/King/Wa 10/01/2025 PAGE 3 OF 4 REPORT NO. EG33739 CASE# 25-8510 DATE AND TIME 10/01/2510:22 OF COLLISION o. s 1� s t 21 r fir � i �s e PAGE 4 OF 4