HomeMy WebLinkAbout25-8096 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 1 27c
COLLISION REP FIT 1591971
SASE 25-8096 2
INTERSTATE ❑ CITY STREET FIRE ❑
RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHIr.I F ❑ LOCAL AOENC 4Y00 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 1332 17 ❑-= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
S GRADY WAY BLOCK NO. e✓ ----� ❑
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ ❑ FEET e S ❑ VV a BENSON RD S
0 1 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
�/No D:2537378013 0 4 30
6� LAST NAME JOHNSON FIRSTNAME CYNTHIA MIDDLE F 1 1 2 31
INITIAL
STREET ❑ 34610 2ND LN S APT G112 CITY FEDERAL WAY ST WA ZIP 980036787 z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
INTERLOCK YES[:]NO INTERLOCKYEs NO YES NO
8❑ LDRIVER # STATE WA SEX'F MID
.O B 10 1— 16 — 1964 2 32
9 ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 H USEET ICNLJAURY 1 NATURE OF INJURIES z❑
3
10❑ P1 aT�S� CNE3240 sTArI WAurN# WAUDACF52MA012179
TRAILER STATE TRAILER STATE
11 3 5 PLATE# PLATE# FR.. To
TRLR. TRLR 7 3 33
12 3 5 VIN#' VIN#'
>; FROM TO
❑ VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN T /g[ GOVT.VEHICLE 3 $ 34
13 3 2021 AUDI A5 DAMAGE YES NOBS YES[:] No✓
REGISTERED OWNER INFO OWNEDBYDRIVER VEHICLE NO. 1
SHADE IN DAMAGED AREA ❑ 35
14 LIABILITY INSURANCE INSURANCE CO PROGRESSIVE 991529492 3 4
IN EFFECT &POLICY# 9TOP
VEH" CHARGE 5 36
LEGALLY YES❑NO❑ CITATION# 10 BOTTOM
15❑ STANDING 6
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES 1/ NO D:4254639623
16 a
LAST NAME S/MIS FIRST NAME BRIAN MIDDLE I D
INITIAL
17❑ STREET ❑', 10220 SE 217TH PL CITY KENT ST WA ZIP 980312062 37
NEW ADDRESS ❑
18� CDL IGNITION REQUIRED IGNITION PR—E-1SENT MEDICAL TRANSPORTED ❑ 38
INTERLOCK YEs❑NOR INTERLOCK YEs It I NOF YES
t t- l NO❑
19 DRIVER # STATE WA SEX M MMDDW 11 29 _ 1974 El 39
WELMET INJURY1 NATURE OF INJURIES 40
20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 USE CLASS ❑
21❑ LICENSE AYK5506 TAre WA VIN1i 2HKRM4H7XGH605418
❑ 41
PLATE#
42
22❑ PILER LATE# STATE PLATE# STATE
23❑ VIN#. 43
TRLR RLR
'IN#.
TOWED BY GOV HI 44
VEH YEAR 2016 MAKE yOND MODEL CR_I/ STYLE DAMAGE TOWED✓ NOO BLIN BANKERS YES N.%/
24❑ REGISTERED OWNER INFO OWNED SY DRIVER VEHICLE N0.2
SHADE IN DAMAGED AREA
2 3 4
LIABILITY
INSURANCE &POINSURGY#E CO ALLSTATE 807 416 742IN CQl
'E""LE ❑ ,J� CITATION# CHARGE i o
LEGALLY YES N`L J
25
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. EG36330
COLLISION REPORT III III III III III 111
1591972 CASE# 25-8096
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 09-17-25 02:21 PM
NVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
C.JACOBS 1953 10/10/2025 1:22:08 PM
BADGE OR ID# 12509 ORI# WA0171300 TIME POLICE DISPATCHED 1:34 PM TIME POLICE ARRIVED',1:36 PM
PART I PAGE IT]OF 4�
REPORT NO. EG36330 CASE# 25-8096 OF COLLISION
09/17/25 13:32
OF CbLLI510N
NARRATIVE
RTF 25-8096
On 9/17/2025 at 1334 hours I was dispatched to a motor vehicle collision at S Grady Way and
Benson Rd S in the City of Renton, King County, Washington.
Pre-Collision
Driver 2 stated that he was facing West on S Grady Way in the #3 lefthand turn lane preparing to
perform a lefthand turn to proceed South on Benson Rd S.
Driver 1 stated that she was proceeding East on S Grady Way in the #2 lane preparing to go straight
ahead at the intersection of S Grady Way and Benson Rd S.
Collision
Driver 2 stated that his light turned green and he saw a vehicle run a red light in front of him. Driver 2
stated that after this, he began his lefthand turn to proceed South on Benson Rd S from S Grady
Way. Driver 2 stated that while in the middle of the intersection, Unit 1 entered the intersection
against a red light and the front drivers side bumper of Unit 1 collided with the front bumper of Unit 2.
Driver 1 stated that she had a green light and as she proceeded through the intersection in the #2
lane, Unit 2 emerged from the opposing lanes of traffic to perform a lefthand turn in front of her. Driver
1 stated that she did not have time to stop and the front drivers side bumper of Unit 1 collided with the
front bumper of Unit 2.
1 attempted to locate any cameras associated with this intersection and was unable to find any that
would have captured the collision
Injuries
None reported.
Vehicle Disposition
Both vehicles were towed from the scene.
Proximate Cause
Because both drivers stated that they had a green light at the time of the collision, and that there were
no independent witnesses to corroborate either story, I am unable to determine the proximate cause
of this collision at this time.
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 C. Arnold #12509 at 14:18 on 9/17/2025 in the City of Renton, King
County, Washington.
PAGE 3 OF 4
REPORT NO. EG36330 CASE# ' 25-8096 DATE AND TIME 09/17/25 13:32
OF COLLISION
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