HomeMy WebLinkAbout25-7669 a ITFFi "POLCERA II IfI) 1 IlfII ('II (Illf If( fI I . 1 27c
COLLISION REP FIT 1591971
SASE 2sasss 2
INTERSTATE ❑ CITY STREET FIRE ❑RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHICI F ❑ LOCAL AOENC 4Y00 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 1 TOTAL#OF OBJECT 1 1 8 28
TRIBAL UNITS 03 STRUCK
RESERVATION
z
3❑ DATE OF M M D D Y Y Y Y TIME(2400) COUNTY# MILES N E IN CITY# ❑
COLLISION'. 09 - 1-- 2025 1645 17 ❑.= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓
HARRINGTON AVE NE BLOCK NO. e✓ 900
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ 100 00 FMILES EET e S B W e NE SUNSET BLVD
0 1 29
MOTOR ✓ PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE ❑ YES ✓NO D:2062802653 1 4 30
6� LAST NAME GAINES FIRSTNAME TREYVONN MIDDLE D 1 0 6 31
INITIAL
STREET 01 2519 NE 5TH PL C{TY RENTON ST WA ZIP 98056 z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
iNTERLOCKYEs No✓ INTERLOCKYEs NO✓ YES R No
8❑ LRIIVER #
ON DUTY❑ STATUS AIRBAG 3 RESTR 4 EJECT 1 HELMET U E 2 CLASS 1 NATURE OF INJURIES z❑
3
10❑ P1 aT�S� CCW4146 sTArI WAurN# KMBSMDHFXHW 67043
TRAILER STATE TRAILER STATE
11 3 0 PLATE# PLATE# FROM TO
TRLR. TRLR. 5 1 33
12 0 0 VIN#' VIN#
2017 HYUN SANTA UTYES[:]
❑ FROM
34
❑ VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE
13 4 DAMAGE YES NO ✓ YES NO✓
REGISTERED OWNER INFO HOLLI MOLNAR 2519 NE 5TH PL RENTON WA 98056 D:2062802653 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
14❑ LIABILITY INSURANCE z INSURANCE CO FIRST NATIONAL M2054740 4
LI EFFECT &SUR N# TOPVEHICLE CHARGE 36
LEGALLv res❑NO❑ CITATION# <1�3
OTTOM
15❑ STAIN,DIING 7 6
UNIT VEHIMOTCCLE CYCLE ❑Z PEDAL- PEDESTRIAN ❑ OWNER
❑ DAM
YES✓ NO OLD MET PHONE
16❑
LAST NAME UNKNOWN FIRST NAME MIDDLE
INITIAL
STREET CITY LACEY ST ZIP 4
17❑ NEW ADDRESS❑ ❑ 37
18❑ CDL IGNITION REQUIRED IGNITION PR—E-1SENT MEDICAL—T�RANSPORTED � 38
INTERLOCK YEs❑No� INTERLOCK YEs It I NOF YES
t l NOF,/
19 LLIICENS# STATE SEX U MMODYY —�_ 39
WELMET {NJURY NATURE OF INJURIES 40
20❑ ON DUTY STATUS AIRBAG 2 RESTR 1 EJECT 1 USE 2 CLASS I1 ❑
❑LICENSE 21❑ PLA E# CCL7739 TAre 41
WA VIN# 1C46JWFG7CL139347 1
42
22❑ PLATE# STATE PLATE# STATE
23❑ 43
TRLR RLR
UIN#. 'IN#.
VEH YEAR 2012 MAKE JEEP MODEL WRANGL STYLE VT VEHICLETOWED TO BLIN TOWEDBY GOV HI �44
L4❑ DAMAGE YES NO✓ YES NO✓
REGISTERED OWNER INFO JOSE ZAMORA 380014TH AVE SE LACEY WA 98503 D:3605614414 VEHICLE NO.2
SHADEDAMAGEbAREA
s Cd
INAEFFIECTTY NSURANCE❑ &POINSULICY#E CO 9TOP
VE""Le ❑ ,J� CITATION# CHARGE io BOTTOM
LEGALLY YES N J
25 '
7NE
NAME(PRINT) OFFICER PHONE BADGE OR ID# JAGENCY
26
ON 12327 WA0171300
PART A PAGE 01 OF
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EG36331
COLLISION REPORT III III III III III 111
1591972 CASE# 25-7669
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.
T.NELSON 09-05-25 11:44 AM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
C.JACOSS 1953 1011012025 1:27:03 PM
BADGE OR ID# 12327 OR]#' WA0171300 TIME POLICE DISPATCHED; 5:12 PM TIME POLICE ARRIVED',5:21 PM
PART I PAGE IT]OF 5�
REPORT NO. EG36331 CASE# 25-7669 OF COLLISION
09/02/25 16:45
OF CbLLI510N
NARRATIVE
25-7660
Unless otherwise noted, the following occurred in the City of Renton, County of King, WA.
I was dispatched to a collision that occurred in the 900 block of Harrington AVE NE. Dispatch
advised: "NO INJUIRES.. SIL VEH HIT 3 PARKED VEHS.."
I arrived and located the involved vehicles, all on the east side of the roadway. Unit 1, a silver
Hyundai Sante Fe (WA/CCW4146), had sustained significant front-end damage and had airbag
deployment. I observed unit 1's rear passenger side tire was completely deflated. Unit 2, a black Jeep
Wrangler (WA/CCL7739), had significant rearend damage as well as a cracked rear passenger side
rim, and a rear passenger side shock which had separated from the control arm. Unit 2 also had
apparent front bumper damage with what appeared to be white paint transfer from unit 3. The front
passenger side tire of unit 2 was on the sidewalk but I was led to believe that it was legally parked
prior to the collision. Unit 3, a white Silverado (WA/C98060Y), had sustained significant damage to
the rear tailgate from being struck by unit 2's bumper.
The driver of unit 1, Treyvonn, was a minor. Treyvonn's mother and owner of unit 1, Holli, responded
to the scene. After speaking with both Holli and Treyvonn, I gathered the following:
Treyvonn was travelling north on Harrington AVE NE when unit 1's steering became unstable.
Suddenly unit 1 veered to the right due to the rear passenger side wheel/tire failure and unit 1 struck
unit 2 from behind which caused a chain reaction and unit 2 struck unit 3. Treyvonn advised he was
travelling approximately 25-30 MPH at the time of the collision. Unit 2 and unit 3 were both
unoccupied at the time of the collision.
The information relayed to me was consistent with my observations of the scene.
Unit 2 & 3 happen to have the same registered owner, Jose. Jose resides in Lacey, WA and was not
on location, but Jose's friend who intended to purchase both vehicles responded. I reached Jose by
phone, and he was unable to provide insurance information for either vehicle. I provided the involved
parties with an exchange of information as well as my card and the Renton Police case number.
Unit 1 and unit 2 were both impounded due to them being inoperable and not legally standing. Unit 3
was legally standing before and after the collision.
I photographed the scene and uploaded the photos to the case file.
Based on my observations of the scene and the information relayed to me, I am led to believe that
unit 1's equipment failure was the proximate cause of the collision.
I declare under penalty of perjury under the laws of the State of Washington that the foregoing is true
and correct.
Electronically signed by T. Nelson 12327 on 09-05-2025 at 1131 hours in Renton, WA.
PAGE 3 OF 5
SUPPLEMENTAL REPORT No. EG36331
r`) POLICE TRAFFIC 1 1 8 27
COLLISION REPORT CASE# 25-7669
1 COMMERCIAL MOTOR CARRIER INTERSTATE INTRASTATE G
UNIT'# USDOT ICC# VEHICLE TYPE CARGO BODY
;TYPE
2 ❑ 1 28
CARRIER
NAME
3 CARRIER
ADDRESS `
CITY ST ZIP—1 I '
4 ❑ NAME # PLACARD: :❑
GWVR NAME IF NO NUMBER
SOURCE AXLES +
4a ❑ ADDITIONAL UNITS
MOTOR PEDAL-
PROPERTY DAMAGETHRESHOLD MET PHONE
5 ❑ UNIT# 3 VEHICLE t_"J � PEDESTRIAN YEs� NO
1 4 29
LAST NAME : UNKNOWN FIRST NAME MIDDLE
INITIAL
STREET 30
NEW AnDRFS CITY LACEY ST ZIP
6 1
CDL GNITIttN REQUIRED GNITION PRESENT MEDICAL TANSPORTED 1 31
INTERLOCK YES NO NTERLOCK YES❑N0� vES N
DRIVER'S STATE I SEX U M��DYSYv' -� 2
LICENSE
7
ON DUTY STATUS AIRBAG 9 RESTR. 9 EJECT 1 HELMET 9 INJURY 0 NATURE OF INJURIES
F�
USE CLASS
8 ❑ 1 32
LICENSE C98060Y TAr WA VIN# 1GCNCPEHOEZ138984
PLATE#
9 TRAILER TRAILER
TE# STATE PLATE# STATE
10 ❑ TRLR TRLR
VIN.#. VIN.#.
11 O O VEH.YEAR MAKE MODEL STYLE VEHICLE TOWS E T SABLIN TOWED BY anvi vEHlci F FROM TO
2014 CHEV SILVERA PK DAMAGE YES NO YES NO
REGISTERED OWNER INFOJOSEZAMORA 380014THAVE SE D173 LACEY WA 98503 D:3605614414 m 33
12 � SHADE IN DAMAGED AREA
�2�
FROM TO
LIABILITY INSURANCE❑ INSURANCE CO
IN EFFECT &POLICY# tvewFFCLE 34
13 LEGALLY YES N001 CITATION# CHARGE
STANDING } MOTOR
8 7
14 ❑ UNIT Tr Vd 1RE O CYCLE 1:1OWNER
YES AGE NOHRESHOLD MET PHONE ❑ 35
PEDESTRIAN
15 LAST NAME FIRST NAME INITIALMIDDLE
F� ITIAL
❑
STREET
16 TRE "F-]' CITY ST NEW ZIP
CDL IGNITION REdUiRED IGNITION PRESENT MEDICALTANSPORTED
NTERLUCK YES NO NTERLOCK YES NO 'YES NO ❑
17 5 37
LICENSE# STATE SEX MMDDDYBYY
18 ❑ ON DUTY� STATUS AIRBAG RESTR. ; EJECT HELMET INJURY NATURE of INJURIES 38
USE (CLASS
19 ❑ 39
LICENSE rnr VIN#
PLATE#
20 ❑ TRAILER' TRAILER El40
PLATE#< STATE PLATE# STATE
21 ❑ [441
TRLR TRLR
VIN# YIN#i
42
22 VEH.YEAR MAKE I MODEL STYLE I VEHICLE TO DUET SABLIN TOWED BY GOVT.VEHICLE
DAMAGE YES NO YES NO
23 REGISTERED OWNER INFO SHADE IN DAMAGED 3 4 4 AREA F 43
z
LIABILITY INSURANCE INSURANCE CO '
VINE
EFFECT &POLICY# i 97OP - 4 E:l
44
24 LEwcLE YES❑ NO❑ CITATION# CHARGE iq 6OTiOM
LeGALLv
STANDING & 7 6
1 CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT.
T.NELSON 09-05-25 11:44 AM
25 INVESTIGATING OFFICER'S SIGNATURE OFFICER'S PHONE UNIT OR DIST DET DATED: PLACE SIGNED
26 OI BADGE 12327 O#I',WA0171300 APJACOBS 10/10/202 PAGE F41 OF F
3000-345-013(R 11118)
REPORT NO. EG36331 CASE# ' 25-7669 DATE AND TIME 09/02/25 16:45
OF COLLISION
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PAGE 5 OF 5