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HomeMy WebLinkAbout25-8820 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 1 27c COLLISION REP FIT 1591971 ❑ ❑ FIRE ❑ CRSE# 2$-8820 2 0 4 INTERSTATE CITY STREET RESULTED 1 STOLEN STATE ROUTE ❑ OTHER ❑ VFHIC;I F ❑ LOCAL AGENCI 4100 3 HIT 8 RUN CODING COUNTY RD PRIVATE WAY INVOLVED 2 TOTAL#OF OBJECT 1 8 28 TRIBAL UNITS 04 STRUCK M/SC OBJECT OR DEBRIS ON ROAD RESERVATION 2 3❑ DATE OF M M D D Y Y Y Y TIME(2400) COUNTY# MILES N E IN CITY# ❑ CowsloN 10 - 11 - 2025 1915 17 ❑.= S 8 IN e 1070 3 4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓ UNION AV NE BLOCK NO. e✓ 1700 4a❑ MILE POST DISTANCE OF(REFERENCE OR CROSS STREET) 5❑ 20 00 FEET MILES e S B W e NE 18TH ST 0 1 29 MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE UNIT 01 VEHICLE ❑ CYCLE El �/No D:2533359798 1 2 30 6� LAST NAME YADROVA FIRSTNAME SVITLANA MIDDLE 1 2 31 INITIAL STREET ❑✓ 2214 VASHON AVE NE CITY RENTON ST WA Zjp, 98059 2 NEW ADDRESS 7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3 iNTERLOCKYEs �/NO INTERLOCKYEs NO Z/ YES R No�/ $ LICIENSE# STATE yyq SEXI F MMDDVY' 11 - 14 - 1983 1 2 32 9 ON DUTY❑ STATUS AIRBAG 6 RESTR 4 EJECT 1 HELMETU SE CLASSS 1 NATURE OF INJURIES 2❑ 3 10 9❑ P1 ATNES# CTV6756 sTAr WAu N# 2FMDK49C87B629723 0 TRAILER STATE TRAILER STATE 11 3 0 PLATE# PLATE# FROM TO TRLR. YRLR. 5 1 33 12 3 0 VIN#' VIN# >; FROM TO ❑ VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TR Y GOVT.VEHICLE 34 13 4 D OW FORD EDGE DAMAGE YES NO �MEYER 7 5 YES[:] ✓ REGISTERED OWNER INFO SVITLANA YADROVA2214VASHONAVENE RENTONWA98059 VEHICLE NO. 1 ❑ SHADE IN DAMAGED AREA 35 14 LIABILITY INSURANCE❑ INSURANCE CO NONE <1�3 4 IN EFFECTPOLICV# TOPVEHICLE CHARGE 36 LEGALLY YES❑NO CITATION# 5A0663866 OP MOT VEH W/OUT INSURANCorrom 15❑ STANDING 7 6 MOTOR PEDAL- PROPERTY DAM THR OLD MET PHONE UNIT 02 VEHICLE CYCLE ❑ PEDESTRIAN ❑ OWNER ❑ YES 1/ NO D:2066923162 16 a LAST NAME BARNES-CREDIT FIRST NAME ROLANDA MIDDLE INITIAL 17❑ STREET ❑', 1700 UNION AVE NE CITY RENTON ST WA ZIP 980593900 37 NEW ADDRESS ❑ 18� CDL IGNITION REQUIRED IGNITION PR-E-1SENT MEDICAL TRANSPORTED 38 INTERLOCK YEs❑NO� INTERLOCK YEs It I NOF YES t l NOF,/ 19[—] LDI IVEW # STATE WA ]SEX IF M D.C.B. 07 01 1959 0 39 WELMET INJURY 1 NATURE OF INJURIES 40 20❑ ON DUTY STATUS AIRBAG 6 RESTR 4 EJECT 1 USE CLASS ❑ 21❑ LICENSE I CHR8373 TAre WA VIN# 5UXTR9C52KLP90464 ❑ 41 PLATE# 42 22❑ PLATE# STATE PLATE# STATE TRLR 23❑ UIN#. IN#. 43 RLR ' VEH YEAR 2019 MAKE BMW MODEL X3 STYLE VEHICLE TOWED TO BLIN TOWEDBY GOV HI 44 24 DAMAGE YES 1/ NO GENE MEYER YES NO REGISTERED OWNER INFO DEITRA CREDIT 210 LOTTIE ST BELLINGHAM WA 98225 VEHICLE NO.2 SHADEDAMAGEDAREA 3 4 LIABILITY INSURANCE INSU8 PORGY#E CO STATE FARM 5444072B2647BIN STOP 5 VE"LE ❑ N,J� CITATION# CHARGE to BOTTOM LEGALLY YES 6 25 OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY J 26 HANSEN HSU 12651 WA0171300 PART A PAGE 01 OF 3000-345-159 OR 11/181 STATE OF POLICETRAFFICN CORRECTION REPORT NO. EG37520 COLLISION REPORT III III III III III 111 1591972 CASE# 25-8820 ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY) NAME MIDDLE INITIAL) CREDIT DEITRA R (LAST FIRST, ADDRESS&PHONE# D O.B. ' 1700 UNION AVE NE RENTON WA 980593900 SEXi F MMDDYyry 01 - 03 - 1988 SEAT HELMET INJURY NATURE OF INJURIES PASSENGER Z WITNESS❑ UNIT# 2 POS 3 AIRBAG 6 RESTR. 4 EJECT USE CLASS 7 HEAD E OF INJ ACK NAME (LAST,FIRST,MIDDLE INITIAL) ADDRESS&PHONE# Id I DOB E MMDDYYYY PASSENGER ❑WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET NJURY 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' Unit 1 speeding northbound along 1700 block of Union Av NE. Unit 2 merging into traffic onto Union Av NE, facing west making a left turn south from the driveway of 1700 Union Av NE. Unit 1 strikes Unit 2 causing major disabling reportable damage to both Unit 1 and Unit 2. The impact of the crash forces Unit 2 to rotate to the right, northbound and ends up facing northboun on Union Av NE. Unit 1 careers diagonally and ends up in the front yard of 1807 Union Av NE, causing a secondary collision with Unit 3, which was legally parked, unoccupied, within the driveway at said property. Unit 3 sustained minor reportable damage to driver side. Unit 4 resident and property owner of Unit 3 also sustained shrubbery and yard damage from the path Unit 1 took to enter into said property. No injuries reported save for front passenger of Unit 2, who was assessed on scene by Renton Fire and later self transported to hospital for further treatment. Unit 1 driver was the proximate cause of the collision due to her excessive speed and for the fact that it was illegal for Unit 1 driver to have been driving in the first place as a check of her WA DOL status returned with a pre trial ignition interlock device which was not affixed to Unit 1 at the time of collision. Unit 1 driver also did not have proof of vehicle insurance. Unit 1 driver was assessed on scene and did not exhibit any signs of impairment. Unit 1 driver cited for IID violation and no insurance. I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT. HANSEN HSU 10-11-25 09:19 PM INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED APPROVED BY DATE J.CHRISTIANSEN 10437 10/14/2025 2:31:24 PM BADGE OR ID# 12651 OR]#' ' WA0171300 TIME POLICE DISPATCHED 7:16 PM TIME POLICE ARRIVED',7:20 PM PART I PAGE IT]OF 4] SUPPLEMENTAL REPORT NO. EG375520 r`) POLICE TRAFFIC 1 1 8 27 COLLISION REPORT (CASE# 25-8820 1 COMMERCIAL MOTOR CARRIER INTERSTATE INTRASTATE G UNIT'# USDOT ICC# VEHICLE TYPE CARGO BODY ;TYPE 2 ❑ 1 28 CARRIER NAME 3 CARRIER L 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� IN 1 4 29 LAST NAME NONE FIRST NAME MIDDLE INITIAL STREET 30 NEW AnDRFS CITY RENTON ST ZIP 6 [2 P CDL IGNITIttN REQUIRED IGNITION PRESENT MEDICAL TANSPORTED 1 31 INTERLOCK YES NO zERLOCK YES❑N0� YES N DRIVER'S STATE I SEX U M��DVSYv' —� 2 LICENSE 7 ON DUTY STATUS AIRBAG 2 RESTR. 1 EJECT 1 HELMET 9 INJURY 1 NATURE OF INJURIES F� USE CLASS 8 ❑ 1 32 LICENSE I C23538S [TAT INA VIN# 1FTFWlETODFA93011 PLATE# 9 TRAILER TRAILER PLATE# STATE PLATE# STATE 10 ❑ TRLR TRLR VIN.#. VIN.#. 11 0 0 VEH.YEAR MAKE MODEL STYLE VEHICLE TOWS E T SABLIN TOWED BY anvi vEH1C P FROM TO 2013 FORD F150 TR DAMAGE vES NO �/ YES NO 33 SHADE IN DAMAGED AREA REGISTERED OWNER INFOJESUS RENTERIA CORRAL 1807 UNION AVNERENTONWA98059 D:4256524447 m 12 7GQ j4 FROM TO LIABILITY INSURANCE[] INSURANCE CO IN EFFECT &POLICY# tEHIELE 34 13 ❑ LEGALLY YES❑ NO❑ CITATION# CHARGE STANDING 4 MOT{7R PEDAL PROPERTY a e DAMAGE THRESHOLD MET PHONE ❑ 35 14 ❑ UNIT# VEHICLE CYCLE PEDESTRIAN1:1 OWNER YES NO D:4256524447 36 15 ❑ LAST NAME RENTERIA CORRAL FIRST NAME 1JES US MIDDLE INITIAL 16 ❑ STREET ❑; 1807 UNION AV NE CITY RENTON STI WA Z!P 98059 NEW AnnR".% CDL IGNITION REQUIRED IGNITION PRESENT MEDICALTANSPORTED 17 ❑ INTERLOCK YES NO INTERLOCK YEs N. YEs NO ElDRIVER'S STATE SEX U moo 37 D,O 18 ❑ LICENSE# MMDDYYY ON DUTY STATUS AIRBAG RESTR, EJECT HELMET INJURY NATURE OF INJURIES ❑ 38 USE (CLASS 19 ❑ 39 LICENSE VIN# PLATE# rnr 20 ❑ TRAILER' STATE TRAILER STATE ❑ 40 PLATE#< PLATE# 21 ❑ TRLR TRLR 41 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 970P - 4 E:l 44 24 LEwcLE YES❑ NO❑ CITATION# CHARGE iq 60TiOM Lec E STANDING 8 7 6 1 CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT. HANSEN HSU 10-11-25 09:19 PM 25 INVESTIGATING OFFICER'S SIGNATURE OFFICER'S PHONE UNIT OR DIST DET DATED: PLACE SIGNED 26 ORID# 12651 O#I',WA0171300 APPROVED BY 10/14/202 PAGE F OF 4 3000-345-013(R 11118) REPORT NO. EG37520 CASE# 25-8820 DATE AND TIME 10/11/2519:15 OF COLLISION s �c F 'a £ ar yes l 1 II d' Yv4.' a to� 4t1ydF�� "aa 1 L t S�otR i PAGE 4 OF 4