HomeMy WebLinkAbout25-8817 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 0 27c
COLLISION REP FIT 1591971
CASE 25-8817 z
INTERSTATE ❑ CITY STREET FIRE ❑RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHIC;I F ❑ LOCAL AOENC 4900 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 2 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 10 - 11 - 2025 1811 17 �. S 8 W H OF e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
BLOCK
NE SUNSET BLVD MILEPOST ST e✓ 2825 ❑
4a❑
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ e S ❑ W❑ FEET e NE 11TH ST
1 2 29
MOTOR PEDAL- DAMAGE THRESHOLDHONE
UNIT 01 VEHICLE ❑ CYCLE El MET P
YES ✓NO D:6176101315 0 11
30
6� LAST NAME CHOI FIRSTNAME HEEYUN MIDDLE 1 2 31
INITIAL
STREET ❑1 2715 SUNSET LN NE#315 CITY RENTON ST WA 21p 98056 z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
1/ I iNTERLOCKYEs NO NTERLOCKYEs Z/NO YEs �No /
LRIIVER # STATE WA SEX'F MM D Y' 07 - 22 -
8❑ 1994 1 2 32
[NATURE OF INJURIES
9 ON DUTY❑ STATUS' AIRBAG 2 RESTR 4 EJECT 1 HELMET U E 2 6 CLASS NECK AND HEAD PAIN 2❑
3
10 9❑ PI ATE14 CLZ5832 sTAr WAVN#' WP1AG2A55JL660492
5 TRAILER STATE TRAILER STATE
11 3 5 PLATE# PLATE# ROM ro
TRLR. TRLR 7 3 33
12 3 5 VIN#j VIN#
:: FROM TO
VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE 5 1 34
13 2 2018 PORS MACAN SD DAMAGE YES NO YES[:] No✓
REGISTERED OWNER INFO OWNEDBYDRIVER VEHICLE NO. 1
SHADE IN DAMAGED AREA 35
2 INSURANCE CO 3 4
14 LIABILITY INSURANCE ALLSTATE INSURANCE 2031345492
IN EFFECT &POLICY# 9TOP
15❑ vEwCLE to BOTTOM 5 36
LEGALLY YES�No D CITATION# 5A0319259,5A0319259 CHARGE FAIL TO YIELD MOTOR VEHICLE,NO 5
STANDING 8 7 6
MOTOR PEDAL PR OWNER OPERTY DAM THR OLD MET PHONE
16
U VEHICLE CYCLE'02 ❑✓ ❑ PEDESTRIAN ❑ YES 1/ NO D:2062491314
a
LAST NAME PEREZ PAREDES FIRST NAME WILBER MIDDLE A
INITIAL
17 STREET❑ NEW ADDREO 904 FERNDALE CIR NE CITY RENTON ST WA ZIP 980594455 4❑ 37
18❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL—T�RANSPORTED � 38
INTERLOCK YEs❑NO� INTERLOCK Y�EsI I I NOF YEs t l NO�
19 LICENSE# STATE WA SEX M M.C... 10 _ 26 _ 1996 39
20❑ ON DUTY STATUS I
AIRBAG 2 RESTR 4 EJECT 1 H U EET 2 NJAURSY 1 NATURE OF INJURIES ❑ 40
❑21❑ PLA E# CTT6973 TArE 41
WA vIN# 2HGES26702H502958 1
42
22❑ PLATE# STATE PLATE# STATE
TRLR
23❑ VIN#. IN#. 43
RLR
'
I
VEH YEAR 2002 MAKE yOND MODEL CIVIC STYLE $D DAMAGE TO WED NOO✓ BLIN TOWED BY Gov 44
jVEHl Yr
H YES NO
24❑ REGISTERED OWNER INFO OWNED SY DRIVER VEHICLE N0.2
SHADE IN DAMAGED AREA
2 3 4
LIABILITY
INSURANCE❑ I POLICY#E CO NONEIN STOP 5
VEHICLE ❑ ,.I—I CITATION# CHARGE i o BOTTOM
LEGALLY YES N`LJ
25 $
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
26
MAR/A FERNANDES 12848 WA0171300
PART A PAGE 01 OF
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EG38003
COLLISION REPORT III III III III III 111
1591972 CASE# 25-8817
ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY)
NAME(LAST FIRST,MIDDLE INITIAL) LE SHAWN
ADDRESS&PHONE#
2715 SUNSET LN NE#315 RENTON WA 98056 SEX M MMDDYyry 12 - 27 - 2020
PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT ' HELMET INJURY NATURE OF INJURIES
❑✓ �. 1 POS. 9 2 10 1 USE 1 2 CLASS 11
NAME
(LAST,FIRST,MIDDLE INITIAL)
ADDRESS&PHONE# DOB
SEX MMDDYYYY
PASSENGER ❑WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET INJURY NATURE OF INJURIES
POS. USE CLASS
NAME
(LAST FIR57 MIDDLE INITIAL)
AppRESS&PHONE#
SEX D.O.B.
MMDDYYYY. _
PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET NJURY NATURE OF INJURIES
❑ ❑ POS. USE CLASS ----�
NARRATIVE'
Vehicle 1 was driving eastbound on 11TH ST NE and approached the intersection of NE Sunset
BLVD. The driver of Vehicle 1 said she drove across two southbound lanes of NE Sunset BLVD
before stopping in the center turn lane. She then crossed two northbound lanes of NE Sunset BLVD
in an attempt to enter a parking lot, when she struck Vehicle 2 in the eastern lane. Vehicle 1's front
right bumper struck Vehicle 2's left rear quarter panel, disabling its left rear tire. Driver 1 said that she
saw Vehicle 2 but he was speeding and that's why she hit him. Driver 2 said he was driving 25 or 30
mph and he observed Vehicle 1 cross all four lanes of traffic before striking his left rear quarter panel.
Vehicle 2 was not driveable and was privately towed. Vehicle 1 had damage on the front right bumper
and it was driveable. Driver 1 failed to yield to vehicle 2's right of way when entering NE Sunset BLVD
attempting to cross oncoming traffic. Driver 1 also failed to produce her driver's license upon request
and advised that she had left it at home since she had apple pay. Driver 1 was cited for RCW
46.20.017 and 46.61.180. Driver 1 reported neck and head pain, and Driver 2 reported no injuries.
I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT.
MAR/A FERNANDES 10-12-25 01:17 AM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
J.CHRISTIANSEN 10437 1 1011512025 5:42:56 PM
BADGE OR ID# 1Y848 ORI# WA0171300 TIME POLICE DISPATCHED! 6:14 PM TIME POLICE ARRIVED',6:17 PM
PART I PAGE IT]OF
REPORT NO. EG38003 CASE# ' 25-8817 DATE AND TIME 10/11/25 18:11
OF COLLISION
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