HomeMy WebLinkAbout25-8915 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 5 27c
COLLISION REP FIT 1591971
CASE 25-8915 z
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 10 - 1-- 2025 0716 17 ❑.= S 8 IN e 1070 3
4❑ oN (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
BLOCK NO. e✓ --- ----� ❑
SE 168TH ST MILEPOST
4a❑
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ ❑ FEET e S ❑ VV e 127THAVE SE
0 1 29
MOTOR PEDAL- DAMAGE THRESHOLDPHONE
UNIT 01 VEHICLE ❑ CYCLE El MET YES NO D:2068061278 0 11
30
6� LAST NAME ZOU FIRSTNAME WENNI MIDDLE 1 2 31
INITIAL
STREET ❑ 16704 126TH AVE SE CITY RENTON ST WA 21p 98058 z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
iNTERLOCKYEs NO INTERLOCKYEs NO YES NO
8❑ LRIIVER #
ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 H USEET ICNLJAURY 1 NATURE OF INJURIES z❑
3
LICENSE CNC6936 STATE WA vN# 1FMSK8JH3RGA40482
10 9❑ Pr ATE�
TRAILER STATE TRAILER STATE
11 2 0 PLATE# PLATE# FROM TO
TRLR. TRLR 3 7 33
12 2 0 VIN It VIN#
FROM TO
❑ VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE 7 3 34
13 4 2024 FORD EXPLOR DAMAGE YES No YES❑ NO
REGISTERED OWNER INFO OWNEDBYDRIVER VEHICLE NO. 1
SHADE IN DAMAGED AREA ❑ 35
14 LIABILITY INSURANCE INSURANCE CO COUNTRYFINACIAL PA4197752 3 4
IN EFFECT &POLICY# 9TOP
VEHae CHARGE 1 5 36
LEGALLY YES❑NO❑ CITATION# 5A0625798 INATTENTIVE DRIVING I o BorroM
15❑ STANDING 6
MOTOR PEDAL- 'PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT U2 VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES 1/ No D:2065510631
16 a
LAST NAME PUENTE RAYGOZA FIRST NAME JOSE MIDDLE I L
INITIAL
17❑ STREET ❑', 16823 116TH AVE SE CITY RENTON ST WA ZIP 980585955 37
NEW ADDRESS ❑
18� CDL IGNITION REQUIRED IGNITION PRESENT MEDICALTRANSPORTED ❑ 38
INTERLOCK YEs❑NOR INTERLOCK YEs❑NOF YES❑NO❑
19 DRIVER #
INJURY1 NATURE OF INJURIES 40
20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 USE CLASS ❑
21❑ LICENSE I BRH7569 TATe WA VIN. 2C4RC1EGOKR741400
❑ 41
PLATE#
42
22❑ PLATE# STATE PLATE# STATE
23❑ VIN#. 43
TRLR RLR
'IN#.
TOWED BV Gov HI 44
VEH YEAR 2019 MAKE CHRY MODEL pgCIFICA STYLE —7EHICLE
TOWED✓ NOO BLIN GENE MEYERS YES No�/
24❑ REGISTERED OWNER INFO OWNED SY DRIVER VEHICLE N0.2
SHADE IN DAMAGED AREA
2 3 4
LIABILITY
INSURANCE INSU&PORGY#E CO FARMERS INSURANCE 540945071IN IQ �VE""LE
❑ ,J� CITATION# CHARGE i o LEGALLYYES N`L J25 $
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. EG38127
COLLISION REPORT III III III III III 111
1591972 CASE# 25-8915
ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY)
NAME MIDDLE INITIAL) ORTIZ MEDIA VALENTINA
(I.P.ST FIRST,
ADDRESS&PHONE# D O.B. '
4010 NE 12TH ST RENTON WA 98056 4255459152 SEXi F MMDOYyry 02 - 14 - 2008
PASSENGER Z WITNESS UNIT# 2 SEAT POS 3 AIRBAG 2 RESTR. 4 EJECT ? 1 HELMET NATURE OF INJURIES
USE CLASS
11
NAME
'(LASTr FIRS' MIDDLE INITIAL)
ADDRESS&PHONE# D O B
SEX MMDDVYYY
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.
MMDDYVYY. -
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 10-15-25 08:39 AM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
RAYMOND GORAJEWSKI 12399 1 1011612025 7:15:15 AM
BADGE OR ID# 12509 OR]4$ WA0171300 TIME POLICE DISPATCHED 7:99 AM TIME POLICE ARRIVED',7:27 AM
PART I PAGE IT]OF 5�
REPORT NO. EG38127 CASE# 25-8915 OF COLLISION
10/15/25 07:16
OF CbLLI510N
NARRATIVE
CC 25-8915
On 10/15/2025 at 0719 hours I was dispatched to a motor vehicle collision at the intersection of SE
168th St and 127th Ave SE in the City of Renton, King County, Washington.
Pre-Collision
Driver 2 stated that he was traveling East on SE 168th St approaching 127th Ave SE in the #1 lane.
Driver 2 originally reported that this was a hit and run collision as Driver 1's vehicle moved
approximately 2 blocks away from the scene of the collision.
Driver 1 was later located and read her Miranda Warnings as she was detained as a suspect of hit
and run.
Driver 1 stated that she had just dropped her child off at school and was headed home. Driver 1
stated that she was proceeding West on SE 168th St approaching 127th Ave SE.
Collision
Driver 2 stated that as they entered the 12700 block of SE 168th St, Unit 1 collided with the rear
driver's side quarter panel and wheel of Unit 2.
Driver 1 stated that she was unaware that she had even struck another vehicle and only noticed that
her tire was not operating correctly. Driver 1 stated that she continued driving and turned onto 125th
Ave SE and proceeded North. I located Unit 1 at 16630 125th Ave SE, and saw that there were tire
marks in the roadway from the front left tire where it appeared that the front left tire was completely
deflated and that there were internal metal portions of the axel that were destroyed. I saw that there
was minimal damage to the front drivers side bumper of Unit 1, indicating that the majority of the
collision was between the front left tire of Unit 1 and the rear drivers side quarter panel and wheel of
Unit 2. For this to happen it is more likely than not that Driver 1 was distracted by something and
drifted across the center line of the roadway. Evidence within the roadway indicated that the collision
occurred further into the Eastbound lane of travel as most of the debris was on that side of the
roadway.
When speaking with Driver 1 1 asked if she was inattentive to the fact that there was another vehicle
in front of her to which she said yes.
Injuries
None reported.
Vehicle Disposition
Unit 1 and 2 were both rendered inoperable. Unit 2 was towed from the scene and Unit 1 was later
towed by Driver 1.
Proximate Cause
I determined that Driver 1 is the proximate cause of this collision because it shall be a traffic infraction
for any person to drive a motor vehicle on any public highway, street, alley, or road in
an inattentive manner in the City of Renton. "Inattentive manner" in this section means a lack of: 1)
attentiveness required to safely operate the vehicle under the prevailing conditions, including, but not
limited to, the nature and condition of the roadway, the weather conditions, the presence of
pedestrians, the presence of other traffic, or by the driver focusing or directing the driver's attention to
something other than driving the motor vehicle; or 2) attentiveness that would permit the driver of a
motor vehicle to observe anything resting on, or traveling on, or entering the roadway in time to take
appropriate action as circumstances require.
Driver 1 violated this RMC because she was inattentive to the fact that there was another vehicle that
was approaching her. Driver 1 admitted that she was distracted by the school zone signs and in the
process of trying to be more observant she was less aware of the prevailing traffic upon the roadway.
Driver 1 was cited per RMC 10-12-25
1 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 08:32 on 10/15/2025 in the City of Renton, King
County, Washington.
PAGE 3 OF 5
REPORT NO. EG38127 CASE# 25-8915 OF COLLISION
10/15/25 07:16
OF CbLLI510N
NARRATIVE
PAGE 4 OF 5
REPORT NO. EG38127 CASE# 25-8915 DATE AND TIME 10/15/25 07:16
OF COLLISION
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