HomeMy WebLinkAbout25-8748 IT si " II IIIII III IIIII II IIII IIIII I . 27c REPORT NO EG40768OLCERA
COLLISION REPORT 1591971
CASE�# 25-8748 2
INTERSTATE CITY STREET FIRE ❑
RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VEHICLE ❑ LOCAL AGENCY 4100 3
COUNTY RD NVOLVED CODING
PRIVATE WAY
2❑ TRIBAL TOTAL 1
UNITS#OF 02 SO BJECT TRUCK 1 8 28
RESERVATION 2
3� M M D D Y Y Y Y TIME(2400) COUNTY# MILES CITY#
DATE OF'. N E
coulsloN' 10 - 09 - 2025 0720 17 =.= S 8 W e IN OF M 1070 a
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION �✓ NON INTERSECTION ❑
NE 4TH ST BLOCK NO. e 5100 .�
4a❑ MILE POST
❑ DISTANCE OF(REFERENCE OR CROSS STREET)
5 �. FEET H S 8 W e HOQUTAM AVE NE
0 4 29
MOTtlR ✓ PEDAL- DAM AG THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE ❑ YEs Vl No D:4254307500 0 1 30
g LAST NAME BATTLE FIRST NAME MICAH MIDDLE C [; 2
31
INITIAL
STREET ❑✓ 1055 S GRADY WAY CITY RENTON ST WA ZIP 98057 2
NEW ADDRESS
7 CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED: 3
INTERLOCKYEs NO✓ INTERLOCKYEs NO✓ YES NO✓
8❑ LICIENS# STATE WA 8EX'M MMor YY' 09 — 27 — 1991 1 2 32
9 ON DUTY A STATUS AIRBAG 2 RESTR 4 EJECT 1 HELMET 2 INJURY 7 NATURE of INJURIES 2
USE CLASS COMPLAINT OF RIGHT SHOULDER PAIN
10 1 LI ENSE 78307D STATE WA VN# 1GNSKLED4RR207538 3
TRAILER STATE TRAILER ,STATE
11 3 5 PLATE# PLATE# ROM To
TRLR TRLR 7 1 33
1 3 5 VIN# vN#
FROM TO
2
VER YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN 7 v GOVT VEHICLE 3 7 34
13 3 2024 CHEV TAHOE UT DAMAGE YES TO
�MEYER TOWING YEs❑ No✓
REGISTERED OWNER INFO CITY OF RENTON 3555 NE 2ND ST RENTON WA 98056 D:4254307500 VEHICLE NO. 1
[ijSHADE IN DAMAGED AREA 35
LIABILITY INSURANCE❑ INSURANCE CO 2 3 4
14 ✓ CITY OF RENTON FLEET COVERAGE/SELF INSURED
IN EFFECT &POLICY# 4TOP
VEHicLE CHARGE 5
Lemur yes❑NO❑ CITATION# 36
7 0 60TTOM
15❑ STMDNG 7 e
III MOTCYR ✓ PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT 02 VEHICLE CYCLE nWNER YES�/ NO D:2062578600
16�
LAST NAME FUDA FIRST NAME DOMINIC MIDDLE I R
INITIAL
STREET ❑ 37
17 ❑ 24718 237TH PL SE CITY MAPLE VALLEY ST, WA ZIP 980388375 4
NEW ADDRESS
18❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDIOAL TRANSPORTED' 38
INTERLOCKYEs NO✓ INTERLOCK YES No✓ YEs No✓
19 DRIVER'S STATE WA SEX M D.C.B. 07 14 1996 39
LICENSE# MMDOYY —
20❑ ON DUTY STATUS AIRBAG'6 RESTR 4 EJECT 1 HELMET 2 INJURY' 7 NATURE OF INJURIES 40
USE CLASS COMPLAINT OF STIFFNESS/SORENESS
21 LICENSEPLATE# CJM9861 TATE I WA YIN# 5XXG64J22PG222858 41
22❑ PLATE# STATE PATE# STATE ❑ 42
23 TRLR r RLR 43
UIN#. 'IN#.
VEH.YEAR 2023 MAKE KIA MODEL K5 STYLE SD I VEHICLE TOWED TO BLIN TOWED BY GOV HI 44
24 DAMAGE YEs�/ No GENE MEYER TOWING YES No✓
REGISTERED OWNER INFO DOMINIC FUDA 24718237TH PL SE MAPLE VALLEY WA 98038 VEHICLE NO.2
SHADE IN DAMAGED AREA
2 3 4
LIABILITY INSURANCE INSURANCE CO AMICA 95114622CF
IN EFFECT &POLICY# 9TOP
vemcLe
LEGALLY YES❑ N`LJ,.I—I CITATION# CHARGE t080TTOM
--J
25 OFFICER'S NAME IPRINTI OFFICER PHONE BADGE OR ID# AGENCY
26
D.NELSON 12421 WA0171300
PAGE 01 OF
PART A 3000-345-159(R 11/18)
POLIICFETRAFFICN CORRECTION REPORT NO. EG40768
COLLISION REPORT III III III III III 111
1591972 CASE# 25-8748
ADDITIONAL PERSONS INVOLVED(PASSENGERS AND/OR WITNESSES ONLY)
'NAME
(LAST,FIRST MIDDLE INTTIAL)
ADDRESS&PHONE#
SEX' D.O.B. — [----------�
MMDDYYYY
PASSENGER F-1 WITNESS Ej UNIT# SEAT AIRBAG RESTR. EJECT HELMET INJURY NATURE OF INJURIES--�
POS. USE CLASS
'NAME
(LAST FIRS,MIDDLE INITIAL)
ADDRESS&PHONE#
SEX' D.O.B. — L----------�
MMDDYYYY
PASSENGER DWITNESSD UNIT# SEAT AIRBAG RESTR. EJECT HELMET NJURY NATURE OF INJURIES
POS. : USE CLASS ----�
'.NAME
(LAST,FIRST,MIDDLE INITIAL)
ADDRESS&PHONE#
SEX D.O.B. — L----------�
MMDDYYYY
PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET INJURY NATURE OF INJURIES
❑ Q POS. USE CLASS �____ ----j
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.
D.NELSON 10-09-25 11:13 AM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST.DET DATED PLACE SIGNED
APPROVED BY DATE
C.JACOBS 1953 10/23/2025 1:37:36 PM
BADGE OR ID# 12421 ORI# ( WA0171300 TIME POLICE DISPATCHED'; 7:30 AM TIME POLICE ARRIVED 7:30 AM
PART B 3 Do-3mx-,ao(Rtrras) PAGE 27 OF 47
REPORT No.` EG40768 CASE# 25-8748 COLLI SICiN TIME OF 10/09/25 07:20
COLLI
NARRATIVE
25-8748 ACCBLK
On 10/9/2025 at 0730 hours I was working as a uniformed patrol officer and driving a marked patrol
vehicle for the City of Renton. Officer Battle advised via radio that he was in a collision in the
intersection of NE 4th St and Hoquiam Ave NE Renton/King/WA. He asked for a supervisor, and I
added myself at this time as well.
While enroute he advised it was non-injury.
I arrived on scene and located both vehicles blocking the #1 lane of westbound NE 4t St just west of
the intersection.
I went and spoke with the driver of the gray 2023 Kia K5 WA/CJM9861 (Unit 2), he was identified by
his WADL as Dominic R Fuda DOB: 7/14/1996. Dominic advised he was driving west in the #2 lane
with a green light through the intersection. He said that the patrol vehicle made a left turn in front of
him causing the collision. There was damage to the front bumper, front driver side quarter panel, and
front driver door. There was front and side airbag deployment inside the Kia.
Dominic advised he was not injured other that some general stiffness. RRFA was called to the scene
and Dominic refused to be evaluated.
Gene Meyers Towing removed the Kia from the scene and Det. K. Lane took Dominic to his
workplace.
Officer Battle advised he had some soreness to his right shoulder but was otherwise not injured.
Officer Battle was driving Patrol Vehicle #373 which is a black/white 2024 Chevrolet Tahoe
WA/XMT78307D (Unit 1). Officer Battle said that he was in the left turn lane to go north onto Hoquiam
Ave NE, he said that he was distracted by radio traffic of a possible foot pursuit downtown and was
looking at his MDT. He said that he turned left with a solid green light and collided with the Kia. There
was no airbag deployment inside the Tahoe.
There was damage to the front bumper and push bars on the Tahoe. The vehicle was drivable, but
Gene Meyers Towing removed the Tahoe from the scene.
The collision was captured on Axon in-car dash camera. I reviewed the video, and it shows a solid
green light as Officer Battle begins his turn. The Kia is in the #2 lane with a green light and collides
with the front of the Tahoe. This video was tagged with the case number.
No other property or vehicles were involved.
I took photographs and uploaded them to Axon Evidence.
Nothing further.
I certify under penalty of perjury under the laws of the State of Washington that the foregoing is true
and correct.
D. Nelson #191 10/9/2025 Renton WA
PAGE 3 OF 4
REPORT NO. EG40768 CASE# 25-8748 DATE AND TIME 10/09/25 07:20
OF COLLISION
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