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Home My WebLink About25-6432 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 1 27c COLLISION REP FIT 1591971 CASE 25-6432 z INTERSTATE ❑ CITY STREET FIRE ❑RESULTED 1 STOLEN STATE ROUTE ❑ OTHER ❑ VFHICI F ❑ LOCAL AOENC 4900 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# ❑ cowsloN 07 - 1-- 2025 1816 17 ❑.= S 8 IN e 1070 3 4❑ oN (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓ SE PETROVITSKY RD BLOCK NO. e✓ 12750 4a❑ MILEPOST DISTANCE OF(REFERENCE OR CROSS STREET) 5❑ 50 00 FEET MILES e S ❑ W e 128THAVESE 0 1 29 MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE UNIT 01 VEHICLE ❑ CYCLE El ,/No D:4253628805 0 11 30 6� LAST NAME WALLER FIRSTNAME JOSHUA MIDDLE E 1 2 31 INITIAL STREET ❑, 2428 S 300TH ST CITY FEDERAL WAY ST WA Zjp, 98003 z NEW ADDRESS 7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3 INTERLOCK YES[:]NO 1/ INTERLOCKYEs NO�/ YES R No�/ 8❑ LRIIVERS STATE WA SEX'M MM DAY' 09 1- 08 - 1981 2 32 CENSE 9 ON DUTY❑ STATUS AIRBAG 6 RESTR 4 EJECT 1 HELMETU E 2 CLASS 1 NATURE OF INJURIES z❑ 3 LICENSE CFJ7433 sTArI WAurN# 5XXG64J28NG097670 10 F91 PI ATE# TRAILER STATE TRAILER STATE 11 3 5 PLATE# PLATE# FROM TO TRLR. TRLR 7 3 33 12 3 5 VIN#' VIN#' >; FROM TO ❑ VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN T jZ GOVT.VEHICLE 34 4 2022 KIA K5 SD D AMA G 3 ]E YES NO TOW YES[:] ✓ 13 REGISTERED OWNER INFO OWNEDBYDRIVER VEHICLE NO. 1 SHADE IN DAMAGED AREA ❑ 35 14 LIABILI INSURANCE INSURANCE CO PROGRESSIVE 9888 64 771 <�3 4 IN EFFECT &POLICY#VE"'CLE CHARGE 36 LEGALLY YES❑NO❑ CITATION# TTOM 15❑ STANDING 6 MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE UNIT 02 VEHICLE ❑ CYCLE ❑ ❑ OWNER [:]EA. YES 1/ No D:2533478372 16 a LAST NAME SMITH FIRST NAME LAIRD MIDDLE A INITIAL 17❑ NEW STREETREs7 4509 S 263RD ST CITY' KENT ST WA ZIP 98032 4❑ 37 18❑ CDL IGNITION REQUIRED IGNITION PtR-E-S1ENT MEDICAL-T�RANSPORTED � 38 INTERLOCKYES�NO� INTERLOCK Y�EsI I I NOF YEs t l NO� 19 LICENSE STATE WA SEX M M D.C.B. 09 _ 16 _ 1970 39 20 ON DUTY STATUS AIRBAG,6 RESTR 4 EJECT 1 H EET 2 NJAU SY 6 COMPLAINT OF HEAD PAIN/CONCUSSION F—NATURE OF INJURIES 40 LICENSE ❑21❑ PLA E# C52855V TArE 41 WA vIN# 1FTPW14518FB09987 1 42 22❑ PLATE# STATE PLATE# STATE 23❑ VIN#. 43 TRLR RLR 'IN#. I VEH YEAR 2008 MAKE FORD MODEL F150 STYLE 4C IVEHI DAMAGE TO ✓WED NO BANKERS TOWING YES NoO BLIN TOWED BY Gov 44 H 24❑ REGISTERED OWNER INFO OWNED SY DRIVER VEHICLE N0.2 SHADE DAGED AREA 4 LIABILITY INSURANCE &POINSURGY#E CO pROGRESSIVE 941 332 951IN STOP 5 VEHICLE ❑ C[:] CITATION# CHARGE to BOTTOM LEGALLY YES N J 6 25 OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY 26 JAREN JOKELA 12805 WA0171300 PART A PAGE 01 OF 3000-345-159 OR 11/181 STATE OF POLICETRAFFICN CORRECTION REPORT NO. EG39002 COLLISION REPORT III III III III III 111 1591972 CASE# 25-6432 ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY) NAME MIDDLE INITIAL) SMITH SANDRA J (LAST FIRST, ADDRESS&PHONE# 745 2ND AVE NW#1071SSAQUAH WA 98027 SEXi F MMDOYyry 09 - 13 - 1972 SEAT HELMET INJURY NATURE OF INJURIES PASSENGER WITNESS❑ UNIT# 2 POS 3 AIRBAG 6 RESTR. q EJECT USE CLASS 6 NECK,HIP,ABDOMINAL PAIN NAME (LAST,FIRST,MIDDLE INITIAL) ADDRESS&PHONE# Ly O B SEX MMDDYYYY PASSENGER ❑WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET NJURY POS. NATURE OF INJURIES 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' 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. JAREN JOKELA 07-26-25 09:57 PM INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED APPROVED BY DATE CASEY PROCTER 12123 1 1011912025 2:08:21 AM BADGE OR ID# 12805 OR]# WA0171300 TIME POLICE DISPATCHED! 6:18 PM TIME POLICE ARRIVED',6:25 PM PART I PAGE IT]OF 6� REPORT NO. EG39002 CASE# 25-6432 OF COLLISION 07/26/25 18:16 OF CbLLI510N NARRATIVE Renton Case #25-6432 On 07/26/2025 at 1818 hours I was dispatched to SE Petrovitsky RD/128th Ave SE, in the City of Renton, King County, Washington. I was responding to a call of an accident with injury. This incident was captured on my body worn video camera. This report is a summation of events that occurred and is not an exact sequence of events. At approximately 1825 hours, I arrived on scene located all involved vehicles. Both Unit 1 and Unit 2 vehicles were blocking westbound travel on SE Petrovitsky RD, just west of 128th Ave SE, and Unit 3 had moved off the roadway. I identified Unit 1 as a black 2022 Kia K5 (WA LIC # CFJ7433) being driven by the registered owner of the vehicle, identified by his WA DOL photo as Joshua E Waller (DOB 09/08/1981). Upon arrival, Unit 1 driver was being evaluated by Renton Fire a short distance away from his vehicle. I was immediately informed by Fire that Unit 1 driver did not appear to have sustained any injuries however he was declining to be fully evaluated. In speaking with Unit 1 driver, he stated that he was traveling eastbound on SE Petrovitsky RD approaching 128th Ave SE. Unit 1 driver said that as he set up to turn north on 128th Ave SE, he was struck by Unit 2 vehicle. I observed significant damage to the front of Unit 1 vehicle, with most of the impact effecting the front left of the vehicle. All airbags inside the vehicle appeared to have been activated. Unit 1 vehicle was later removed from the scene by Bankers Towing. Unit 1 driver provided me with his WADL, registration and proof of insurance. I identified Unit 2 as a maroon 2008 Ford F150 (WA LIC # C52855V) being driven by Unit 2 driver, identified by his WA DL as Laird A Smith (DOB 09/16/1970), and Unit 2 passenger, identified as Sandra J Smith (DOB 09/13/1972). 1 did not speak with Unit 2 driver or passenger, but responding officers informed me that Unit 2 driver complained of head/neck pain and appeared to have sustained a concussion as a result of the accident. I was also informed that Unit 2 passenger complained of neck, hip and abdominal pain. Both Unit 2 driver and passenger were later transported to Valley Medical Center for further treatment/evaluation. At the time of this report, the extend of their sustained injuries are unknown. Prior to being transported to Valley Medical Center, Unit 2 driver and passenger told officers that as they were traveling westbound on SE Petrovitsky Rd, just west of 128th Ave SE, Unit 1 vehicle veered into their lane of travel and collided with Unit 2 vehicle head on. Significant front-end damage was observed to Unit 2 vehicle. Unit 2 vehicle was later removed from the scene by Bankers Towing. I identified Unit 3 as a black 2012 Ford Mustang (WA LIC # BMA5562) being driven by the registered owner of the vehicle, identified by her WA DOL photo as Ava V Schubert (DOB 09/01/1993). In speaking with Unit 3 driver, she stated that she was traveling westbound on SE Petrovitsky RD in the number 1 lane of travel, directly next to Unit 2 vehicle. Unit 3 driver said that after Unit 2 vehicle was struck by Unit 1 vehicle, Unit 2 vehicle then partially entered her lane of travel, making slight contact with the driver side of Unit 3 vehicle. PAGE 3 OF 6 REPORT NO. EG39002 CASE# 25-6432 OF COLLISION 07/26/25 18:16 OF CbLLI510N NARRATIVE Minor scratches were observed on the driver side of Unit 3 vehicle. Photographs were taken of the crash scene to include all involved vehicles. All photographs were later uploaded to Axon Evidence. In further evaluating the crash scene, and the debris/tire marks left behind as a result, it does appear that Unit 1 vehicle entered opposing lanes of travel, resulting in colliding with Unit 2 vehicle head on. All involved parties were provided with a case number. No involved parties showed any signs of impairment. I then cleared the scene. This ends my report. I certify under penalty of perjury under the laws of the State of Washington that the foregoing is true and correct. Electronically signed by Ofc. Jaren Jokela #12805, 07/26/2025 at 2045 hours in Renton, Washington. PAGE 4 OF 6 SUPPLEMENTAL REPORT NO. EG39002 r`) POLICE TRAFFIC 1 1 8 27 COLLISION REPORT CASE# 25-6432 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 DAMAGE THRESHOLD MET PHONE 5 ❑ UNIT# 3 VEHICLE tSJ CYCLE I_) PEDESTRIAN OWNER YES NO D:8139199415 rOF 1 Zg LAST NAME SCHUBERT FIRST NAME AVA MIDDLE'.. V INITIAL STREET 30 NEW AnDRFSP' 17419 119TH LN SE#E14 CITY RENTON ST WA ZIP 98058 6 [2 1 1 2 31 CDL IGNITIttN REQUIRED IGNITION PRESENT MEDICAL TANSPORTED INTERLOCK YEs NO zERLOCK YES❑N0� YES N DRIVER'S LICENSE STATE I WA SEX F MMDDYYv', 09 TO] - 1991 7 ON DUTY� STATUS AIRBAG' 2 RESTR. Q EJECT 1 HELMET 2 INJURY 1 1 NATURE OF INJURIES USE CLASS 8 ❑ 1 32 LICENSE BMA5562 [TAT WA VIN# 1ZVBP8AM5C5280734 PLATE# 9 9] TRAILER TRAILER PLATE# STATE PLATE# STATE 10 ❑ TRLR TRLR VIN.It VIN.#. 11 3 5 VEH.YEAR2012 MAKE FORD MODELMUSTAN STYLE SD I VEHICLE TOWE E T SABLIN TOWED BY anvi vFH1C P FROM TO DAMAGE YES NO YES NO REGISTERED OWNER INFO OWNED BY DRIVER 3 ] 33 12 � SHADE IN DAMAGED AREA 3 4 FROM TO ((ABILITY INSURANCE INSURANCE CO PROGRESSIVE 936 800 725 q"i"Olx IN EFFECT &POLICY# 1 EHICLE 34 CITATION# CHARGE 10 BOTTOM 13 LFcnuv YES NO STANDING S} 6'& 14 ❑ UNIT Tr Vd 1RE O CYDCLE 1:1OWNERRTY YES AGE NOHRESHOLD MET PHONE ❑ 35 PEDESTRIAN 15 LAST NAME FIRST NAME MIDDLE': INITIAL36 STREETTIAL ❑ 16 NEn+AnnRFs.�' CITY'. ST ZIP CDL IGNITION REdUiREE7 IGNITION PRESENT MEDICALTANSPORTED INTERLOCK YES No INTERLOCK YEs NO YES NO ❑ 17 4 37 LICENSE# STATE SEX MMDDDYBYY 18 ❑ ON DUTY� STATUS AIRBAG RESTR. ; EJECT HELMET INJURY NATURE of INJURIES 38 USE CLASS 19 ❑ LICENSE rnr VIN# 39 PLATE# 20 ❑ TRAILER' STATE TRAILER STATE ❑ 40 PLATE#< PLATE# 21 ❑ ❑ 41 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 AREA 43 3 4 71 LIABILITY INSURANCE INSURANCE CO ' VINE EFFECT &POLICY# i 970P - 4 E:l 44 24 VEHICLE YES❑ NO❑ CITATION# CHARGE iq 60TiOM LEGALLv 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. JAREN JOKELA 07-26-25 09:57 PM 25 INVESTIGATING OFFICER'S SIGNATURE OFFICER'S PHONE UNIT OR DIST DET DATED: PLACE SIGNED APPROVED BY DATE 26 OR ID# 12805 O#I',WA0171300 PROCTER 10/19/202 PAGE OF 6 3000-345-013(R 11118) REPORT NO. EG39002 CASE# ' 25-6432 DATE AND TIME 07/26/25 18:16 OF COLLISION 3� k i kt �k 1 134 i is 1�{ t y S �r i� 13n, i `y 9 Yy} Y DIY t t� {xt R: � I U PAGE 6 OF 6