HomeMy WebLinkAbout25-8835 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 4 27c
COLLISION REP FIT 1591971
CASE 25-8835 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 2 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 10 - 1-- 2025 1445 17 ❑.= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓
BLOCK
NE SUNSET BLVD MILEPOST ST e✓ 3200
4a❑
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ ❑ FEET e S ❑ W e 0 6 29
MOTOR PEDAL- DAMAGE THRESHOLDHONE
UNIT 01 VEHICLE ❑ CYCLE El MET P
YEs �/No D:3603485519 0 7 30
6� LAST NAME TORREY FIRSTNAME SAGE MIDDLE E 1 1 2 31
INITIAL
STREET ❑ 950 HARRINGTON AVE NE APT S41 CITY RENTON ST WA ZIP 980563480 z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
INTERLOCK YES[:]NO INTERLOCKYEs NO YES R NO
8❑ LRIIVER #
ON DUTY❑ STATUS AIRBAG 3 RESTR 4 EJECT 1 H USEET ICNLJAURY 1 NATURE OF INJURIES z❑
3
LICENSE CLW3606 STATE WA uN# 3GNAXSEV5JL358139
10 9❑ Pr ATE�
TRAILER STATE TRAILER STATE
11 3 5 PLATE# PLATE# FROM To
TRLR. TRLR 3 7 33
12 3 5 VIN#j VIN#
:: FROM TO
VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED By GOVT.VEHICLE g 9 34
13 2018 CHEV EQU/NO UT DAMAGE YES NO YES[:] No
REGISTERED OWNER INFO SCHANAKIESOW 950 HARRINGTON AVE NE APT S41 RENTONWA98056 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
14 LIABILITY INSURANCE INSURANCE CO STATE FARM 5580478DI647A 4
LI EFFECT I SUR N# TOPVEHICLE CHARGE 36
LEGALLYYES NO CITATION# 5AO487896 INATTENTIVE DRIVING <1�3
orrom
15❑ STANDING 7 6
MOTOR PEDAL-: :.PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT 02 VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES 1/ NO D.2532758191
16 a
LAST NAME AGUINALDO FIRST NAME JESSIE MIDDLE
INITIAL
17❑ STREET ❑' 133 4TH AVE N CITY ALGONA ST' WA ZIP 98001 37
NEW ADDRESS ❑
18� CDL IGNITION REQUIRED IGNITION PR—E-1SENT MEDICAL TRANSPORTED 38
INTERLOCKYES�NOR INTERLOCK yEs It I NOF YES
t t— l NO❑
19 D IVEW #
INJURY1 NATURE OF INJURIES 40
20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 USE CLASS ❑
21❑ LICENSE BVL2155 TATe WA vIN# 19UU61F33JA006262
❑ 41
PLATE#
42
22❑ PLATE# STATE PLATE# STATE
23❑ VIN#. 43
TRLR RLR
'IN#.
GoI
VEH YEAR 2018 MAKE /a C(fR MODEL TLX STYLE $D DAMAGE TOWED NOO✓ BLIN TOWED BY v HyES NO 44
24❑ ES
REGISTERED OWNER INFO OWNED SY DRIVER VEHICLE N0.2
SHADEDAMAGEbAREA
s Cd
LIABILITY
INSURANCE 8 POINSURGY#E CO STATE FARM 522213OA0647AIN STOP
'E""LE CITATION# CHARGE
25 to BOTTOM
LEGALLY YES N�
❑ OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
26
J.W/SNIEWSK/ 12598 WA0171300
PAGE 01 OF
PART A
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EG39389
COLLISION REPORT III III III III III 111
1591972 CASE# 25-8835
ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY)
NAME MIDDLE INITIAL) PENA DIVINE G
(IAST FIRST,
ADDRESS&PHONE# D O.B.
RENTON SEX F MMDOYyry 10 - 14 - 1993
PASSENGER Z WITNESS 'UNIT# j 3 POS USE CLASS 8 AIRBAG 2 RESTR. 4 EJECT ? 1 HELMET LASS NATURE OF INJURIES
' 1
NAME
(LAST,FIRST,MIDDLE INITIAL) PENA AMELIA G
ADDRESS&PHONE# D Q B
RENTON SEX F MMDDYyvv 10 _ 20 _ 2024
SEAT HELMET INJURY NATURE OF INJURIES
PASSENGER WITNESS UNIT# 3 POS 9 AIRBAG 2 RESTR. 11 EJECT 1 USE CLASS 1
NAME
(LAST FIR57 MIDDLE INITIAL)
AppRESS&PHONE#
SEX D.Q.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.
J.WISN/EWSKI 10-12-25 04:23 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
s.wooDWARD 11528 10/20/2025 8:50:00 AM
BADGE OR ID# 12598 OR]4f WA0171300 TIME POLICE DISPATCHED 3:08 PM TIME POLICE ARRIVED',3:17 PM
PART I PAGE IT]OF
REPORT NO. EG39389 CASE# 25-8835 OF COLLISION
10/12/25 14:45
OF CbLLI510N
NARRATIVE
On Sunday, October 12, 2025, at 1508 hours, I was dispatched to a three-vehicle collision in the area
of the NE Sunset Blvd and NE 12th St.
The following occurred within the City of Renton, King County; Unit 1 -WA/CLW3606 was being
driven by Sage Torrey and headed west on NE Sunset Blvd in the 3200 block. Unit 2 - WA/BVL2155
was being driven by Jessie Aguinaldo and was stopped in traffic on NE Sunset Blvd in the 3200
block. Unit 3 -WA/B88928H was being driven by Ronald Pena and was stopped in traffic on NE
Sunset Blvd in the 3200 block.
Sage stated she was driving westbound and her mom messaged her on her phone, and she grabbed
it and was reading the message and was unable to stop resulting in a collision. The front bumper
collided with the rear bumper of Unit 2. The force of the impact caused the front bumper of Unit 2 to
collide with the rear bumper of Unit 3.
Jessie stated he was stopped in traffic, when he was struck from behind by Unit 1.
Ronald stated he was stopped in traffic, when he was struck from behind by Unit 2.
Based on the statements, Unit 1 was responsible for the collision. All vehicles involved sustained
significant damage.
The driver of Unit 1 was also issued Traffic Infraction 5A0487896, for inattentive driving since she
was not paying attention to the roadway while using a device and reading.
I declare under penalty of perjury under the laws of the State of Washington that the foregoing is true
and correct.
Electronically signed by Officer J. Wisniewski/#12598 on 10/12/25 at 1616 in Renton, WA
PAGE 3 OF 5
SUPPLEMENTAL REPORT NO. EG39389
r`) POLICE TRAFFIC 1 1 8 27
COLLISION REPORT CASE# 25-8835
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:2068548809
0 7 29
LAST NAME PENA FIRST NAME RONALD MIDDLE' E
INITIAL
STREET 30
NEW AnDRFSP' 11914 SE 246TH PL CITY KENT ST WA ZIP 1 98030
6
CDL IGNITIttN REQUIRED IGNITION PRESENT MEDICAL TANSPORTED 1 1 2 31
INTERLOCK YEs No zERLOCK YES[:]NO[:] YES N
DRIVER'S
LICENSE STATE I WA SEX M MMDDYYv 11 - 20 - 1985
7
ON DUTY� STATUS AIRBAG' 2 RESTR. Q EJECT 1 HELMET I INJURY 1 1 NATURE OF INJURIES
USE CLASS
8 ❑ 1 32
LICENSE B88928H [TAT WA VIN# 2HJYK16528H527353
PLATE#
9 9] TRAILER TRAILER
PLATE# STATE PLATE# STATE
10 ❑ TRLR TRLR
VIN.It VIN.#.
11 3 5 VEH.YEAR200$ MAKE HOND MODELRIDGELIN STYLE 4C VEHICLE TOME E T SABLIN TOWED BY anvi vFH1C P FROM TO
DAMAGE YES NO YES NO
REGISTERED OWNER INFO OWNED BY DRIVER J 9 33
12 � SHADE IN DAMAGED AREA
7 j FROM TO
LIABILITY INSURANCE INSURANCE CO PEMCO CA1834232 RTOp
IN EFFECT &POLICY# 1
EHICLE 34
13 4 LEGALLY YESZ NO❑ CITATION# CHARGE 0 BOTTOM
STANDING } 7
14 ❑ UNIT Tr Vd IRE O CYDCLE OWNERRTY YES AGE NOHRESHOLD MET PHONE ❑ 35
PEDESTRIAN
15 LAST NAME FIRST NAME MIDDLE
❑ 36
STREET
16Fl TEETFs.�' CITY ST ZIP
CDL IGNITION REdUiR rD IGNITION PRESENT MEDICALTANSPORTED
INTERLOCK YES No INTERLOCK YEs NO YEs NO El
17 37
LICENSE# STATE SEX MMDDDYBYY
18 ❑ ON DUTY� STATUS AIRBAG RESTR. ; EJECT HELMET INJURY NATURE of INJURIES 38
USE (CLASS
19 ❑ 39
LICENSE rnr vIN#
PLATE#
20 ❑ TRAILER' TRAILER El40
PLATE#< STATE PLATE# STATE
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
LECALLv
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.
J,WISNIEWSKI 10-12-25 04:23 PM
25 INVESTIGATING OFFICER'S SIGNATURE OFFICER'S PHONE UNIT OR DIST DET DATED: PLACE SIGNED
APPROVED
026 � BADGE O#IIWA0171300 OA 12 PAGE FOFOI
3000-345-013(R 11118)
REPORT NO. EG39389 CASE# 25-8835 DATE AND TIME 10/12/2514:45
OF COLLISION
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PAGE 5 OF 5