HomeMy WebLinkAbout25-8599 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 6 27c
COLLISION REP FIT 1591971
SASE 25-8599 2
INTERSTATE ❑ CITY STREET FIRE ❑
RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHIC;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#
cawsloN 10 - 1-- 2025 0800 17 ❑-= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
e✓ --- ----� ❑
N 4TH ST MILEPOST
4a❑
DISTANCE OF(REFERENCE OR CROSS STREET) BLOCK NO.
5❑ ❑ FEET e S ❑ VV a BURNETT AVE N
0 4 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
NO D:2066834661 0 11
30
6� LAST NAME WU FIRSTNAME ALICE MIDDLE 1 2 31
INITIAL
STREET ❑✓ 10007 S 38TH CT CITY RENTON ST WA 21p 98055 z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
1/ I iNTERLOCKYEs NO NTERLOCKYEs NO�/ YES R No�/
8❑ LRIIVER #
ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 HELMET
2 CLASS 1 NATURE OF INJURIES z❑
3
LICENSE CFP4032 sTATI WA vIN# 4T1C31AK9PU049979
10 F91 PI ATE#
TRAILER STATE TRAILER STATE
11 3 0 PLATE# PLATE# FROM TO
TRLR. TRLR $ 7 33
12 2 5 VIN#' VIN#
>; FROM TO
VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE 3 ] 34
13 1 2023 TOYT CAMRY P4 DAMAGE YES NO ves❑ No
REGISTERED OWNER INFO ALICE WU 10007 S 38TH CT RENTON WA 98055 D:2066834661 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
14 LIABILI INSURANCE U INSURANCE CO AMICA 96024625LC 3 4
IN EFFECT &POLICY# 9TOP
VEIF" CHARGE 5 36
LEGALLv Yes❑NO❑ CITATION# 1 o BOTTOM
15❑ STANDING 8 6
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT VEHICLE ❑ CYCLE ❑ ❑ : OWNER ❑ YES 1/ NO D:2068175832
16 a
LAST NAME BAGLEY FIRST NAME JANELLE MIDDLE L
INITIAL
17 STREET NEW ADDREs7 13732 217TH AVE SE CITY lSSAQUAH ST WA ZIP 98027 4❑ 37
18� CDL IGNITION REQUIRED IGNITION PtR—E—S1ENT MEDICAL TRANSPORTED 38
INTERLOCKYES�NO� INTERLOCK YEs I I NOF YEs t l NOF,/
19 DRIVER'S STATE WA ]SEX IF D.C.B. 07 29 _ 1975 39
LICENSE# MMDDYY
20❑ ON DUTY STATUS I
AIRBAG 2 RESTR 4 EJECT 1 H U EET 2 NJAURSY 1 NATURE OF INJURIES ❑ 40
❑21❑ PLATE# CTZ6075 TATE WA vlNti 7YAKRDDC1SY024346 41
1
42
22❑ PILER LATE# STATE PLATE# STATE
23❑ UIN#. 43
TRLR RLR
'IN#.
VEH YEAR 2025 MAKE HYUN MODEL ►ONIQS STYLE P4 VEHICLE TOWED TO BLIN TOWEDBv GOV HI �44
24❑ DAMAGE YES NO GENE MEYER YES NO
REGISTERED OWNER INFO JANELLE BAGLEY 13732217TH AVE SE lSSAQUAH WA 98027 D:2068175832 VEHICLE NO.2
SHADE IN DAMAGED AREA
2 3 4
LIABILITY
INSURANCE INSU PORGY#E CO ACMIC 1101461819
IN ®TOP
VEHICLE YES[:] ,.I—I CITATION# CHARGE i o BOTTOM
LEGALLY N
25 s 6
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# JAGENCY
26
RAYMOND WATSON 13127 WA0171300
PAGE 01 OF
PART A
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EG40688
COLLISION REPORT III III III III III 111
1591972 CASE# 25-8599
ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY)
NAME MIDDLE INITIAL) PARTA/N MATTHEW
(LAST FIRST,
ADDRESS&PHONE# D.O.B.
2057935227 SEX M MMDDYYYY -❑
---------------------------
PASSENGER WITNESS SEAT AIRBAG RESTR. EJECT ' HELMET INJURY NATURE OF INJURIES
❑ a UNIT# POS. USE CLASS
NAME
'(LAST,FIRST MIDDLE INITIAL)
ADDRESS&PHONE# Ly O B
SEX MMDDYYYY
PASSENGER ❑WITNESS❑ UNIT# SEAT AIRBAG RESTR. EJECT HELMET NJURY NATURE OF INJURIES
POS. USE CLASS
NAME
(LAST FIR57 MIDDLE INITIAL)
AppRESS&PHONE#
SEX D.O.B.MMDD -❑
YYYY.
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.
RAYMOND WATSON 10-19-25 11:24 AM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
J.TRADER 4553 1012312025 9:01:08 AM
BADGE OR ID# 13127 OR]# WA0171300 TIME POLICE DISPATCHED 8:02 AM TIME POLICE ARRIVED',8:05 AM
PART I PAGE IT]OF 4�
REPORT NO. EG40688 CASE# 25-8599 OF COLLISION
10/04/25 08:00
OF CbLLI510N
NARRATIVE
25-8599
This report is a summary of events that occurred and is not an exact sequencing of events.
Statements have been paraphrased and summarized.
On 10/04/2025 at approximately 0802 hours, myself, Officer R. Watson, was dispatched to a blocking
accident, no injuries, at the intersection of N 4th ST and Logan AVE N, within the City Limits of
Renton, County of King, State of Washington.
Dispatch notes stated that there were two vehicles involved, no injuries, and they were blocking N 4th
ST.
When I arrived on scene, I observed the two blocking the two right lanes and the occupants outside of
vehicles speaking to each other.
Unit#1 driven by Alice Wu (DOB 10/14/1961) verified by WA DOL photo, stated she was driving a
Gray 2023 Toyota Camry, WA plate #CFP4032. There were no other passengers in the vehicle. Alice
stated she was traveling north bound on Burnett AVE N heading to the gym, when she pulled out
after stopping at the stop sign to pull onto N 4th ST. She did not see unit#2 coming when she
attempted to turn onto N 4th ST, and they collided. Alice stated she had no injuries and declined aid.
When I asked for Alice's license, registration and insurance she was able to provide all
documentation. Unit#1 had moderate front end damage. Unit#1 was able to be driven from the
scene and had no airbag deployment.
Unit#2 driven by Janelle L. Bagley (DOB 07/29/1975) verified by WA DOL photo, stated she was
driving a Gray 2025 Hyundai loniq 5, WA plate #CTZ6075. There were no other passengers in the
vehicle. Janelle stated that she was traveling west bound on N 4th ST when unit#1 went through the
stop sign and collided with the side of her vehicle. Janelle said that she had no injuries and declined
aid. When I asked for Janelle's license, registration and insurance she was able to provide all
documentation. Unit#2 had moderate left side damage. Unit#2 was towed from the scene by Gene
Meyer and had no airbag deployment.
A witness, Matthew Partain said he was driving on N 4th ST also and saw unit#1 fail to stop at the
stop sign and collide with unit#2. He provided his information.
An exchange of information was completed and provided to each party. Pictures were taken of each
vehicle and uploaded to evidence.com.
I certify (or declare) under penalty of perjury under the laws of the State of Washington that the
foregoing is true and correct.
Electronically signed by Officer R. Watson #13127 10/19/2025 1123 hours, Renton, King County,
WA.
PAGE 3 OF 4
REPORT NO. EG40688 CASE# 25-8599 DATE AND TIME 10/04/25 08:00
OF COLLISION
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PAGE 4 OF 4