HomeMy WebLinkAbout25-8810 �oLcRaiTFFiN 0 7 27c REPORT NO. EG40967
"i ,one COLLISION REP F 1591971
CASE# 25-8810 2
INTERSTATE CITY STREET FIRE ❑
RESULTED
STOLEN
1 1 STATE ROUTE OTHER VFHICI F LOCAL AGENCY 4200 3[�
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 TRIBAL UN 75 TOTAL#OF STRUCK OBJECT 11 8 2$
RESERVATION 2
3 M M D D Y Y Y Y TIME I2400) COUNTY# MILES CITY#
COAT sloN 10 - 11 - 2025 1523 17 a. S e W 8 IN
OF 8 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION BLO❑
HOQUTAMAV MILEPOST
❑ MILE PO 8 5100
4a .�
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ FEET e S e W 8 NE 4TH ST
OF 3 29
MOTOR PEDAL- : DAM ETHRESHOLD MET PHONE
UNIT 01 VEHICLE CYCLE YES No F,/ D:2012536214 0 3 30
6❑ LAST NAME I SEQUEIRA TORREZ FIRST NAME MARCELA MIDDLE D 1 2 31
INITIAL
STREET E:1' 13710 156TH AVE SE CITY RENTON WA
NEW ADDRESS S7 ZIP 98059 z
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
INTERLOCK YES
No INTERLOCKYEs No YES Na
LDRIVE STATE WA SEX'F MM flYY 12 - 04 - 1998 1 2 32
8❑
9 ON DUTY STATUS AIRBAG 2 RESTR 9 EJECT 1 H U5 E7 CLASRS 1 NATURE OF INJURIES 2
LICn NStt CNZ4099 srnrF WA WIN#' ZFBCFAAH8EZ017351 3
10 1❑
R TRAILER
11 0 0 PLATE# STATE PLATE# STATE FROM To
TRLR TRLR. 1 7 33
12 0 0 VIN#' VIN#
FROM TO
VEH.YEAR 2014 MAKE FIAT MODEL 500E STYLE P4 IVEHDAMIAGE TOWEED Ftj NO2fBLIN TOWED BY GOVT..VEHIICL✓ 1 7 34
13❑ REGISTERED OWNER INFO MARCELA SEQUEIRA TORREZ 13710156TH AVE SE RENTON WA 98059 D:20125362}4-11 VEHICLE�NIIO—.I11 NO
SHADE 1N DAMAGED AREA ❑ 35
14❑ LIABILITY INSURANCE❑ NSURANCE CO 4
IN EFFECT &POLICY# 9_TOP
VEHICLE CHARGE 5 ❑ 36
LEGAL V Yes❑No CITATION# 5A0610524 OP MOT VEH W/OUT INSURANCE a BorroM
15❑ sranowc a 7 6
I�
MOTOR PEDAL- PROPERTY DAM THR OLD MET PHONE
UNIT PEDESTRIAN T Q2 VEHICLE CYCLE OWNER YES NO }/ D:4257364483
16�
LAST NAME ASABA FIRST NAME NELSON MIDDLE I T
INITIAL r
17❑ STREET El 5303 NE 11TH PL CITY RENTON ST', WA ZIP 980594995 37
NEW ADDRESS I I I ❑
18❑ CDL IGNITION REQUIRED IGNITION pRESEIJT MEDfCALTRANSPORTED ❑ 38
1NTERLOCKYEs ND INTERLOCK YEs NO YES No
19❑ DRIVER'#
❑ ON DUTY EA STATUS AIRBAG 2 RESTR 9 EJECT 1 N U MEET C�$Y 1 NATURE OF INJURIES ❑ 40
21❑ LICENSE 145ZXH rAre WA v)N# JHMGE8H48AC008755
❑ 41
PLATE#
TRAILER TRAILER ❑22 PLATE# STATE PLATE STATE 42
23 43
TRLR RLR
VIN#. '[N#,
VEH.YEAR 2010 MAKE HOND MODEL FIT STYLE DAMIAGE TOWED NOO✓ BLIN TOWED BY GO YES N HI 44
O
24 YES
REGISTERED OWNER INFO MOE TSUBOIKE 5303 NE 11TH PL RENTON WA 98059 VEHICLE NO.2
SHADE IN DAMAGED AREA
LIABILITY INSURANCE INSURANCE CO PROGRESSIVE 929666039 E 3 4
IN EFFECT &POLICY# t 4TOP
LEeALL ❑ „I�1 CITATION# CHARGE tOBOTTOM
LEGALLY YES N`'L-1
25 s
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# JAGENCY
26
SULIASI TAMA/VENA 12788 WA0171300
PART A . PAGE 01 OF
9000-345-159(R 11(181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EG40967
COLLISION REPORT III III III III III 111
1591972 CASE# 25-8810
ADDITIONAL PERSONS INVOLVED(PASSENGERS AND/OR WITNESSES ONLY)
'.NAME
(LAST,FIRST,MIDDLE INITIAL)
ADDRESS&PHONE#
SEXi D.O.B. -
MMDDYYYY
PASSENGER❑WITNESS❑;UNIT# SEAT AIRBAG RESTR. EJECT HELMET INJURY NATURECFINJURIES
POS. ' USE GLASS 1 ----�
:NAME
(LAST FIRST MIDDLE INITIAL)
ADDRESS&PHONE#
SEX D.O.B. -
MMDDYYYY
PASSENGER❑WITNESS UNIT# : SEAT AIRBAG RESTR. EJECT HELMET INJURY: NATURECFINJURIES
POS. USE CIASS ----�
:NAME
(LOST,FIRST,MIDDLE INITIAL)
ADDRESS&PHONE#
SEX MMDDYY D.O.B.
YY
PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET NJU S' NATURE OF INJURIES
❑ ❑ POS. I USE GLASS
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.
SULIASI TAMAIVENA 10-11-25 05:11 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST.DET DATED PLAGE SIGNED
APPROVED BY DATE
S.WOODWARD 11528 1 1012412025 5:27:14 AM
BADGE OR ID# 12788 ORI#1 WA0171300 TIME POLICE DISPATCHED 1 3:25 PM TIME POLICE ARRIVED i 3:40 PM
PART B 3000-345.160(R1Vt8) PAGE 0 OF 47
REPORT NO. EG40967 CASE# 25-8810 OF COLLI ION 10/11/25 15:23
OF COLLISION
NARRATIVE
On 10/11/2025, at approximately 1533 hours, I was dispatched to an accident at NE 4TH
ST/HOQUTAM AVE NE, in the City of Renton, while I was employed as a uniformed Patrol officer for
the City of Renton, County of King, State of Washington. Dispatched advised both drivers have pulled
over to a bus lane, and one driver is uninsured.
I contacted Unit#1, identified as MARCELA. She advised that she was facing Southbound in lane #1,
the nearest to the curve, and stated she was on Hoquiam Ave NE behind Unit#2, attempting to also
make a right onto NE 4th Street heading westbound. Marcela said Unit#2 completely passed the
white line, and she also moved up, but she is still behind Unit#1. She then stated that her vehicle
was stopped and believed that Unit#2 reversed into it, causing damage. The vehicle sustained
damage to the front right bumper. Marcela and her child were not hurt and denied medical attention.
I contacted Unit#2, the driver identified as Nelson. Nelson stated he was Southbound in lane #1, the
nearest to the curve, and stated he was on Hoquiam Ave NE in front of Unit#1, attempting to also
make a right onto NE 4th Street heading westbound. He said that while he moved closer to the
intersection on 4th ST, he stopped his vehicle in order to ensure he cleared the street before making
the turn. While he stopped, Unit#1 hit his vehicle from behind, damaging the left back bumper. His
wife, who is the registered owner of the vehicle, advised the same story. A child was also in the
vehicle, and all parties claimed no injuries.
Both vehicles were still drivable. Both parties received a copy of their information and case number.
Unit#1, Marcela will receive a ticket for not providing insurance while operating a vehicle.
I'm unable to determine who's at fault as Unit#1 claimed Unit#2 reversed into her vehicle and Unit
#2 claiming that his vehicle was stopped when it was hit from behind by Unit#1.
This concludes my report.
My Axon camera was on for this call.
I certify (declare) under penalty of perjury under the laws of the State of Washington that the
foregoing is true and correct. This report was electronically signed by Officer S. Tamaivena #12788,
October 11, 2025, at 1707, Renton, WA.
PAGE 3 OF 4
REPORT NO. EG40967 CASE# 25-8810 DATE AND TIME 10/11/25 15:23
OF COLLISION
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