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HomeMy WebLinkAbout25-8879 ITFF' "POLCERA 1�1 . 1 27c I II COLLISION REP FIT 1591971 SASE 25-8879 2 INTERSTATE ❑ CITY STREET FIRE ❑ RESULTED 1 STOLEN STATE ROUTE ❑ OTHER ❑ VFHICI F ❑ LOCAL AGENCI 4100 3 HIT&RUN CODING COUNTY RD PRIVATE WAY INVOLVED 2❑ TOTAL#OF OBJECT 6 0 2$ TRIBAL 1 02 STRUCK RESERVATION z 3 DATE OF M M D D Y Y Y Y TIME(2400) COUNTY# MILES N E IN CITY# GawsloN 10 - 14 - 2025 0632 17 ❑.= S IN 1070 3 4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑ BLOCK NO. e✓ --- ----� ❑ PARK AVE N MILEPOST 4a❑ DISTANCE OF(REFERENCE OR CROSS STREET) 5❑ ❑ FEET e S ❑ W e N 3RD ST OF,1 29 MOTOR ✓ PEDAL- DAMAGE THRESHOLD MET PHONE UNIT 01 VEHICLE ❑ CYCLE ❑ YES NO �/ D:2066407795 30 6 LAST NAME MORRIS FIRSTNAME CHRISTOPHER MIDDLE W 1 1 2 31 INITIAL STREET ❑ 16122 128TH AVE SE CITY RENTON ST WA 21p 980585537 z NEW ADDRESS 7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3 iNTERLOCKYEs NO INTERLOCKYEs NO YES NO 8❑ LDRIVER # STATE WA SEX'M MID -O B 03 — 17 — 1960 32 9❑ ON DUTY❑ STATUS AIRBAG 1 RESTR 4 EJECT 1 H USEET ICNLJAURY 1 NATURE OF INJURIES z❑ 3 10❑ P1 ATNFS14 B8367C STATE WA v N# 1 BABNBSA7JF339147 TRAILER STATE TRAILER STATE 11 0 0 PLATE# PLATE# FROM TO TRLR. TRLR 1 5 33 12❑ vIN If VIN# FROM TO ❑ VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE 7 3 34 13 4 2018 BLUE SCHOO DAMAGE vesNo ves❑ NO REGISTEREDOWNERINFO RENTON SCHOOL DISTRICT 300 SW 7TH ST RENTON INA 98057 VEHICLE NO. 1 ❑ SHADE IN DAMAGED AREA 35 4 INSURANCE CO 3 4 14 IN EF IT INSURANCE SCHOOLS INSURANCE ASSOCIATION OF WA SlAW252634033 IN EFFECT &POLICY# 9TOP VeHICLE CHARGE 5 36 LECALLv Yes❑NO❑ CITATION# 10 BOTTOM 1 5❑ ANF. 8 6 MOTOR PEDAL- PEDESTRIAN ✓ PROPERTY DAM THR OLD MET PHONE UNIT 02 VEHICLE ❑ CYCLE ❑ ❑ OWNFR ❑ YES 1/ NO D:2064304894 16 2 LAST NAME MELBERG FIRST NAME SIDNEY MIDDLE L INITIAL 17❑ STREET ❑', 211 PARK A VE N#2 CITY' RENTON ST WA ZIP 98057 37 NEW ADDRESS ❑ 18� CDL IGNITION REQUIRED IGNITION PtR—E—S1ENT MEDICAL TRANSPORTED ❑ 38 INTERLOCKYES�NOR INTERLOCK YEs I I NOF YEs t l NO❑ 19 F] DRIVE # STATE SEX F MMODYY 08 _ 13 _ 2009 39 ❑ ON DUTY STATUS 3 AIRBAG RESTR EJECT WEB MEET LASS SCRAPES Y 6 [NATURE OF INJURIES TO LEFT KNEE.POSSIBLY HIT HEAD ❑ 40 ❑21❑ LICENSE TATE VIN# 41 PLATE# 42 22❑ PLATE# STATE PLATE# STATE TRLR 23❑ UIN#. IN#. 43 RLR ' VEH YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED By Gov HI 44 L4 Q 2 DAMAGE YES NO YES NO REGISTERED OWNER INFO VEHICLE NO.2 SHADE IN DAMAGED AREA 2 3 4 LIABILITY INSURANCE❑ INSURANCE #E CO IN EFFECT &PO I 9TOP 5 VE""LE ❑ ,J� CITATION# CHARGE i o BOTTOM LEGALLY YES N J 25 s e OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY 26 C.ARNOLD 12509 WA0171300 PAGE 01 OF PART A 3000-345-159 OR 11/181 STATE OF POLICETRAFFICN CORRECTION REPORT NO. EG41004 COLLISION REPORT III III III III III 111 1591972 CASE# 25-8879 ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY) NAME (LAST FIRST,MIDDLE INITIAL)_ ADDRESS&PHONE# SEX D.O.B. - - MMDDYYYY. PASSENGER❑WITNESS UNIT# SEAT AIRBAG RESTR. EJECT ' HELMET INJURY NATURE OF INJURIES POS. USE CLASS NAME '(LAST,FIRST MIDDLE INITIAL) ADDRESS&PHONE# D D B SEX MMDDYYYY PASSENGER ❑WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET INJURY NATURE OF INJURIES POS. USE CLASS NAME (LAST FIR57 MIDDLE INITIAL) AppRESS R 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. C.ARNOLD 10-16-25 08:40 AM NVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED APPROVED BY DATE C.JACOBS 1953 1012412025 7:41:45 AM BADGE OR ID# 12509 ORI# WA0171300 TIME POLICE DISPATCHED 6:33 AM TIME POLICE ARRIVED',6:33 AM PART B PAGE IT]OF 5� REPORT NO. EG41004 CASE# 25-8879 FC LNaoy L isI©�ON O 10/14/25 06:32 F cu NARRATIVE CC 25-8879 On 10/14/2025 at 0633 hours I was dispatched to a vehicle vs. pedestrian collision at N 3rd St and Park Ave N in the City of Renton, King County, Washington. Pre-Collision Driver 1 stated that he was traveling South on Park Ave N at around the 400 block in the #2 lane. Driver 1 stated that as approached the intersection of N 3rd St and Park Ave N, he merged from the #2 lane to the #1 lane as there was another vehicle waiting to turn left in the #2 lane. Pedestrian 1 was on the West side of the roadway at the Northwest corner of the intersection of Park Ave N and N 3rd St. Collision Driver 1 stated that as he came closer to the intersection, Pedestrian 1 left the sidewalk and entered the roadway. Driver 1 did not have time to react and stop or slow to avoid a collision, and the front passenger side bumper of Unit 1 collided with Pedestrian 1, forcing her to the ground. Driver 1 stated that he had a green light to proceed straight. Upon review of the interior video from Unit 1 1 saw that the approximate speed of Unit 1 at the time of collision was about 24mph per the video. Pedestrian 1 fell to the ground following the collision and then was able to stand and walk under her own power, running back into the roadway and then back to the sidewalk. I heard from the video that Driver 1 immediatley radioed to hiss dispatch the situation and started the process of getting an emergency response to his location. While doing so, Driver 1 attempted to console Pedestrian 1 who had come back to the sidewalk and sat down to await emergency services. I later went back to observe this intersection and saw that when North/Southbound traffic has a green light, the pedestrian crossing displays a steady red hand indicating that pedestrians are not to enter the intersection. Injuries Pedestrian 1 sustained minor scrapes on her knee and complained of a bump on her head. Pedestrian 1 was transported via tri-med but I later learned that the ambulance was cancelled and Pedestrian 1 never made it to the hospital. Vehicle Disposition Unit 1 was operational. Proximate Cause This report is to document this collision. I certify (declare) under penalty of perjury under the laws of the State of Washington that the foregoing is true and correct. Electronically signed by Officer C. Arnold #12509 at 14:56 on 10/14/2025 in the City of Renton, King County, Washington. PAGE 3 OF 5 SUPPLEMENTAL REPORT NO. EG41 004 r` POLICE TRAFFIC 1 27 COLLISION REPORT CASE# 25-8879 1 COMMERCIAL MOTOR CARRIER INTERSTATE INTRASTATE ✓ G UNIT'# 1 USDOT ICC# ' VEHICLE TYPE 1 CARGO 6ODY 1 ;TYPE 2 ❑ 1 28 CARRIER RENTON SCHOOL DISTRICT NAME 3 CARRIER L ADDRESS 300 SW 7TH ST CITY RENTON ST WA ZIP'', 98057 4 ❑ NAME # PLACARD: :❑ SOURCE 3 AXLES 02 GwvR 20000 + NAME IF NO NUMBER 4a ❑ ADDITIONAL UNITS MOTOR PEDAL- PROPERTY DAMAGE THRESHOLD MET PHONE 5 ❑ UNIT# VEHICLE I_J CYCLE _) PEDESTRIAN � OWNER � YES NO i MIDDLE'... 29 LAST NAME FIRST NAME INITIAL STREET 30 NFW AnnRFrtP. CITY ST ZIP 6 � CDL GNITIttN REQUIRED GNITION PRESENT MEDICAL TANSPORTED 1 31 INTERLOCK YES No NTERLOCK YES❑N0� vES N LLIICIENSE STATE I SEX M��DYRYY' 2 7 F-1 ON DUTYl STATUS AIRBAG' RESTR. EJECT HELMET INJURY NATURE OF INJURIES USE CLASS 8 ❑ ' 1 32 LICENSE+ rar VIN.# PLATE# 9 TRAILER TRAILER PLATE# STATE PLATE# STATE 10 ❑ TRLR TRLR VIN.#. VIN.#. 11 VEH.YEAR MAKE MODEL STYLE VEHICLE TOWS T SABLIN TOWED BY anvi vEHIG P FROM TO DAMAGE Y EES NO YES NO REGISTERED OWNER INFO. m 33 12 SHADE IN DAMAGED AREA FROM TO ((ABILITY INSURANCE❑ INSURANCE CO IN EFFECT &POLICY# t 9 1"01? VEHICLE 1 o BarroM 34 13 ❑ LEGALLY YES❑ NO❑ CITATION# CHARGE STANDING S} 8 7 6 14 ❑ UNIT Tr Vd 1 RE O CYCLE � OWNER YES AGE NOHRESHOLD MET PHONE El 35 El PEDESTRIAN 15 LAST NAME FIRST NAME MIDDLE INITIAL TIAL ❑ STREET 16 STREET"[—] CITY ST ZIP CDL IGNITION REDUIREE7 IGNITION PRESENT MEDICALTANSPORTED NTERLUCK YES NO NTERLOCK 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 ❑ vIN# 39 LICENSE PLATE# rnr 20 ❑ TRAILER' TRAILER ❑ 40 PLATE# STATE PLATE# STATE 21 ❑ TRLR TRR 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 a 4 AREA F 43 z LIABILITY INSURANCE INSURANCE CO ' VINE EFFECT &POLICY# i 970P - 4 E:l 44 24 LEHIcLE YES❑ NO❑ CITATION# CHARGE iq 60TiOM LeGALLv STANDING S 7 6 1 CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT. C.ARNOLD 10-16-25 08:40 AM 25 INVESTIGATING OFFICER'S SIGNATURE OFFICER'S PHONE UNIT OR DIST DET DATED: PLACE SIGNED APPROVED BY DATE 26 ORID# 12509 O#I',WA0171300 JACOBS 10/24/202 PAGE F OF 5 3000-345-013(R 11118) REPORT NO. EG41004 CASE# 25_8879 DATE AND TIME 10/14/25 06:32 OF COLLISION k1{y s i y *t' ytsr� y t ya: P a ( ,s t s�t 1 � r a, ( PAGE 5 OF 5