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HomeMy WebLinkAbout25-9389 a ITFFi "POLCERA II IfI) 1 IlfII ('II (Illf If( fI I . 6 27c COLLISION REP FIT 1591971 CASE 25-9389 z INTERSTATE ❑ CITY STREET FIRE ❑RESULTED 1 STOLEN STATE ROUTE ❑ OTHER ❑ VFHIl.I F ❑ LOCAL AOENC 4900 3 HIT&RUN CODING COUNTY RD PRIVATE WAY INVOLVED 2❑ TOTAL#TRIBAL OF 02 OBJECT 1 1 8 28 UNITS RESERVATION I STRUCK z 3 DATE OF M M D D Y Y Y Y TIME(2400) COUNTY# MILES N E IN CITY# cawsloN 10 - 1-- 2025 1901 17 ❑.= S IN 1070 3 4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑ SE PETROVITSKY RD BLOCK NO. e✓ --- ----� ❑ 4a❑ MILEPOST DISTANCE OF(REFERENCE OR CROSS STREET) 5❑ MILES❑ FEET e S ❑ W e 128THAVESE OF,1 29 MOTOR ✓ PEDAL- DAMAGETHRESHOLD MET PHONE UNIT 01 VEHICLE ❑ CYCLE ❑ YES ✓NO D:4253060782 0 1 30 6 LAST NAME MICHEL FIRSTNAME KEVIN MIDDLE J 1 1 2 31 INITIAL STREET ❑1 11100 SE PETROVITSKY RD APT M CITy RENTON ST WA 2jp, 980555663 z NEW ADDRESS 7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3 1/ I iNTERLOCKYEs NO NTERLOCKYEs NO�/ YES R No�/ 8❑ LDRIVER # STATE WA SEX'M MID D-O B 11 - 04 - 1970 1 2 32 [NATURE OF IN 9❑ ON DUTY❑ STATUS' AIRBAG 6 RESTR 4 EJECT 1 H USE 2 7 CLASS HEAD PAIN JURIES 2❑ 3 10[1Pi ATE 14 CKM3506 STATE WA v N# 2GNFLEEK8G6237076 TRAILER STATE TRAILER STATE 11 3 5 PLATE# PLATE# IR.. ro TRLR. TRLR 7 3 33 12 3 5 VIN#' VIN# :: FROM TO ❑ VEH.YEAR MAKE MODEL STYLE IVEHICLE TOWED TO BLIN T GOVT.VEHICLE 5 1 34 13 4 2016 CHEV EQU/NO SV DAMAGE YES �LII� RS vEs❑ No REGISTEREDOWNERINFO KEVINMICHEL11100SEPETROVITSKYRDAPTMRENTONWA98055 D:4253060782 VEHICLE NO. 1 ❑ SHADE IN DAMAGED AREA 35 14 LIABILI INSURANCE NSURANCE CO TRAVELERS 6069805892031 4 IN EFFECT &POLICY# TOPVEHICLE CHARGE36 LEGALLv Yes❑NO CITATION# <1�3 OTTOM 15❑ STANDING 7 6 MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE UNIT 02 VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES 1/ NO D:2063138612 16 a LAST NAME BELMONTE FIRST NAME ALEKSANDRA MIDDLE A INITIAL 17❑ NEW STREETREs7 12852 SE 175TH CT CITY RENTON ST WA ZIP 980586703 4❑ 37 18❑ CDL IGNITION REQUIRED IGNITION PtR-E-S1ENT MEDICAL-T�RANSPORTED � 38 INTERLOCK YEs❑No� INTERLOCK YEs I I NOF YEs t l NOF,/ 19 D IVERI # STATE WA SEX F M D.O.B. 08 _ 05 _ 1981 39 20❑ ON DUTY STATUS I AIRBAG 2 RESTR 4 EJECT 1 H U EET 2 NJAU EY 1 NATURE OF INJURIES ❑ 40 ❑ILICENSE 21❑ PLA E# 51014 TATE 41 WA VIN1 JF1VBAN69N8018546 1 42 22❑ PILER LATE# STATE PLATE# STATE TRLR 23❑ UIN#. N#. 43 RLR 'I VEH YEAR 2022 MAKE SUBA MODEL WRX STYLE 4D VEHICLE TOWED TO BLIN TOWED BY GOV HI 44 L4❑ DAMAGE YES NO YES NO REGISTERED OWNER INFO RYAN BELMONTE 12852 SE 175TH CT RENTON WA 98058 VEHICLE NO.2 SHADE IN DAMAGED AREA 2 3 4 LIABILITY INSURANCE INSU&PORGY#E CO COUNTRY FINANCIAL PA5165938IN 1UR VEHICLe ❑ ,.II CITATION# CHARGELEGALLY YES N J 25 OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# JAGENCY 26 ROBIN SMITH 12986 WA0171300 PART A PAGE 01 OF C7 3000-345-159 OR 11/181 STATE OF POLICETRAFFICN CORRECTION REPORT NO. EG43541 COLLISION REPORT III III III III III 111 1591972 CASE# 25-9389 ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY) NAME MIDDLE INITIAL) SEGOVIA TOMAS E (I.P.ST FIRST, ADDRESS&PHONE# 2815 LINCOLN PL NE RENTON WA 98056 5053399507 SEX i M MMDOYyry 07 - 01 - 1987 PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT ' HELMET INJURY NATURE OF INJURIES ❑ ❑✓ POS. USE CLASS NAME (LAST,FIRST,MIDDLE INITIAL) MINHAS ANIQA M ADDRESS&PHONE# DOB 4807 MORRIS AVE S UU101 RENTON WA 98055 4253129558 SEX F MMD-:VB a 09 - 18 - 1991 PASSENGER UNIT# SEAT AIRBAG RESTR. EJECT HELMET INJURY NATURE OF INJURIES []WITNESS 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. ROBIN SMITH 10-29-25 09:06 PM INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED APPROVED BY DATE QUINT TIBEAU 7691 1 1013112025 5:56:36 PM BADGE OR ID# 9Y988 OR]# WA0171300 TIME POLICE DISPATCHED 7:02 PM TIME POLICE ARRIVED',7:06 PM PART B PAGE IT]OF 4] REPORT NO. EG43541 CASE# 25-9389 F LNa O 10/29/25 19:01 F coy�isI©�ON u NARRATIVE 25-9389 Unless otherwise stated, the following occurred in the City of Renton, County of King, State of Washington. On 10-29-2025 at approximately 1902 hours I was dispatched to a non-injury blocking collision that occurred in the intersection at SE Petrovitsky RD and 128th AVE SE. Upon arrival, I contacted the involved parties and determined that the driver of Unit#1 was complaining of head pain. I requested the Renton Regional Fire Authority (RRFA) respond to the scene to evaluate injuries. While on scene, I collected the involved parties driving documents and their independent recollection of events leading up to the collision. The driver of Unit#1 was the sole occupant of his vehicle and traveling in lane 2 of 2. He was traveling eastbound on SE Petrovitsky RD approaching 128th AVE SE when he saw he had a red light. He was unable to stop in time and proceeded through the red light. As he continued eastbound through the intersection, he collided with Unit#2. Both front and side airbags deployed in Unit#1. The driver of Unit#1 said he felt tingly and that his head hurt. Unit#1 sustained front end damage. The driver of Unit#2 said she was traveling northbound on 128th AVE SE in lane 1 of 1. As she approached the intersection of SE Petrovitsky RD, she had a green light. As she proceeded northbound through the intersection, she was struck on her driver side door by Unit#1. The driver of Unit#2 had no complaints of pain. Her vehicle was drivable, and sustained damage to the driver side front and rear door. Witness #1 (Tomas) was driving behind Unit#1, headed eastbound on SE Petrovitsky RD approaching 128th AVE SE. Before reaching the intersection, he saw there was a red light and Unit #1 proceeded through the red light. As Unit#1 proceeded through the red light, it struck the driver side of Unit#2. Witness #2 (Aniq) was Tomas's passenger. She said they were headed eastbound on SE Petrovitsky RD approaching 128th AVE SE. Before reaching the intersection, she saw there was a red light and Unit#1 proceeded through the red light, striking the driver side of Unit#2. 1 determined Unit#1 to be the proximate cause of the collision. RCW 46.61.050 states, "(1) The driver of any vehicle, a person operating a bicycle, and every pedestrian shall obey, and the operation of every personal delivery device shall follow, the instructions of any official traffic control device applicable thereto, and as specified in this chapter, placed in accordance with the provisions of this chapter, unless otherwise directed by a traffic or police officer, subject to the exception granted the driver of an authorized emergency vehicle in this chapter." The driver of Unit#1 violated this when he failed to stop at the red light displayed on the traffic control device. An exchange of information was provided to all involved parties. RRFA medically cleared all involved at the scene. Bankers towing arrived and collected Unit#1. The driver of Unit#1 was given a courtesy transport home by Officer lurco. I did not cite the driver of Unit#1. The driver of Unit#2 drove her vehicle away from the scene. 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 Robin Smith #12986 on 10/29/2025 @ 2056 hours in Renton, WA. PAGE 3 OF 4 REPORT NO. EG43541 CASE# 25-9389 DATE AND TIME 10/29/2519:01 OF COLLISION s t t t � i a y � t� i sy 3 � i tti� ri V i 1!y � 12� .. a t >A t'4 PAGE 4 OF 4