HomeMy WebLinkAbout25-8960 j ITFC II IIIII III IIIII II IIII IIIII I . 27I
OOLCERAF EG44864
COLLISION REPRT 1591971
INTERSTATE CITY STREET FIRE ❑
CASE# 25-8960 2
RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VEHICLE LOL`CO AGENCY. 4200 3
COUNTY RD NVOLVED CODING
2 PRIVATE WAY
❑ TRIBAL TOTAL 1
UNITS#OF 02 SO BJECT TRUCK 1 8 28
RESERVATION 2
3� M M D D Y Y Y Y TIME(2400) COUNTY# MILES CITY#
DATE OF'. N E
coulsloN' 10 - 16 - 2025 1141 17 =.= S 8 W e IN OF M 1070 a
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION
BRONSON WAY N MILE POST
e 1300 .�
4a❑ MILE POST
❑ DISTANCE OF(REFERENCE OR CROSS STREET)
5 20 00 FEET e✓ S 8 W e HOUSER WAY
0 3 29
MOTtlR PEDAL- DAM AG THRESHOLD MET PHONE
UNIT 01 VEHICLE CYCLE' YES Vl NO D:2063916284 0 1 30
6 LAST NAME HAMPTON FIRST NAME ROBERT MIDDLE I E 1 1 2 31
INITIAL
STREET 12036 71ST AVE S E272 CITY SEATTLE ST WA ZIP 98178 2
NEW AbDRESS
7 CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
INTERLOCK YES No W/ INTERLOCKYES NO�/ YES No,/
8❑ LICIENS# STATE WA SEX M MMOCSYY' 01 1 2 32
9 ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 HELMET USE 2 1 INJURY
CLASS 1 NAruRE of INJURIES 2
10 LI ENSE'ti� D36926H STATE WA VN# 1GCCS14EXM8116428 3
11[-j— TRAILER STATE TRAILER ,STATE ROM TO
11 2 5 PLATE# PLATE#
TRLR TRLR 1 7 33
12 2 5 VIN# VIN#
( FROM TO
VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED By GOVT VEHICLE
13 4 1991 CHEV S10 TR DAMAGE YES NO ✓ YEs_ No 3 7 34
REGISTERED OWNER INFO OWNEDBYDRIVER VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
INSURANCE CO 2 3 4
14 INLIABILITYEFFECT
INSURANCE NONE NONE
IN EFFECT &POLICY# iQ�Q
5
VEHICLE CHARGE 36
15cyes❑NO❑ CITATION# 5A0882616,5A0882617, OWLS 3RD DEGREE,OP MOT VEH
III MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT VEHICLE CYCLE nWNFR YES�/ NO D:2066182854
16�
LAST NAME BALL FIRST NAME JOSPHINE MIDDLE L
INITIAL
37
17 STREET'O 19325 133RD AVEA VE SE CITY RENTON ST, Wq ZIP 980587771
NEW AbORESS
18� CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED' 38
INTEIRLOCKYES 'KYES No�/ yEs No
19 DRIVER'S STATE WA SEXIF DADDY 08 08 1978 39
LICENSE# DM011 Y —
HELMET INJURY' NATURE OF INJURIES 40
20❑ ON DUTY STATUS' AIRBAG 2 RESTR 4 EJECT 1 USE 2 CLASS 1 ❑
21 LICENSLATE E CGK8901 rarE WA vIN# 7FARS6H99PE017631 41
22❑ PLATE# STATE PATE# STATE ❑ 42
23 TRLR kRLR 43
UIN#. 'IN#.
VEH.YEAR 2023 MAKE HOND MODEL (�`R_�/ STYLE $D VEHICLE TOWED TO BLIN
TOWED BY GOV HI 44
24 DAMAGE YES NO�/ YES NO
REGISTERED OWNER INFO JOSPHtNE OTIENO 19325133RD AVE SE RENTON WA 98658 VEHICLE NO.2
SHADE DAGAREA
LIABILITY INSURANCE INSURANCECO STATE FARM 3831686 C2447K
IN EFFECT &POLICY# t STOP 5
veeiae ❑ ,J—I CITATION# CHARGE t080TTOM
LecnLLy YES N`[
25 s 7 a
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
26
D.NELSON 12421 WA0171300
PAGE 01 OF
PART A 3000-345-159(R 11/18)
POLIICFETRAFFICN CORRECTION REPORT NO. EG44864
COLLISION REPORT III III III III III 111
1591972 CASE# 25-8960
ADDITIONAL PERSONS INVOLVED(PASSENGERS AND/OR WITNESSES ONLY)
'NAME
(LAST,FIRST MIDDLE INTTIAL)
ADDRESS&PHONE#
SEX' D.O.B. - [----------�
MMDDYYYY
PASSENGER F-1 WITNESS Ej UNIT# SEAT AIRBAG RESTR. EJECT HELMET INJURY NATURE OF INJURIES--�
POS. USE CLASS
'NAME
(LAST FIRS,MIDDLE INITIAL)
ADDRESS&PHONE#
SEX' D.O.B. - L----------�
MMDDYYYY
PASSENGER DWITNESSD UNIT# SEAT AIRBAG RESTR. EJECT HELMET NJURY NATURE OF INJURIES
POS. : USE CLASS ----�
'.NAME
(LAST,FIRST,MIDDLE INITIAL)
ADDRESS&PHONE#
SEX D.O.B. - L----------�
MMDDYYYY
PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET INJURY NATURE OF INJURIES
❑ Q POS. USE CLASS �____ ----j
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.
D.NELSON 10-17-25 04:05 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST.DET DATED PLACE SIGNED
APPROVED BY DATE
C.JACOBS 1953 1 111412025 12:06:44 PM
BADGE OR ID# 12421 ORI# ( WA0171300 TIME POLICE DISPATCHED'; 11:44 AM TIME POLICE ARRIVED 11:46 AM
PART PAGE 27 OF 47
REPORT NO.` EG44864 CASE# 25-8960 O COLLI COLLISION TIME
OF 10/16/25 11:41
COLLI
NARRATIVE
25-8960 ACC
On 10/16/2025 1 was working as a uniformed patrol officer and driving a marked patrol vehicle for the
City of Renton. 1 was dispatched to a report of a two-vehicle, non-injury collision near the intersection
of Garden Ave NE and Bronson Way NE Renton/King/WA.
I arrived on scene and located both involved parties, they were not blocking the roadway and
confirmed there was no injury.
The driver of the white 1991 Chevrolet S Pickup WA/D36926H (Unit 1), was identified by his WADL
as Robert E Hampton DOB: 1/18/1962. Robert advised that he was pulling out of the parking lot of
Bigfoot Java to head west on Bronson Way NE. He said that he stopped, checked the roadway, and
as he pulled out, he was struck by Unit 2. There was damage to the front driver side bumper and
quarter panel. Robert was not able to provide me with his license, registration, or proof of insurance.
He confirmed his address as 12036 71 st Ave S #E272 Seattle WA.
The driver of the 2023 Honda CRV WA/BGK8901, was identified by her WADL as Josphine L Ball
DOB: 8/8/1978. Josphine said that she was driving west on Bronson Way NE in the #1 lane when
Unit 1 pulled out of the parking lot in front of her. She said that she collided with the truck on her
passenger side. There was damage to the passenger side front and rear quarter panels, and both
doors. The airbags did not deploy.
Robert emphasized several times that he stopped before trying to pull onto Bronson Way, 1 advised
him that he still must yield to traffic that is already in Bronson since he is exiting a parking lot. Robert
appeared confused as to why he had to yield to traffic if he stopped before entering the roadway.
Both vehicles were drivable and able to leave the scene.
Robert advised he was late for an appointment, so 1 provided him with his exchange of information,
and he left the scene.
After he left, I saw his driving status showed at DWLS 3rd Degree, his status showed as DWLS since
1/12/2012 under citation #2Z0133520.
1 cited Robert for DWLS 3rd Degree RCW 46.20.342.1 C under Sector citation #5A0882616.
I also cited Robert for the following violations under Sector citation #5A0882617:
RCW 46.61.205.1 Failure to Yield Right of Way Motor Vehicle
RCW 46.30.020 Operating a Motor Vehicle Without Proof of Insurance
RCW 46.16A.180.2 Fail to Sign/Carry/Display Vehicle Registration
RCW 46.20.017 No Driver's License on Person.
These citations should be mailed to Robert at his DOL address.
Nothing further.
I certify under penalty of perjury under the laws of the State of Washington that the foregoing is true
and correct.
D. Nelson #191 10/16/2025 Renton WA
PAGE 3 OF 4
REPORT NO. EG44864 CASE# 25-8960 DATE AND TIME i 10/16/25 11:41
OF COLLISION s
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PAGE 4 OF 4