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HomeMy WebLinkAbout25-8992 iiTFiNII IIIII III IIIII II IIII IIIII I . 27c REPORT NO EG44061oc� RA COLLISION REPORT 1591971 CASE# 25-8992 2 INTERSTATE CITY STREET FIRE ❑ RESULTED 1 STOLEN STATE ROUTE ❑ OTHER ❑ VEHICLE ❑ LOCAL AOENC'Y 4100 3 COUNTY RD ❑ NVOLVED CODING PRIVATE WAY 2❑ 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 - 17 - 2025 1558 17 =.�� S WE IN OF 1070 3 4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION NE SUNSET BLVD BLOCK POST e 4a MILE POST 3100 .� ❑ ❑ DISTANCE OF(REFERENCE OR CROSS STREET) 5 500 00 FEET e✓ S 8 W e NE 12TH ST 2 0 29 F MOTtlR PEDAL- DAMAG THRESHOLD MET PHON UNIT 01 E VEHICLE ❑ CYCLE ❑ YES No �/ D:5094321346 0 1 30 6 LAST NAME MAYES FIRST NAME LOGAN MIDDLE F 1 1 2 31 INITIAL STREET ❑ 317 112TH AVE NE APT 353 CITY I BELLEVUE ST WA ZIP 980045824 2 NEW ADDRESS 7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEflICAL TRANSP©RTED 3 INTERLOCK YES NO Z/ INTERLOCKYES No�/ YES No�/ 8❑ LICIENS# STATE WA SEX M MMor YY' 05 1 2 32 9 ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 N USEET 2 1 INJURY CLASS 1 NAruRE of INJURIES 2 LICENSE, CTB7465 STATE WA VN# 3CZRZ2H50SM758892 3 10[9� PI ATP rt 11[-j- TRAILER STATE TRAILER ..STATE ROM TO 11 3 5 PLATE# PLATE# rRLR TRLR 5 1 33 12 3 5 VIN# vI. FROM TO VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED By GOVT VEHICLE 13 4 2025 HOND HR-V DAMAGE YES�No ✓� Yes 34 REGISTERED OWNER INFO LOGAN MAYES 610 SE EDGE KNOLL DR PULLMAN WA 99163 D:5094321346 VEHICLE NO. 1 ❑ SHADE IN DAMAGED AREA 35 4 LIABILITY INSURANCE NSURANCE CO 3 4 14 GEICO 4545730451 IN EFFECT &POLICY# 4TOP VEHICLE CHARGE 5 36 Le ALLY YES❑NO❑ CITATION# 70 80TTOM 15❑ sTnNowc s 7 rL� MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE UNIT VEHICLE ❑ CYCLE' ❑ ❑ OWNER D:2534099462 16� LAST NAME ✓ARBAH FIRST NAME BLESSING MIDDLE' INITIAL STREET ❑ 37 17 ❑ 2023 155TH PL NE APT 103 CITY BELLEVUE ST, Wq ZIP 980075078 4 NEW ADDRESS 18❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED: 38 INTERLOCKYEs No INTERLOCK YES No YEs ND 19 DRIVER'S STATE Ij WA SEX F D.O.e. 02 05 2000 39 LICENSE# MMDDYY 20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 HELMET 7 2 INJURY NATURE OF INJURIES 40 USE CLASS SORE NECK AND BACK 21 LICENSLATE E CEU5869 rarE WA vIN# KMHLM4AGOPU395588 41 22❑ PLATE# STATE PATE# STATE ❑ 42 23 TRLR kRLR 43 UIN#. 'IN#. VEH.YEAR 2Q23 MAKE HYUN MODEL ELANTRA STYLE VEHICLE TOWED TO BLIN TOWED BY GOV HI 44 24 DAMAGE YES NO YES NO REGISTERED OWNER INFO BLESSMGJARBA1650DUVALLAVENEAPTE512I?.TONWA98059 VEHICLE NO.2 SHADEDAMAGEDAREA 3 4 LIABILITY INSURANCE INSURANCE CO THE GENERAL 53WAS031320 IN EFFECT &POLICY# 9TOP veeiae ❑ ,J—I CITATION# CHARGE 1060TTOM LecnLLY YES N`[ 25 s 7 a OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY J 26 E.CHANG 10065 WA0171300 PAGE 01 OF PART A 3000-345-159(R 11/18) POLIICFETRAFFICN CORRECTION REPORT NO. EG44061 COLLISION REPORT III III III III III 111 1591972 CASE# 25-8992 ADDITIONAL PERSONS INVOLVED(PASSENGERS AND/OR WITNESSES ONLY) 'NAME (LAST,FIRST MIDDLE INITIAL) 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 On 10-17-2025 at about 1558 hours, I was sent to a collision reported in the near NE Sunset Blvd and NE 12th St, with in the City of Renton, King County, Washington. I located the scene of the collision in the 3100 block of NE Sunset Blvd. I contacted the driver of unit 2 who was out of her vehicle sitting in front of her car. She was hysterical and was not able to give me a statement. I spoke with the driver of unit 1 and he said he was rear ended by unit 2 while he was in the double left turn lane. I saw debris and it was in lane 2 eastbound. I spoke with the driver of unit 2 and she said she was in lane 2 and unit 1 merged into her lane from lane 1. I inspected the damage on both vehicle and it was consistent with the accounts of unit 2. Damage to unit 1 was on the rear driver side. Damage to unit 2 was on the front passenger corner. The driver of unit 2 said she had pain to her neck and back. I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT. E.CHANG 11-02-25 05:05 PM INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST.DET DATED PLACE SIGNED APPROVED BY E J.TRADER 4553 DAT 111212025 5:51:07 PM BADGE OR ID# 10065 ORI# ( WA0171300 TIME POLICE DISPATCHED'; 3:58 PM TIME POLICE ARRIVED 4:06 PM PART B 3aaa-345-,aa(R11Y1s) PAGE 27OF 37 REPORT NO. EG44061 CASE# 25-8992 DATE AND TIME 10/17/25 15:58 OF COLLISION ,t t' t- �t y3 i A A£s4r °ttU 4 q Y n � � u, t S � PAGE 3 OF 3