HomeMy WebLinkAbout25-9475 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 0 27c
COLLISION REP FIT 1591971
CASE 25-9475 z
INTERSTATE ❑ CITY STREET FIRE ❑
RESULTED
1 STATE ROUTE OTHER STOLEN
❑ ❑ H F ❑ LOCAL AOENC 3
HIT IT&RUN � CODING
COUNTY RD PRIVATE WAY INVOLVED
2 TOTAL#OF OBJECT 1 8 28
TRIBAL UNITS 03 STRUCK
RESERVATION
z
3❑ DATE OF M M D D Y Y Y Y TIME(2400) COUNTY# MILES N E IN CITY# ❑
DawsloN 11 - 01 - 2025 1305 17 ❑. S 8 W H OF e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓
RAINER AVE S BLOCK NO. e✓ 400
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ ❑ FEET e S ❑ W e 0 1 29
MOTU '�01 VEHtOR Z CLE CYDCLE. El �ESAGE NHORE✓LD MET PHONE O 7 30
6❑ LAST NAME UNKNOWN FIRSTNAME MIDDLE 1 1 2 31
INITIAL
STREET ❑ CITY ST ZIP 2
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
:NTERLOCKYEs NO INTERLOCK YES NO YES No
8 DRIVER'S STATE SEX O.B. 1 2 32
❑ :LICENSE# MMDDYY
U D.
-�
9 ON DUTY❑ STATUS AIRBAG 9 RESTR 9 EJECT 9 HELMET USE 9 CLAY 0 NATURE OF INJURIES 2❑
3
10❑ PI ATNE 14 g53968X sTATe WAu N# 1 FTCR10AOVPA57380
0 TRAILER STATE TRAILER STATE
11 0 0 PLATE# PLATE# Rom ro
TRLR. A'RLR. 1 5 33
12 0 0 VIN#' VIN#
>; FROM TO
❑ VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN T GOVT.VEHICLE 9 9 34
13 A 1997 FORD RANGE TR DAMAGE vE5 0NO f �LII� RS ves❑ No
REGISTERED OWNER INFO UNKNOWN VEHICLE NO. 1
SHADE IN DAMAGED AREA ❑ 35
14 A LIABILITY INSURANCE❑ INSURANCE CO < _3 4
LI EFFECT I POLICY# 9TOP
VEHICLE CHARGE 5 36
LEGALLv res❑NO❑ CITATION# 1 o BOTTOM
15❑ STANDING 6
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT 02 VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES NO ,/ D:2066010198
16 a
LAST NAME HARRIS FIRST NAME KEVIN MIDDLE H
INITIAL
17❑ STREET ❑', 16915 144TH AVE SE CITY RENTON ST WA ZIP 98058 37
NEW ADDRESS ❑
18� CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 38
INTERLOCK YEs❑NO� INTERLOCK vEs❑NOF YES
❑NOF,/
19[—] DRIVER'S STATE WA SEX M D.C.B. 08 _ 05 _ 1978 39
LICENSE# MMDDYY
20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 H U EET 2 NJAURSY 1 NATURE OF INJURIES 40
21❑ LICENSE I CEN9423 TATE I WA VIN# 1G1FY6S01N4130218
❑ 41
PLATE#
42
22❑ PLATE# STATE PLATE# STATE
TRLR
23❑ UIN#. IN#.
43
RLR
'
G HI 44
VEH YEAR 2022 MAKE CHEV MODEL BOLT STYLE $D DAMAGE TOWED NOO✓ BLIN TOWED By ov yES NO
24❑ ES
REGISTERED OWNER INFO OWNED SY DRIVER VEHICLE N0.2
SHADE IN DAMAGEbAREA
2 3 Cd
LIABILITY
INSURANCE INSU PORGY#ECO STATE FARM 580427OD2447IN 1 9TOP
VEHICLE CITATION# CHARGE i o BOTTOM
LEGALLY YES N�
25❑ s
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
J
26
BLAKE BOWIE 12105 WA0171300
PAGE 01 OF
PART A
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EG43886
COLLISION REPORT III III III III III 111
1591972 CASE# 25-9475
ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY)
NAME MIDDLE INITIAL) HARRIS ANNABELLE
(I.P.ST FIRST,
ADDRESS&PHONE# D O.B. '
16915 144TH AVE SE RENTON WA 98058 2069992047 SEXi F MMDovyry 11 - 08 - 1974
PASSENGER I�I WITNESS R UNIT# 2 POS. 3 AIRBAG 2 RESTR. 4 EJECT ? 1 HELMET LASS ' NATURE of INJURIES
L�!1 USE 2 CLASS I O
NAME
(LAST,FIRST,MIDDLE INITIAL) TRINH WENDY H
ADDRESS&PHONE# D O B
3900 NE 11TH PL RENTON WA 98056 2067790300 SEX IF MMDovvvv 05 _ 13 _ 2000
SEAT HELMET INJURY NATURE OF INJURIES
PASSENGER WITNESS UNIT# 3 POS. 3 AIRBAG 2 RESTR. 4 EJECT 1 USE 2 CLASS 1
NAME
(LAST FIR57 MIDDLE INITIAL)
AppRESS&PHONE#
SEX D.Q.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.
SLAKE BOWIE 11-01-25 02:38 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
D.SKELTON 9139 1 111212025 4:01:57 AM
BADGE OR ID# 12105 OR]# ! WA0171300 TIME POLICE DISPATCHED; 1:10 PM TIME POLICE ARRIVED:1:14 PM
PART I PAGE IT]OF 5�
REPORT NO. EG43886 CASE# 25-9475 OF COLLISION
11101/25 13:05
OF CbLLI510N
NARRATIVE
On 11-1-2025 at 1310 hours I was dispatched to the area of Rainer Ave S / S 4th PL, in the City of
Renton, County of King, State of Washington, for a reported three car collision with possible injuries.
While enroute, dispatch advised that the driver of a white Ford Ranger (WA LIC: B53968X) was trying
to leave the scene.
Upon arrival, the fire department advised me that the two occupants of the Ranger climbed up onto
the railroad tracks and ran away on foot. Both subjects were described as Hispanic males.
I contacted the driver of Unit 2 and he stated he was stopped in traffic waiting for the light to turn
green. He heard a long screeching sound like tires sliding and eventually he was rear ended by Unit
3. The occupants of Unit 1 were trying to get the truck to drive but ended up just running away onto
the railroad tracks. Both subjects were described as short Hispanic males wearing baseball hats,
sweatshirts, and jeans. He was able to get some partial picture's of the subjects and he will be
emailing me those photos. See photos for further information.
Unit 3 did not complain of injuries nor did his passenger. They were able to leave the scene in their
vehicle as it was still drivable.
I contacted the driver of Unit 3 and he stated he was stopped in traffic behind Unit 2 while waiting for
the light to turn green. He heard tires screeching and was rear ended by Unit 1 which pushed him into
Unit 2.
Unit 2 had some neck and head pain which the fire department looked at while his passenger did not
complain of any injuries. They were able to leave the scene in their vehicle as it was drivable.
Additional officers conducted an area check for the suspects in Unit 1 but they were unable to find
them.
I provided both Unit 2 and Unit 3 with my business card which contained the case number for their
records. Unit 1 was towed from the road as the driver left on foot.
I certify (declare) under penalty of perjury under the laws of the State of Washington that the
foregoing is true and correct.
Electrically signed by Officer B. Bowie / 12105 on 11-1-2025 at 1429 hours in the City of Renton.
PAGE 3 OF 5
SUPPLEMENTAL REPORT NO. EG43886
r`I POLICE TRAFFIC 1 1 8 27
COLLISION REPORT CASE# 25-9475
1 COMMERCIAL MOTOR CARRIER INTERSTATE INTRASTATE G
UNIT'# USL70T !CC# VEHICLE TYPE CARGO BODY
TYPE
2 ❑ 1 28
CARRIER
NAME
3 CARRIER
ADDRESS `
CITY ST' ZIP'
4 ❑ NAME # PLACARD: :❑
GWVR NAME IF NO NUMBER
SOURCE AXLES +
4a ❑ ADDITIONAL UNITS
MOTOR PEDAL- PROPERTY DAMAGETHRESHOLD MET PHONE
5 ❑ UNIT# 3 VEHICLE tSJ CYCLE I_) PEDESTRIAN � OWNER � YES NO
D:2068904656
0 7 29
LAST NAME MARTINEZ FIRST NAME : JASE MIDDLE'.. M
INITIAL
STREET 30
❑ NEW AnDRFSP 429 S 189TH ST CITY BURIEN ST WA ZIP 98148
6 CDL IGNITIttN REQUIRED IGNITION PRESENT MEDICAL TAN5PORTE6 1 1 2 31
INTERLOCK YEs NO NTERLOCK YES❑N0� vES N
DRIVER'S
LICENSE STATE I WA SEX M MMDDYYv', 11 - 24 - 2004
7
HELMET :INJURY' NATURE OF INJURIES
ON DUTY STATUS AIRBAG 2 RESTR. 4 EJECT 1 USE 2 CLASS 7 NECK&HEAD PAIN
8 ❑ 1 32
LICENSE 9084R52 TAT NV VIN# WDDZF4JB0HA021956
PLATE#
9 TRAILER TRAILER
PLATE# STATE PLATE# STATE
10 ❑ TRLR TRLR
VIN It VIN.#.
11 0 0 VEH.YEAR2017 MAKE MERZ MODELS CLASS STYLE SO VEHICLE TOWS E T SABLIN TOWED BY anvi vEH1O P FROM TO
DAMAGE YES NO YES NO
REGISTERED OWNER INFO OWNED BY DRIVER J 9 33
12 � SHADE IN DAMAGED AREA
j FROM TO
LIABILITY INSURANCE INSURANCE CO STATE FARM 5444491BO747A q"i"Olx
IN EFFECT &POLICY#
v—EL. 10 BOTTOM 34
A CITATION# CHARGE
13 LEcnuv YES NO01
gg�@
STANDING } l:9 7
14 ❑ UNIT# Vd 1 RE O CYCLE � OWNERRTY YE SAGE NOHRESHOLD MET PHONE ❑ 35
PEDESTRIAN
15 LAST NAME FIRST NAME INITIAL
36
MIDDLE ❑
STREET
16 NEW An "[-] CITY ST ZIP
CDL IGNITION REdUiRrD IGNITION PRESENT MEDICALTANSPORTED
NTERLOCK YES No INTERLOCK YEs NO YEs NO ❑
17 4 37
LICENSE# STATE SEX MMDDDYBYY
18 ❑ ON DUTY� STATUS AIRBAG RESTR. ; EJECT HELMET INJURY NATURE of INJURIES 38
USE CLASS
19 ❑ LICENSE TAT VIN# 39
PLATE#
20 ❑ TRAILER' TRAILER El40
PLATE#< STATE PLATE# STATE
21 ❑ ❑ 41
TRLR TRLR
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 4 4 AREA F 43
z
LIABILITY INSURANCE INSURANCE CO '
VINE
EFFECT &POLICY# i 970P - 4 E:l
44
24 LERICLE YES❑ NO❑ CITATION# CHARGE iq 60TiOM
LecALLv
STANDING 8 7 6
1 CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT.
BLAKE BOWIE 11-01-25 02:38 PM
25 INVESTIGATING OFFICER'S SIGNATURE OFFICER'S PHONE UNIT OR DIST DET DATED: PLACE SIGNED
26 � OI BADGE 12105 O#I',WA0171300 APSKELTON 111212025 PAGE F41 OF F
3000-345-013(R 11118)
REPORT NO. EG43886 CASE# ' 25-9475 DATE AND TIME 11/01/25 13:05
OF COLLISION
r
}
� t
e�
3
7
z
rz
�Z
PAGE 5 OF 5