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Home My WebLink About25-9158 )STATE TFcN 6 0 27i t Oc� RA EG44820 COLLISION REPRT 1591971 CASE# 25-9158 2 INTERSTATE CITY STREET FIRE ❑ RESULTED 1 STOLEN STATE ROUTE ❑ OTHER ❑ VEHICLE ❑ LOCCO A`OENC'Y 4100 3 COUNTY RD INVOLVED 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 - 22 - 2025 1614 17 =.= S 8 W E IN OF M 1070 a 4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION �✓ NON INTERSECTION ❑ BLOCK NO. e .� 4a LIND AVE SW MILE POST ❑ ❑ DISTANCE OF(REFERENCE OR CROSS STREET) 5 �. FEET S 8 W e SW 12TH ST 0 4 29 MOTtlR PEDAL- DAM AG THRESHOLD MET PHONE UNIT 01 VEHICLE ❑ CYCLE' ❑ YES ✓NO D:2062678443 0 1 30 5 LAST NAME BOLONG FIRST NAME NATHAN MIDDLE A 1 1 2 31 INITIAL STREET ❑ 1148 NE MULTNOMAH DR CITY FAIRVIEW ST OR ZIP 97024 2 NEW ADDRESS 7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED' 3 INTERLOCKYEs Na INTERLOCK YE! No YES NO 8 DRIVERS STATE OR SEX'M MDOB. 12 - 23 - 1994 1 2 32 9 ON DUTY STATUS AIRBAG 6 RESTR 4 EJECT 1 HELM USEET CLASS 1 NAruRE of INJURIES 2 10 LI ENSE ti� 877QMV STATE OR ylN 1GCPTBEK8S1180465 3 TRAILER STATE TRAILER ,STATE 11 3 5 PLATE# PLATE# FROM TO TRLR TRLR 3 5 33 12 3 5 VIN# VN# ( FROM TO VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN T v GO , NO g 1 34 13 4 2025 CHEV COLOR DAMAGE ves ✓ No � �MEYERS ves❑ No REGISTERED OWNER INFO ACUREN INSPECTION INC 8155 SE DEER CREEK LN STE A MILWAUKlEOR97222 VEHICLE NO. 1 ❑ SHADE IN DAMAGED AREA 35 LIABILITY INSURANCE❑ INSURANCE CO 3 4 14 �I ZURICH AMERICAN INSURANCE CO 1 GCPTBEKSSY180465 IN EFFECT &POLICY# 4TOP CHARGE t 5 36 Lemur yes❑NO❑ CITATION# 7 0 80TTOM 15❑ STM ING PEDAL- s 7 e MOTCYR PEDESTRIAN PROPERTY DAM THR OLD MET PHONE UNIT 02 VEHICLE CYCLE' ❑ ❑ nWNFR YES,/ No D:2063530849 16� LAST NAME LE FIRST NAME LAN MIDDLE' T INITIAL 37 ❑ 17 STREET'❑ 14827 42ND AVE S CITY TUKWILA ST, WA ZIP 981684435 NEW ADDRESS 18� CDL IGNITION REQUIRED IGNITION PRESENT MEDICALTRANSPORTED' 38 INTERLOCKYEs No INTERLOCK YES NO Es NO' 19[ DRIVER'S STATE WA SEXI F I D.O.e. 12 22 1967 39 LICENSE# MMIIDYY - HELMET INJURY' NATURE OF INJURIES 40 20❑ ON DUTY STATUS' AIRBAG 6 RESTR 4 EJECT 1 7 ❑ USE CLASS SMALL ABRASIAN TO LEFT SHIN LICENSE I CKU5417 TATE WA YIN# 2T2HZMDA8LC222293 21 PLATE# El 41 22❑ PLATE# STATE PATE# STATE ❑ 42 23 TRLR r RLR 43 UIN#. 'IN#. VEH.YEAR 2020 MAKE LEXS MODEL RJ( STYLE VEHICLE TOWED TO BLIN TOWED BY GOV HI 44 24 DAMAGE vEs�/ No GENE MEYERS ves No�/ REGISTERED OWNER INFO OWNEDBYDRIVER VEHICLE NO,2 SHADE IN DAMAGEJOAREA 2 3 �A LIABILITY INSURANCE INSURANCECO STATE FARM 5038845-F02.478 IN EFFECT &POLICY# 9TOP vewae ❑ ,.I—I CITATION# CHARGE to BOTTOM LE—�Y YES N`L J 25 8 OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY 26 C.ARNOLD 12509 WA0171300 PAGE 01 OF PART A 3000-345-159(R 11/18) POLIICFETRAFFICN CORRECTION REPORT NO. EG44820 COLLISION REPORT III III III III III 111 1591972 CASE# 25-9158 ADDITIONAL PERSONS INVOLVED(PASSENGERS AND/OR WITNESSES ONLY) NAME OWENS SAMUEL L (LAST,FIRST MIDDLE INITIAL} ADDRESS&PHONE# D(� 4604 SW MONROE ST SEATTLE WA 98136 2064728213 SEX' M MMooYYYv 05 - 09 - 1987 PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET INJURY NATURE OF INJURIES �' POS. USE GLASS TU 'NAME (LAST FIRS,MIDDLE INITIAL) ADDRESS&PHONE# S ' D.O EX .B.MMDD -F L----------� YYYY EAT HELMETNJURY URE OF PASSENGER ❑WITNESS UNIT# S AIRBAG RESTR. EJECT NAT INJURIESPOS. : USE CLASS ----� '.NAME (LAST,FIRST,MIDDLE INITIAL) ADDRESS&PHONE# SEX' D.O.B.M -T L----------� MDDYYYY PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET INJURY rNATURE OF INJURIES ❑ Q' POS USE GLASS — ----� 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 10-23-25 03:56 PM INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST.DET DATED PLACE SIGNED APPROVED BY DATE C.JACOBS 1953 11/4/2025 10:54:07 AM BADGE OR ID# 12509 ORI# ( WA0171300 TIME POLICE DISPATCHED'; 4:14 Pry] TIME POLICE ARRIVED 4:17 Pry PART B 3 Do-3mx-,ao(Rtrras) PAGE 27 OF 47 REPORT NO.` EG44820 CASE# 25-9158 O COLLI COLLISION TIME OF 10/22/25 16:14 COLLI NARRATIVE CC 25-9158 On 10/22/2025 at 1614 hours I was dispatched to a motor vehicle collision at SW 12th St and Lind Ave SW in the City of Renton, King County, Washington. Pre-Collision Driver 2 stated that she was traveling North on Lind Ave SW in the #2 lane. Driver 1 stated that he was stopped at a stop sign facing West on SW 12th St at Lind Ave SW preparing to perform a lefthand turn to proceed South on Lind Ave SW. Driver 1 was facing a stop sign on SW 12th St facing West. Collision Driver 2 stated that as she approached the intersection of SW 12th St and Lind Ave SW still within the #2 lane, Unit 1 emerged from stopped traffic and the front passenger side bumper of Unit 1 collided with the rear passenger side wheel and quarter panel of Unit 2, causing Unit 2 to spin out and come to a rest facing South on Lind Ave SW partially blocking the #2 lane and 2 way center turn lane. Driver 1 stated that he did not see Unit 2 approaching and did not have time to react and stop to avoid a collision. Driver 1 stated the front passenger side bumper of Unit 1 collided with the rear passenger side wheel and quarter panel of Unit 2, causing Unit 2 to spin out and come to a rest facing South on Lind Ave SW partially blocking the #2 lane and 2-way center turn lane. Witness 1 stated that he observed a vehicle ahead of Unit 1 cross across the Northbound lanes of Lind Ave SW and Unit 1 followed. Witness 1 stated that he was unable to observe the entire collision but was able to see Unit 2 approaching and Unit 1 cross in front of Unit 2 resulting in a collision. Witness 1 drives a Tesla and stated that he has video footage of the incident. I provided him with an evidence.com link to upload the footage. Injuries Driver 2 sustained a minor abrasion on her left shin. Vehicle Disposition Both vehicles were towed from the scene. Proximate Cause I determined that Driver 1 is the proximate cause of this collision because except when directed to proceed by a duly authorized flagger, or a police officer, or a firefighter vested by law with authority to direct, control, or regulate traffic, every driver of a vehicle approaching a stop sign shall stop except as provided in (b) of this subsection at a clearly marked stop line, but if none, before entering a marked crosswalk on the near side of the intersection or, if none, then at the point nearest the intersecting roadway where the driver has a view of approaching traffic on the intersecting roadway before entering the roadway, and after having stopped shall yield the right-of-way to any vehicle in the intersection or approaching on another roadway so closely as to constitute an immediate hazard during the time when such driver is moving across or within the intersection or junction of roadways. Driver 1 was cited per RCW 46.61.190. 1 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 15:53 on 10/23/2025 in the City of Renton, King County, Washington. PAGE 3 OF 4 REPORT NO. EG44820 CASE# 25-9158 DATE AND TIME i 10/22/25 16:14 OF COLLISION �v �r t t ti t� } �t Y v ft t tf: 3 s rt t� l PAGE 4 OF 4