HomeMy WebLinkAbout25-9256 IT si " II IIIII III IIIII II IIII IIIII I . 27c REPORT NO EG45707OLCERA
COLLISION REPORT 1591971
CASE# 25-9256 2
INTERSTATE CITY STREET FIRE ❑
RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VEHICLE ❑ LOCAL ANG 4200 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 - 26 - 2025 0848 17 =.= S 8 W e IN OF M 1070 a
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION �✓ NON INTERSECTION ❑
NE 3RD ST BLOCK NO. e 300 .�
4a❑ MILE POST
❑ DISTANCE OF(REFERENCE OR CROSS STREET)
5 �. FEET e S 8 W e SUNSET BLVD N
2 0 29
MOTtlR PEDAL- DAMAG THRESHOLD MET PHON
UNIT 01 E
VEHICLE ❑ CYCLE ❑ YES No �/ D:2068546267 0 4 30
5❑ LAST NAME MAR-DEYOE FIRST NAME LINDSAY MIDDLE M 1 2 31
INITIAL
STREET ❑ 4916 NE 7TH ST CITY RENTON ST I WA Zip 980594677 2
NEW ADDRESS
7 CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED' 3
INTERLOCKYEs ND INTERLOCKYEs NO YES[—]NO
8 DRIVECEN # STATE WA SEX F MMor YY' 01 — 16 — 1979 1 2 32
9 ON DUTY STATUS AIRBAG 2 RESTR 9 EJECT 1 HELM
USEET INJURY CLASS 1 NAruRE of INJURIES 2
LICENSE, CSX1507 STATE WA VN# KNDNC5KA6S6034833 3
10 PI ATF#
TRAILER STATE TRAILER ,STATE
11 0 0 PLATE# PLATE# FROM TO
TRLR TRLR 3 7 33
1 0
( FROM TO
2 0 VIN# VIN#
VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWEDBY GOVT VEHICLE 3 5 34
13 4 2025 KIA CARNIV $V DAMAGE YES DNO YES❑ NO
REGISTERED OWNER INFO JOSHUA DE YOE 4916 NE 7TH ST RENTON WA 98059 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
LIABILITY INSURANCE❑ INSURANCE CO 3 4
14 FIRST NATIONAL INSURANCE H2389562
IN EFFECT &POLICY# 4TOP
VEHICLE CHARGE 5 36
LEcgLL. YES❑NO❑ CITATION# 7 o BOTTOM
15❑ sTnNowc B 7 e
rL� MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT VEHICLE ❑ CYCLE' ❑ ❑ nWNFR YEs�/ NO D:2532054910
16�
LAST NAME AQUIINO ISABEL FIRST NAME ANTONIA MIDDLE'
INITIAL
STREET ❑
17 ❑ 12403 169TH AVE SE CITY RENTON ST, WA ZIP 98057 37
NEW ADDRESS
18❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDIGALTRANSPORTED^ 38
INTERLOCKYES No INTERLO XYEs 0No Yes NDi
19 DRIVER'S STATE JAL SEXI F I D•013- 04 10 1980 39
LICENSE# MMDOYY —
HELMET INJURY NATURE OF INJURIES 4Q
20❑ ON DUTY❑ STATUS' AIRBAG 2 RESTR g EJECT 1 USE CLASS 1 ❑
21 ILICENSE PLATE# BVX0840 TATE WA VIN It 41
22❑ [TILER AILER
PLATE# STATE PATE# STATE ❑ 42
23 TRLR kRLR 43
UIN#. 'IN#.
VEH.YEAR 2013 MAKE $Ugq MODEL OUTBAC STYLE p4 VEHICLE TOWED TO BLIN
TOWED BY GOV HI 44
24 DAMAGE YES NO YES NO
REGISTERED OWNER INFO ANTONIA AQUIINO ISABEL 12403169TH AVE SE RENTON WA 98057 D:2532054910 VEHICLE NO.2
SHADE IN DAMAGED AREA
2 3 4
LIABILITY INSURANCE❑ INSURANCE CO ALLSTATE UNKNOWN
IN EFFECT &POLICY# IU�o
`Hine ❑ ,.I—I CITATION11 CHARGE
LecnLLY YES N J
25 OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
26
SULIASI TAMAIVENA 12788 WA0171300
PAGE 01 OF
PART A 3000-345-159(R 11/18)
POLIICFETRAFFICN CORRECTION REPORT NO. EG45707
COLLISION REPORT III III III III III 111
1591972 CASE# 25-9256
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.
SULIASI TAMAIVENA 10-26-25 01:11 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST.DET DATED PLACE SIGNED
APPROVED BY E
DAT
S.WOODWARD 11528 11/6/2025 9:42:55 AM
BADGE OR ID# 12788 ORI# ( WA0171300 TIME POLICE DISPATCHED'; 8:52 AM TIME POLICE ARRIVED 9:02 AM
PART B 3 Do-345-,ao(Rtrras) PAGE 27 OF 47
REPORT No.` EG45707 CASE# 25-9256 O COLLI COLLISION TIME
OF 10/26/25 08:48
COLLI
NARRATIVE
On 10/26/2025, at approximately 0848 hours, I was dispatched to an accident at NE 3RD
ST/SUNSET BLVD N, in the City of Renton, while I was employed as a uniformed Patrol Officer for
the City of Renton, County of King, State of Washington.
I spoke with the Driver of Unit#1, and she advised that she was in lane #3 (lane #1 being the closest
to the sidewalk) on NE 3rd ST, traveling westbound, attempting to cross the intersection to the other
side. She advised that she knew she was in the left-turn lane, but believed she had enough room to
get into lane #2, which is also a left-turn lane, or could choose to drive straight to access the other
side of the street. Well, as she made the right turn to enter lane #2 in the middle of the intersection,
her vehicle collided with Unit Vs.
Unit 1's vehicle had minor damage to its front right bumper. The vehicle was still drivable. She and
her son were okay and claimed no injuries. The driver of the vehicle admitted that she was at fault for
failing to turn left and attempt to enter another lane in the middle of a busy intersection.
spoke with the driver of Unit#2, who advised that she was in lane #3, trying to make a left onto
Sunset Boulevard North. While making a turn in the middle of the intersection, she stated that the Unit
#1 vehicle collided with hers. She had no other explanation of what happened, but stated Unit#1 hit
her. The vehicle is still drivable but has minor damage to the left side of the bumper, the driver's, and
the passenger's door. The driver claimed she and her family were not hurt and declined to be
medically evaluated.
Photos were taken at the scene and uploaded as evidence.
This concludes my involvement.
My Axon camera was on for this call.
I certify (declare) under penalty of perjury under the laws of the State of Washington that the
foregoing is true and correct. This report was electronically signed by Officer S. Tamaivena #12788,
October 26, 2025, at 1309, Renton, WA.
PAGE 3 OF 4
REPORT NO. EG45707 CASE# 25-9256 DATE AND TIME i 10/26/25 08:48
OF COLLISION
s
i
��4d yUs
�A
a
r 4
t
by
Y
�Ys z
C 1 �
q9
1�
YC
Y�
1.As t
s�
t
t
3
4
4.
d u t
PAGE 4 OF 4