HomeMy WebLinkAbout25-9280 )STATE
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Oc� RA EG44828
COLLISION REPRT 1591971
INTERSTATE CITY STREET FIRE ❑
CASE# 25-9280 2
RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VEHICLE LOCALA`OENC'Y 4200 3[--�HIT&RUN CODING
DING
COUNTY RD PRIVATE WAY INVOLVED
2❑ TRIBAL UNITS#OF 02 TRUCK TRAFFIC SIGNAL POLE BJECT 1 28
RESERVATION '. + 2
3� M M D D Y Y Y Y TIME(2400) COUNTY# MILES CITY#
DATE OF'. N E
cDLLIsfoN' 10 - 27 - 2025 0343 17 =.= S 8 W e IN OF 8 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION
SE CARR RD BLOCK NO, e 10300 .�
4a❑ MILE POST
❑ DISTANCE OF(REFERENCE OR CROSS STREET)
5 C------�.� FEET e S B W
2 3 29
MOTtlR ✓ PEDAL- DAM AG THRESHOLD MET PHONE
UNIT 01 VEHICLE CYCLE' YES ✓NO D:2063078665 30
5 LAST NAME MONTEMAYOR FIRST NAME JEFFREY MIDDLE D 1 1 2 31
INITIAL
STREET 1908 BEACON WAY SE CITY RENTON ST; WA ZIP 980584603 2
NEW ADDRESS
7 CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
INTERLOCKYES ND INTERLOCKYES N YES R NO
8� LCEENSE#RVER' STATE WA SEX M MMDO
DCSYY' 07 - 09 - 1979 32
9 ON DUTY STATUS AIRBAG 4 RESTR 4 EJECT 1 N USEET INJURY
CLASS 1 NAruRE of INJURIES 2
LICENSE, CJZ5736 STATE WA VIN# 2HGFG128X6H550858 3
10 as ATF tt
TRAILER STATE TRAILER STATE
11 3 5 PLATE# PLATE# ROM To
rRLR TRLR 3 7 33
12 VIN# VIN
'.....: FROM TO
VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BUN 7 v I GOVT VEHICLE m 34
13 4 2006 HOND CIVIC DAMAGE YES ✓ NO� 69Wg MEYERS YES H ✓
REGISTERED OWNER INFO OWNEDBYDR/VER VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
14❑ UABILITYINSURANCE[—%/] INSURANCECO STATE FARM 5572922-D02-478 3 4
IN EFFECT &POLICY# i 4TOP 5
YEs
srgALLNG NO CITATION# 5A0625820 CHARGE SPEED TOO FAST FOR CONDITIONS B o eoTrob 36
15
. PROPERTY ✓
1:1 YAMTHR PHONEPEDAL-: PEDESTRIAN O UNIT 02 VMEOHTIOCRLE CYCLE OWNER
16❑
LAST NAME CITY OF RENTON FIRST NAME MIDDLE'
INITIAL
STREET ❑
17 ' 1
O 055 S GRADY WAY CITY RENTON ST, WA ZIP 98057 37
NEW ADDRESS
18� CDL IGNITION REQUIRED IGNITION PRESENT MEDIGALTRANSPORTED 38
INTERLOCKYES No INTERLOCK YES NO Yes ND
19 LICEENSE# STATE SEX U MM DYY —� E 39
HELMET INJURY'. NATURE OF INJURIES 40
20❑ ON DUTY STATUS' AIRBAG RESTR EJECT USE CLASS ❑
21 1
PLATE# rarE VIN# 41
22❑ [TILER AILER
PLATE# STATE PATE# STATE ❑ 42
23 TRLR kRLR 43
UIN#. 'IN#.
VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN
TOWED BY GOV HI 44
24 DAMAGE YES NO YES NO
REGISTERED OWNER INFO VEHICLE NO.2
SHADE IN DAMAGED AREA
2 3 4
LIABILITY INSURANCE❑ INSURANCE CO
IN EFFECT &POLICY# 9TOP
1-1— ❑ ,.I—I CITATION# CHARGE tO BOTTOM
ALLY YES N`LJ
25 a a
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
26
C.ARNOLD 12509 WA0171300
PART A PAGE 01 OF
3000-345-159(R 11/181
POLIICFETRAFFICN CORRECTION REPORT NO. EG44828
COLLISION REPORT III III III III III 111
1591972 CASE# 25-9280
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.
C.ARNOLD 10-27-25 04:27 AM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST.DET DATED PLACE SIGNED
APPROVED BY DATE
11/4/2025 10:24:19 AM
C.JACOBS 1953
BADGE OR ID# 12509 ORI# ( WA0171300 TIME POLICE DISPATCHED'; 3:47 AM TIME POLICE ARRIVED 3:49 AM
PART B 3 Do-3mx-,ao(Burls) PAGE 27 OF 47
REPORT No.` EG44828 CASE# 25-9280 O COLLI COLLISION TIME
OF 10/27/25 03:43
COLLI
NARRATIVE
CC 25-9280
On 10/27/2025 at 0347 hours I was dispatched to a motor vehicle collision at around the 10300 block
of SE Carr Rd in the City of Renton, King County, Washington.
Pre-Collision
Driver 1 stated that he was traveling West in the #2 lane of SE Carr Rd at around the 10300 block.
Collision
Driver 1 stated that as he was negotiating a curve, he lost control of Unit 1 and began to spin
clockwise. Driver 1 stated that he performed 1 full rotation as he crossed over the center line, across
both Eastbound lanes of travel, and off of the roadway. Driver 1 stated that the front passenger side
bumper of Unit 1 collided with a school zone sign that was on the South side of the roadway.
It should be noted that at this time the roadway was wet and slippery due to rain overnight.
Injuries
None reported
Vehicle Disposition
Unit 1 was rendered inoperable and was towed from the scene.
Proximate Cause
I determined that Driver 1 is the proximate cause of this collision because no person shall drive a
vehicle on a highway at a speed greater than is reasonable and prudent under the conditions and
having regard to the actual and potential hazards then existing. In every event speed shall be so
controlled as may be necessary to avoid colliding with any person, vehicle or other conveyance on or
entering the highway in compliance with legal requirements and the duty of all persons to use due
care.
Driver 1 was cited per RCW 46.61.400.
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 04:14 on 10/27/2025 in the City of Renton, King
County, Washington.
PAGE 3 OF 4
REPORT NO. EG44828 CASE# 25-9280 DATE AND TIME i 10/27/25 03:43
OF COLLISION
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