HomeMy WebLinkAbout25-9376 IT si " II IIIII III IIIII II IIII IIIII I . 27c REPORT NO EG44860OLCERA
COLLISION REPORT 1591971
ASE# 25-9376 2
INTERSTATE CITY STREET FIRE ❑
RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VEHICLE ❑ LOCAL AGENCY 4200 3
COUNTY RD NVOLVED CONING
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
coLLISION' 10 - 29 - 2025 1019 17 =.= S 8 W e IN OF M 1070 a
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION
BRONSON WAY N MILE POST
e 1500 .�
4a❑ MILE POST
❑ DISTANCE OF(REFERENCE OR CROSS STREET)
5 C------�.� FEET e S B W
0 3 29
MOTtlR PEDAL- DAMAG THRESHOLD MET PHON
UNIT 01 E
VEHICLE ❑ CYCLE ❑ YES No �/ D:3058032701 0 3 30
5 LAST NAME BAHRAMI FIRST NAME SASAN MIDDLE 1 2 31
INITIAL
STREET ❑ 432 BARRYLOOP CITY( MOUNT VERNON ST WA ZIP 982749201 2
NEW ADDRESS
7 CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
INTERLOCKYEs No INTERLOCKYEs No YES[—]No
DRIVER'S II8❑ LICENSE# STATE WA SEX M MMor YY' 09 1 2 32
9 ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 N USEET INJURY
CLASS 1 NAruRE of INJURIES 2
LICENSE, CHG4415 STATE WA VIN# WDBRF92H77F932411 3
10[9� PI ATP rt
11[—j— TRAILER STATE TRAILER ,STATE ROM TO
11 2 5 PLATE# PLATE#
rRLR TRLR 5 3 33
12 2 5 VIN# VIN#
( FROM TO
VEH.YEAR 2007 MAKE MERz MODEL C STYLE VEHICLE TOWED TO BLIN TOWED By GOVT VEHICLE g 3 34
13 3 DAMAGE YES�NO� YES NO
REGISTERED OWNER INFO OWNEDBYDRIVER VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
3 LIABILITY INSURANCE INSURANCE CO 2 3 4
14 GE1C0 6152031313
IN EFFECT &POLICY# 4TQ, ,
VEHICLE CHARGE t 36
mur YES❑NO❑ CITATION# 7 0 80 11
15 sTnNowcs
III MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT 02 VEHICLE CYCLE OWNER YES NO �/ D:2538808272
16�
LAST NAME CORBIN FIRST NAME KYLE MIDDLE I R
INITIAL
17 F1 STREET �/ ❑
2112 120TH ST CT E CITY BONNEY LAKE ST, WA ZIP 98391 37
NEW ADDRESS ':
1g❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICALTRANSPORTED: 38
INTERLOCKYEs No INTERLOCK YES No yEs No
19[ DRIVER'S STATE WA SEY M I E.O.B. 11 24 1989 ❑ 39
LICENSE# MMDDYY —
HELMET INJURY' NATURE OF INJURIES 40
20❑ ON DUTY❑ STATUS' AIRBAG 2 RESTR 4 EJECT 1 USE CLASS 1 ❑
21 LICENSLATE E C54091V TATE WA VIN# 3GCUYDET2LG411775 41
22❑ [TILER TRAILER
PLATE# STATE PATE# STATE ❑ 42
23 TRLR kRLR 43
UIN#. 'IN#.
VEH.YEAR 2Q2Q
24= MAKE CHEV MODEL SILVERA STYLE VEHICLE TOWED TO BLIN
TOWED BY GOV HI 44
DAMAGE YES NO YES NO
REGISTERED OWNER INFO SCOTT DENNIS 14019 ERVINE RD ANACORTES WA 98221 VEHICLE NO.2
SHADEDAMAGEDAREA
3 4
LIABILITY INSURANCE INSURANCECO ALLSTATE 920055149
IN EFFECT &POLICY# 9TOP
veHiaE ❑ ,.I—I CITATION# CHARGE t08OTTOM
LecnLLr YES No
25 a e
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. EG44860
COLLISION REPORT III III III III III 111
1591972 CASE# 25-9376
ADDITIONAL PERSONS INVOLVED(PASSENGERS AND/OR WITNESSES ONLY)
'NAME
(LAST,FIRST MIDDLE INITIAL)
ADDRESS&PHONE#
SEX' D.O.B. - [----------�
MMDDYYYY
PASSENGER WITNESS 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
CC 25-9376
On 10/29/2025 at 1021 hours I was dispatched to a motor vehicle collision at the 1500 block of
Bronson Way N in the City of Renton, King County, Washington.
Pre-Collision
Driver 2 stated that he was driving in the #2 lane of Houser Way N and in the process of turning right
onto Bronson Way N to proceed East in the #3 lane.
Driver 1 stated that he was in the #1 lane of Houser Way N in the process of turning right onto
Bronson Way N to proceed East in the #2 lane.
Collision
Driver 2 stated that during the turn, the front drivers side door and mirror of Unit 1 collided with the
front passenger side bumper of Unit 2.
Driver 1 stated that during the turn, the front drivers side door and mirror of Unit 1 collided with the
front passenger side bumper of Unit 2.
Injuries
None reported
Vehicle Disposition
Both vehicles were operational.
Proximate Cause
I am unable to determine proximate cause at this time as neither driver is sure as to whether the other
encroached into the others lane.
I 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 11:07 on 10/29/2025 in the City of Renton, King
County, Washington.
I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT.
C.ARNOLD 10-29-25 02:34 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST.DET DATED PLACE SIGNED
APPROVED BY DATE
11/4/2025 11:58:09 AM
C.JACOBS 1953
BADGE OR ID# 12509 ORI# ( WA0171300 TIME POLICE DISPATCHED'; 10:21 AM TIME POLICE ARRIVED 10:29 AM
PART B 3aaa-345-,aa(R11Y1s) PAGE 27OF 37
REPORT NO. EG44860 CASE# 25-9376 DATE AND TIME 10/29/25 10:19
OF COLLISION
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