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HomeMy WebLinkAbout25-9449 iiTFiNII IIIII III IIIII II IIII IIIII I . 27c REPORT NO EG49021oc� RA COLLISION REPORT 1591971 CASE# 25-9449 2 INTERSTATE CITY STREET FIRE ❑ RESULTED 1 STOLEN STATE ROUTE ❑ OTHER ❑ VEHICLE ❑ LOCAL AGENCY 4200 3 COUNTY RD ❑ NVOLVED 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 GDLLISION' 10 - 31 - 2025 1825 17 =.= S 8 W E IN OF M 1070 a 4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION �✓ NON INTERSECTION ❑ 116TH AVE SE BLOCK NO. e 16800 .� 4a❑ MILE POST ❑ DISTANCE OF(REFERENCE OR CROSS STREET) 5 �. FEET S 8 W e SE 168TH ST 2 0 29 MOTtlR ✓ PEDAL- DAM AG THRESHOLD MET PHONE UNIT 01 VEHICLE ❑ CYCLE ❑ YEs Vl No D:4256525536 0 1 30 5 LAST NAME PEARSON FIRST NAME JOHN MIDDLE H 1 1 2 31 INITIAL STREET ❑ 18303 130TH AVE SE CITY RENTON ST WA ZIP 98058 2 NEW ADDRESS 7 CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3 INTERLOCKYES NO✓ INTERLOCKYES NO✓ YES NoF,/ 8 DCIENS STATE WA SEX M MMorYY' 11 1 2 32 9 ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 HELM USEET 2 1 INJURYCLASS 1 NAruRE of INJURIES 2 LICENSE, CSD6646 STATE WA VN# 4A4JN2AS8BE032291 3 10 PI ATF# TRAILER STATE TRAILER ,STATE 11 3 5 PLATE# PLATE# ROM TO TRLR TRLR 5 1 33 1 3 5 VIN# vI. FROM TO 2 VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN T Y GOVT VEHICLE 1 5 34 13 4 2011 MITS ENDEAV UT DAMAGE YES ONo � �MEYER Yes❑ No✓ REGISTERED OWNER INFO OWNEDBYDRIVER VEHICLE NO. 1 ❑ SHADE IN DAMAGED AREA 35 14 LIABILITY INSURANCE❑ NSURANCE CO NONE NONE 3 4 IN EFFECT &POLICY# 4TOP _ srgNOLNG [:]NO[:] 5AO731551 CHARGE OP MOT VEH W/OUT INSURANCE o ooTrob 36 Yes CITATION# 15 rL� MOTOR ✓ PEDAL- PEDESTRIAN PROPERTY DAM NO OLD MET PHONE UNIT VEHICLE ❑ CYCLE' ❑ ❑ nWNFR YEs✓ No D:4254441044 16� LAST NAME HOLMES FIRST NAME THERON MIDDLE D INITIAL STREET ❑ 17 '❑ 11845 SE 188TH ST CITY RENTON ST, yyq ZIP 98058 4 37 NEW ADDRESS 18❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED: 38 INTERLOCKYES No✓ jNTERLOCK YES NO✓ YEs NO',✓ 19 DRIVER'S STATE WA SEX M D D B Y 12 04 1973 39 LICENSE# MD,01 — 20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 H UET 2 CLAY 1 NATURE OF INJURIES 40 21 PATE# AUY2459 rarejI W/a vIN# 3N1AB7AP2EY307995 41 22❑ PLATE# STATE PAAILER TE# STATE ❑ 42 23 TRLR kRLR 43 UIN#. 'IN#. VEH.YEAR 2014 MAKE NI$$ MODEL SENTRA STYLE SD VEHICLE TOWED TO BLIN TOWED BY GOV HI 44 24 DAMAGE YES l/ NO GENE MEYER YES No✓ REGISTERED OWNER INFO OWNEDBYDRIVER VEHICLE NO,2 SHADE IN DAMAGED AREA 2 3 4 LIABILITY INSURANCE INSURANCE CO PROGRESSIVE 71702035 IN EFFECT &POLICY# 9TOP vewaE ❑ CITATION11 CHARGE to BOTTOM EEGnEEv YES N 6 25 OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY 26 JAREN JOKELA 12805 WA0171300 PAGE 01 OF PART A 3000-345-159(R 11/18) POLIICFETRAFFICN CORRECTION REPORT NO. EG49021 COLLISION REPORT III III III III III 111 1591972 CASE# 25-9449 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. JAREN JOKELA 11-01-25 01:15 AM INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST.DET DATED PLACE SIGNED APPROVED BY DATE J.THIELMAN 11462 11/16/2025 12:27:06 AM BADGE OR ID# 12805 ORI# ( WA0171300 TIME POLICE DISPATCHED'; 7:27 Pry TIME POLICE ARRIVED 7:32 Pb1 PART B 3 Do-345-,ao(Rtrras) PAGE 27 OF 57 REPORT NO.` EG49021 CASE# 25-9449 OLI?TIME OF 10/31/25 19:25 COLLISION NARRATIVE Renton Case #25-9449 On 10/31/2025 at 1928 hours I was dispatched to the intersection of 116th Ave SE/SE 168th ST, in the City of Renton, King County, Washington. I was responding to a call of an unknown injury accident. This incident was captured on my body worn video camera. This report is a summation of events that occurred and is not an exact sequence of events. At approximately 1932 hours, I arrived on scene located the two involved vehicles. Both Unit 1 and Unit 2 vehicle were in the middle of the above reference intersection, blocking southbound travel on 116th Ave SE. I identified Unit 1 as a black 2011 Mitsubishi Endeavor (WA LIC #CSD6646) being driven by the registered owner of the vehicle, identified by his WA DOL photo as John H Pearman (DOB 11/09/2004). Unit 1 driver told me he was not injured. I asked Unit 1 driver what happened, he stated that while attempting to turn westbound on SE 168th ST, from 116th Ave SE, he struck Unit 2 vehicle who was driving southbound through the intersection on 116th Ave SE. Unit 1 vehicle stated he though he had a green light giving him the protected westbound turn. Damage was observed to the front bumper of Unit 1 vehicle as a result of the collision. Unit 1 driver advised that he did not have valid vehicle insurance. I identified Unit 2 as a gray 2014 Nissan Sentra (WA LIC #AUY2459) being driven by the registered owner of the vheicle, identified by his WA DL as Theron D Holmes (DOB 12/04/1973). Unit 2 driver told me he was not injured. Unit 2 driver said that as he was traveling southbound on 116th Ave SE, he proceeded through the intersection of SE 168th ST with a green light, when he was struck by Unit 1 vehicle who was attempting a westbound turn onto SE 168th ST. I observed significant damage to the front bumper/left front quarter panel unit 2 vehicle. Unit 2 driver provided me with his WA DL, registration and vehicle insurance. Though neither party complained of injury, Renton Fire was dispatched and evaluated both involved drivers as a precaution. No injuries were noted. Photographs were taken of both vehicles at the scene, along with the sustained vehicle damage to each unit. All photos were later uploaded to Axon Evidence. All observed damage was consistent with the version of events provided both Unit 1 and Unit 2 drivers. I provided each involved unit with a business card, case number and answered their remaining questions. I also informed Unit 1 driver that because he had been operating a motor vehicle without motor vehicle insurance, he would be receiving a citation in the mail. I then confirmed Unit 1 driver's current mailing address and later authored Sector citation #5AO731551. Both Unit 1 and Unit 2 vehicles were removed from the scene by Gene Meyer Towing. PAGE 3 OF 5 REPORT NO.` EG49021 CASE# 25-9449 OLI?TIME OF 10/31/25 19:25 COLLISION NARRATIVE At the time of this report, I was unable to access traffic cameras that may have captured the collision. Furthermore, no independent witness' were located at the scene to provide further clarification as to how the collision occurred. I then cleared the scene. This ends my report. I certify under penalty of perjury under the laws of the State of Washington that the foregoing is true and correct. Electronically signed by Ofc. Jaren Jokela #12805, 11/01/2025 at 0114hours in Renton, Washington. PAGE 4 OF 5 REPORT NO. EG49021 CASE# 25-9449 DATE AND TIME i 10/31/25 19:25 OF COLLISION �l �i v \vv v r � � c c r v � �t P V l � � r PAGE 5 OF 5