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
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