HomeMy WebLinkAbout25-9496 IT si " II IIIII III IIIII II IIII IIIII I . 27c REPORT NO EG45852OLCERA
COLLISION REPORT 1591971
CASE# 25-9496 2
INTERSTATE CITY STREET FIRE ❑RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VEHICLE ❑ LOCAL A`GENC'Y 4100 3
COUNTY RD INVOLVED CODING
PRIVATE WAY TOTAL 1
2❑ TRIBAL 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' 11 - 02 - 2025 1228 17 =.= S 8 W e IN OF M 1070 a
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION
AIRPORT WAY BLOCK NO. e 250 .�
4a❑ MILE POST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ 100 00 FEET e✓ S 8 W e SHATTUCK AVE S
OF11
29
MOTtlR PEDAL- DAMAG THRESHOLD MET PHON
UNIT 01 E
VEHICLE ❑ CYCLE ❑ YES No �/ D:2063075723 0 7 30
5 LAST NAME DECHEVSKA FIRST NAME MAYA MIDDLE T 1 2 31
INITIAL
STREET ❑ 155 164TH AVE SE CITY BELLEVUE ST I WA Zip 98008 2
NEW ADDRESS
7 CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
INTERLOCKYEs NO Z/ INTERLOCKYEs NO�/ YES D NoZ
8 DRIVECEN
STATE WA SEx F MMor YY' 05 - 12 - 1970 1 2 32
9� ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 N USEET 2 1 INJURY
CLASS 1 NAruRE of INJURIES 2
10 1❑ LI ENSE'ti�, BZP4460 STATE WA VN# JTHKD5BH4C2070203 3
TRAILER STATE TRAILER ,STATE
11 3 5 PLATE# PLATE# FROM TO
TRLR TRLR 3 7 33
1 3 5 VIN# vI.
( FROM TO
2
VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED By GOVT VEHICLE 34
13 2 2012 LEXS CT P4 D 3 9 AMAGE YES NO YES NO
REGISTERED OWNER INFO MAYA DECHEVSKA 155164TH AVE SE BELLEVUE WA 98008 D:2063075723 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
LIABILITY INSURANCE❑ INSURANCE CO 2 3 4
14 AMERICAN FAMILY BX11533289
IN EFFECT &POLICY# 4TOP
5 VEHICLE
CHARGE 36
Lemur YES❑NO❑ CITATION# 7 o BOTTOM
15❑ ANowc B e
III MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT VEHICLE CYCLE: nWNFR YES NO �/ D:2063969994
16�
LAST NAME MATHEWS FIRST NAME COURTNEY MIDDLEI M
INITIAL
STREET ❑
17 ' 1❑ 0524 14TH AVE S BSMT CITY SEATTLE ST, WA ZIP 98168 4 37
NEW ADDRESS
1g❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDIGALTRANSPORTED 38
INTERLOCKYEs ND INTERLOCK Yrs NO✓ YEs NO
19 DRIVER'S STATE WA SEX.F I D.O.B. 08 30 1997 39
LICENSE# MMDDYY —
20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 HELMET 7 2 INJURY NATURE A INJURIES 40
USE CLASS BACK PAIN
21 LICENSLATE E CAB5624 rarE WA vIN# 3CZRU6H39KM731923 41
22❑ [TILER AILER
PLATE# STATE PATE# STATE ❑ 42
23 TRLR kRLR 43
UIN#. 'IN#.
VEH.YEAR 2019 MAKE HOND MODEL HRV STYLE P4 VEHICLE TOWED TO BLIN TOWED BY GOV HI 44
24 DAMAGE YES NO YES NO
REGISTERED OWNER INFO COURTNEYMATHEWS 1052411TH AVE S BSMTSEATTLE WA 18168 D:2063969994 VEHICLE NO.2
SHADE IN DAMAGED AREA
2 3 4
LIABILITY INSURANCE INSURANCE CO PROGRESSIVE 987370841
IN EFFECT &POLICY# t 9TOP
VEHICLE LEGAtLv ❑ NNv
,.III CITATION# CHARGE to BOTTOM
25 YES a 7 a
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
26
RAYMOND WATSON 13127 WA0171300
PAGE 01 OF
PART A 3000-345-159(R 11/18)
POLIICFETRAFFICN CORRECTION REPORT NO. EG45852
COLLISION REPORT III III III III III 111
1591972 CASE# 25-9496
ADDITIONAL PERSONS INVOLVED(PASSENGERS AND/OR WITNESSES ONLY)
NAME MIDDLE IN YODER LILYANNA
(LAST,FIRST ITIAL}
ADDRESS&PHONE# DOB
11603 SE 276TH ST KENT WA 98039 SEX' F MMDDYYYY 06 — 01 1— 1998
SEAT HELMET INJURY NATURE OF INJURIES
PASSENGER WITNESS�'I UNIT 2 POS. 3 AIRBAG 2 RESTR. 4 EJECT 1 USE 2 CLASS 7 BACK PAIN
'NAME
(LAST FIRS,MIDDLE INITIAL)
ADDRESS&PHONE#
SEX' D.O.B. — L----------�
MMDDYYYY
PASSENGER F]WITNESSD UNIT# SEAT AIRBAG RESTR. EJECT HELMET NJURY NATURE OF INJURIES
POS. : USE CLASS ----�
'.NAME
(LAST,FIRST,MIDDLE INITIAL)
ADDRESS&PHONE#
SEX' D.O.B.M —
MDDYYYY
PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET INJURY rNATURE OF INJURIES
❑ Q' POS. GLASS — ----�
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.
RAYMOND WATSON 11-06-25 02:29 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
J.TRADER 4553 11/6/2025 3:46:11 PM
BADGE OR ID# 13127 ORI# WA0171300 TIME POLICE DISPATCHED'; 12:29 PM TIME POLICE ARRIVED 12:32 PM
PART B 3 Do-3mx-,ao(Rtrras) PAGE 27 OF 47
REPORT NO.` EG45852 CASE# 25-9496 O COLLI COLLISION TIME
OF 11/02/25 12:28
COLLI
NARRATIVE
25-9496
This report is a summary of events that occurred and is not an exact sequencing of events.
Statements have been paraphrased and summarized.
On 11/02/2025 at approximately 1229 hours, myself, Officer R. Watson, was dispatched to a blocking
accident with injuries, at the intersection of Airport Way and Shattuck AVE S, within the City Limits of
Renton, County of King, State of Washington.
Dispatch notes stated that there were two vehicles involved, blocking, and that there were complaints
of lower back pain.
When I arrived on scene, I saw two vehicles stopped in the number 2 lane of Airport Way.
Unit#1 driven by Maya T. Dechevska (DOB 05/12/1970) verified by WA DOL photo, stated she was
driving a Gray 2012 Lexus CT, WA plate #BZP4460. There were no other occupants in the vehicle.
Maya said she was traveling west bound on Airport Way when she looked down at something and
then looked up again and unit#2 was stopped in front of her. Maya said she had no injuries and
declined aid. When I asked for Maya's license, registration and insurance she was able to provide all
documentation. Unit#1 had slight damage to the front of the bumper, no airbag deployment and she
was able to drive the vehicle from the scene.
Unit#2 driven by Courtney M. Mathews (DOB 08/30/1997) verified by WA DOL photo, stated she was
driving a Black 2019 Honda HRV, WA plate #CAB5624. There as a second occupant in the vehicle in
the front right seat, Lilyann A. Yoder (DOB 06/01/1998). Courtney said she was stopped in traffic that
was back up for the light at the intersection of Rainier AVE S when unit#1 collided with the rear of her
vehicle. Both Courtney and Lilyann complained of back pain and were seen by Renton Fire
Department but declined further treatment. Unit#2 had slight rear end damage, no airbag deployment
and she was able to drive the vehicle from the scene.
An exchange of information was completed and provided to each party. Pictures were taken of each
vehicle and uploaded to evidence.com.
I certify (or declare) under penalty of perjury under the laws of the State of Washington that the
foregoing is true and correct.
Electronically signed by Officer R. Watson #13127 11/06/2025 1426 hours, Renton, King County,
WA.
PAGE 3 OF 4
REPORT NO. EG45852 CASE# 25-9496 DATE AND TIME i 11/02/25 12:28
OF COLLISION
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