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HomeMy WebLinkAbout25-9561 iiTFiNII IIIII III IIIII II IIII IIIII I . 27c REPORT NO EG48309oc� RA COLLISION REPORT 1591971 CASE# 25-9561 2 INTERSTATE CITY STREET FIRE I RESULTED STOLENSTATE ROUTE OTHER VEHICLE LOCAI-AGENCY 4100 3 HIT&RUN CODING COUNTY RD PRIVATE WAY INVOLVED 2 TOTAL#OF OBJECT 1 s 28 TRIBAL UNITS 02 STRUCK RESERVATION : 1 1 2 3� M M D D Y Y Y Y TIME(2400) COUNTY# MILES CITY# DATE OF N E IN eOLLISION' 11 - 03 - 2025 2216 17 =.= S 8 W E OF M 1070 a 4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑ BLOCK NO. LOGAN AVE N 4a❑ MILE POST ❑ DISTANCE OF(REFERENCE OR CROSS STREET) 5 MILES 1.1 FEET e S 8 W e N 3RD ST 0 4 29 MOTOR ✓ PEDAL- DAM AG THRESHOLD MET PHONE UNIT 01 VEHICLE ❑ CYCLE ❑ YES ✓NO D:2069991080 0 1 30 6 LAST NAME STERNIK FIRST NAME ELIZABETH MIDDLE M 1 2 31 INITIAL STREET ] 11835 MILITARY RD S NEW ADDRESS CITY I SEATTLE ST: WA ZIP 981681231 2 7 CDL IGN(TIUN REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED. 3 INTERLOCKYES NO✓ INTERLOCKYEs NO✓ YES NO✓ 8❑ DRIVER # STATE WA SEXI F MMDDYY' 11 — 09 — 1957 1 2 32 9 ON DUTY STATUS' AIRBAG 2 RESTR 4 EJECT 1 HELMET 2 INJURY 7 NATURE OF INJURIES 2 USE :CLASS NECK PAIN LICENSE, CKT2661 STATE WA VIN# JTJBJRBZXF2010955 3 10 Fl I as ATP rt STATE STATE TRAILER TRAILER 11 0 0 PLATE# PLATE# FROM To TRLR TRLR 8 3 33 12 3 5 VIN# vIN# FROM TO 13 4 VEH.YEAR2015 MAKE LEXS MODEL NX STYLE UT VEHICLE TOYED NO�iS46LIN T�VyED.6LR$ GES❑END 5 1 34 DAMAGE IIII._IIII HHttVVii((tt REGISTERED OWNER INFO ELIZABETH STERNIK 11835 MILITARY RD SEATTLE 98168123t D:206999f080 VEHICLE NO. 1 SHADE IN DAMAGED AREA 35 4 LIABILITY INSURANCE INSURANCE CO 14 AMERICAN COMMERCE ACPA-000165719 IN EFFECT &POLICY# 9TOP VEHICLE CHARGE 5 36 Lemur YES[:]NO[:] CITATION# t a 80TFOM 15❑ sTnNowc s 7 e MOTOR ✓ PEDAL- 02 PEDESTRIAN PROPERTY DAM THR OLD MET PHONE UNITVEHICLE CYCLE nWNFR YES NO �/ D:2062678917 16� LAST NAME TEDLA FIRST NAME ADANE MIDDLE' T INITIAL STREET ❑ 37 17 ❑ 8537 S 119TH ST CITY SEATTLE ST, WA ZIP 981784038 4 NEW ADDRESS 18 CDL : IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 38 INTERLOCKYES NO✓ INTERLOCK YES NO✓ YES NO✓ 19 DRIVERS STATE WA SEX M I D.O.B. 02 08 1979 � 39 LICENSE# MMDDYY — 20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 R USE 2 CLASSY 1 NATURE OF INJURIES 40 21 LICENSE C1235C raTE OVA vIN# 5FYH8YU07JC053248 41 22❑ [TILER TAILER PLATE# STATE PLATE# STATE 42 23 TRLR RLR 43 UIN#. 'IN It VEH.YEAR 201$ MAKE NEW MODEL XDE 60 STYLE BU VEHICLE TOWED TO BLIN TOWED BY GOV HI 44 24 DAMAGE YES NO✓ VES NO✓ REGISTERED OWNER INFO ADANE TEDLA 8537 S 119TH ST SEATTLE WA 981784038 D:2062678917 VEHICLE NO.2 SHADFjy DAMAGED AREA 3 4 LIABILITY INSURANCE INSURANCE CO METRO TRANSIT GIVEN TO PERSONAL IN EFFECT &POLICY# 9TOP VEHICLE ❑ ,J—I CITATION11 CHARGE t080TTOM EEEILY YES N 25 e OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY J 26 KEVIN PETERSON 12808 WA0171300 PAGE 01 OF PART A 3000-345-189(R 11/18) STATE OF POLICETRAFFICN CORRECTION REPORT NO. EG48309 COLLISION REPORT III III III III III 111 1591972 CASE# 25-9561 ADDITIONAL PERSONS INVOLVED(PASSENGERS AND/OR WITNESSES ONLY) '.NAME (LAST,FIRST,MIDDLE INITIAL) ADDRESS&PHONE# SEXi D.O.B. — MMDDYYYY PASSENGERQ WITNESS UNIT# SEAT AIRBAG RESTR. EJECT ; HELMET NJURY NATURE OF INJURIES POS. ' USE CLASS 1 ----� :NAME (LAST FIRST MIDDLE INITIAL) ADDRESS&PHONE# SEX D.O.B. — MMDDYYYY PASSENGER❑WITNESS UNIT# : SEAT AIRBAG RESTR. EJECT HELMET INJURY: NATURECFINJURIES POS. USE CLASS ----� :NAME (LOST,FIRST,MIDDLE INITIAL) ADDRESS&PHONE# SEX MMDDYY D.O.B. YY PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET NJURY NATURE OF INJURIES POS. I USE CLASS NARRATIVE I was dispatched to a vehicle collision unknown injury on 11/03/25 at the intersection of N 3rd St and Logan Ave N, in city Renton, King County WA. Unit 1 CKT2661 Driver: Elizabeth M. Sternik (DOB 11/09/1957) Unit 1 C1235C Driver: Adane T. Tedla (DOB 02/08/1979) Upon arriving on scene, I could see the Metro bus and vehicle in the intersection. I spoke with the driver of Unit 1 who told me that she was going South on Logan Ave N when she went to make a left turn onto N 3rd St. When making the turn she told me she thought the Metro bus was at a further distance then it was. She said that she saw the Metro bus with its right blinker on. I spoke to the driver of Unit 2, and he told me that he was traveling North in lane 1 on Logan Ave N when approaching the intersection of N 3rd St when he had Unit 1 turn in front of him and he crashed into her. Unit 2 said that he had a green light. Renton Fire came to scene and evaluated all personal. Unit 1 complained of neck pain. I certify (declare) under penalty of perjury under the laws of the State of Washington that the foregoing is true and correct. Electronically signed: Officer Kevin L. Peterson Date and Place: 11/04/2025, 0143 hours at Renton, WA I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT. KEVIN PETERSON 11-04-25 01:43 AM INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST.DET DATED PLACE SIGNED APPROVED BY E DAT M.BRAUN 2194 1111312025 11:49:18 PM BADGE OR ID# 12808 ORI# WA0171300 TIME POLICE DISPATCHED 10:18 PM TIME POLICE ARRIVED 10:21 PM D'ART B a Da-3mx-attar(txIMR) PAGE 2�OF 4 SUPPLEMENTAL REPORT No. EG48309POLICE TRAFFIC 1 27 ... ^'� COLLISION REPORT CASE# 25-9561 t113197 1 COMMERCIAL MOTOR CARRIER INTERSTATE INTRASTATE UNIT# 2 USDOT ICC# VEHICLE TYPE ? CARGO BODY: ? TYPE 2 ❑ 1 28 CARRIER NAME. METRO BUS ..; 3 CARRIER L ADDRESS CITY ST ZIP 4 ❑ NAME # PLACARD NAME IF NO NUMBER SOURCE 3 AXLES 03 GWVR 25000 + 4a ❑ ADDITIONAL UNITS NIT MOTOR PEDAL- PROPERTY DAMAGE THRESHOLD MET PHONE 5 VEHICLE ❑ CYCLE CI PEDESTRIAN OWNER YES NO MIDDLE; 29 LAST NAME FIRST NAME INITIAL STREET 30 CITY ST ZIP NEW ARI3RFfi . 6 ❑ PRESENT MEDICAL TANSPORTED:. 1 31 CDL IGNITION REQUIRED IGNITION INTERLOCK YES NO .;INTERLOCK YES No I YES NCO ©GEESE STATE SEX M oDvB '[- C 2 7 ON DUTY STATUS AIRBAG RESTR. EJECT HELMET INJURY NAruRE of INJURIEs USE CLASS 8 ❑ 1 32 LICENSE TAT UIN. PLATE# 9 TRAILER TRAILER L PLATE# STATE PLATE STATE 0 10 ❑ TRLR TRLR .VIE.# VIN#. 11 VEH.YEAR MAKE MODEL STYLE VEHICLE TOWE E T ABLIN TOWED BY G(,)V VFHICI E FROM TO DAMAGE YES NO YES NO m 33 REGISTERED OWNER INFO.� SHADE IN DAMAGED AREA 12 LIABILITY INSURANCE❑ INSURANCE CO 4 FROM TO IN EFFECT &POLICY# �GQl 34 13 vewc�e YES NO CITATION# CHARGE ecauv sTnNoiNc MOTOR PEDAL- ' 1:1PROPERTY : DAMAGE THRESHOLD MET PHONE 35 14 ❑ UNIT# VEHICLE CYCLE PEDESTRIAN OWNER YES NO 36 15 LAST NAME FIRST NAME NID L 16 ❑ STREET �' CITY ST ZIP NFW ADDRFSa CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TANSPORTED. INTERLOCK YES NO INTERLOCK YES No 'YES NO' ❑ 17 37 LDICENSE RIVER # STATE SEX Moog _ ❑ ❑ HELMET 'INJURY: 18 NATURE OF INJURIES 38 ON DUTY STATUS' AIRBAG RESTR. EJECT USE CLASS. 19 ❑ ❑ 39 LICENSE AT vIN# PLATE# T 20 TRAILER TRAILER 40 PLATE# STATE PLATE# STATE ❑ 21 ❑ TRLR TRLR 41 VIN# VIN#:' 42 22 VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED DUE T ABLIN TOWED BY GOVT.VEHICLE DAMAGE YES NO YES NO El 23 REGISTERED OWNER INFO. SHADE IN DAMAGED AREA 43 2 3 4 LIABILITY INSURANCE INSURANCE CO IN EFFECT I &POLICY# .. ) E 44 24 YES❑ NO CITATION# CHARGE OM S _G 8 3 G 1 CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT. KEVIN PETERSON 11-04-25 01:43 AM 25 INVESTIGATING OFFICER'S SIGNATURE OFFICER'S PHONE UNIT OR DIST DET DATED: PLACE SIGNED 26 BADGE OR ID# 12808 O#RI WA0171300 APPROVED BY 11/13/202 PAGE�OF 3000-345-013(R 11/18) REPORT NO. EG48309 CASE# 25-9561 DATE AND TIME 11/03/25 22:16 OF COLLISION 4� t c ti s t� k 0 1ti ui s t � qq { 4 h Q t tf 4 + �t J' 4 4 v PAGE 4 OF 4