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HomeMy WebLinkAbout25-9849 IT si " II IIIII III IIIII II IIII IIIII I . 27c REPORT NO EG49477OLCERA COLLISION REPORT 1591971 INTERSTATE CITY STREET El CASE# 25-9849 2 STATE ROUTE OTHER LOCALANG 4250 3 C©DINGCOUNTY RD PRIVATE WAY 2 TOTAL#OF OBJECT 1 1 8 28 TRIBAL UNITS 03 STRUCK RESERVATION : 2 3� M M D D Y Y Y Y TIME(2400) COUNTY# MILES CITY# DATE OF N E IN eDL�ISION' 11 - 13 - 2025 0815 17 =.= S 8 W E OF M 1070 a 4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑ LIND AVE SW BLOCK NO. e 1900 .� 4a❑ MILE POST ❑ DISTANCE OF(REFERENCE OR CROSS STREET) 5 MILES 1.1 FEET e S 8 W e SW 19TH ST 0 4 29 MOTOR PEDAL- DAM AG THRESHOLD MET PHONE UNIT 01 VEHICLE ❑ CYCLE ❑ YES ✓NO 0 1 30 6 LAST NAME UNKNOWN FIRST NAME MIDDLE t 1 2 31 INITIAL STREET ❑) CITY', ST ZIP 2 NEW ADDRESS 7 CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3 INTERLOCKYEs NOW] INTERLOCKYEs No�/ YES NOZ 8❑ LCEENSE# SRVERISTTATE SEX U MMDDYY' -=- 1 2 32 9 ON DUTY STATUS' AIRBAG 9 RESTR 9 EJECT 1 HELM USEET 9 CLASSY 0 NATURE OF INJURIES 2 LICENSE, 3 10� PI ATP# STATE V(N TRAILER STATE TRAILER STATE 11 2 5 PLATE# PLATE# ROM To TRLR zRLR 1 3 33 12 2 5 VIN#' VIN# FROM TO VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED By GOVT VEHICLE g 1 34 13� DAMAGE YES�NO� YES❑ NO REGISTERED OWNER INFO VEHICLE NO. 1 SHADE IN DAMAGED AREA 35 14❑ LIABILITY INSURANCE❑ INSURANCE CO DAMAGED- AREA EFFECT &POLICY# vEnicLE CHARGE 5 36 LE,,ALLY YES❑NO❑ CITATION# C;Q 15❑ STM ING 7 5 MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE UNIT VEHICLE CYCLE nWNFR YES'/ NO D:2068506282 16� LAST NAME MATTSON FIRST NAME RYAN MIDDLE' INITIAL 17 F1 STREET ❑ ❑ 6000 NE 2ND CT CITY RENTON ST, WA ZIP 98059 g 37 NEW ADDRESS 18❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 38 INTERLOCKYEs NO INTERLOCK YES NO vEs No 19 DRIVER'S STATE WA SEX M I D.o.a. 08 1975 39 LICENSE# MMDDYY 04 — 20❑ ON DUTY❑ STATUS AIRBAG 6 RESTR 4 EJECT 1 R USEET 2 CLASSY 1 NATURE OF INJURIES 40 21 LICENSE BMF2791 TATe WA VIN# 4T4BF1FK2GR523384 41 22❑ PLATE# STATE PLATE# STATE 42 23 TRLR r RLR 43 UIN#. 'IN# VEH.YEAR ZQ16 MAKE TOYT MODEL CgMRy STYLE SD VEHICLE TOWED TO BLIN TOWED BY GOV HI 44 24 DAMAGE YES �/ No GENE MEYER TOWING REGISTERED OWNER INFO RYAN MATTSON 6000 NE 2ND CT RENTON WA 98059 D:2068506282 VEHICLE NO.2 SHADEd DA GED AREA 4� 4 LIABILITY INSURANCE INSURANCE CO SAFECO H2600888 IN EFFECT &POLICY# 9TOP LY—ve ❑ N,J—I CITATION# CHARGE tO BOTTOM LEGnL YES 25 OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# JAGENCY 26 R.PHILlIPS 11649 WA0171300 PAGE 01 OF PART A 3000-345-189(R 11/18) STATE OF POLICETRAFFICN CORRECTION REPORT NO. EG49477 COLLISION REPORT III III III III III 111 1591972 CASE# 25-9849 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 INJURY NATURE OF INJURIES POS. ' USE GLASS 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 CIASS ----� :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 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. R.PHILL►PS 11-13-25 05:30 PM INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST.DET DATED PLAGE SIGNED APPROVED BY DATE P.KORDEL 9676 1111712025 1:15:44 PM BADGE OR ID# j 11649 ORI# WA0171300 TIME POLICE DISPATCHED 8:17 AM TIME POLICE ARRIVED i 8:26 AM PAST B 3 Do-3mx—attar(t 1Mff) PAGE 2�OF F5 REPORT NO. EG49477 CASE# 25-9849 DATE OF COLLI r�510NN + 11/13/25 08:15 L1 NARRATIVE On 11-13-2025 at 0817 hours I was dispatched to a three vehicle accident at Lind Ave SW and SW 19th St in the city of Renton, King County WA. While enroute to the scene dispatch informed me the at fault vehicle fled the scene. I arrived on scene and observed a Toyota Camry, Unit 2 with front end damage and deployed airbags blocking the right north bound lane. Unit 3, a Dodge Ram was parked facing westbound on SW 19th ST at the traffic light. I made contacted with the driver of unit 2, Ryan Mattson who told me the following: Ryan was northbound on Lind Ave SW approaching the intersection of SW 19th ST. Ryan entered the intersection as a southbound silver vehicle made a left turn in front of him. Ryan could not stop in time and struck unit 1. Unit 1 fled the scene. Ryan stated he had a green light. spoke with the driver of unit 3, Nurufa Seyfiyeva who told me the following: Nurufa was waiting at the traffic light facing westbound on SW 19th ST. She had a red so Unit 2 must have had a green light. A silver smaller SUV, similar to a Kia Soul made a left turn in front of unit 2 causing the collision. After the collision, unit 1 fled the scene. Unit 1 should have passenger side damage. Unit 2 sustained heavy front end damage and multiple airbags were deployed. Unit 3 sustained a dented front drivers side bumper. Unit 2 had to be towed from the scene. The driver's of unit 2 and 3 were given the case number. I conducted an area check for the suspect but was not able to locate them. I certify (declare) under penalty of perjury under the laws of the State of Washington that the foregoing is true and correct. This report was electronically signed by Officer R. PHILLIPS #11649, November 13th, 2025 Renton, WA. PAGE 3 OF 5 SUPPLEMENTAL REPORT NO. EG49477 POLICE TRAFFIC 1 1 8 27 µ ^'� COLLISION REPORT CASE# 25-9849 t113197 1 COMMERCIAL MOTOR CARRIER INTERSTATE INTRASTATE UNIT# USDOT ICC# VEHICLE TYPE CARGO BODY 3 TYPE 2 ❑ 1 28 CARRIER NAME 3 CARRIER L ADDRESS CITY ST ZIP 4 ❑ NAME # PLACARD GWVR NAME IF NO NUMBER SOURCE AXLES 'F 4a ❑ ADDITIONAL UNITS MOTOR PEDAL- PROPERTY DAMAGETHRESHOLD MET PHONE UNIT# 3 �✓ PEDESTRIAN :. ❑', YES NO 5 VEHICLE CYCLE OWNER ✓ D:5125544401 0 8 29 FIRST NAME MIDDLE LAST NAME SEYF/YEVA NURUFA INITIAL STREET 01 30 NEW ADDRFs 4224 S 148TH ST CITY TUKWILA ST WA ZiP 98168 6 ❑ 1 1 2 31 CDL IGNITION REQUIRED 1{iNiTION :: PRESENT MECiICALTANSPORTED'. INTERLOCK YES NO�/ INTERLOCK YES -Z L DRIVER'S LICENSE WA SEX MMDD F D.O,B 04 14 - 1982' : Y 7 ON DUTY STATUS AIRBAG 2 RESTR. 4 EJECT g HELMET 2 INJURY 1 REOFINJURIES USE CLASS NATU 8 ❑ 1 32 LICENSE C75373L TAT WA VIN 1C6RR7PM2HS857104 PLATE# 9 TRAILER I I TRAILER L PLATE# STATE PLATE# STATE 0 10 ❑ TRLR TRLR VIN.# VIN#. 11 2 5 VEH.YEAR2017 MAKE DODG MODELRAM I STYLE TR VEHICLE TOWE E T ABLIN TOWED BY GovT vEHICI F FROM To DAMAGE YES NO ✓ YES NO ✓ NURUFA SEYFIYEVA 4224 S 148TH ST TUKWILA WA 98168 D:5125544401 9 9 33 REGISTERED OWNER INFO. SHADE IN DAMAGED AREA 12 4 FROM TO INSURANCE CO LIABILITY INSURANCE SAFECO H2593448 IN EFFECT ✓ &POLICY# E�,;0if,6:w - 5 m34 13 vewc�e YES NO[JI CITATION# CHARGE ecauv s-rnNoiNc ✓ (� 7 C+. MOTOR PEDAL_ ' 1:1PROPERTY : DAMAGE THRESHOLD MET PHONE 35 14 ❑ UNIT# VEHICLE CYCLE PEDESTRIAN OWNER YES NO 36 15 LAST NAME FIRST NAME NIT AL 16 ❑ STREETF�j CITY ST ZIP NFW ADDRESS" CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TANSPORTED. INTERLOCK YES NO INTERLOCK YES No 'YES NO ❑ 17 4 37 LIRIVER'SICENSE# STATE SEX M oo B L - C-----� 18 ❑ HELMET 'INJURY NATURE OF INJURIES 38 ON DUTY STATUS AIRBAG RESTR. EJECT USE CLASS.: 19 ❑ LICENSE TAT VJN# 39 PLATE# 20 TRAILER TRAILER 40 PLATE# STATE PLATE# STATE ❑ 21 ❑ ❑ 41 TRLR TRLR VIN# VIN#: 42 22 VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED DUET ABLIN TOWED BY GOVT.VEHICLE DAMAGE YES NO YES NO 23 REGISTERED OWNER INFO. SHADE IN DAMAC ED AREA 43 2 3 4 LIABILITY INSURANCE INSURANCE CO IN EFFECT I &POLICY# 7c;Q y. 44 vewc�e ❑ ❑ CITATION# CHARGE 24 I..TF" YES NO STIWDING 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. R.PHILLIPS 11-13-25 05:30 PM 25 INVESTIGATING OFFICER'S SIGNATURE OFFICER'S PHONE UNIT OR DIST DET DATED: PLACE SIGNED 26 OR Ib# 11649 O#RI WA0171300 APPROVED BY 11/17/202 PAGE OF � 3000-345-013(R 11/18) REPORT NO. EG49477 CASE# 25-9849 DATE AND TIME 11/13/25 08:15 OF COLLISION AR a i 1 \12 �4 a� �' 4 4l 4°Y t iL 8 e d rr. t ^t PAGE 5 OF 5