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HomeMy WebLinkAbout25-9634 iiTFiNII IIIII III IIIII II IIII IIIII I . 27c REPORT NO EG50758oc� RA COLLISION REPORT 1591971 CASE# 25-9634 2 INTERSTATE CITY STREET El STATE ROUTE OTHER LOCAI-AGENCY 4250 3 C©DING COUNTY RD PRIVATE WAY 2 TOTAL#OF OBJECT 1 1 7 28 TRIBAL UNITS 02 STRUCK RESERVATION : 2 3� M M D D Y Y Y Y TIME(2400) COUNTY# MILES CITY# eaCL s o v' 11 - 06 - 2025 1321 17 =.= S 8 W e IN OF e 1070 s 4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓ SW 43RD ST BLOCK NO. e 600 .� 4a❑ MILE POST ❑ DISTANCE OF(REFERENCE OR CROSS STREET) 5 75 00 FEET e✓ S 8 W e LIND AVE SW OF 7 29 MOTOR ✓ PEDAL- DAM AG THRESHOLD MET PHONE UNIT 01 VEHICLE ❑ CYCLE ❑ YEs Vl No D:2537376008 0 1 30 5 LAST NAME PETERSON FIRST NAME HEATHER MIDDLE L 1 1 2 31 INITIAL STREET ❑ 35802 55TH AVE S CITY; ROY ST I WA ZIP 1 985809268 2 NEW ADDRESS 7 CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3 INTERLOCK YEs No,/ INTERLOCICvEs Nay/ YES No� 8❑ DRIVER # STATE WA SEXI F MMDDYY' 02 - 08 - 1978 1 2 32 -NJUR 9 ON DUTY STATUS' AIRBAG 2 RESTR 4 EJECT 1 HELMET 2 CLASSY 1 [NATURE of INJURIES 2 LICENSE, C76974W STATE WA V(N#; 1FTFW1E80MFB10496 3 10 Fq I as ATE rt TRAILER STATE TRAILER STATE 11 3 5 PLATE# PLATE# FROM To TRLR zRLR. 9 9 33 12 0 0 VIN#' VIN# FROM TO VEH.YEAR 2021 MAKE FORD MODEL F150 STYLE PK VEHICLE TOWED fj TO ZBLIN TOWED BY GOVT VEHICLE 3 7 34 13 DAMAGE YES II_II NO YESII_I) NO REGISTERED OWNER INFO OWNEDBYDRIVER VEHICLE NO. 1 SHADE IN DAMAGED AREA 35 14❑ LIABILITY INSURANCE NSURANCE CO ALLSTATE 807 712 084 3 4 IN EFFECT &POLICY# 4TOP 11 CHARGE t VEHICLE 5 LEGALLY yes NO❑ CITATION# 36 7 0 80TTOM 15❑ sTANowc s 7 UNIT 02 MOTOR PEDAL- ❑ PEDESTRIAN PROPERTY DAM THR OLD MET PHONE VEHICLE CYCLE nWNRR 16� LAST NAME UNKNOWN FIRST NAME MIDDLE' INITIAL 17❑ STREET ❑ CITY, ROY ST ZIP ❑ 37 NEW ADDRESS 1a❑ CDL IGNITION REQUIRED IGNITION PRESENT MED[CALTRANSPORTED: 38 INTERLOCKvEs No INTERLOCK YES No YEs No 19 DRIVERS # STATE SEX'U MMDDYY' —� 39 HELMET INJURY: NATURE OF INJURIES 40 20❑ ON DUTY STATUS AIRBAG g RESTR g EJECT 1 USE 9 CLASS 0 ❑ 21 PLATE# TATE VIN#LICENSE 41 22❑ [TILER TAILER PLATE# STATE PLATE# STATE 42 23 TRLR RLR 43 UIN#. 'IN# VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOV HI 44 24 DAMAGE YES NO VES NO REGISTERED OWNER INFO UNKNOWN UNKNOWN ROY VEHICLE NO.2 SHADE DAMAGED AREA 3 4 LIABILITY INSURANCE❑ INSURANCE CO UNK UNK IN EFFECT &POLICY# 9TOP VEHICLE ❑ ,J—I CITATION11 CHARGE t080TTOM EEEILY YES N J 25 e OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY J 26 D.NELSON 12421 WA0171300 PAGE 01 OF PART A 3000-345-189(R 11/18) STATE OF POLICETRAFFICN CORRECTION REPORT NO. EG50758 COLLISION REPORT III III III III III 111 1591972 CASE# 25-9634 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 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 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 25-9634 H R RTF On 11/6/2025 1 was working as a uniformed patrol officer and driving a marked patrol vehicle for the City of Renton. I was dispatched to a report of a hit and run collision that had occurred on SW 43rd St just west of Lind Ave SW Renton/King/WA. The reporting party was advising the other vehicle had fled the scene and there was no injury. I arrived on scene and identified the driver of the 2021 Ford F150 WA/C76974W by her WADL as Heather L Peterson DOB: 2/8/1978. Heather said that she was in the #1 lane of westbound SW 43rd St. She said that she was stopped waiting for a pedestrian to cross the sidewalk on the south entrance to the Ikea parking lot. Heather said that while she was stopped, she was hit by another vehicle. Heather said that she did not see the vehicle, the driver, or which way it fled the scene. There was damage to the driver's side rear bumper and taillight. There was white paint transfer in the Ford. The damage to the suspect vehicle would be on the front. No witnesses identified themselves to Heather or called 911 to report that hit and run. Nothing further at this time. I certify under penalty of perjury under the laws of the State of Washington that the foregoing is true and correct. D. Nelson #191 11/6/2025 Renton WA I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT. D.NELSON 11-07-25 04:04 PM INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST.DET DATED PLACE SIGNED APPROVED BY E DAT C.JACOBS 1953 1112012025 3:03:04 PM BADGE OR ID# 12421 ORI# WA0171300 TIME POLICE DISPATCHED 1:27 Pry] TIME POLICE ARRIVED i 1:36 PM PAST B 3 Da-3mx—attar(txIMR) PAGE 2�OF F3 REPORT NO. EG50758 CASE# 25-9634 DATE AND TIME 11/06/25 13:21 OF COLLISION z i� fir} 2 i a �R z Q e Y y 3 g�u�t, { 1 ` PAGE 3 OF 3