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HomeMy WebLinkAbout25-9945 iiTFiNII IIIII III IIIII II IIII IIIII I . 27c REPORT NO EG51205oc� RA COLLISION REPORT 1591971 INTERSTATE CITY STREET FIRE ❑ CASE# 25-9945 2 RESULTED 1 STOLEN STATE ROUTE ❑ OTHER ❑ VEHICLE LOt`CO A`GENC'Y 4100 3 COUNTY RD INVOLVED CODING PRIVATE WAY 2❑ TRIBAL UNITS#OF 01 TRUCK STREET LIGHT POLE BJECT 1 28 RESERVATION 2 3� M M D D Y Y Y Y TIME(2400) COUNTY# MILES CITY# DATE OF'. N E coulsfoN' 11 - 15 - 2025 2220 17 =.= S 8 W E IN OF M 1070 a 4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION BLOCK NO. MALE VALLEY HWY 4a❑ MILE POST ❑ DISTANCE OF(REFERENCE OR CROSS STREET) 5 1000 FEET S 8 W e SE 5TH ST 2 3 29 MOTtlR PEDAL- DAM AG THRESHOLD MET PHONE UNIT 01 VEHICLE CYCLE' YES ✓NO D:2062801474 30 5 LAST NAME LAURIELLO FIRST NAME JENNIFER MIDDLE P 1 1 2 31 INITIAL STREET 3409 SE 7TH ST CITY RENTON ST WA ZIP 98058 2 NEW ADDRESS 7 CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3 INTERLOCK YES NOT/ INTERLOC YES D NO,/ 8❑ LICIENS# STATE WA SEX F Dmo,"Yy F 05 - 09 - 1976 32 9 ON DUTY STATUS AIRBAG 6 RESTR 4 EJECT 1 N USEET 2 1 INJURY CLASS 1 NAruRE of INJURIES 2 10❑ LI ENSE ti� BPP7836 STATE WA VN# 2T1BURHEXGC582156 3 TRAILER STATE TRAILER STATE 11 4 5 PLATE# PLATE# FROM To TRLR TRLR 7 3 33 1 2 VIN# VIN# '.....: FROM TO VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN 7 Y GOVT VEHICLE m 34 13 4 2016 TOYT COROL SD DAMAGE YES ✓ No � 9 MEYER TOWING vEs� No REGISTERED OWNER INFO JENNIFER LAURIELLO 3409 SE 7TH ST RENTON WA 98058 D:20 6 2 8 014 74 VEHICLE NO. 1 ❑ SHADE IN DAMAGED AREA 35 14❑ LIABILITY INSURANCE NSURANCE CO USAA 05071-49-2TR IN EFFECT &POLICY# 9TOP CHARGE 36 VEHICLE Lemur yes❑NO❑ CITATION# 7 o BOTTOM 15❑ sTANowc �y MOTOR PEDAL-:. PROPERTY DAM THR OLD MET PHONE UNIT©2 PEDESTRIAN VEHICLE CYCLE' OWNER YES NO 16❑ LAST NAME FIRST NAME MIDDLE' INITIAL 17❑ STREET CITY ST ZIP 4❑ 37 NEW ADDRESS 1$❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED ❑ 38 INTERLOCKYEs No INTERLOCK YES0-001 Es NOi 19 LICIENSE# STATE SEY MMDDYY' 39 HELMET INJURY' NATURE OF INJURIES 40 20❑ ON DUTY STATUS' AIRBAG RESTR EJECT USE CLASSLICENSE ❑ 21 PLATE# TATE VIN# 41 22❑ [TILER AILER PLATE# STATE PATE# STATE ❑ 42 43 23 TRLR UIN#. ''NIN#. VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOV HI 44 24 DAMAGE YES NO YES NO REGISTERED OWNER INFO VEHICLE NO.2 SHADE IN DAMAGED AREA 2 3 4 LIABILITY INSURANCE❑ INSURANCE CO IN EFFECT &POLICY# 9TOP VEHICLE ❑ ,.I—I CITATION# CHARGE tO BOTTOM LEEAILY YES N`LJ 25 a a OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY 26 KEVIN PETERSON 12808 WA0171300 PAGE 01 OF PART A 3000-345-159(R 11/18) POLIICFETRAFFICN CORRECTION REPORT NO. EG51205 COLLISION REPORT III III III III III 111 1591972 CASE# 25-9945 ADDITIONAL PERSONS INVOLVED(PASSENGERS AND/OR WITNESSES ONLY) NAME MIDDLE INITIAL} LANGAMAN CESCEANIG (LAST,FIRST, ADDRESS&PHONE# 1652 N 201ST ST SHORELINE WA 98133 SEX' F MMDDYYYv O6 - 08 - 1968 SEAT HELMET INJURY NATURE OF INJURIES PASSENGER WITNESSEl I UNIT 1 POS 3 AIRBAG±6 RESTR. 4 EJECT 1 USE 2 CLASS 16 SCRATCHED KNEES AND KNEE PAIN 'NAME LAsr F RST,MIDDLE INITIAL) MIFFITT STAR A ADDRESS&PHONE# 3409 SE 7TH ST RENTON WA 98058 SEX' MMDDYYYY F D.O.B. _F_[---------� SEAT HELMET INJURY NATURE OF INJURIES PASSENGER WITNESS UNIT# 1 SOS. 9 AIRBAG 6 RESTR. 4 EJECT 1 USE 2 CLASS 1 ----� '.NAME (LAST,FIRST,MIDDLE INITIAL) ADDRESS&PHONE# SEX' D.O.B.M _F L----------� MDDYYYY PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET INJURY NATURE OF INJURIES ❑ Q POS. USE CLASS �____ ----j NARRATIVE I was dispatched to a vehicle roll over on 11/15/25 at Maple Valley HWY just East of Classic Sports Bar, in city Renton, King County WA. Unit 1 BPP7836 Driver: Jennifer P. Lauriello (DOB 05/09/1976) Upon arriving I could see a vehicle rolled over into the ditch on West bond lanes. I could see all 3 personals out of the car. 1 then spoke to the driver and passenger who reported no injuries outside of the front passenger having scraps on her knees and some pain. The driver told me that she was driving into the curve, and she started to lose control spinning her into a complete 360 before hitting the curb and rolling the vehicle into the ditch. She said that they all were able to climb out of the car safely. Renton Fire came to the scene and evaluated all personal that were in the vehicle. No major injuries reported besides the passenger knee pain and scratches. The light poll #1964D was slightly hit by the rolling over vehicle and a Origami was completed for the damage to the poll. 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: 11/16/2025, 0214 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 11-16-25 02:57 AM INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST.DET DATED PLACE SIGNED APPROVED BY DATE M.BRAUN 2194 11/22/2025 1:26:51 AM BADGE OR ID# 12808 OR# ( WA0171300 TIME POLICE DISPATCHED'; 10:21 PM TIME POLICE ARRIVED 10:23 PM PART B 3aaa-345-,aR(R11r1s) PAGE 27OF 37 REPORT NO. EG51205 CASE# 25-9945 DATE AND TIME 11/15/25 22:20 OF COLLISION 2' 1 l rti'i i a 0. 5, a Y y i 1 l i I IJ�V 7 flri YI j r 4� is t fl i y � 2 1},�4 , r 1 it PAGE 3 OF 3