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HomeMy WebLinkAbout25-80208 IT �i " II IIIII III IIIII II IIII IIIII I . 27c REPORT NO EG54338OLCERA COLLISION REPORT 1591971 CASE�# 25-80208 2 INTERSTATE CITY STREET FIRE ❑RESULTED 1 STOLEN STATE ROUTE ❑ OTHER ❑ VEHICLE ❑ LOCAL INN 4250 3 COUNTY RD NVOLVED CODING PRIVATE WAY 2❑ TRIBAL UNITS#OF 02 SO TRUCK 5 1 28 RESERVATION 2 3� M M D D Y Y Y Y TIME(2400) COUNTY# MILES CITY# DATE OF'. N E coulsloN' 11 - 27 - 2025 0001 17 =.�� S W e OF 1070 3 4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION �✓ NON INTERSECTION ❑ RAINIER AVE S BLOCK NO. e 300 .� 4a❑ MILE POST ❑ DISTANCE OF(REFERENCE OR CROSS STREET) 5 C------�. FEET H S 8 W e SOUTH 3RD ST 0 1 29 PEDAL- DAMAG THRESHOLD MET E UNIT 01 VEHICLEMOTtlR PHON ❑ CYCLE ❑ YES NO ✓ 30 6❑ LAST NAME UNKNOWN FIRST NAME MIDDLE 1 2 31 INITIAL STREET ❑ CITY ST ZIP' 2 NEW ADDRESS 7 CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED. 3 INTERLOCKYEs NO INTERLOCKYEs No YES NO LCEENSE# STATE SEX U MMDDYY'. —=— t 32 8❑ VER'S 9 ON DUTY STATUS AIRBAG 9 RESTR 9 EJECT 1 HELM USEET 9 CLASS 0 NATURE OF INJURIES 2 LICENSE, 3 1 O PI ATF# STATE V(N TRAILER STATE TRAILER ,STATE 11 Q 0 PLATE# PLATE# FROM TO TRLR TRLR m 33 12 VIN# VIN# ( FROM TO VER YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN 3 7 TOWED By GOVT VEHICLE 34 13� DAMAGE YES�NO� YES❑ NO REGISTERED OWNER INFO UNKNOWN VEHICLE NO. 1 ❑ SHADE IN DAMAGED AREA 35 14❑ LIABILITY INSURANCE❑ NSURANCE CO 2 3 4 IN EFFECT &POLICY# __4_TO_P_ LEn LE CHARGE t 5 ❑ 36 `Lr YES❑NO❑ CITATION# 10 BOTTOM 15❑ TM ING 1 7 e UNIT©2 MOTOR ❑ PEDAL ❑ PEDESTRIAN ❑✓ PROPERTY DAM THR OLDMET PHONE VEHICLE CYCLE pWNER : YES NO 16� LAST NAME MILLER FIRST NAME DYLAN MIDDLE L INITIAL ❑ 17 F1 STREET' 77 S WASHINGTON ST CITY SEATTLE ST, WA ZIP 98104 g 37 NEW AbbRESS❑ 1$❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED', 38 INTERLOCKYEs No INTERLOCKYES NO vEs NO 19 DRIVER'S STATE WA SEX M I D.O.B. 12 19 1982 39 LICENSE# MMDDYY — 20❑4 HELMET INJURY' NATURE OF INJURIES 3 40 ON DUTY STATUS 3 AIRBAG RESTR EJECT USE 2 CLASS 7 COMPLAINT OF PAIN TO RIGHT ANKLELICENSE I ❑ 21 PLATE# rarE vIN# 4� 41 22❑ [TILER AILER PLATE# STATE PATE# STATE ❑ 42 23 TRLR kRLR 43 UIN#. 'IN#. GOV H 44 VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY I 24 Q 1 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 vemcLE ❑ ,.I—I CITATION# CHARGE i060TTOM ALLY YES N`LJ 25 a a OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY 26 BRYAN GROZAV 12489 WA0171300 PAGE 01 OF PART A 3000-345-159(R 11/18) POLIICFETRAFFICN CORRECTION REPORT NO. EG54338 COLLISION REPORT III III III III III 111 1591972 CASE# 25-80208 ADDITIONAL PERSONS INVOLVED(PASSENGERS AND/OR WITNESSES ONLY) 'NAME (LAST,FIRST MIDDLE INTTIAL) ADDRESS&PHONE# SEX' D.O.B. — [----------� MMDDYYYY PASSENGER F-1 WITNESS Ej UNIT# SEAT AIRBAG RESTR. EJECT HELMET INJURY NATURE OF INJURIES--� POS. USE CLASS 'NAME (LAST FIRS,MIDDLE INITIAL) ADDRESS&PHONE# S ' D.O EX .B.MMDD —F L----------� YYYY EAT HELMETNJURY URE OF PASSENGER ❑WITNESS UNIT# S AIRBAG RESTR. EJECT NAT INJURIESPOS. : USE CLASS ----� '.NAME (LAST,FIRST,MIDDLE INITIAL) ADDRESS&PHONE# SEX D.O.B. — L----------� MMDDYYYY PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET INJURY NATURE OF INJURIES ❑ Q POS. USE CLASS �____ ----j 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. BRYAN GROZAV 11-27-25 02:30 AM INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST.DET DATED PLACE SIGNED APPROVED BY DATE M.BRAUN 2194 1 12/2/2025 12:33:10 AM BADGE OR ID# 12489 ORI# ( WA0171300 TIME POLICE DISPATCHED'; 12:05 AM TIME POLICE ARRIVED 12:05 AM PART B 3 Do-3mx-,ao(Rtrras) PAGE 27 OF 47 REPORT NO.` EG54338 CASE# 25-80208 O COLLI COLLISION TIME OF 11/27/25 00:01 COLLI NARRATIVE CASE 25-80208 This incident was captured on my body worn video camera. This report is a summary of events that occurred and is not an exact sequencing of events. On Wednesday November 27th, 2025, at approximately 00:05, 1 responded to a 911 call regarding a subject yelling at the Safeway gas pumps located at 112 South 3rd St within the City of Renton, King County, Washington. The reporting party requested a welfare check on the subject screaming. 'CALL REMARKS: NOW... RP REQ WELCHK FOR MALE SUBJ YELLING TO HIMSELF NEAR PUMPS....NO WEPS SEEN. I was in the Safeway parking lot when I was dispatched to the call. Upon arriving at the gas pumps, I noticed a male later identified as Dylon L. Miller (DOB: 12.19.1982) who matched the description provided in the call. Dylan was sitting on the ground leaned up against a gas pump but no longer screaming. When I asked Dylon if he was ok, Dylan indicated he was struck by a vehicle and requested aid. Although I did not see an obvious injury on Dylan, he was complaining of severe pain to his right ankle. Dylan's right ankle did not have any signs of trauma or injury. Dylon reported the following; he was crossing Rainier Ave South from the east of the street to the west side of Rainier Ave South. He was headed to the bus stop located on the north side of the street of SW Sunset Blvd. He was fast walking across the street when he suddenly struck by the side of a vehicle knocking him to the ground. He made contact with the front passenger side of the vehicle. The vehicle then ran over his right ankle with its rear tire. The vehicle than stopped at the red light at Rainier Ave South and SW Sunset Blvd which then continued west on SW Sunset Blvd when the light turned green. He was able to hop over to the bus stop to try and have someone call 911 but no one would so he made his way over to the Safeway gas pumps, where he was able to have someone call 911. Dylan initially told me he was in the cross walk while he was crossing the street when he as hit but he also said the vehicle that struck him stopped at the red light at the cross walk he was crossing after hitting him. I tried to ask for clarification, but Dylan was adamite he was in the cross walk. Dylan described the vehicle as a late 1990's or early 2000's gold Lexus sedan driven by an older Asian female. Renton fire arrived and transported Dylan to Valley Medical Center for further treatment. Dylan indicated he did not have a phone and was currently transient but checks his email frequently; integritypro.dylanm@gmail.com. I provided Dylan a business card with the case number. This concludes my involvement in this case. I certify/declare under penalty of perjury under the laws of the State of Washington that the foregoing is true and correct. Electronically signed by B. Grozav#12489 on 11.27.2025 at 02:24 in Renton, WA. PAGE 3 OF 4 REPORT NO. EG54338 CASE# 25-80208 DATE AND TIME i 11/27/25 00:01 OF COLLISION �Y e� 3 } vi 4 t a a X iq 'Y day y y. 9iS ..btu m* 4t qr'�0 � strvS° .e x {btu y V�tYr t i 1 4 t � �o �r t ti l� PAGE 4 OF 4