HomeMy WebLinkAbout25-9846 j ITFC II IIIII III IIIII II IIII IIIII I . 27I
OOLCERAF EG54754
COLLISION REPRT 1591971
CASE# 25-9846 2
INTERSTATE CITY STREET FIRE ❑
RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VEHICLE ❑ LOCAL AGENC'Y 4100 3[--�
COUNTY RD ❑ NVOLVED CODING
PRIVATE WAY
2❑ TRIBAL TOTAL 1
UNITS#OF 02 SO BJECT TRUCK 1 8 28
RESERVATION 2
3� M M D D Y Y Y Y TIME(2400) COUNTY# MILES CITY#
DATE OF'. N E
COLLISION'. 11 - 13 - 2025 0708 17 =.= S 8 W E IN OF M 1070 a
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION �✓ NON INTERSECTION ❑
BLOCK NO.
SW GRADY WAY
4a❑ MILE POST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ C------�. FEET e S 8 W e LIND AVE SW
0 4 29
MOTtlR PEDAL- DAM AG THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE ❑ YEs Vl No D:2536179232 0 1 30
5 LAST NAME DOMINGUEZ FIRST NAME ASHLEY MIDDLE P 1 1 2 31
INITIAL
STREET ❑ 600 SW 5TH CT APT J106 CITY RENTON ST I WA ZIP 98057 2
NEW ADDRESS
7 CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
INTERLOCKYEs NO INTERLOCKYEs Nt YES R NOF
8� LICIENS# STATE WA SEX F MMor YY' 09 — 27 — 1993 1 2 32
9 ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT, 1 HELMET INJURY 7 NATURE of INJURIES 2
USE ;CLASS RIGHT ARM/SHOULDER PAIN
10 1 LI ENSE AZW2641 STATE WA VN# 4T4BE46K89R072758 3
TRAILER STATE TRAILER ,STATE
11 3 5 PLATE# PLATE# FROM To
TRLR TRLR 7 1 33
12 3 5 VIN# VN#
FROM TO
VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN 7 Y GO VEHICLE 34
13 4 2009 TOYT CAMRY DAMAGE ves ✓ No � g MEYERS YeS❑ 3 7 No
REGISTERED OWNER INFO JUAN HERNANDEZ NUNEZ 600 SW 5TH CTAPT J106 RENTON WA 98057 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
LIABILITY INSURANCE❑ INSURANCE CO 3 4
14 STATE FARM 473 0767-A27-47
IN EFFECT &POLICY
srgNOLNG ❑ ❑ 5A0909601 CHARGE FAIL YIELD LEFT TURN MOTOR s o ooTrob 36
Yes NO CITATION#
15
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT VEHICLE ❑ CYCLE' ❑ ❑ nWNFR YEs�/ NO D:2533320274
16�
LAST NAME SANTOS GRANDE FIRST NAME KEVIN MIDDLE J
INITIAL
17 F1 STREET ❑❑ 31600 126TH AVE SE SPC 166 CITY AUBURN ST, yyq ZIP 980923690 37
NEW ADDRESS
18❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICALTRANSPORTED 38
INTERLOCKYEs No INTERLOCK YES No YEs NO'
19 DRIVER'S STATE I WA SE}(M I D.O.B. 08 19 2004 39
LICENSE# MMDDYY —
HELMET INJURY' NATURE OF INJURIES 40
20❑ ON DUTY STATUS' AIRBAG 6 RESTR 4 EJECT 1 USE CLASS 1 ❑
21 LICEN� B01706Y rarE WA vIN# 1N6ED29X34C457618 41
PLATE 22❑ PLATE# STATE PATE# STATE ❑ 42
23 TRLR kRLR 43
UIN#. 'IN#.
VEH.YEAR 2QQ4 MAKE NISS MODEL FRONTIE STYLE VEHICLE TOWED TO BLIN TOWED BY GOV HI 44
24 DAMAGE YE
�/ No GENE MEYERS ves No�/
REGISTERED OWNER INFO SANDRA ORTIZ 17304 ROAD 9 NW QUINCY WA 98848 VEHICLE NO.2
SHADE IN DAMAGED AREA
2 3 4
LIABILITY INSURANCE INSURANCE CO PROGRESSIVE 71234716
IN EFFECT &POLICY#
1-1— YES❑ N,— CITATION#
LE—Y CoQ
25 J CG
8 6
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
26
C.ARNOLD 12509 WA0171300
PAGE 01 OF
PART A 3000-345-159(R 11/18)
POLIICFETRAFFICN CORRECTION REPORT NO. EG54754
COLLISION REPORT III III III III III 111
1591972 CASE# 25-9846
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#
SEX' D.O.B. — L----------�
MMDDYYYY
PASSENGER DWITNESSD UNIT# SEAT AIRBAG RESTR. EJECT HELMET NJURY NATURE OF INJURIES
POS. : 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.
C.ARNOLD 11-13-25 10:03 AM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST.DET DATED PLACE SIGNED
APPROVED BY DATE
C.JACOBS 1953 12/3/2025 8:04:16 AM
BADGE OR ID# 12509 ORI# ( WA0171300 TIME POLICE DISPATCHED'; 7:10 AM TIME POLICE ARRIVED 7:11 AM
PART B 3 Do-3mx-,ao(Rtrras) PAGE 27 OF 47
REPORT NO.` EG54754 CASE# 25-9846 O COLLI COLLISION TIME
OF 11/13/25 07:08
COLLI
NARRATIVE
CC 25-9846
On 11/13/2025 at 0710 hours I was dispatched to a motor vehicle collision at SW Grady Way and
Lind Ave SW in the City of Renton, King County, Washington.
Pre-Collision
Driver 2 stated that he was traveling West on SW Grady Way approaching Lind Ave SW in the #2
lane. Driver 2 stated that he had a green light.
Driver 1 stated that she was facing East on SW Grady Way in the lefthand turn lane preparing to
perform a lefthand turn to proceed North on Lind Ave SW.
Collision
Driver 2 stated that as he entered the intersection, Unit 1 began it's lefthand tun in front of him. Driver
2 stated that he did not have time to slow or stop to avoid a collision, and attempted to swerve to
avoid a collision. Driver 2 stated that the front bumper of Unit 2 collided with the front passenger side
bumper of Unit 1.
Driver 1 stated that she thought she had time to perform a lefthand turn. Driver 1 stated that it
appeared to her that Unit 2 sped up prior t entering the intersection. Driver 1 stated that the front
bumper of Unit 2 collided with the front passenger side bumper of Unit 1.
Injuries
Driver 1 complained of right arm/shoulder pain.
Vehicle Disposition
Both Unit 1 and 2 were inoperable and were towed from the scene.
Proximate Cause
I determined that Driver 1 is the proximate cause of this collision because the driver of a vehicle
intending to turn to the left within an intersection or into an alley, private road, or driveway shall yield
the right-of-way to any vehicle approaching from the opposite direction which is within the intersection
or so close thereto as to constitute an immediate hazard.
Driver 1 was cited per RCW 46.61.185.
1 certify (declare) under penalty of perjury under the laws of the State of Washington that the
foregoing is true and correct.
Electronically signed by Officer C. Arnold #12509 at 07:45 on 11/13/2025 in the City of Renton, King
County, Washington.
PAGE 3 OF 4
REPORT NO. EG54754 CASE# 25-9846 DATE AND TIME i 11/13/25 07:08
OF COLLISION
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PAGE 4 OF 4