HomeMy WebLinkAbout25-9639 IT �i " II IIIII III IIIII II IIII IIIII I . Q 27c REPORT NO EG54943OLCERA
COLLISION REPORT 1591971
CASE# 25-9639 2
INTERSTATE CITY STREET FIRE I
RESULTED STOLENSTATE ROUTE OTHER VEHICLE LdCAI-A`NG 4200 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 TOTAL#OF OBJECT s 28
TRIBAL UNITS 02 STRUCK
RESERVATION : 1 1
2
3� M M D D Y Y Y Y TIME(2400) COUNTY# MILES CITY#
EDGE s o v' 11 - 06 - 2025 1503 17 =.[� S 8 W e OF e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
BLOCK NO. e .�
4a
84TH AVE S MILE POST
❑
❑ DISTANCE OF(REFERENCE OR CROSS STREET)
5 MILES 1.1 FEET e S 8 W e S 130TH ST
0 3 29
MOTOR ✓ PEDAL- DAM AG THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE ❑ YES ✓NO Q 8 30
5 LAST NAME HARPER FIRST NAME KHYREE MIDDLE A t 1 2 31
INITIAL '
STREET ❑ 227 BOYLSTON AVE E APT A8 CITY; SEATTLE ST WA ZIP; 981026249 2
NEW ADDRESS
7 +CDL IGN(TIUN REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
INTERLOCKYES NO INTERLOCKYEs N YES NO
DRIVER # STATE WA SEX M MM0,13. 09 — 02 — 1995 t 1 2 32
8❑
9 ON DUTY STATUS' AIRBAG 2 RESTR 4 EJECT 1 1HELM
USEET CLASSY 1 NAruRE of INJURIES 2
LICENSE, CNY9056 STATE WA VIN# 2FMDK4JC7DBC29738 3
10 F as ATP rt
TRAILER STATE TRAILER STATE ROM To 11 3 5 PLATE# PLATE#
TRLR rRLR 1 7 33
12 0 Q VIN#' VIN#
FROM TO
LE
13 2 VEH.YEAR 2013 MAKE FORD MODEL EDGE STYLE VEHICLE TO YED NOIyS46LIN diW9YMEYER GESr`-IVT ENp 9 9 34
DAMAGE IIII._IIII I_I
REGISTERED OWNER INFO KHYREE HARPER 22780YLSTON AVE EAPTAB SEATTLE WA 98102 VEHICLE NO. 1
SHADE IN DAMAGED AREA 11
35
14 LIABILITY INSURANCE NSURANCE CO SAME. 3 4
IN EFFECT &POLICY# 4TOP
srgNOLNG ❑ 5A0900757 CHARGE SPEED TOO FAST FOR CONDITIONS o oorro6 36
VEHICLE YES NO CITATION#
15
MOTOR PEDAL- Ty
PROPERTY DAM THR OLD MET PHONE
UNIT VEHICLE CYCLE nWNFR YES�/ NO D:2534867747
16�
LAST NAME CARRILLO ESCALERA FIRST NAME KARLA MIDDLE Y
INITIAL
17 F1 STREET ❑ 8223 S 130TH ST CITY SEATTLE ST, WA ZIP 98178 37
NEW ADDRESS I I I I I I [I
18❑ CDL IGNITION REQUIRED (GNITION PRESENT MEDICAL TRANSPC7RTE6' 38
INTERLOCKYES ND INTERLOCK YES R No YEs Nd
19 DRIVER'S STATE WA SEX F I D.O.B. 07 09 1987 39
LICENSE# MMDDYY —
HELMET INJURY: NATURE OF INJURIES 40
20❑ ON DUTY� STATUS AIRBAG 6 RESTR 4 EJECT 1 USE CLASS 1 ❑
21[ LICENSEPLATE# CTT9638 rare WA vIN# SALSF25478A120181 41
I El
22❑ STATE PLAAILER TE# STATE 42
PLATE#
23= TRLR RLR 43
UIN#. 'IN#
VEH.YEAR 200$ MAKE LNDR MODEL RANGE STYLE VEHICLE TOWED TO BLIN
TOWED BY GOV HI 44
24 DAMAGE YES NO VES NO
REGISTERED OWNER INFO KARLA CARRILLO ESCALERA 8223 S 130TH ST SEATTLE WA 98178 D:2534867747 VEHICLE NO.2
SHADE IN DAMAGED AREA
2 3 4
LIABILITY INSURANCE INSURANCE CO SAME.
IN EFFECT &POLICY# t STOP
VEHICLE ,.I—I CITATION11 CHARGE to BOTTOM
EEEILY YES[Z N
25 s e
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
J
26
M.LEVERTON 2517 WA0171300
PAGE 01 OF
PART A 3000-345-189(R 11/18)
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EG54943
COLLISION REPORT III III III III III 111
1591972 CASE# 25-9639
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 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
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.
M.LEVERTON 11-07-25 08:08 AM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST.DET DATED PLAGE SIGNED
APPROVED BY DATE
C.JACOBS 1953 12/3/2025 3:51:14 PM
BADGE OR ID# ; 2517 ORI# WA0171300 TIME POLICE DISPATCHED 1 3:04 PM TIME POLICE ARRIVED i 3:13 PM
PAST B 3 Do-3mx—attar(t 1Mff) PAGE 2�OF 4
REPORT NO. EG54943 CASE# 25-9639 O OF COLLI 510N TIME 11/06/25 15:03
COLLISION
NARRATIVE
blk/2 stopped wht/1 rt
CC
Within the city limits of Renton/King/Wa I responded to a 2 car crash at the intersection of 84th Ave S
at S 180th St.
I contacted the driver of unit 2 who told me she was on 130th stopped at the stop sign waiting to turn
left to head towards the elementary school to pick up her kids. She said unit 1 made a right turn and
slid across the street and into the side of her car even deploying the airbags. She did not complain of
injury and damages should have required a tow truck but she was able to move he car several
hundred feet back to her house.
I contacted the driver of unit 1 ID'd by his picture WADL. He told me he was making a turn from
southbound 84th onto 130th and slid across the intersection and hit unit 2. He did not complain of
injury and damages required a tow truck.
I cited unit 1 ref RCW 46.61.400, Speeds too fast for conditions 2 car crash via complaint.
I certify (declare) under penalty of perjury under the laws of the State of Washington that the
foregoing is true and correct.
M.Leverton/2517 City of Renton/King/Wa 11/7/2025
PAGE 3 OF 4
REPORT NO. EG54943 CASE# 25-9639 DATE AND TIME 11/06/25 15:03
OF COLLISION
i• `� titer �Y t t��� �t i t"��
8'
ti
h
Y t
h
4
i
t
4
a <
t
S
S r
W
�5
�ti l2 5
lit 1{t
3t=� rd`t
t
PAGE 4 OF 4