HomeMy WebLinkAbout25-9632 iiTFi " II IIIII III IIIII II IIII IIIII I . 27c REPORT NO EG54941oc� RA
COLLISION REPORT 1591971
CASE# 25-9632 2
INTERSTATE CITY STREET FIRE I
RESULTED STOLENSTATE ROUTE OTHER VEHICLE LOCALANG 4200 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 TOTAL#OF OBJECT 1 s 28
TRIBAL UNITS 02 STRUCK
RESERVATION : 1 1
2
3I M M D D Y Y Y Y TIME(2400) COUNTY# MILES CITY#
eDCL s on' 11 - 06 - 2025 1250 17 =.= S 8 W e OF e 1070 s
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
BLOCK NO.
SW GRADY WAY
4a❑ MILE POST
❑ DISTANCE OF(REFERENCE OR CROSS STREET)
5 �. FEET e S 8 W e OAKESDALE AVE SW
0 3 29
MOTOR ✓ PEDAL- DAM AG THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE ❑ YEs Vl No D:2537229060 0 1 30
6 LAST NAME JENSEN FIRST NAME ERIKA MIDDLE G 1 1 2 31
INITIAL
STREET ] 12062 69TH AVE S
NEW ADDRESS CITY I SEATTLE ST WA ZIP 981784125 2
7 +CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
INTERLOCKYES No INTERLOCKVEs Na YEs No
8❑ DRIVER # STATE WA SEXI F MMDDYY' 08 — 22 — 1989 1 2 32
9 ON DUTY STATUS' AIRBAG 2 RESTR 4 EJECT 1 H USEET INJUR
CLASSY 14 1
NATURE of INJURIES 2
10 LI ENSE' AYM8301 STATE WA VIN# KMHD35LH000300353 3
TRAILER STATE TRAILER STATE
11 3 5 PLATE# PLATE# FROM To
TRLR rRLR. 1 1 7 33
12 3 5 VIN# vIN#
FROM TO
VEH.YEAR ZOI6 MAKE HYUN MODEL ELANTR STYLE VEHICLE TOWED[n TO ZBLIN TOWEDBY 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
3 4
14 LIABILITY INSURANCE NSURANCE CO GE/CO 6160-86-94-07
IN EFFECT &POLICY# 4TOP
VEHICLE
Yes❑ ❑ 5A0909597 CHARGE PROHAMPROPER TURN t s I000Trom- z 36
NO CITATION#
15
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT VEHICLE CYCLE nWNFR YES NO �/ D:3605089597
16�
LAST NAME WOOLVERTON FIRST NAME RICHARD MIDDLE D
INITIAL
17 F1 STREET ❑❑ 7 18209 PRESLEYPRESLEYLN SW CITY' ROCHESTER ST, WA ZIP 985799400
NEW ADDRESS
18❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDTCAL TRANSPORTED. 38
INTEI2LOCKYEs No INTERLOCK YEs No ves No
19 DRIVERS
MMDDYY I —
HELMET INJURY NATURE OF INJURIES 40
20❑ ON DUTY� STATUS AIRBAG 2 RESTR 4 EJECT 1 USE CLASS 1 ❑
21 PLATE# 3536179 rare IN vIN# 1 FDUF4HN5NDA28671 41
22❑ PLATE# STATE PLATE# STATE 42
23 TRLR RLR 43
UIN#. 'IN#
VEH.YEAR 2022 MAKE FORD MODEL F450 STYLE VEHICLE TOWED TO BLIN
TOWED BY GOV HI 44
24 DAMAGE YES NO VES NO
REGISTERED OWNER INFO UNITED NORTH AMERICA INC 300 WEST CHICAGO AVE EAST CHICAGO IN 463120000 VEHICLE NO.2
SHADFY DAMAGED AREA
3 4
LIABILITY INSURANCE INSURANCE CO ZURICH AMERICAN INSURANCE CO BAP593970816
IN EFFECT &POLICY# 9TOP
Hiae CHARGE
L'vEeGnLY YES❑ NL] CITATION 11
t080TTOM
25 a e
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
26
C.ARNOLD 12509 WA0171300
PAGE 01 OF
PART A 3000-348-189(R 11/18)
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EG54941
COLLISION REPORT III III III III III 111
1591972 CASE# 25-9632
E NA ADDITIONAL PERSONS INVOLVED(PASSENGERS AND/OR WITNESSES ONLY)
M
(LAST,FIRST,MIDDLE INITIAL) BROUSSEAU PETERA
ADDRESS&PHONE# D�
1136 FITZ HUGH DR SE OLYMPIA WA 98513 3605840406 SEXi M MMDDYYYY B. 10 — 16 — 1985
PASSENGER Z WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET INJURY NATURE OF INJURIES
�, 2 POS. 3 2 4 1 USE CLASS 1 ---�
:NAME
(LAST FIRST MIDDLE INITIAL)
ADDRESS R PHONE#
SEX D.O.B. —
MMDDYYYY
PASSENGER❑WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET INJURY: NATURE OF INJURIES
POS. USE CLASS ----�
:NAME
(LOST,FIRST,MIDDLE INITIAL)
ADDRESS&PHONE#
SEX MMDDYY D.O.B.
YY
PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET INJURY 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.
C.ARNOLD 11-06-25 01:52 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST.DET DATED PLACE SIGNED
APPROVED BY DATE
12/3/2025 3:55:22 PM
C.JACOBS 1953
BADGE OR ID# 12509 ORI# WA0171300 TIME POLICE DISPATCHED 12:52 PM TIME POLICE ARRIVED i 1:03 PM
PAST B 3 Do-3mx—attar(t 1Mff) PAGE 2�OF 4
REPORT NO. EG54941 CASE# 25-9632 O OF COLLI 510N TIME 11/06/25 12:50
COLLISION
NARRATIVE
CC 25-9632
On 11/6/2025 at 1252 hours I was dispatched to a motor vehicle collision at SW Grady Way and
Oakesdale Ave SW in the City of Renton, King County, Washington.
Pre-Collision
Driver 2 stated that he was traveling West on SW Grady Way in the #2 lane approaching Oakesdale
Ave SW
Driver 1 stated that she was facing South on Oakesdale Ave SW in the #1 lane preparing to perform a
righthand turn to proceed West onto SW Grady Way. Driver 1 stated that she was facing a steady red
circle.
Collision
Driver 2 stated that as he crossed over the intersection of Oakesdale Ave SW with a green light, Unit
1 emerged from the North side on the intersection and attempted to enter the #2 lane of Westbound
SW Grady Way. Driver 2 stated that upon doing so, the rear drivers side wheel well, tire, and quarter
panel of Unit 1 collided with the front passenger side bumper of Unit 2.
Driver 1 stated that she was not paying attention and performed her righthand turn going directly into
the #2 lane of Westbound SW Grady Way. Driver 1 stated that the rear drivers side wheel well, tire,
and quarter panel of Unit 1 collided with the front passenger side bumper of Unit 2.
Injuries
None reported
Vehicle Disposition
Both vehicles were operational after Driver 2 changed Driver 1's rear drivers side tire for her.
Proximate Cause
I determined that Driver 1 is the proximate cause of this collision because both the approach for a
right turn and a right turn shall be made as close as practicable to the right-hand curb or edge of the
roadway.
Driver 1 was cited per RCW 46.61.290.
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 13:48 on 11/6/2025 in the City of Renton, King
County, Washington.
PAGE 3 OF 4
REPORT No• EG54941 CASE# 25-9632 DATE AND TIME 11/06/25 12:50
OF COLLISION
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