HomeMy WebLinkAbout25-890041 iiTFiNII IIIII III IIIII II IIII IIIII I . 27c REPORT NO EG55529oc� RA
COLLISION REPORT 1591971
INTERSTATE CITY STREET FIRE I
CASE# 25-890041 2
RESULTEDSTOLENSTATE ROUTE OTHER VEHICLE LOCCODICENC'Y 420 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 TOTAL#OF OBJECT 1 s 28
TRIBAL UNITS 02 STRUCK
RESERVATION : 1 1
2
3� M M D D Y Y Y Y TIME(2400) COUNTY# MILES CITY#
DATE OF N E
eDL�ISION' 11 - 21 - 2025 1234 17 =.�� S W OF 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓
BLOEASTVALLEYHWY MILE POST
e 4200 .�
4a❑ MILE POST
❑ DISTANCE OF(REFERENCE OR CROSS STREET)
5 MILES 1.1 FEET B S B W e
0 4 29
MOTOR ✓ PEDAL- DAM AG THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE ❑ YEs Vl No D:2533788031 0 1 30
6 LAST NAME CONTRERAS GALVAN FIRST NAME ALDAIR MIDDLE N 1 1 2 31
INITIAL
STREET ❑ 17123 120TH LN SE APT S204 CITY; RENTON ST I WA ZIP 1 980585991 2
NEW ADDRESS
7 CDL IGNITION REQUIRED IGNITION ENT MEDICAL TRANSPORTED 3
INTERLOCKYEs NO INTERLOCKYePRES NO YES No
8 DCIENSE# STATE WA SEXI M MMDDYY' 12 — 30 — 2000 1 2 32
❑
9 ON DUTY STATUS' AIRBAG 2 RESTR 4 EJECT 1 N USEET INJUR
CLASSY 14 1
NATURE of INJURIES 2
LICENSE, CLD4265 STATE WA VIN#; 4T1BE46K99U900665 3
10 Fq I PI ATP rt
TRAILER STATE TRAILER STATE
11 3 5 PLATE# PLATE# 11ROM To
TRLR TRLR 3 5 33
12 3 5 VIN# VIN#
FROM TO
VEH.YEAR 2009 MAKE TOYT MODEL CAMRY STYLE VEHICLE TOWED fn TO ZBUN TOWEBBY GOVT VEHICLE 1 $ 34
13� DAMAGE YES II_II NO YESII_I) NO
REGISTERED OWNER INFO ALDAIR CONTRERAS GALVAN 17123 120TH LN SE APT S204 RENTONWA980585991 D:2533788031 VEHICLE NO. 1
SHADE IN DAMAGED AREA 35
3 4
14 LIABILITY INSURANCE� INSURANCE CO PROGRESSIVE 998852529
IN EFFECT &POLICY# 4TOP _
srgN, ❑ ❑ 5A0900780 CHARGE FA►L YIELD PRIVATE RD MOTOR o ooTrofi 36
Yes NO CITATION#
15
MOTCYR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT O2 VEHICLE CYCLE nWNFR YES�/ NO D:2064030077
16�
LAST NAME MIRANTE FIRST NAME AILEEN MIDDLE' M
INITIAL
STREET ❑ 37
17 ❑ 8936132ND PL SE CITY' NEWCASTLE ST, WA ZIP 980593334
NEW ADDRESS
18❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED' ❑ 38
INTERLLOCKYEs ND INTERLOCK YES R N.Fj ves No
19 DRIVER'S STATE WA SEXI F DOZ. 07 14 1965 � 39
LICENSE# MMDDYY -
HELMET INJURY: NATURE OF INJURIES 40
20❑ ON DUTY� STATUS AIRBAG 2 RESTR 4 EJECT 1 USE CLASS 1 ❑
21 LICENSE
LATE# CHR7803 rare WA vIN# SADHD2S13K1F61550 41
22❑ PLATE# STATE PLATE# STATE 42
23 TRLR RLR 43
UIN#. 'IN#
TOWED BY GOV HI 44
VEH.YEAR 2019 MAKE JAGU MODEL I-PACE STYLE DAMIAGE
24 TOWED V NO BLIN BANKERS
REGISTERED OWNER INFO AILEEN MtRANTE 8936132ND PL SE NEWCASTLE WA 980593334 D:2064030077 VEHICLE N0.2
SHADE IN DAMAGED AREA
2 3 4
LIABILITY INSURANCE INSURANCE CO PROGRESSIVE 993025110
IN EFFECT &POLICY# 9TOP
vewaE ,J— #I CITATION CHARGE tO BOTTOM
N 6
25 EEGnEEY YES❑ --J
7'OFFLIl'tER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
26
VERTON 2517 WA0171300
PAGE 01 OF
PART A 3000-345-189(R 11/18)
STATE OF
" POLICETRAFFICN CORRECTION REPORT NO. EG55529
COLLISION REPORT III III III III III 111
1591972 CASE# 25-890041
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 NJURY NATURE OF INJURIES
POS. ' USE CLASS 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
unit2/blk lane 3 unit 1/grn It from spot
CC
Within the city limits of Renton/King/Wa I observed the following crash take place at about the 4200
block of East Valley Rd.
Unit 2 was southbound in the inside left turn lane when she was hit in the front wheel driver side of
her car. He car traveled a short distance after impact but was unable to move at POR. She did not
complain of injury and damages required a tow truck.
Unit 1, ID'd by his matching picture WADL was pulling from a private drive into the roadway making a
left turn and drove into the side of unit 2. He admitted he was "at fault" for the collision while on
scene. He did not complain of injury and damages did not require a tow truck.
I cited unit 1 Ref RCW 46.61.205 FTYROW from Private Drive onto roadway 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 11/21/2025
I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT.
M.LEVERTON 11-21-25 01:07 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST.DET DATED PLACE SIGNED
APPROVED BY DATE
C.JACOBS 1953 1 121512025 12:12:12 PM
BADGE OR ID# ; 2517 ORI# WA0171300 TIME POLICE DISPATCHED 12:34 PM TIME POLICE ARRIVED i 12:34 PM
PAST B 3 Da-3mx—attar(t 1Mff) PAGE 2�OF F3
REPORT NO. EG55529 CASE# 25-890041 DATE AND TIME 11/21/25 12:34
OF COLLISION
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