HomeMy WebLinkAbout25-80012 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 1 27c
COLLISION REP FIT 1591971
CASE 25-80012 z
INTERSTATE ❑ CITY STREET FIRE ❑RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHIr.I F ❑ LOCAL AOENC 4Y00 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 2 TOTAL#OF OBJECT 1 1 8 28
TRIBAL UNITS OZ STRUCK
RESERVATION
z
3❑ DATE of M M D D Y Y Y Y TIME(2400) COUNTY# MILES CITY# ❑
cowsloN 11 - 19 - 2025 1622 17 ❑.❑ N E IN S 8 W H OF e 1070 3
4❑ oN (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓
116TH AVE SE BLOCK NO. e✓ 17300
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ ❑ FEET e S ❑ W e 0 1 29
MOTOR PEDAL- DAM THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El YES NO �/ D:2063722395 0 7 30
6� LAST NAME LEOS-TORRES FIRSTNAME ARICEL MIDDLE 1 1 2 31
INITIAL
STREET ❑; 1204 21ST ST SE CITY AUBURN ST I WA 2jp, 98002 z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
iNTERLOCKYEs NO INTERLOCKYEs NO YEs NO
8❑ LRIIVER #
ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 H USEET ICNLJAURY 1 NATURE OF INJURIES z❑
3
10 9❑ P1 aT�S� C47372R sTArI WAVIN# 2FTRX17294CA70742
TRAILER STATE TRAILER STATE
11 3 5 PLATE# PLATE# FROM TO
TRLR. A'RLR. 1 5 33
12 3 5 VIN#j VIN#
FROM TO
❑ VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN T GOVT.VEHICLE J 9 34
13 2 2004 FORD F-150 DAMAGE vEs 0NO f �AWkkRS vEs❑ No
REGISTERED OWNER INFO .01A11410S CRU131600126THAVE SESPC 155 AUBURN WA 98092 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
14 ❑ INSURANCE CO 3 4
LIABILITY INSURANCE
IN EFFECT &POLICY# 9TOP
VEwcLE CHARGE 10BOTTOM 5 36
15❑
LEGALLY YES❑NO CITATION# 5A0900778,5A0900778, INATTENTIVE DRIVING,FOLLOW
STANDING 8 7 6
MOTOR PEDAL PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES 1/ No PRO
9176457540
16 a
LAST NAME CROWN FIRST NAME CAMAY MIDDLE I T
INITIAL
17❑ STREET ❑', 18841 175TH PL SE CITY RENTON ST WA ZIP 980587501 37
NEW ADDRESS ❑
18� CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 38
INTERLOCKYES�NOR INTERLOCK YEs❑No� YES❑NO❑
19 DRIVER'S STATE WA ]SEX IF D.C... 09 _ 18 _ 1979 39
LICENSE# MMDDYY
HELMET I INJURY NATURE OF INJURIES 40
20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 USE CLASS 1 ❑
21❑ LICENSE I BZZ2528 TAre WA vIN1t 1V2RR2CA8MC600264
❑ 41
PLATE#
42
22❑ PILER LATE# STATE PLATE# STATE
23❑ 43
TRLR RLR
VIN#. IN#.
VEH YEAR 2021 MAKE VOLK MODEL ATLAS STYLE VEHICLETOWED TO BLIN TOWEDBY GOV HI 44
24❑ DAMAGE YES NO YES NO✓
REGISTERED OWNER INFO CAMAY CROWN 18841175THPL SE RENTONWA980587501 VEHICLE NO.2
SHADE IN DAMAGED AREA
2 3 4
LIABILITY
INSURANCE INSU&PORGY#E CO ST FARM 543 3819 BO747AIN 1 GD
VE""LE CITATION# CHARGE
25
LEGALLY YES Nu
❑ s e
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
J
26
M.LEVERTON 2517 WA0171300
PART A PAGE 01 OF C7
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EG59041
COLLISION REPORT III III III III III 111
1591972 CASE# 25-80012
ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY)
NAME
(LAST FIRST,MIDDLE INITIAL)_
ADDRESS&PHONE#
SEX D.O.B. - -
MMDDYYYY.
PASSENGER❑WITNESS UNIT# SEAT AIRBAG RESTR. EJECT ' HELMET INJURY NATURE OF INJURIES
POS. USE CLASS
NAME
'(LAST,FIRST MIDDLE INITIAL)
ADDRESS&PHONE# D D B
SEX MMDDYYYY
PASSENGER ❑WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET INJURY NATURE OF INJURIES
POS. USE CLASS
NAME
(LAST FIR57 MIDDLE INITIAL)
AppRESS R PHONE#
SEX D.O.B.
MMDDYYYY. -
PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET NJURY NATURE OF INJURIES
❑ ❑ POS. 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 11-21-25 07:43 AM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY E
DAT
C.JACOBS 1953 12/15/2025 2:01:46 PM
BADGE OR ID# 2517 OR]#' WA0171300 TIME POLICE DISPATCHED 4:22 pry TIME POLICE ARRIVED',4:Y7 pry
PART I PAGE IT]OF 4�
REPORT NO. EG59041 CASE# 25-80012 OF COLLISION
11/19/25 16:22
OF CbLLI510N
NARRATIVE
wht/1 rear wht/2 sb
CC
On 11/19/2025 at about 1622 hours within the city limits of Renton/King/Wa Def was driving
southbound on 116th Ave SE and later verbally ID'd as Leos-Torres, Aricel 10-08-2001.
I was dispatched to a 2 vehicle partially blocking crash at about the 17300 block of 116th Ave SE. I
located unit 1/Leos vehicle stopped behind unit 2.
Ref RCW 46.61.145
Ref RMC 10-12-25
Ref RCW 46.20.342
Ref RCW 46.30.020
1 contacted the driver of unit 2 who told me she was stopped in traffic when she was hit from behind
by unit 1. She told me she didnt want to involve the police because it was minor damage and non-
injury but, unit 1 driver had no ID or insurance. She did not complain of injury and damages were
minor and did not require a tow truck.
I contacted the driver of unit 1 verbally ID'd. She told me right away she knew she was suspended
but chose to driver regardless. She had a 4 month old Rottweiler puppy leashed to the passenger
grab rail. This puppy was somewhat rowdy and misbehaved. She told me the puppy distracted her
and she hit unit 2 from behind. She was unable to provide valid proof of insurance for the truck she
was driving.
A WACIC/DOL check was negative because Access was down at the time. I waited until Access was
back up and re-ran Leos which revealed she is suspended in the third degree. She was driving a
vehicle that did not belong to her and told me the owner of the truck knew she was a suspended
driver. Bankers impounded the truck she was driving.
I cited Unit 1/Leos ref the above listed civil infractions for not paying attention to her driving while
being distracted by her puppy, following too close to traffic and no valid proof of insurance via
complaint. I cited her via the Renton Prosecutors office ref RCW 46.20.342 Driving while Suspended
3rd degree.
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
PAGE 3 OF 4
REPORT NO. EG59041 CASE# ' 25-80012 DATE AND TIME 11/19/25 16:22
OF COLLISION
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PAGE 4 OF 4