HomeMy WebLinkAbout25-9324 POLICETRAFF'c" III !�� I IIIllI111IN II II I REPORT NO. EG56186 170
27
COLLISION REP FIT 1591971
CASE 25-9324 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 1 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 N E IN CITY# ❑
COLLISION'. 10 - 1-- 2025 0457 17 ❑.= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
N 4TH ST BLOCK NO. e✓ 1000 ❑
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ �.❑ FEET e S ❑ VV e PARKAVE N
0 4 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
No ,/ I D:9542356223 0 11
30
6� LAST NAME MCINTOSH FIRSTNAME KENNETH MIDDLE T 1 1 2 31
INITIAL
STREET ❑✓ 1205 N 10TH PL#2443 C{TY RENTON ST WA 21p 98057 z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
INTERLOCK YES[:]NO,/ INTERLOCKYEs NO Z/ YES R No�/
8❑ LRIIVER #
ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 HELMET USE 2 'NJCLASSY 1 NATURE OF INJURIES z❑
3
10❑ Pi aT�S� CLV1852 sTArI WAurN# 4JGFD6BB6MA399380
TRAILER STATE TRAILER STATE
11 3 5 PLATE# PLATE# FROM To
TRLR. TRLR 3 5 33
12 3 5 VIN#' VIN#
>; FROM TO
VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE 3 ] 34
13 1 2021 MERZ GLE 5D DAMAGE YES NO YES❑ NO✓
REGISTEREDOWNERINFO OWNEDBYDRIVER VEHICLE NO. 1
SHADE IN DAMAGED AREA ❑ 35
14 LIABILI INSURANCE INSURANCECO PROGRESSIVE 00593645.1 3 4
IN EFFECT &POLICY# Q�,Q,
VE—L' CHARGE 36
LEGALLY YEs No clTAnoN# 5A0887124 DRIVER INATTENTION 15❑ STANDING
MOTOR PEDAL- PROPERTY DAM THR OLD MET PHONE
�2 ❑✓ ❑ PEDESTRIAN ❑ ❑UNIT D:2536862473
VEHICLE CYCLE OWNER YES,/ NO
16 a
LAST NAME SOBKO FIRST NAME YEGENIY MIDDLE lY
INITIAL
17❑ STREET ❑' 4329 122ND AVE E CITY' EDGEWOOD ST' WA ZIP 98372 37
NEW ADDRESS ❑
18� CDL IGNITION REQUIRED IGNITION PRESENT MEDICALTRANSPORTED ❑ 38
INTERLOCK YEs❑NO� INTERLOCK YEs❑NOF YEs❑NoF,/
19[—] D IVEW # STATE WA SEX M M .C... 09 _ 29 _ 1995 El 39
HELMET {NJURY 1 NATURE OF INJURIES 40
20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 USE 2 CLASS ❑
21❑ LICENSE I CKP3496 TAre I WA vIN1t WAUFMAFC7EN007623
❑ 41
PLATE#
42
22❑ PLATE# STATE PLATE# STATE
23❑ VIN#. 43
TRLR RLR
'IN#.
TOWED BY GOV HI 44
VEH YEAR 2014 MAKE /�(fD1 MODEL�Q6 STYLE 4D DAMAGE TOWED NOO✓ BLIN YES NO,/
24❑ REGISTERED OWNER INFO OWNED SY DRIVER VEHICLE N0.2
SHADE IN DAGED AREA
2 4
LIABILITY
INSURANCE INSU&PORGY#E CO PROGRESSIVE 78992907756IN 1GQ'E""LE
❑ ,J� CITATION# CHARGE
LEGALLY YES N`L J
25
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# JAGENCY
26
C.STEED 8770 WA0171300
PART A PAGE 01 OF C7
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EG56186
COLLISION REPORT III III III III III 111
1591972 CASE# 25-9324
ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY)
NAME MIDDLE INITIAL) KISSING,ER SEAN A
(I.P.ST FIRST,
ADDRESS&PHONE#
2014 VASHON AVE NE RENTON WA 98059 2065301332 SEX M MMDDYyry 06 - 15 - 1971
PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT ' HELMET INJURY NATURE OF INJURIES
�✓ POS. USE CLASS
NAME
(LAST,FIRST,MIDDLE INITIAL)
ADDRESS&PHONE# Id D O E4
E MMDDYYYY
PASSENGER ❑WITNESS UNIT# SEAT I AIRBAG RESTR. EJECT HELMET NJURY NATURE OF INJURIES
POS. USE CLASS
NAME
(LAST FIRST MIDDLE INITIAL)
AppRESS&PHONE#
SEX D.O.B.
MMDDYYYY. -
PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET NJURY NATURE OF INJURIES
❑ ❑ POS. USE CLASS ----�
NARRATIVE'
On 10/28/25 at about 0509 hrs I arrived at N 4th St and Park Ave N for a collision report, in the City of
Renton, County of King, and State of Washington. The driver of Unit#2 was later identified by his
WADL and the driver of Unit#1 was later identified by his Florida DL. The driver of Unit#2 said he
was WB on N 4th St approaching Park Ave N in the inside lane. He said Unit#1 was in the lane to his
right or middle lane. Driver#2 said Unit#1 turned left from the middle lane directly in front of him and
collided with the middle of his vehicle on the passenger side. The driver of Unit#1 claimed he was in
the inside lane and Unit#2 sped up along side him and caused the collision. Driver#2 had a camera
in his vehicle that showed the collision occurring exactly how he had described it. The witness said he
was behind Unit#1 in the middle lane when Unit#1 made a left turn to go south on Park Ave N and
collided with Unit#2 who was in the inside lane. Driver#1 was issued an infraction for Driver
Inattention.
This incident was captured on my body worn video camera. This report is a summary of events that
occurred and is not an exact sequencing of events. Statements have been paraphrased and
summarized. The video was uploaded to evidence.com.
I 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 Steed on 1 0/28/25 0610 hrs, Renton Washington
Cassidy Steed/8770
I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT.
C.STEED 10-28-25 06:21 AM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
D.SKELTON 9139 12/8/2025 3:47:15 AM
BADGE OR ID# 8770 OR]# ! WA0171300 TIME POLICE DISPATCHED 5:06 AM TIME POLICE ARRIVED'5:09 AM
PART I PAGE IT]OF 3�
REPORT NO. EG56186 CASE# 25-9324 DATE AND TIME 10/28/25 04:57
OF COLLISION
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