HomeMy WebLinkAbout25-80611 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 5 27c
COLLISION REP FIT 1591971
❑ ❑ FIRE ❑ CASE# 2$-80611 z 0 7
INTERSTATE CITY STREET RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHICI F ❑ LOCAL AOENC 4900 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 3 TOTAL#OF OBJECT 1 1 8 28
TRIBAL UNITS OZ STRUCK
RESERVATION
2
3❑ DATE of M M D D Y Y Y Y TIME(2400) COUNTY# MILES N E IN CITY# ❑
cowsloN 12 - 11 - 2025 1722 17 ❑.❑ S 8 W H OF e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓
S 43RD ST BLOCK NO. e✓ 100
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ 120 00 FMILES EET e S ❑ E e EAST VALLEYRD
0 1 29
MOTOR PEDAL- DAM THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El YEs NO ,/ D:4255234878 0 6 30
6� LAST NAME CHEN FIRSTNAME JAY MIDDLE 1 2 31
INITIAL
STREET ❑, 11603 SE 163RD ST C{TY RENTON ST WA 2jp, 98058 2=
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
1/ I INTERLOCK YES[:]NO NTERLOCKYEs NO�/ YES R No�/
8❑ LRIIVER #
ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 HELMET USE 2 CLASS 1 NATURE OF INJURIES 2❑
3
10 9❑ PI ATFBit BIT7201 sTATI WA urN#' 5TDBT48A41S014423
TRAILER STATE TRAILER STATE
11 3 5 PLATE# PLATE# FROM TO
TRLR. TRLR 7 3 33
12 3 5 VIN#' VIN#
>; FROM TO
VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE 7 $ 34
13 3 2001 TOYT SEQUOI UT DAMAGE YES NO YES[:] NO✓
REGISTERED OWNER INFO OWNEDBYDRIVER VEHICLE NO. 1
SHADE IN DAMAGED AREA ❑ 35
14 LIABILI INSURANCE❑ INSURANCE CO 3 4
IN EFFECT &POLICY# 9TOP
15❑ VEHLE 5 36
LEGALLICY YES�No D CITATION# 5A0942671 CHARGE NO INSURANCE I o Borrom
STANDING 8 7 6
1.' MOTOR Z PEDAL PROPERTY DAM THR OLD MET PHONE
T VEHICLE CYCLE ❑ PEDESTRIAN ❑ OWNER ❑ YES,/ No D:4252733157
16 a UNI
LAST NAME WON FIRST NAME ALLEN MIDDLE
INITIAL
17❑ STREET ❑', 10015 SE 192ND PL CITY RENTON ST WA ZIP 98055 37
NEW ADDRESS ❑
18� CDL IGNITION REQUIRED IGNITION PR—E-1SENT MEDICAL TRANSPORTED 38
INTERLOCK YES❑NO� INTERLOCK YEs It I NOF YES
t l NoF,/
19 DRIVER'S STATE WA SEX M D.C... O6 _ O6 _ 1984 39
LICENSE# MMDDYY
WELMET {NJURY NATURE OF INJURIES 40
20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 USE 2 CLASS 6 NECK/BACK PAIN ❑
21❑ LICENSE I CTY8794 TATe WA vIN# 5UX53GP09S9132182
❑ 41
PLATE#
42
22❑ PLATE# STATE PLATE# STATE
23❑ VIN#. 43
TRLR RLR
'IN#.
TOWED BY Gov HI 44
VEH YEAR 2025 MAKE Bry1H/ MODEL X3 STYLE UT DAMAGE TOWED NOO✓ BLIN YES NO 1/
24❑ REGISTERED OWNER INFO OWNED SY DRIVER VEHICLE N0.2
SHADE IN DAMAGED AREA
2 3 4
LIABILITY INSURANCE INSU&PORGY#E CO AMERICAN FAMILY CONNECT PROP&CASUALTY BX14527855 IGQO,
IN EFFECT
VEHICLE ❑ ,.I—I CITATION# CHARGE
LEGALLY YES N`E]
25 s � a
7Q"u,'
S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
J
26
TIBEAU 7691 WA0171300
PART A PAGE 01 OF C7
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EG57866
COLLISION REPORT III III III III III 111
1591972 CASE# 25-80611
ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY)
NAME MIDDLE INITIAL) WON ARAM M
(LAST FIRST,
ADDRESS&PHONE#
10015 SE 192ND PL RENTON WA 98055 4254493693 SEXi F MMDovyvv 02 - 11 - 1984
SEAT HELMET INJURY NATURE OF INJURIES
PASSENGER WITNESS❑'UNIT# 1 2 POS 3 AIRBAG j 2 RESTR. q EJECT 1 USE 2 CLASS 17 NECKIBACKPAIN
NAME
(LAST,FIRST,MIDDLE INITIAL) WON HARIM
ADDRESS&PHONE# D O B
10015 SE 192ND PL RENTON WA 98058 SEX F MMDDvyvv 10 _ 11 _ 2019
SEAT HELMET INJURY NATURE OF INJURIES
PASSENGER �WITNESS� UNIT# 2 POS 9 AIRBAG'2 RESTR. 4 EJECT 1 USE 2 CLASS 7 CHEST AND BACK PAIN
NAME
(LAST FIR57 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'
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.
QUINT TIBEAU 12-11-25 10:02 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY E
DAT
QUINT TIBEAU 7691 1211112025 10:30:07 PM
BADGE OR ID# j 7699 OR]# WA0171300 TIME POLICE DISPATCHED' 5:36 PM TIME POLICE ARRIVED 5:55 PM
FART I PAGE IT]OF 4]
REPORT NO. EG57866 CASE# 25-80611 OF COLLISION
12/11/25 17:22
OF CbLLI510N
NARRATIVE
25-80611
Narrative
The following occurred in the City of Renton, County of King, State of Washington.
On 12/11/2025 at about 1836 hours I was dispatched to an injury collision near S 180th St and East
Valley Rd, with the Fire Department already on scene.
I arrived at about 1855 hours and contacted the driver of V-1. He identified himself as Jay Chen, the
registered owner and sole occupant of V-1, a 2001 Toyota Sequioa, WA license (BIT7201). Chen
stated that both vehicles were in the # 1 lane of east bound traffic in the 100 block of S 43rd St. He
had stopped right behind V-2 and was close, when suddenly another vehicle struck his vehicle from
the rear, pushing him into V-1. Chen then claimed the other vehicle; a smaller red car drove off. He
pointed to damage on his rear bumper as proof. In looking at the damage it did not appear to be
fresh, but rather from a previous collision. There was a green mildew on part of it and paint peeling
from another part. No red paint transfer was visible either. Chen tried to provide an expired
homeowners insurance policy for proof of insurance. When I called him out on this, he stated that he
did not think he had current vehicle insurance.
I spoke to Allen Won, the driver and registered owner of V-2, a 2025 BMW X3, WA license
(CTY8794). Won told me that they were eastbound on S 43rd St and started to slow for traffic, when
they were struck from the rear by V-2. Won then showed me a video from his vehicle's rear camera
showing the collision. This shows V-1 traveling at a good speed directly into the back of V-2. At no
point does it stop and then get pushed into V-2. It does not support Chens claims of how the collision
occurred.
I sent Won a link to upload the videos from his vehicle to evidence.com and later received an email
notifying me that he had done so.
I issued Chen an infraction for Operating a Vehicle without Insurance.
This incident was captured on my Axon 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.
Nothing further at this time.
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 Sgt. Q. Tibeau #07691 12/11/2025 2011 hours, Renton, WA.
PAGE 3 OF 4
REPORT NO. EG57866 CASE# ' 25-80611 DATE AND TIME 12/11/25 17:22
OF COLLISION
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