HomeMy WebLinkAbout25-80762 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 1 27c
COLLISION REP FIT 1591971
CASE 25-80762 z
INTERSTATE ❑ CITY STREET FIRE ❑
RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHIr.I F ❑ LOCAL AGENCI 4250 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 TOTAL#OF OBJECT 1 8 2$
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#
cawsloN 12 - 1-- 2025 1432 17 ❑-= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
e✓ --- ----� ❑
S 4TH ST MILEPOST
4a❑
DISTANCE OF(REFERENCE OR CROSS STREET) BLOCK NO.
5❑ ❑ FEET e S ❑ W e W/L!IAMS AVE S
0 1 29
MOTU '�01 VEHtOCLEZ PEAL-CYMLE. El �ESAGE NHORE✓LD MET PHONE 0 1 30
6� LAST NAME UNKNOWN FIRSTNAME MIDDLE 1 1 2 31
INITIAL
STREET ❑ CITY ST zIP 2
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
iNTERLOCKYEs NO INTERLOCK YES NO YES No
8❑ LIRCIENSRE#
STATE I
SEX u MMDDYY '❑- 1 1 2 32
9 ON DUTY❑ STATUS I
AIRBAG 9 RESTR 9 EJECT 1 H U EEr 9 CLAY 0 NATURE OF INJURIES z❑
3
10 2❑ P1 ATE 14 CPA1291 STATE WA VIN# 1GCHG39K091112695
TRAILER STATE TRAILER STATE
11 2 5I PLATE# PLATE# FROM TO
TRLR 3 7. TRLR 33
12 2 5 VIN# VIN#
FROM TO
❑ VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE 5 1 34
13 2 2009 CHEV EXPRES DAMAGE YES NO YES : NO✓
REGISTERED OWNER INFO ALLEN LEUNG 492151ST STAVES SEATTLEWA98118 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
14 LIABILI INSURANCE❑ INSURANCE CO 3 4
IN EFFECT &POLICY# 9TOP
vErIGALLY ICLE YES CHARGE 5 36
❑NO❑ CITATION# 10 BOTTOM
15❑ LE STANDING 8 7 6
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
uNiT 02 VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES 1/ NO D:2065519500
16 a
LAST NAME DUONG FIRST NAME NIA MIDDLE I T
INITIAL
17 STREET I❑ 6509 34TH AVENUE CT E CITY TACOMA ST WA ZIP 984431364 37
NEW ADORE55❑'
18❑ CDL IGNITION REQUIRED IGNITION PtR-E-S1ENT MEDICAL-T�RANSPORTED ❑ 38
INTERLOCK YEs❑NoR INTERLOCK YEs I I NOF YES t l NO❑
19 DRIVER'S STATE WA SEX M D.C.B. 01 13 _ 1969 39
LICENSE# MMDDYY
HELMET INJURY NATURE OF INJURIES 40
20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 USE CLASS 1 ❑
❑ILICENSE 21❑ PLA E# BVN0173 TATE 41
WA VIN# WMWXU3C5XK2H87736 4
42
22❑ PILER LATE# STATE PLATE# STATE
23❑ UIN#. 43
TRLR RLR
'IN#.
VEH YEAR 2019 MAKE MNNI MODEL COOPER STYLE VEHICLE TOWED TO BLIN TOWEDBY GOV HI 44
24❑ DAMAGE YES NO BANKERS YES NO
REGISTERED OWNER INFO NIA DUONG 650934TH AVENUE CT E TACOMA WA 984431364 D:2065519500 VEHICLE NO.2
SHADEDAMAGEDAREA
3 4
LIABILITY
INSURANCE INSU&PORGY#E CO TRAVELERS 611016036 203 1IN 1 STOP 5
vE""LE ❑ ,J� CITATION# CHARGE io BOTTOM
LEGALLY YES N J
25 s a
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
26
M.lEVERTON 2517 WA0171300
PAGE 01 OF
PART A
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EG60721
COLLISION REPORT III III III III III 111
1591972 CASE# 25-80762
ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY)
NAME MIDDLE INITIAL) [NEW] GINA
(IAST FIRST,
ADDRESS&PHONE# D O.B.
2066593691 SEX' U MMDDYYYY -❑
PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT ' HELMET CLASS U NATURE OF INJURIES
❑ ❑✓ ' POS. USE I
NAME
'(LASTr FIRS' MIDDLE INITIAL)
ADDRESS&PHONE# DOB
SEX MMDDYYYY
PASSENGER ❑WITNESS❑ UNIT# SEAT I AIRBAG RESTR. EJECT HELMET NJURY NATURE OF INJURIES
POS. USE CLASS
NAME
(LAST FIR57 MIDDLE INITIAL)
AppRESS&PHONE#
SEX D.O.B.MMDD -❑
YYYY.
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 12-17-25 07:20 AM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY E
DAT
C.JACOBS 1953 12/19/2025 1:05:12 PM
BADGE OR ID# 2517 OR]#' WA0171300 TIME POLICE DISPATCHED'I 2:33 PM TIME POLICE ARRIVED',2:51 PM
PART I PAGE IT]OF 4]
REPORT NO. EG60721 CASE# 25-80762 OF COLLISION
12/16/25 14:32
OF CbLLI510N
NARRATIVE
orange nb wht wb h/r
Within the city limits of Renton/King/Wa I responded to a 2 vehicle hit and run crash at the
intersection of S 4th St at Williams Ave S.
I contacted the driver of unit 2 who told me he was hit in the intersection but did not provide many
other details. He tried to move his vehicle out of lane blocking traffic, but it had heavy damage to the
passenger side including the front wheel leaning way over to the inside of the engine compartment.
A witness said unit 1 was "imbedded" into the side of unit 2 when they saw them in the intersection.
Then unit 1 simple backed up and fled the scene.
Based on POI and POR I could see that unit 1 was west on S 4th St at Williams. A 4 way intersection
controlled with stop signs. Unit 1 ran the stop sign as unit 2 was a good portion through the
intersection north on Williams Ave S. Unit 1 forced unit 2 into the head on lanes of Williams Ave S,
left unit 2 in the roadway without even a check on his wellbeing and fled the scene. Unit 1 did leave a
license plate behind from the front of his van.
Unit 2 or any other witness could not ID who was actually driving unit 1.
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 12/17/2025
PAGE 3 OF 4
REPORT NO. EG60721 CASE# ' 25-80762 DATE AND TIME 12/16/25 14:32
OF COLLISION
tt
a
t
i
�L
t
k
? t
s ,y
y� N
1 Y,
r�
ti
PAGE 4 OF 4