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Home My WebLink About25-80764 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 0 27c COLLISION REP FIT 1591971 CASE 25-80764 z INTERSTATE ❑ CITY STREET FIRE ❑RESULTED 1 STOLEN STATE ROUTE ❑ OTHER ❑ VFHICI F ❑ LOCAL AGENC 4200 3 HIT&RUN CODING COUNTY RD PRIVATE WAY INVOLVED 2 3 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# ❑ cawsloN 12 - 1-- 2025 1535 17 ❑.= S 8 IN e 1070 3 4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓ BLOCK OAKESDALEAVESW ST e✓ MILEPOST 2600 4a❑ DISTANCE OF(REFERENCE OR CROSS STREET) 5❑ ❑ FEET e S ❑ W e 0 1 29 MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE UNIT 01 VEHICLE ❑ CYCLE El NO D:2069411165 0 11 30 6 LAST NAME ARCEZEPEDA FIRSTNAME DEJESUS MIDDLE N 1 1 2 31 INITIAL STREET ❑, 10404 SE 174TH ST APT B314 CITY RENTON ST WA 2jp, 980550009 z NEW ADDRESS 7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3 iNTERLOCKYEs NO INTERLOCKYEs NO YES NO 8❑ LRIIVER # ON DUTY❑ STATUS AIRBAG 3 RESTR 4 EJECT 1 H USEET ICNLJAURY 1 NATURE OF INJURIES 2❑ 3 10 9❑ PI ATFBit CPV8517 sTArI WA urN#' JA4MT41X28Z020702 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 TR Y GOVT.VEHICLE 1 $ 34 13 2 2008 MITS OUTLAN DAMAGE YES NO �MEYER YES : NO✓ REGISTERED OWNER INFO DEJESUSARCE ZEPEDA 10404 SE 174TH STAPTB314 RENTON WA 980550009 D:2069411165 VEHICLE NO. 1 ❑ SHADE IN DAMAGED AREA 35 4 14 LIABILITY INSURANCE❑ INSURANCE CO 3 IN EFFECT &POLICV# 9TOP VEHICLE CHARGE 5 36 LEGALLY YES NO CITATION# 5A0900800 OP MOT VEH W/OUT INSURANCE )o eorrom 15❑ STANDING 6 MOTOR PEDAL PROPERTY DAM THR OLD MET PHONE UNIT 02 ❑✓ ❑ PEDESTRIAN ❑ ❑ YES NO �/ VEHICLE CYCLE OWNER 16 a LAST NAME LEWING FIRST NAME SHAWN MIDDLE I P INITIAL 17❑ STREET ❑', 18806 120TH AVE SE CITY RENTON ST WA ZIP 980587246 37 NEW ADDRESS ❑ 18� CDL ., IGNITION REQUIRED IGNITION PtR—E—S1ENT MEDICAL TRANSPORTED 38 INTERLOCKYES�NOR INTERLOCK YEs I I NOF YEs t l NO❑ 19[ DRIVER'S STATE WA SEX M D.O.B. 10 _ 02 _ El 39 LICENSE# MMDDYY WELMET INJURY1 NATURE OF INJURIES 40 20❑ ON DUTY STATUS AIRBAG 1 RESTR 4 EJECT 1 USE CLASS ❑ 21❑ LICENSE D46018G TAre WA vIN1t 1XPTDP0X4DD214073 ❑ 41 PLATE# ❑ 42 22❑ TRAILER G44B9AH STATE WA TRAILER STATE PLATE# PLATE# 43 23❑ �NL� 1S13GC489M6671424 INL# YEAR 2013 MAKE PTRg MODEL 367 STYLE VEHICLE TOWED TO BLIN TOWEDBY GOV HI 44 VEH 24❑ DAMAGE YES NO YES NO REGISTERED OWNER INFO CONSTRUCTION INTERNATIONAL LL 19407144TH AVE NE WOODINVILLE WA 98072 VEHICLE NO.2 SHADE IN DAMAGED AREA 2 3 4 INAEFFITY ECTNSURANCE INSU&POLICY#E CO SAME. IGQVE""LE ❑ ,J� CITATION# CHARGE LEGALLY YES N`L J 25 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. EG60723 COLLISION REPORT III III III III III 111 1591972 CASE# 25-80764 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 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 1:07:50 PM BADGE OR ID# 2517 OR]#' WA0171300 TIME POLICE DISPATCHED I` 3:35 PM TIME POLICE ARRIVED',3:38 PM PART I PAGE IT]OF 5� REPORT NO. EG60723 CASE# 25-80764 OF COLLISION 12/16/25 15:35 OF CbLLI510N NARRATIVE red/1 lane 2 rear moving semi RTF Within the city limits of Renton/King/Wa I responded to a car vs semi truck trailer at about the 2600 block lane 2 of Oakesdale Ave SW. I located both vehicles stopped and blocking lane 2 southbound. Both vehicles had hazard lights flashing. I contacted the driver of unit 2 who told me he was going about 25-30 mph in his commercial vehicle and was empty. He said he thought he "dropped a gear" meaning his trucks manual transmission when from a positive gear engagement to a neutral position. He realized this wasnt what had happened, it was unit 1 crashing into the back of his his rig while he was underway. He did not complain of injury and aside from some paint left behind on unit 2 trailer T-bar and a tiny tear in his left rear mud flap there was no other damage. I contacted the driver of unit 1. He explained to me that he didnt realize unit 2 was going that much slower than he was, the roads were wet and he was not able to stop in time before hitting the back of unit 2. Unit 1 did not complain of injury and damages did require a tow truck. Unit 1 damage looked to be a total loss. I cited unit 1 ref RCW 46.30.020 no valid proof of insurance 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 12/17/2025 PAGE 3 OF 5 SUPPLEMENTAL REPORT NO. EG60723 r`) POLICE TRAFFIC 1 27 COLLISION REPORT CASE# 25-80764 1 COMMERCIAL MOTOR CARRIER INTERSTATE INTRASTATE ✓ G UNIT# 2 USDOT 2919725 ICC# VEHICLE TYPE 4 CARGO BODY 8 TYPE 2 ❑ 1 28 CARRIER NAME CONTRUCTION GROUP INT LLC ....... 3 CARRIER ADDRESS 19407 144TH AVE NE CITY WOODINVILLE ST WA ZIP 98072 4 ❑ NAME # PLACARD: :❑ NAME IF NO NUMBER SOURCE 3 AXLES 07 " 105500 + 4a ❑ ADDITIONAL UNITS MOTOR PEDAL- PROPERTY DAMAGE THRESHOLD MET PHONE 5 ❑ UNIT# VEHICLE I_J CYCLE _) PEDESTRIAN � OWNER � YES NO i MIDDLE'... 29 LAST NAME FIRST NAME INITIAL STREET 30 NEW AnnRFSP CITY ST ZIP 6 � CDL GNITIttN REQUIRED GNITION PRESENT MEDICAL TANSPORTED 1 31 INTERLOCK YES No zERLOCK YES❑N0� vES N LLIICIENSE STATE SEX M��DYRYY' 2 7F-1 ON DUTY STATUS AIRBAG RESTR. EJECT HELMET INJURY NATURE OF INJURIES USE CLASS 8 ❑ ' 1 32 LICENSE+ rar V1N.# PLATE# 9 TRAILER TRAILER PLATE# STATE PLATE# STATE 10 ❑ TRLR TRLR VIN.#. VIN.#. 11 VEH.YEAR MAKE MODEL STYLE VEHICLE TOWS T SABLIN TOWED BY anvi vEHIC P FROM TO DAMAGE Y EES NO YES NO REGISTERED OWNER INFO. m 33 12 SHADE IN DAMAGED AREA FROM TO LIABILITY INSURANCE❑ INSURANCE CO IN EFFECT &POLICY# tGQ EHILLE 34 13 ❑ LEGALLY YES[:] NO❑ CITATION# CHARGE STANDING } 8 7 6 14 ❑ UNIT Tr Vd 1RE O CYDCLE OWNERRTY YES AGE NOHRESHOLD MET PHONE ❑ 35 PEDESTRIAN 15 LAST NAME FIRST NAME MIDDLE': INITIAL36 STREET"[—] ❑ 16 NEW AnnRFs.� CITY'. ST 21P CDL IGNITION REQUIRED IGNITION PRESENT MEDICALTANSPORTED INTERLOCK YES No INTERLOCK YEs NO YEs NO El 17 37 LICENSE# STATE SEX MMDDDYBYY 18 ❑ ON DUTY� STATUS AIRBAG RESTR. ; EJECT HELMET INJURY NATURE of INJURIES 38 USE (CLASS 19 ❑ vIN 39 LICENSE # PLATE# rnr 20 ❑ TRAILER TRAILER ❑ 40 PLATE# STATE PLATE# STATE 21 ❑ TRLR TRLR 41 VIN# YIN#i 42 22 VEH.YEAR MAKE I MODEL STYLE I VEHICLE TO DUET SABLIN TOWED BY GOVT.VEHICLE DAMAGE YES NO YES NO 23 REGISTERED OWNER INFO SHADE IN DAMAGED 3 4 4 AREA F 43 z LIABILITY INSURANCE INSURANCE CO ' VEHICLE EFFECT &POLICY# I 970P - 4 44 24 LEwGLE YES NO❑ CITATION# CHARGE iq 60TiOM E:l C=DLv STANDING 8 7 6 1 CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT. K LEVERTON 12-17-25 07:20 AM 25 INVESTIGATING OFFICER'S SIGNATURE OFFICER'S PHONE UNIT OR DIST DET DATED: PLACE SIGNED 26 OI BADGE 2517 O#I',WA0171300 APJACOBS 12119/202 PAGE F41 OF F 3000-345-013(R 11118) REPORT NO. EG60723 CASE# 25-80764 DATE AND TIME 12/16/2515:35 OF COLLISION t 1 �y�EiSSv`44�h � `t �,; rk�`'•� � � r�` a€� S., �`�� £�'�5�1ci�. 'k� " '.. � <'iS �i � .��S ?„S PAGE 5 OF 5