HomeMy WebLinkAbout25-80874 IT si " II IIIII III IIIII II IIII IIIII I . 27c REPORT NO EG61071OLCERA
COLLISION REPORT 1591971
INTERSTATE CITY STREET FIRE I
CASE# 25-80874 2
RESULTED STOLENSTATE ROUTE OTHER VEHICLE LDCAI-AGENCY 4100 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY ❑ INVOLVED
2 TOTAL#OF OBJECT 1 s 28
TRIBAL UNITS 02 STRUCK
RESERVATION : 1 1
2
3� M M D D Y Y Y Y TIME(2400) COUNTY# MILES CITY#
eDCL s on' 12 - 19 - 2025 2125 17 =.= S 8 W e OF e 1070 s
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
NE4TH BLOCK NO. e 4600 .�
4a❑ MILE POST
❑ DISTANCE OF(REFERENCE OR CROSS STREET)
5 1. FEET e S 8 W e DUVALL AV NE
0 1 29
MOTOR ✓ PEDAL- DAM AG THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE ❑ YEs Vl No D:4255256032 0 8 30
5 LAST NAME GUADARRAMA PEDROZA FIRST NAME DIEGO MIDDLE 1 2 31
INITIAL
STREET ❑) 1432 JONES AVE NE CITY; RENTON ST WA ZIP; 980562808 2
NEW ADDRESS
7 CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
INTERLOCKYEs No✓ INTERLOCKVEe Nb✓ YES No,/
8 DCIENSE# STATE WA SEXI M MMDDYY' 11 — 14 — 2000 1 2 32
9 ON DUTY❑ STATUS' AIRBAG 2 RESTR 4 EJECT 1 N USE ET CLASSY',1 [NATURE of INJURIES 2
10 PI ENSttEI D99288F STATE WA VIN# 1FTCR15X7RPA27327 3
TRAILER STATE TRAILER STATE ROM To 11 3 5 PLATE# PLATE#
TRLR TRLR 7 1 3 33
12 3 5 VIN# vIN#
FROM TO
13 3 VEH.YEAR 1994 MAKE FORD MODEL RANGE STYLE VEHICLE TO YED NO�iS46LIN T�VyED.6LRS GES❑END 9 9 34
DAMAGE IIII._IIII HHttVVii((tt
REGISTERED OWNER INFO DIEGO GUADARRAMA PEDROZA 1432 JONES AVE NE RENTON WA 98056 VEHICLE NO. 1
SHADE IN DAMAGED AREA 35
❑ INSURANCE CO 3 4
14 LIABILITY INSURANCE NONE
IN EFFECT &POLICY# 9TOP
V""' CHARGE 7080TTOM 5 36
15
srnNowc YES❑NO❑ CITATION# 5AO875566 FOLLOW VEHICLE TOO CLOSELY,OP 7 e
MOTCYR ✓ PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT 02 VEHICLE ❑ CYCLE ❑ ❑ nWNER vEs✓ No D:4255035714
16�
LAST NAME PRUMMER FIRST NAME MICHAEL MIDDLE' F
INITIAL
17 F1 STREET ❑❑ 11905 164TH AVE SE CITY RENTON ST, yyq ZIP 980596146 37
NEW ADDRESS
18❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDIOALTRANSPORTED' ❑ 38
INTERLOCKYES No✓ INTERLOCI£YES NO✓ YEs No'✓
19 DRIVER'S ' STATE WA SEX M D.aa. 08 07 1952 � 39
LICENSE# MMDDYY
HELMET INJURY: NATURE OF INJURIES 40
20❑ ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 USE CLASS 1 ❑
21 LICEN E LATEID64465D rare WA vIN# 3C63R3HL4PG623573 41
22❑ PLATE# STATE PLATE# STATE 42
23 TRLR RLR 43
UIN#. 'IN#
VEH.YEAR 2023 MAKE RAM MODEL 3500 STYLE VEHICLE TOWED TO BLIN
TOWED BY GOV HI 44
24 DAMAGE YES NO✓ VES NO✓
REGISTERED OWNER INFO MICHAEL PRUMMER 11905164TH AVE SE RENTON WA 98059 VEHICLE NO.2
SHADE IN DAMAGEAREA
2 3
LIABILITY INSURANCE[Z INSURANCE CO FARMERS 0072205703
IN EFFECT &POLICY# I STOP
HICL
L'—L YES N CL] CITATION# CHARGE to BOTTOM
VEE
25
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
26
HANSEN HSU 12651 WA0171300
PAGE 01 OF
PART A 3000-345-189(R 11/18)
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EG61071
COLLISION REPORT III III III III III 111
1591972 CASE# 25-80874
E NA ADDITIONAL PERSONS INVOLVED(PASSENGERS AND/OR WITNESSES ONLY)
M
(LAST FIRST,MIDDLE INITIAL) MARTINEZ-ESPINOZA GERARDOA
ADDRESS&PHONE# D�
1432 JONES AVE NE RENTON WA 980562808 4259817144 SEXi M MMDD.O E3. 11 — 14 — 2000
SEAT HELMET I INJURY NATURE OF INJURIES
PASSENGER Z WITNESS[,UNIT# 1 POS. 3 AIRBAG 2 RESTR. 1 EJECT 1 USE CLASS '5 FOREHEAD INTO WINDSHIELD
NAME
(Lnsr EIRS7 MIDDLE INITIAL) t CAlVO SEMA L
ADDRESS R PHONE#
4252606737 SEX' F MMoowr 03 _ 30 _ 1970
PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET LASS NATURE OF INJURIES
❑ �✓ POS. USE NJUR �----�
NAME MIDDLE INITIAL) MCPHERSON BRYON D
(LAST,FIRST,
ADOREssaPHONE# 2539299543 SEX M I D.O.B. 04 _ 24 _ 1973
MMDDYYYY
PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET INJURY NATURE OF INJURIES
�' POS. USE CLASS __ ----�
NARRATIVE
Unit 2 stopped eastbound at the intersection of NE 4th St and Duvall Av NE on a red light. Unit 1
traveling behind Unit 2 and rear ends Unit 2 causing reportable disabling front end damage to Unit 1
and reportable non disabling rear end damage to Unit 2. Unit 1 front passenger sustains bleeding
facial wound and suspected cranial injuries consistent with not wearing a seatbelt and firmly planting
his forehead into the front winshield upon impact. No other injuries reported. Unit 1 driver no evidence
of impairment. Witnesses listed reported traveling in the adjoining eastbound lane next to collision.
Unit 1 impounded. Unit 1 driver cited for following too closely, speed too fast for conditions, and no
insurance.
I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT.
HANSEN HSU 12-19-25 10:38 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST.DET DATED PLACE SIGNED
APPROVED BY DATE
M.BRAUN 2194 12/20/2025 5:46:57 PM
BADGE OR ID# 12651 ORI# WA0171300 TIME POLICE DISPATCHED 1 9:26 PM TIME POLICE ARRIVED i 9:27 PM
PAST B 3 Da-3mx—attar gt 1Mffp PAGE 2�OF F3
REPORT NO. EG61071 CASE# 25-80874 DATE AND TIME 12/19/25 21:25
OF COLLISION
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