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Home My WebLink About25-80723 iiTFi " II IIIII III IIIII II IIII IIIII I . 27c REPORT NO EG61544oc� RA COLLISION REPORT 1591971 CASE# 25-80723 2 INTERSTATE CITY STREET FIRE I RESULTEDSTOLENSTATE ROUTE OTHER VEHICLE LOCCODICENC'Y 4100 3 HIT&RUN CODING COUNTY RD PRIVATE WAY INVOLVED 2 TOTAL#OF OBJECT 1 7 28 TRIBAL UNITS 03 STRUCK RESERVATION : 1 1 2 3� M M D D Y Y Y Y TIME(2400) COUNTY# MILES CITY# EDGE s o v' 12 - 15 - 2025 1502 17 =.[� S 8 W e OF IN e 1070 3 4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓ NE 4TH ST BLOCK NO. e 4513 .� 4a❑ MILE POST ❑ DISTANCE OF(REFERENCE OR CROSS STREET) 5 MILES 1.1 FEET B S B W e 0 4 29 MOTOR ✓ PEDAL- DAM AG THRESHOLD MET PHONE UNIT 01 VEHICLE ❑ CYCLE ❑ YES ✓NO 0 1 30 6 LAST NAME LOPEZ MENDOZA FIRST NAME MISAEL MIDDLE N 1 1 2 31 INITIAL STREET ❑ 3815 NE 4TH ST APT D119 CITY; RENTON ST WA ZIP; 980568539 2 NEW ADDRESS 7� +CDL IGN(TIUN REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED: 3 INTERLOCKYEs No INTERLOCKVEs NO YES NOD 8 DRIVER # STATE WA SEX M MM0,13. 01 - 29 - 1988 t 1 2 32 9 ON DUTY STATUS' AIRBAG 3 RESTR 4 EJECT 1 HELM U SETSS 1LAINJURY 7 L LEGE OF INJURIES 2 LICENSE, CSG8434 STATE WA V(N# JTDBDMHE9SJO14142 3 10 Fq I as ATP rt TRAILER STATE TRAILER STATE 11 3 5 PLATE# PLATE# ROM To TRLR TRLR 5 1 7 33 12 3 5 VIN# vIN# FROM TO 13 2 VEH.YEAR2025 MAKE TOYT MODEL COROL STYLE VEHICLE TOYED NO�iS46LIN T�VyED.6LRS GESIT` CLE 7 3 34 DAMAGE IIII._IIII HHttVVii((tt u REGISTERED OWNER INFO M/SAEL LOPEZ MENDOZA 3815NE 4TH STAPTD1t9 RENTON WA 980568539 VEHICLE NO. 1 SHADE IN DAMAGED AREA 35 2 3 4 14 2 LIABILITY INSURANCE❑ NSURANCE CO IN EFFECT &POLICY# 4TOP V""' CHARGE 7080TTOM z 36 15 srnNowc YES❑NO❑ CITATION# 5A0900796,5AO900796 FA►L YIELD PRIVATE RD MOTOR MOTCSR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE UNIT VEHICLE CYCLE nWNFR D:5623410622 16� LAST NAME WILLIAMS FIRST NAME SARAH MIDDLE A INITIAL 17 F1 STREET ❑ 433 BREMERTON AVE NE APT A102 CITY RENTON ST, yyq ZIP 98059 37 NEW ADDRESS I I I I I I [I 1$� IGNITION REQUIRED IGNITION PRESENT MEDICALTRANSPORTED' 38 CDL INTERLOCKYES ND INTERLOCK YES NO YEs No 19 DRIVER'S STATE WA SEXI F I D.O•B. 11 20 1997 39 LICENSE# MM"t Y — HELMET INJURY: NATURE OF INJURIES 40 20❑ ON DUTY STATUS AIRBAG 3 RESTR 4 EJECT 1 USE CLASS 1 ❑ 21 LICENSLATE E CKV9726 TATe WA VIN# 4T1BF32K64U571719 41 22❑ PLATE# STATE PLATE# STATE 42 23 TRLR r RLR 43 UIN#. 'IN# TOWED BY GOV HI 44 VEH.YEAR 2004 MAKE TOYT MODEL CAMRY STYLE VEHICLE TOWED✓ No BLIN BANKERS 24 REGISTERED OWNER INFO SARAH WILLIAMS 433 BREMERTON AVE NE APT Af02 RENTON WA 98059 D:56234f0622 VEHICLE NO.2 SHADFjy DAMAGED AREA 3 4 LIABILITY INSURANCE INSURANCE CO SAME. IN EFFECT &POLICY# 9TOP VEHICLE ❑ ,J—I CITATION11 CHARGE t080TTOM LE —Y YES N J 25 e OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY J 26 M.LEVERTON 2517 WA0171300 PAGE 01 OF PART A 3000-345-189(R 11/18) STATE OF POLICETRAFFICN CORRECTION REPORT NO. EG61544 COLLISION REPORT III III III III III 111 1591972 CASE# 25-80723 ADDITIONAL PERSONS INVOLVED(PASSENGERS AND/OR WITNESSES ONLY) '.NAME (LAST,FIRST,MIDDLE INITIAL) ADDRESS&PHONE SEXi D.O.B. — MMDDYYYY PASSENGERQ WITNESS� UNIT SEAT AIRBAG RESTR. EJECT ; HELMET INJURY NATURE OF INJURIES POS. ' USE GLASS 1 ----� :NAME (LAST FIRST MIDDLE INITIAL) ADDRESS&PHONE# SEX D.O.B. — MMDDYYYY PASSENGER❑WITNESS UNIT# : SEAT AIRBAG RESTR. EJECT HELMET INJURY: NATURECFINJURIES POS. USE CLASS ----� :NAME (LOST,FIRST,MIDDLE INITIAL) ADDRESS&PHONE# SEX MMDDYY D.O.B. YY PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET NJURY NATURE OF INJURIES POS. I 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 12-15-25 04:08 PM INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST.DET DATED PLAGE SIGNED APPROVED BY DATE C.JACOBS 1953 1 1212212025 9:57:45 AM BADGE OR ID# ; 2517 ORI# WA0171300 TIME POLICE DISPATCHED 1 3:03 PM TIME POLICE ARRIVED i 3:09 PM PAST B 3 Do-3mx—attar(t 1Mff) PAGE 2�OF F5 REPORT NO. EG61544 CASE# 25-80723 DATE OF COLLI r�510NN + 12/15/25 15:02 L1 NARRATIVE 1/blk It from bank gry/2 in 2wcltl early for duvall wht/3 unit 2 swung post impact hit 3 CC Within the city limits of Renton/King/Wa I responded to a 3 car blocking injury crash at the 4513 block of NE 4th St. I located 3 vehicles blocking the 2WCLTL in front of US Bank. I contacted the driver of unit 2 who told me she had just merged into the 2WCLTL when unit 1 made a left turn from the bank driveway across all lanes without enough room to avoid contact. She did not complain of injury and damaged did require a tow truck. I contacted the driver of unit 3 who told me she was east on NE 4th St in lane 2 when unit 1 and 2 crashed. As a result of post impact unit 2 swung over and contacted the driver door area of unit 3. She did not complain of injury and damages did not require a tow truck. I contacted the driver of unit 1 ID'd by picture WADL. He was unable to provide a registration, valid proof of insurance of a phone number. He did not provide any additional information reference his actions resulting in this crash. He did complain of injury. He was checked and released on scene by Renton Fire. Damage did require a tow truck. I cited unit 1 Ref RCW 46.61.205 FTYROW when entering roadway from a private drive 3 car crash and Ref RCW 46.30.020 no 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 12/15/2025 PAGE 3 OF 5 SUPPLEMENTAL REPORT No. EG61 544 POLICE TRAFFIC 1 1 8 27 COLLISION REPORT CASE# 25-80723 t113197 1 COMMERCIAL MOTOR CARRIER INTERSTATE INTRASTATE UNIT# USDOT ICC# VEHICLE TYPE CARGO BODY 3 TYPE 2 ❑ 1 28 CARRIER NAME 3 CARRIER L ADDRESS CITY ST ZIP 4 ❑ NAME # PLACARD GWVR NAME IF NO NUMBER SOURCE AXLES + 4a ❑ ADDITIONAL UNITS MOTOR PEDAL- PROPERTY DAMAGETHRESHOLD MET PHONE UNIT# 3 �✓ PEDESTRIAN ❑ YEs No D:4255774167 5 VEHICLE CYCLE OWNER 0 1 29 LAST NAME REYNOLDS FIRST NAME VIVA MIDDLE D INITIAL STREET 30 NEW ADDRF 20510 SE 145TH ST CITY RENTON ST WA ZiP gg0598934 6 ❑ PRESENT MEC7ICALTANSPORTED. 1 1 2 31 CDL IGNITION REQUIRED 1{iNiTiON :: .. INTERLOCK YES D NO .;INTERLOCK YES 0- YES N DRIVER'S D-O.B 7 LICENSE STATE wq SEX F MmoDYYv 08 - 22 - 1955 ON DUTY STATUS AIRBAG 2 RESTR. 4 EJECT 1 HELMET INJURY 1 NAruRE of INJURIES USE CLASS 8 ❑ 1 32 LICENSE CFW8168 TAT WA VIN 1GYKPHRS9PZ158134 PLATE# 9 9] TRAILER TRAILER L PLATE# STATE PLATE# STATE 0 10 TRLR TRLR VIN.# VIN#. 11 3 5 VEIL YEAR2023 MAKE CADI MODELX-6 STYLE VEHICLE TOWE E T ABLIN TOWED BY GovT.vFHICI E FROM TO DAMAGE YES NO ✓ YES NO VIVA REYNOLDS 20510 SE 145TH ST RENTON WA 980598934 D:4255774167 7 3 33 REGISTERED OWNER INFO. SHADE IN DAMAGED AREA 12 4 FROM TO INSURANCE CO LIABILITY INSURANCE _CO CA 0658652 IN EFFECT &POLICY# 1 JTt1P--- 5 m 34 13 ❑ ve A YES NO CITATION# CHARGE 10 80Tf- .. e "' LLY MOTOR PEDAL_ ' 1:1PROPERTY DAMAGE THRESHOLD MET PHONE 35 14 ❑ UNIT# VEHICLE CYCLE PEDESTRIAN OWNER YES NO 36 15 LAST NAME FIRST NAME NIT AL 16 ❑ STREET CITY ST ZIP NFW ADDRESS" CDL IGNITION REQUIRED IGNITION PRESENT MEDICALTANSF'ORTED. INTERLOCK YES NO INTERLOCK YEs NO 'YES NO 17 37 DRIVER'S # STATE SEX Moog L 18 ❑ ❑ HELMET NJURY NATURE OF INJURIES 38 ON DUTY STATUS AIRBAG RESTR. EJECT USE CLASS. 19 ❑ ❑ 39 LICENSE TAT AN# PLATE# 20 TRAILER TRAILER 40 PLATE#, STATE PLATE# STATE ❑ 21 ❑ TRLR TRLR 41 VIN#�, VIN#Y 42 22 VEH.YEAR MAKE I MODEL I STYLE VEHICLE TOWED DUET ABLIN TOWED BY GOVT.VEHICLE DAMAGE YES NO YES NO 23 REGISTERED OWNER INFO. SHADE IN DAMAC ED AREA 43 2 3 4 LIABILITY INSURANCE INSURANCE CO IN EFFECT I &POLICY# ).C;Q 5. 44 vewc�e ❑ ❑ CITATION# CHARGE 24 I..TF" YES NO STIWDING 8 3 G 1 CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT. M.LEVERTON 12-15-25 04:08 PM 25 INVESTIGATING OFFICER'S SIGNATURE OFFICER'S PHONE UNIT OR DIST DET DATED: PLACE SIGNED BADGE 1 APPROVED 2 �ORIWA0171300 A 122 PAGE 2517 OF ORID# # 3000-345-013(R 11/18) REPORT NO. EG61544 CASE# 25-80723 DATE AND TIME 12/15/25 15:02 OF COLLISION c ti"•4^.� a �14a� Y fJz� Y z � 4 {k t' I Y t k t r) t �?r h� txFY fi k PAGE 5 OF 5