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Home My WebLink About25-80429 IT �i " II IIIII III IIIII II IIII IIIII I . 0 27c REPORT NO EG61543OLCERA COLLISION REPORT 1591971 INTERSTATE ❑ CITY STREET FIRE I CASE# 25-80429 2 RESULTED STOLENSTATE ROUTE OTHER VEHICLE LOCAI-AGENCY 4100 3 HIT&RUN CODING COUNTY RD PRIVATE WAY INVOLVED 2 TOTAL#OF OBJECT 1 s 28 TRIBAL UNITS 03 STRUCK ❑ RESERVATION : 1 1 2 3I M M D D Y Y Y Y TIME(2400) COUNTY# MILES CITY# eDCL s on' 12 - 05 - 2025 0943 17 =.= S 8 W❑ OF IN e 1070 s 4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑ NE 4TH ST BLOCK NO. e 4100 .� 4a❑ MILE POST ❑ DISTANCE OF(REFERENCE OR CROSS STREET) 5 MILES�.� FEET e S 8 W e UNIONAVENE 0 4 29 MOTOR ✓ PEDAL- DAM AG THRESHOLD MET PHONE UNIT 01 VEHICLE ❑ CYCLE ❑ YEs Vl No D:2063088972 0 1 30 6 LAST NAME NGUYEN FIRST NAME KIM MIDDLE P 1 1 2 31 INITIAL STREET ❑ 12610 SE 168TH ST CITY; RENTON I ST WA ZIP 980586120 2 NEW ADDRESS 7 CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3 INTERLOCK YES No✓ INTERLOCKVEs E ✓ YES NO✓ 8 DRIVER # STATE WA SEXI F MMDDYY' 01 - 21 - 1975 1 2 32 -NJUR 9 ON DUTY STATUS' AIRBAG 4 RESTR 4 EJECT 1 HELMET 2 CLASSY 1 [NATURE of INJURIES 2❑ 10 PI ENSttEI AXG2387 STATE WA VIN# 5TDDK3DC1FS117822 3 11❑ TRAILER STATE TRAILER STATE 3 5 PLATE# PLATE# FROM To TRLR TRLR 7 1 1 33 12 3 5 VIN# vIN# FROM TO 13 4 VEH.YEAR2015 MAKE TOYT MODEL SIENNA STYLE VEHICLE TOYED NO�iS46LIN T� {J RSTOWING Ges❑VEHICLE No✓ 3 7 34 DAMAGE IIII._IIII REGISTERED OWNER INFO KIM NGUYEN 12610 SE 168TH ST RENTON WA 98058 VEHICLE NO. 1 SHADE IN DAMAGED AREA 35 14 LIABILITY INSURANCE� INSURANCE CO AMERICAN FAMILY 410017072155 IN EFFECT &POLICY# 9TOP _ Yes sE"ALLY ❑NO❑ CITATION# 5A0946045 CHARGE FAIL YIELD LEFT TURN MOTOR s a oorrob s 36 15❑ MOTCYR ✓ PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE UNIT 02 VEHICLE CYCLE nWNFR YES�/ NO D:4259817871 16� LAST NAME EVANS FIRST NAME RAEJEAN MIDDLE' N INITIAL 17 STREET ❑ 37 NEW ADORE SS❑ 1133 GLENNWOOD AVE NE CITY RENTON ST, WA ZIP 980563015 18❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED ❑ 38 INTERLOCKYES NO✓ INTERLOCK YES No✓ vEs NO✓ 19 DRIVER'S MMDDYY — HELMET INJURY: NATURE OF INJURIES 4Q 20❑ ON DUTY STATUS AIRBAG 3 RESTR 4 EJECT 1 2 7 ❑ USE CLASS COMPLAINT OF PAIN TO KNEE/LEG 21 LICENSLATE E BGC2281 rare WA VIN# KNDJC733565607873 41 22❑ PLATE# STATE PLATE# STATE 42 23 TRLR RLR 43 UIN#. 'IN# TOWED BY GOV HI 44 VEH.YEAR 200g MAKE /p�Q MODEL SORENT STYLE DAMIAGE TOWED✓ No BLIN BANKERS TOWING ves No✓ 24❑ REGISTERED OWNER INFO RAEJEAN EVANS 11506155TH AVE SE RENTON WA 98059 VEHICLE N0.2 SHADFY DAMAGED AREA 3 4 LIABILITY INSURANCE❑ INSURANCE CO NONE NONE IN EFFECT &POLICY# 9TOP VEHICLE YES❑ NC❑ CITATION# 5A0946044 CHARGE NO VALID OPER LICENSE WITH VALID OUR, E—Lv 25 6 OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY J 26 D.NELSON 12421 WA0171300 ❑ PAGE 01 OF PART A 3000-345-189(R 11/18) STATE OF POLICETRAFFICN CORRECTION REPORT NO. EG61543 COLLISION REPORT III III III III III 111 1591972 CASE# 25-80429 E NA ADDITIONAL PERSONS INVOLVED(PASSENGERS AND/OR WITNESSES ONLY) M (LAST FIRST,MIDDLE INITIAL) BREWER ANGELA M ADDRESS&PHONE# D� 14250 147TH PL SE RENTON WA 98059 2068564699 SEXi F MMDDYYYY 08 — 08 — 1968 PASSENGER E]WITNESSZ II UNIT# SEAT AIRBAG RESTR. EJECT HELMET INJURY NATURE OF INJURIES POS. USE '.CLASS 1 � ----� :NAME (LAST EIFS7 MIDDLE INITIAL} ADDRESS R PHONE# SEX MMDDYYYY D.O.B. — PASSENGER❑WITNESS UNIT# : SEAT AIRBAG RESTR. EJECT HELMET INJURY: NATURE CFINJURIES POS. USE CLASS ----� :NAME (LOST,FIRST,MIDDLE INITIAL) ADDRESS&PHONE# SEX I 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. D.NELSON 12-05-25 03:17 PM INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST.DET DATED PLACE SIGNED APPROVED BY DATE C.JACOBS 1953 12/22/2025 10:16:56 AM BADGE OR ID# 12421 ORI# WA0171300 TIME POLICE DISPATCHED 1 9:44 AM TIME POLICE ARRIVED i 9:44 AM PAST B 3 Do-3mx—attar(t 1Mff) PAGE 2�OF F5 REPORT NO. EG61543 CASE# 25-80429 DATE OF COLLI r�510NN + 12/05/25 09:43 L1 NARRATIVE 25-80429 ACCINJ On 12/5/2025 1 was working as a uniformed patrol officer and driving a marked patrol vehicle for the City of Renton. 1 was driving east on NE 4th St approaching Union Ave NE Renton/King/WA when 1 came across a three-vehicle, blocking collision in the intersection. I exited my vehicle and spoke with a driver who advised she had knee pain, RRFA was started for the complaint of pain and airbag deployment. The driver of the 2015 Toyota Sienna WA/AXG2387 (Unit 1), was identified by her WADL as Kim P Nguyen. Kim said that she was in the left turn lane to turn north on Union Ave NE from east NE 4th St. She said that she had a yellow light when she entered the intersection and was struck by Unit 2. Unit 1 was then pushed into the front of Unit 3 from the impact. There was damage to the passenger side doors and midsection of the van from the initial impact and damage to the driver side front door from the secondary impact. Kim did not have a complaint of pain but was evaluated by RRFA and cleared at the scene. There was front and side airbag deployment inside the Sienna, and it was not drivable. Bankers Towing removed it from the scene. The driver of the 2006 Kia Sorento WA/BGC2281 (Unit 2), was identified by her WAID card as Raejean Evans DOB: 9/24/1982. Raejean said that she was driving west on NE 4th St in the #1 lane when Unit 1 turned in front of her. The front end of the Kia collided with the passenger side of the Sienna. There was heavy damage to the front end of the Kia. There was front airbag deployment inside the Kia, and it was not drivable, Bakers Towing removed it from the scene. Raejean had a complaint of knee pain from the impact and was evaluated and cleared by RRFA at the scene. While speaking with Raejean she admitted to not having a valid license and no valid insurance on the vehicle. A DOL showed Raejean had a driving status of Not Licensed -Eligible. The driver of the 2019 Toyota Camry WA/CCT6841 (Unit 3), was identified by his WADL as Jose G Gonzalez-Ortiz DOB: 12/14/1982. Jose was stopped in the left turn lane to turn east onto NE 4th St from south Union Ave NE. He was completely stopped when Unit 1 collided with him. There was damage to the passenger side front bumper/headlight. There was no airbag deployment, and the vehicle was drivable. Jose was not injured. A witness was stopped for a red light facing north advised she watched as the Sienna turned into the intersection and the Kia collided with it. She could not tell the color of the lights at the time of the collision. I cited Kim under Sector citation #5A0946045 for Failure to Yield Left Turn Motor Vehicle RCW 46.61.185.1. 1 cited Raejean under Sector citation #5A0946044 for No Valid Operators License with Valid ID RCW 46.20.015. These citations should be mailed to Kim and Raejean's DOL address. Nothing further. I certify under penalty of perjury under the laws of the State of Washington that the foregoing is true and correct. D. Nelson #191 12/5/2025 Renton WA PAGE 3 OF 5 SUPPLEMENTAL REPORT No. EG61 543 POLICE TRAFFIC 1 1 8 27 COLLISION REPORT CASE#1 25-80429 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 GWUR : � NAME IF NO NUMBER S SOURCE AXLE H 4a ❑ ADDITIONAL UNITS MOTOR PEDAL- PROPERTY DAMAGETHRESHOLD MET PHONE UNIT# 3 �✓ PEDESTRIAN ❑', YEs� No D:4253219316 5 VEHICLE CYCLE OWNER 0 8 29 LAST NAME GONZALEZ-ORTIZ FIRST NAME , JOSE MIDDLE G INITIAL STREET 30 NEW ADDRFs 129 S 174TH ST APT G203 CITY SEATTLE I ST WA ZIP 981481773 6 ❑ 1 1 2 31 CDL IGNITION REQUIRE6 ;IGNi7ION PRESENT MEDICAL TAN^�PORTED INTERLOCK YES. NO�/ .;INTERLOCK YESO NO I YES N- L DRIVER'S STATE D.O.B LICENSE p►/q SEX;M MMDDYYY 12 - 14 - 1982 7 ON DUTY STATUS AIRBAG 2 RESTR. 4 EJECT 9 HELMET 2 INJURY 1 NAruRE of INJURIES USE CLASS 8 ❑ 1 32 LICENSE CCT6841 TAT WA VIN 4T1B11HK6KU207100 PLATE# 9 TRAILER I TRAILER L PLATE# STATE PLATE# STATE 0 10 ❑ TRLR TRLR VIN.# VIN#. 11 3 5 VEH.YEAR2019 MAKE TOYI MODELCAMRY STYLE SD VEHICLE TOWE E T ABLIN TOWED BY covT vFHICI E FROM To DAMAGE YES NO ✓ YES NO IRIS ZARENCO 129 S 174TH ST APT G203 SEATTLE WA 981481773 D:4253219316 9 9 33 REGISTERED OWNER INFO. SHADE IN DAMAGED AREA 12 4 FROM TO INSURANCE CO LIABILITY INSURANCE SAFECO H2515714 IN EFFECT &POLICY# I TZt1p 5 m 34 13 V"'�e YES NO1:11 CITATION# CHARGE 0 NOTTOM ecaLLv s-rnNoiNc � MOTOR PEDAL_ ' 1:1PF20pERTY 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 ADDRBsa CDL IGNITION REQUIRED IGNITION PRESENT MEDICALTANSF'ORTED. INTERLOCK YES NO INTERLOCK YES NO YES[_ NOD 37 DRIVERS SEX MM L STATE DDB ❑ ❑ HELMET '.INJURY OF INJURIES NATURE 38 18 ON DUTY STATUS AIRBAG RESTR. EJECT USE CLASS. 19 ❑ ❑ 39 LICENSE TAT vIN# PLATE# 20 TRAILER I TRAILER 40 PLATE#,' STATE PLATE# STATE ❑ 21 ❑ TRLR TRLR 41 VIN# VIN#Y 42 22 VEH.YEAR MAKE I MODEL I STYLE VEHICLE TOWED DUE T SABLIN 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 &POLICY# 1 I n— 'TBOTiC?M y 44 24 VEEIwAcLD'LFYGYES❑ NO❑ CITATION# CHARGE G 3 3 G 1 CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT. D.NELSON 12-05-25 03:17 PM 25 INVESTIGATING OFFICER'S SIGNATURE OFFICER'S PHONE UNIT OR DIST DET DATED: PLACE SIGNED 26 BADGE 1 OR ID# 12421 O#RI WA0171300 APJACOBS 1 212 2/2 0 2 PAGE OF 3000-345-013(R 11/18) REPORT NO. EG61543 CASE# 25-80429 DATE AND TIME 12/05/25 09:43 OF COLLISION ti 5 t 4 ; t .. r ..✓RSA. 4 d f ; 1 l\ i z � Y \ Z PAGE 5 OF 5