HomeMy WebLinkAbout25-81194 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 1 27c
COLLISION REP FIT 1591971
CASE 25-81194 z
INTERSTATE ❑ CITY STREET FIRE ❑RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHIC;I F ❑ LOCAL AOENC 4200 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 5 TOTAL#OF OBJECT 1 1 8 28
TRIBAL UNITS OZ RESERVATION STRUCK
z
3❑ DATE OF M M D D Y Y Y Y TIME(2400) COUNTY# MILES N E IN CITY# ❑
CawsloN 12 - 1-- 2025 1912 17 ❑.= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓
E VALLEY RD BLOCK NO. e✓ 1800
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ ❑ FEET e S ❑ W e 0 4 29
MOTOR PEDAL- DAM THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El YEs NO ,/ D:9715155461 0 4 30
6� LAST NAME LATT FIRSTNAME NICOLAS MIDDLE S 1 1 2 31
INITIAL
STREET ❑, 12230 SE STEELE ST CITy PORTLAND ST OR 2jp, 97236 z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
INTERLOCK YES[:]NO 1/ INTERLOCKYEs NO�/ YES R No�/
❑ DRIVER'S' STATE OR SEX'M MDMDD� 11 - 12 1- 1978 1 2 32
8 LICENSE#
9 ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 C.
H USEET 2 I INJURY CLASS 1 NATURE OF INJURIES 2❑
3
10 9� LICENS P1 ATE 14 479QTD STATE OR VN# JTDACACU8S3048279
TRAILER STATE TRAILER STATE
11 3 5 PLATE# PLATE# ROM ro
TRLR. TRLR 7 1 33
12 3 5 VIN#' VIN#
>; FROM TO
VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE 5 7 34
13 8 2025 TOYT PRIUS 4D DAMAGE YES NO YES[:] No✓
REGISTERED OWNER INFO OWNEDBYDRIVER VEHICLE NO. 1
SHADE IN DAMAGED AREA ❑ 35
14 LIABILI INSURANCE INSURANCE CO CONNECT 411272547669 3 4
IN EFFECT &POLICY# 9TOP
v CHARGE 5 36
LECALLvewCLE res❑NO❑ CITATION# 1 o BOTTOM
15❑ STANDING 8 6
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES 1/ NO D:2063134938
16 a
LAST NAME KENYON FIRST NAME WAYNE MIDDLE I T
INITIAL
17❑ NEW STREETREs7 18112 SE 134TH ST CITY RENTON ST WA ZIP 980597109 4❑ 37
18❑ CDL IGNITION REQUIRED IGNITION PR-E-1SENT MEDICAL-T�RANSPORTED � 38
INTERLOCK YEs❑No� INTERLOCK YEs It I NOF YES
t l NOF,/
19 DRIVERS
❑ ON DUTY STATUS I
AIRBAG 2 RESTR 4 EJECT 1 H U EET 2 NJAURSY 1 NATURE OF INJURIES 40
❑21❑ PLATE# 41
C94049S TATE WA VIN1i 1FT8W3BT6KEF40937 1
42
22❑ PILER LATE# STATE PLATE# STATE
TRLR
23❑ VIN#. N#. 43
RLR
'I
VEH YEAR 2019 MAKE FORD MODEL F350 STYLE TR VEHICLETOWED TO BLIN TOWEDBY GOV HI 44
L4❑ DAMAGE YES NO YES NO
REGISTERED OWNER INFO WAYNE KENYON 18112 SE 134TH ST RENTON WA 98059 VEHICLE NO.2
SHADE IN DAMAGED AREA
2 3 4
LIABILITY
INSURANCE &POINSURGY#E CO GEIC04408988741IN 1 VEHICLE [:] CITATION# CHARGE
25 UQ,
LEGALLY YES N
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# JAGENCY
26
ROBIN SMITH 12986 WA0171300
PAGE 01 OF
PART A
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EG65339
COLLISION REPORT III III III III III 111
1591972 CASE# 25-81194
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.
ROBIN SMITH 12-31-25 08:13 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
QUINT TIBEAU 7691 1 1/3/2026 1:59:34 AM
BADGE OR ID# 9Y988 OR]# WA0171300 TIME POLICE DISPATCHED; 7:13 PM TIME POLICE ARRIVED',7:21 PM
FART I PAGE IT]OF 4�
REPORT NO. EG65339 CASE# 25-81194 OF COLLISION
12/31/25 19:12
OF CbLLI510N
NARRATIVE
25-81194
Unless otherwise stated, the following occurred in the City of Renton, County of King, State of
Washington.
On 12-31-2025 at approximately 1913 hours I was dispatched to a non-injury, non-blocking, two
vehicle collision in the 1800 block of E Valley RD.
Upon arrival, I contacted the involved parties and confirmed no one was injured. I collected the
involved parties driving documents and their independent recollection of events leading up to the
collision.
The driver of Unit#1 said he was leaving the parking lot of Larkspur Landing located in the 1800
block of E Valley RD. He did not see Unit#2 in the center turn lane of E Valley RD waiting to turn
westbound into the parking lot. As Unit#1 pulled out of the parking lot eastbound and turned
northbound onto E Valley RD, the front passenger end collided with the driver side front tire of Unit
#2. The driver of Unit#1 said he didn't notice the truck because of the heavy fog. Unit#1 sustained
minor damage to the passenger front just below the headlight.
The driver of Unit#2 said he was facing northbound on E Valley RD in the center turn lane preparing
to turn westbound into the parking lot of Larkspur Landing. As he turned, he saw Unit#1 turn
northbound out of the parking lot, failing to yield to him. Unit#2 is a truck with a lift kit on it. Unit#1
collided with the front driver side tire of Unit#2 and caused minor damage to the front bumper, right in
front of the driver side tire. The driver of Unit#2 said his front driver side tire turning is affected due to
the impact.
I find the proximate cause of the collision to be the driver of Unit#1 for Renton Municipal Code 10-12-
25 inattentive driving. The driver of Unit#1 failed to exercise caution when entering the roadway
when heavy fog was present. I did not cite the driver of Unit#1.
The driver of Unit#1 wanted to exchange information and avoid involving insurance due to the minor
damage, however, both drivers did not agree on the extent of the damages. I took photographs of
both vehicles and uploaded to Axon.
An exchange of information was provided to both parties. Both vehicles were able to drive away from
the scene.
I certify (declare) under penalty of perjury under the laws of the state of Washington that the foregoing
is true and correct.
Electronically signed by Robin Smith #12986 on 12/31/2025 @ 2004 hours in Renton, WA
PAGE 3 OF 4
REPORT NO. EG65339 CASE# ' 25-81194 DATE AND TIME 12/31/25 19:12
OF COLLISION
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