HomeMy WebLinkAbout25-81063 IT si " II IIIII III IIIII II IIII IIIII I . 27c REPORT NO EG65611OLCERA
COLLISION REPORT 1591971
CASE# 25-81063 2
INTERSTATE CITY STREET FIRE I
RESULTEDSTOLENSTATE ROUTE OTHER VEHICLE LOCAI-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
3I M M D D Y Y Y Y TIME(2400) COUNTY# MILES CITY#
eaCL s on' 12 - 27 - 2025 1339 17 =.= S 8 W e OF IN e 1070 s
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
NE 4TH ST BLOCK NO.
4a❑
MILE POST e
❑ DISTANCE OF(REFERENCE OR CROSS STREET)
5 MILES�.� FEET e S 8 W e UNIONAVENE
0 1 29
MOTOR PEDAL- DAM AG THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE ❑ YEs Vl No D:4254964792 0 8 30
5❑ LAST NAME WIENEKE FIRST NAME PAUL MIDDLE M 1 2 31
INITIAL
STREET ❑ 13102 233RD AVE SE CITY; ISSAQUAH ST WA ZIP; 98027 2
NEW ADDRESS
7 CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
INTERLOCKYES NOW] INTERLt)CKYES NO vEs ND
8 DCIENSE# STATE WA SEXI M MMDDYY' 11 - 05 - 1964 1 2 32
9 ON DUTY STATUS' AIRBAG 2 RESTR 4 EJECT 1 N USE ET CLASSY 1 [NATURE of INJURES 2
10 PI ENSttEI ATH9875 STATE WA VIN# 3N1CC11E29L425047 3
5 TRAILER STATE TRAILER STATE
11 3 5 PLATE# PLATE# IE.M To
TRLR TRLR 3 1 7 33
12 3 5 VIN# vIN#
FROM TO
VERYEAR 2009 MAKE NISS MODEL VERSA STYLE HB VEHICLE TOWED TO BLIN TOWEDBY GOVT VEHICLE 3 9 34
13 DAMAGE YES NO YES❑ NO
REGISTERED OWNER INFO PAUL WIENEKE 131CII.3RD AVE SE ISSAQUAH WA 98027 D:4254964792 VEHICLE NO. 1
SHADE IN DAMAGED AREA 35
4 LIABILITY INSURANCE INSURANCE CO 2 3 4
14 ALL STATE 976377913
IN EFFECT &POLICY# 4TOP
VEHICLE CHARGE 5 36
Lemur YES[:]NO[:] CITATION# i o 80TTOM
15❑ sTnNowc s 7 e
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT 02 VEHICLE CYCLE PROPSnWNr YES�/ NO D:4254732242
16�
LAST NAME GOTZ FIRST NAME JEANETTE MIDDLE R
INITIAL
17 F1 STREET ❑ 4318 NE 17TH ST CITY RENTON ST, WA ZIP 98059 37
NEW ADDRESS I I I I I I [I
1$❑ IGNITION RE€]UIRED IGNITION PRESENT MEDICAL TRANSPORTED 38
CDL INTERLOCKYEs NO INTERLOCK YES No�/ YES NO
19 DRIVERS
MMDDYY I —
HELMET INJURY: NATURE OF INJURIES 4Q
20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 7 ❑
USE CLASS NECK PAIN,RIGHT SHOULDER PAIN
21 1 LICENSE602TZX TATE I WA VIN# 1C3AL56U01N676976 41
PLATE#22❑ [TILER TAILER
PLATE# STATE PLATE# STATE 42
23 TRLR RLR 43
UIN#. 'IN#
VEH.YEAR 2001 MAKE CHRY MODEL SEBRING STYLE 4p VEHICLE TOWED TO BLIN
TOWED BY GOV HI 44
24� DAMAGE YES NO� VES NO
REGISTERED OWNER INFO JEANETTE GOTZ 4318 NE 17TH ST RENTON WA 98059 D:4254732242 VEHICLE NO.2
SHADE IN DAMAGED AREA
2 3 4
LIABILITY INSURANCE[Z INSURANCE CO STATE FARM 1817848FZ047B
IN EFFECT &POLICY# I STOP
vewcLe ,.I—I CITATION# CHARGE to BOTTOM
EEGnEEY YES N
25 s ' s
OFFICER'S NAME(PRINT)
26 OFFICER PHONE BADGE OR ID# JAGENCY
SHAWN CROW 12618 WA0171300
PART A PAGE 01 OF
3000-345-189(R 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EG65611
COLLISION REPORT III III III III III 111
1591972 CASE# 25-81063
E NA ADDITIONAL PERSONS INVOLVED(PASSENGERS AND/OR WITNESSES ONLY)
M
(LAST,FIRST,MIDDLE INITIAL) LAY MICHAEL R
ADDRESS&PHONE#
4617 SE 4TH PL RENTON WA 98059 2064550261 SEXi M MMDDD BYYY 12 — 30 — 1967
PASSENGER WITNESS UNIT# + SEAT AIRBAG' RESTR. EJECT HELMET INJURY NATURE OF INJURIES
1:1Q POS. USE CLASS ----�
:NAME
(LAST FIFS7 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 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.
SHAWN CROW 12-28-25 01:16 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST.DET DATED PLACE SIGNED
APPROVED BY DATE
P.KORDEL 9676 11412026 11:36:43 AM
BADGE OR ID# 12618 ORI# WA0171300 TIME POLICE DISPATCHED 1:42 Pry/ TIME POLICE ARRIVED i 1:48 Pry/
PAST B 3 Do-3mx—attar(t 1Mff) PAGE 2�OF 4
REPORT NO. EG65611 CASE# 25-81063 OATS OF COLLI r�510NN + 12/27/25 13:39
L1
NARRATIVE
On 12/27/2025 at about 1339 hours a two-motor vehicle collision occurred near the intersection of NE
4th St/Union Ave NE. When I arrived on scene both vehicles were found pulled into a nearby parking
lot. 1 spoke to both drivers, and they explained what happened.
Driver 1: Paul M. Wieneke; Unit 1: black colored Nissan Versa with Washington state license plate
ATH9875
Driver 2: Jeanette R. Gotz; Unit 2: 2001 Chrysler Sebring with Washington state license plate
602TZX.
Unit 2 was headed westbound on NE 4th St (traveling in the lane closest to the curb) and stopped for
a solid red colored traffic light at the intersection of NE 4th St/Union Ave NE. Unit 1 was stopped
behind Unit 2 at the time. When the traffic light for westbound traffic turned green in color, Unit 2
moved forward and prepared to turn right (north) onto Union Ave NE. Driver 2 noticed pedestrians
crossing Union Ave from west to east on the marked crosswalk. Driver 2 stopped to wait for the
pedestrians to cross the road before making her turn. While Unit 2 was stopped for the pedestrians,
Unit 1 drove straight ahead and collided into the rear of Unit 2. Both drivers pulled their vehicles into
a nearby parking lot and waited for police.
Unit 1 had damage to the front end of the car, but it appeared drivable. Driver 1 did not complain of
any injuries. Unit 2 had damage to the rear end of the vehicle, but it appeared drivable. Driver 2
complained of neck pain and pain to her right shoulder; however, she declined medical aid.
One of the pedestrians (Michael R. Lay) crossing the road at the time of the collision provided his
name and phone number to Driver 2 as a witness to the collision. I spoke to Michael over the phone,
and he confirmed that he did see the collision as he crossed Union Ave NE (from the west side of the
street to the east side of the street). Michael saw Unit 2 stop as he crossed the road. Michael turned
to wave at Driver 2 and saw Unit 1 collide into the rear end of Unit 2.
While I was speaking to both drivers, I heard Driver 1 comment that the collision was his fault. Driver
1 said he was looking at the GPS map on his phone and was distracted when the collision occurred.
Driver 1 admitted he was distracted and looking at the GPS on his cellphone which appeared to
contribute to the circumstances of the collision. I gave both drivers a Renton PD business card with
the case number.
I certify (declare) under penalty of perjury under the laws of the State of Washington that the
foregoing is true and correct.
Signature: Shawn Crow Date and Place: 12/27/2025 at Renton, WA
PAGE 3 OF 4
REPORT NO. EG65611 CASE# 25-81063 DATE AND TIME 12/27/25 13:39
OF COLLISION
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