HomeMy WebLinkAbout25-80935 IT si " II IIIII III IIIII II IIII IIIII I . 27c REPORT NO EG66574OLCERA
COLLISION REPORT 1591971
CASE# 25-80935 2
INTERSTATE CITY STREET FIRE ❑
RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VEHICLE ❑ LOCCODICENC'Y 41000 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
Cad 1
2❑ TRIBAL UN TS#OF 02 TRUCK 1 8 28
i RESERVATION 2
3� M M D D Y Y Y Y TIME(2400) COUNTY# MILES CITY#
22 - 2025 0820 17 =.= S 8 W e OF e 1070 s
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
I
BLOCK NO.
405 OFF RAMP
4a❑ MILE POST
❑ DISTANCE OF(REFERENCE OR CROSS STREET)
5 C------ 1.1 FEET e S 8 W e TALBOT RD S
0 6 29
MOTOR PEDAL- DAMAG THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE ❑ YES No �/ D:2063359476 0 7 30
6 LAST NAME LOBANOVA FIRST NAME KATERYNA MIDDLE N 1 1 2 31
INITIAL
STREET ] 625 WILLIAMS AVE S APT 429 CITY; RENTON ST I WA ZIp; 980572744 2
NEW ADDRESS
7 CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
INTERLOCKYES No INTERLOCKVEs No YES NOD
8 DRIVER # STATE WA SEXI F MMDOYY' 08 - 17 - 2002 t 1 2 32
-NJUR
9 ON DUTY STATUS' AIRBAG 2 RESTR 4 EJECT 1 N USEET 2 CLASSY 1 [NATURE of INJURIES 2
LICENSE, CNH5670 STATE WA VIN# 1FAHP3K24CL468689 3
10 Fl I PI ATP tt
TRAILER
11 0 0 STATE TRAILER STATE PLATE# PLATE# ROM TO
TRLR zRLR 1 5 33
12 0 0 VIN#' VIN#
FROM TO
VEH.YEAR 2012 MAKE FORD MODEL FOCUS STYLE VEHICLE TOWED TO BLIN TOWED By GES VEHICLE 9 9 34
13 DAMAGE YES YES NO
REGISTERED OWNER INFO rATERYNA LOBANOVA 625 WILLIAMS AVE SAPT429 RENTON WA 98057 VEHICLE NO. 1
SHADE IN DAMAGED AREA 35
2 LIABILITY INSURANCE INSURANCE CO 2 3 4
14 PROGRESSIVE 988712489
IN EFFECT &POLICY# 4TOP
CHARGE 5 36
Lemur yes❑NO❑ CITATION# 7 0 80TTOM
15❑ STM ING s 7 e
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT 02 VEHICLE CYCLE nWNFR YES NO �/ D:4252687473
16�
LAST NAME ANGUTANO-DIAZ FIRST NAME MARIA MIDDLE D
INITIAL
❑ 37
17 STREET ❑ 2202 NE 10TH PL APT 105 CITY RENTON ST, WA ZIP 980562958
NEW ADDRESS
18❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICALTRAN3PORTED'. ❑ 38
INTERLOCKYES NO INTERLOCK YESFINOFYEs NO
19[—] DRIVER'S STATE WA SEXI F D.O.B. 06 25 1987 39
LICENSE# MMDDYY —
20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 HELMET 2 INJURY 7 NATURE A INJURIES ❑ 40
USE CLASS NECK PAIN
21 PLAT# MJGIRLS rare WA vIN# 1G1ZB5ST9JF200596 41
22❑ PLATE# STATE PLATE# STATE 42
43
23 TRLR RLR
UIN#. 'IN#
VEH.YEAR 201$ MAKE CHEV MODEL MALIBU STYLE SO VEHICLE TOWED TO BLIN
TOWED BY GOV HI 44
24 DAMAGE YES NO VES NO
REGISTERED OWNER INFO MARIA ANGUTANO•DIAZ 2202 NE 10TH PL APT 105 RENTON WA 98056 VEHICLE NO.2
SHADE IN DAMAGED AREA
2 3 4
LIABILITY INSURANCE INSURANCECO STATE FARM 5039041 E1247B
IN EFFECT &POLICY# tG�Da
Yemae ,.I—I CITATION# CHARGE
LE—LY YES N`.L J
25s ' s
7'0FFCll,tER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
26
TALAN 12007 WA0171300
PAGE 01 OF
PART A 3000-345-189(R 11/18)
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EG66574
COLLISION REPORT III III III III III 111
1591972 CASE# 25-80935
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.
C.CATALAN 12-22-25 10:56 AM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST.DET DATED PLAGE SIGNED
APPROVED BY DATE
C.JACOBS 1953 1/712026 7:33:00 AM
BADGE OR ID# 12007 ORI# WA0171300 TIME POLICE DISPATCHED 8:25 AM TIME POLICE ARRIVED i 8:32 AM
PAST B 3 Do-3mx—attar(t 1Mff) PAGE 2�OF 4
REPORT NO. EG66574 CASE# 25-80935 DATE OF COLLI r�510NN + 12/22/25 08:20
L1
NARRATIVE
On December 22, 2025, at approximately 0820 hours, I was dispatched to a two-vehicle collision at
Home Depot, 920 SW Grady Way, within the City Limits of Renton, County of King, State of
Washington.
Upon my arrival I contacted the involved parties and determined that the driver of Unit 2 was
complaining of neck pain. 1 asked the driver if they required medical assistance, and they said no.
While on scene, I collected the involved parties driving documents and their independent recollection
of events leading up to the collision.
The driver of Unit 1, identified as Kateryna Lobanova, used her husband (Serhil) as a translator. He
stated that Kateryna was traveling southbound on 1405 prior to the collision. Kateryna took the Talbot
Rd S exit and drove down the highway offramp. As she approached Talbot Rd S, she was unable to
stop in time and subsequently collided with the rear of Unit 2 who had slowed down in the roadway.
Serhil stated that their vehicle did not sustain any damage whatsoever, which 1 confirmed. Serhil
mentioned that the driver of Unit 2 was complaining of pain when the vehicle damage did not
substantiate their claim. He was worried that his insurance premiums would raise for a possible
medical issue that was not there.
The driver of Unit 2, identified as Maria Anguiano-Daiz, said she was the sole occupant of her vehicle
and was also traveling southbound on 1405. Maria took the Talbot Rd S exit and was down the
offramp near Talbot Rd S. As Maria yielded for northbound traffic, Unit 1 collided with the rear of Unit
2. 1 could not identify any damage, so 1 asked Maria to point out any new damage. Maria pointed
towards a Pennie sized indentation on the rear bumper and said she believed that was new. Based
on the location of the dent, 1 believe the damage was possibly caused by the front bolt used to carry
Unit 1's front license plate.
While 1 spoke with Maria, she was emotional. Maria was crying and said her neck hurt. 1 asked how it
happened, and she told me her head slammed against the headrest after the collision. I asked Maria
again if she needed the fire department to respond, and she said no. Maria said she would visit the
hospital after the collision is investigated. Before 1 left maria told me she felt dizzy and that she felt a
pinch in her neck when she tried moving it.
Based on the above statements, 1 determined that the Driver of Unit 1 (Kateryna) is the proximate
cause for the collision due to inattention causing a collision
did not issue Kateryna a Sector infraction, and this is an informational report only. An exchange of
information was provided to all involved parties.
I certify (declare) under penalty of perjury under the laws of the State of Washington that the
foregoing is true and correct.
C. Catalan 12/22/2025 Renton
PAGE 3 OF 4
REPORT NO. EG66574 CASE# 25-80935 DATE AND TIME 12/22/25 08:20
OF COLLISION
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