HomeMy WebLinkAbout25-80971 iiTFiNII IIIII III IIIII II IIII IIIII I . 27c REPORT NO EG66575oc� RA
COLLISION REPORT 1591971
INTERSTATE CITY STREET FIRE I
CASE# 25-80971 2
RESULTEDSTOLENSTATE ROUTE OTHER VEHICLE LdCCOAGENCY 4200 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2❑ TRIBAL UN TS#OF 02 OBJESTRUCT
1 1 8 28
TREE OR STUMP
i RESERVATION : 1 2
3� M M D D Y Y Y Y TIME(2400) COUNTY# MILES CITY#
eaCL s o v' 12 - 23 - 2025 0913 17 =.[� S 8 W e OF IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
E
BLOCK NO.
AST VALLEY HWY
4a❑ MILE POST
❑ DISTANCE OF(REFERENCE OR CROSS STREET)
5 MILES 1.1 FEET e S 8 W e SW 41ST ST
0 3 29
MOTOR ✓ PEDAL- DAM AG THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE ❑ YES ✓NO 0 1 30
6 LAST NAME AMISI FIRST NAME NICOLE MIDDLE A 1 1 2 31
INITIAL
STREET ] 27830 PACIFIC HWYS APT L104 CITY; FEDERAL WAY ST WA ZIP; 980032995 2
NEW ADDRESS
7 CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
INTERLOCKYES ND INTERLOCKYES E YEs NO
g❑ DRIVER # STATE WA SEXI F MMDOYY' 09 - 07 - 2005 1 2 32
9 ON DUTY STATUS' AIRBAG 2 RESTR 9 EJECT 1 N USE ET CLASSY 1 [NATURE of INJURIES 2
LICENSE, CNG2396 STATE WA VIN# JTKKT60460159195 3
10 Fl I as ATP tt
STATE STATE
TRAILER TRAILER
11 0 0 PLATE# PLATE# 11ROM To
TRLR TRLR 3 1 33
12 3 5 VIN# VIN#
FROM TO
LE
13 6 VEH.YEAR 2006 MAKE TOYT MODEL SCION STYLE DAMAGE TOWED NO�iS46LIN Tv4MYMEYER GO NO 5 1 34
DAMAGE IIII._IIII I_I
REGISTERED OWNER INFO DEBORAH LAWSON 54438ALLARD AVE NW#202 SEA WA 98f07 VEHICLE NO. 1
SHADE IN DAMAGED AREA 35
14 LIABILITY INSURANCE❑ NSURANCE CO
IN EFFECT &POLICY# CTTOP
VEn" CHARGE BOTTOM ❑ 36
eMLLy
IN YES❑NO❑ CITATION# 5A0900807,5AO900807 FA►L TO OBEY TRAFFIC CONTROL
15❑ owc
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT VEHICLE CYCLE nWNFR D:3602374222
16�
LAST NAME MALDONADO CARRASCO FIRST NAME JORGE MIDDLE N
INITIAL
17 F1 STREET ❑❑ 37 1112 LONG RD TRLR 42 CITY CENTRAL/A ST, WA ZIP 985311078
NEW ADDRESS
1$❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 38
INTERLOCKYES NO INTERLOCK YES NO YES NO
19 DRIVER'S STATE WA SEX M D.o.a. 06 15 1994 39
LICENSE# MMDDYY —
HELMET INJURY: NATURE OF INJURIES 4Q
20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 USE CLASS 1 ❑
21[ LICEN E LATEIC63205R rare WA vIN# 3C7WRSBLXJG159692 41
42
22❑ TRAILER 0103ZK STATE WA TRAILER STATE
PLATE# PLATE#
43
23 ulRruLu 5 NH U C H4 2 5 G B 4 54 73 0 IRiuL#
VEH.YEAR 2Q1$ MAKE RAM MODEL 3500 STYLE VEHICLE TOWED TO BLIN
TOWED BY GOV HI 44
24 DAMAGE YES NO VES NO
REGISTERED OWNER INFO RAINIER ASPHALT SEALING LLC PO BOX 1549 NORTH BEND WA 98045 D:4252232690 VEHICLE NO.2
SHADE IN DAMAGED AREA
2 3 4
LIABILITY INSURANCE INSURANCE CO WESTERN NATL CPPI277799
IN EFFECT &POLICY# 9TOP
YemaE
LE—LY YES❑ NIL]
,.I—I CITATION HARGE
# C to BOTTOM
25 s s
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
26
M.LEVERTON 2517 WA0171300
PAGE 01 OF
PART A 3000-345-189(R 11/18)
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EG66575
COLLISION REPORT III III III III III 111
1591972 CASE# 25-80971
E NA ADDITIONAL PERSONS INVOLVED(PASSENGERS AND/OR WITNESSES ONLY)
M
(LAST,FIRST,MIDDLE INITIAL) AWITI REBECCA A
ADDRESS&PHONE# D O B
27830 PACIFIC HWY S APT L104 FEDERAL WAY WA 980032995 SEXi F MI MDDYYYY 11 IT
16 — 1975
PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET NJURY NATURE OF INJURIES
1 POS. 3 2 9 1 USE CLASS i 1 ----�
: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
(LOST,FIRST,MIDDLE INITIAL)
ADDRESS&PHONE#
SEX MMDDYY D.O.B.
YY
PASSENGER WITNESS UNIT SEAT AIRBAG RESTR. EJECT HELMET INJURY 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 12-23-25 04:05 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST.DET DATED PLAGE SIGNED
APPROVED BY DATE
1/7/2026 7:36:34 AM
C.JACOBS 1953
BADGE OR ID# ; 2517 ORI# WA0171300 TIME POLICE DISPATCHED 9:14 Aryl TIME POLICE ARRIVED i 9:19 AM
PAST B 3 Do-3mx—attar(t 1Mff) PAGE 2�OF 4
REPORT NO. EG66575 CASE# 25-80971 DATE OF COLLI r�510NN + 12/23/25 09:13
L1
NARRATIVE
wht/2 nb blk/1 wb-nb
CC
Within the city limits of Renton/King/Wa I responded to a 2 vehicle rollover crash at the intersection of
SW 41 st St at East Valley Rd.
When I arrived I located a small black car on its roof top with a driver and passenger standing outside
of it. A male walked up to me and ID'd himself as the other driver involved.
I contacted the driver of unit 2 who told me he was northbound East Valley Rd crossing the
intersection on his green light. He was driving a company truck and towing a 2 axle enclosed trailer.
He told me he didnt even realize he had been hit by unit 1 until another person said to him a car
crashed into his trailer. He did not complain of injury and damages were minor to the trailer.
contacted the driver of unit 1 ID'd by her picture WADL. She told me she just got the car and did not
have insurance for her car. She told me she was on the off-ramp from SB SR167 on the red light.
She thought EVR was two lanes so she proceeded to turn right onto EVR but stuck unit 2 trailer. Post
contact unit 2 swerved her car about 45 degrees from the roadway in a NE direction, went up and
over the sidewalk, hitting a tree and eventually rolling over onto her rooftop. She and her passenger
were checked and released on scene by Renton Fire. Damages were significant and required a tow
truck.
cited unit 1 ref RCW 46.61.055, FTCWTCD-free right turn when not clear two vehicle crash and ref
RCW 46.30.020 no valid proof of 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 12/23/2025
PAGE 3 OF 4
REPORT NO. EG66575 CASE# 25-80971 DATE AND TIME 12/23/25 09:13
OF COLLISION
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