HomeMy WebLinkAbout25-422 IT si " II IIIII III IIIII II IIII IIIII I . 27c REPORT NO EG71309OLCERA
COLLISION REPORT 1591971
❑ 0 RESULTED I
$ 25-422 2
INTERSTATE CITY STREET FIRESTOLENSTATE ROUTE OTHER VEHICLE LOCAI-AGENCY 4200 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 TOTAL#OF OBJECT 1 s 28
TRIBAL UNITS 02 STRUCK
RESERVATION : 1 1
2
3� M M D D Y Y Y Y TIME(2400) COUNTY# MILES CITY#
DATE OF N E IN eDLLISION' 01 - 14 - 2026 1556 17 =.= S 8 W E OF M 1070 a
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓
S PUGET DR BLOCK NO. e 1400 .�
4a❑ MILE POST
❑ DISTANCE OF(REFERENCE OR CROSS STREET)
5 2501.1 00 FEET e✓ S 8 W e✓[ GRANT AVE S
0 1 29
MOTOR ✓ PEDAL- DAM AG THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE ❑ YEs Vl No D:2067391272 0 6 30
5 LAST NAME FREEMAN FIRST NAME JOHN MIDDLE R 1 1 2 31
INITIAL
STREET ❑ 33185 GLACIER AVE SW CITY; BLACK DIAMOND ST WA ZIP; 98010 2
NEW ADDRESS
7 CDL IGNITION REQUIRED RES IGNITION PENT MEDICAL TRANSPORTED: 3
INTERLOCKYEs ✓NO INTERLOCKVEs NO✓ YES F NO;✓
8 DCIENSE# STATE WA SEXI M MMDDYY' 08 — 24 — 1980 1 2 32
-NJUR
9 ON DUTY STATUS' AIRBAG 2 RESTR 4 EJECT 1 N USEET 2 CLASSY ? [NATURE of INJURIES 2
LICENSE, CDW1801 STATE WA VIN# WDDLJ7DB8CA009970 3
10 Fq I as ATP rt
TRAILER STATE TRAILER STATE
11 3 5 PLATE# PLATE# ROM To
TRLR TRLR 7 1 3 33
12 3 5 VIN# vIN#
FROM TO
VEH.YEAR 2012 MAKE MERZ MODEL CLS STYLE SD V Y EHICLE TOWED TO BLIN TOWED By GOVT V 7 $
EHICLE 34
13� DAMAGE YES II_II NO ✓ YESII_] NO✓
REGISTERED OWNER INFO JOHN FREEMAN 3240 SE 12TH ST UNIT 1037 RENTON WA 98058 VEHICLE NO. 1
SHADE IN DAMAGED AREA 35
3 4
14 4 LIABILITY INSURANCE❑ NSURANCE CO 11
IN EFFECT &POLICY# 9TOP
V""' CHARGE 10 BOTTOM 5 36
11
15
srnNowc yes❑NO❑ CITATION# 6AO092291,6AO09229Z DWLS 3RD DEGREE,FOLLOW 7 e
MOTOR ✓ PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT VEHICLE CYCLE nWNFR YES�/ NO D:2063917672
16�
LAST NAME ✓OHNSON FIRST NAME JEREMY MIDDLE C
INITIAL
17 STREET ❑ 1919 ROLLING HILLS AVE SE CITY' RENTON ST, WA ZIP 37
980553716
NEW ADDRESS I I I I I I [I
18❑ CDL IGNITION REQUIRED IGNITION : PRESENT MEDICAL TRANSPORTED'. 38
INTERLOCKYEs NO✓ INTERLOCK YES ND✓ YES NO✓
19 DRIVER'S STATE WA SEX M I D.O.B. 1 06 30 1972 39
LICENSE# MMDDYY —
HELMET INJURY: NATURE OF INJURIES 4Q
20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 USE 2 CLASS 1 ❑
21 LICENSE C77545Y rArE WA vIN# USE
41
22❑ PLATE# STATE PLATE# STATE El 42
23 TRLR r RLR 43
UIN#. 'IN#
VEH.YEAR 2019 MAKE RAM MODEL 1500 STYLE pi( I VEHICLE TOWED TO BLIN
TOWED BY GOV HI 44
24� DAMAGE YES NO✓ VES NO✓
REGISTERED OWNER INFO JEREMYJOHNSON 1919 ROLLING HILLS AVE SE RENTON WA 98055 VEHICLE NO.2
SHADE IN DAMAGEAREA
2 3
LIABILITY INSURANCE INSURANCECO STATE FARM 4977539 B0247B
IN EFFECT &POLICY# t STOP
VEHICLE ❑ CITATION11 CHARGE to BOTTOM
LE
—Y YES N
25
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
J
26
D.NELSON 12421 WA0171300
PAGE 01 OF
PART A 3000-348-189(R 11/18)
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EG71309
COLLISION REPORT III III III III III 111
1591972 CASE# 25-422
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 0,SS ----�
: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.
D.NELSON 01-16-26 03:01 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST.DET DATED PLAGE SIGNED
APPROVED BY E
DAT
RAYMOND GORAJEWSKI 12399 112312026 6:48:39 AM
BADGE OR ID# 12421 ORI# WA0171300 TIME POLICE DISPATCHED 1 3:58 PM TIME POLICE ARRIVED i 3:59 PM
PAST B 3 Do-3mx—attar(t 1Mff) PAGE 2�OF 4
REPORT NO. EG71309 CASE# 25-422 O OF COLLI 510N TIME 01/14/26 15:56
COLLISION
NARRATIVE
25-422 ACC
On 1/14/2026 1 was working as a uniformed patrol officer and driving a marked patrol vehicle for the
City of Renton. I was dispatched to a report of a two-vehicle, non-injury, blocking collision near the
intersection of S Puget Dr and Grant Ave S Renton/King/WA. The caller was reporting they were
blocking one lane.
I arrived on scene and located both vehicles blocking eastbound, I confirmed no injuries, and both
vehicles were able to move off the roadway.
The driver of the 2012 Mercedes CLS WA/CDW1801 was identified by his WADL as John R Freeman
DOB: 8/24/1980. John advised he was driving east in the #2 lane of S Puget Dr when Unit 2 suddenly
slowed down. He said that he collided with the rear bumper of Unit 2. There was heavy damage to
the front bumper and hood of the Mercedes. There was no airbag deployment.
A WADOL check of John showed he was DWLS 3rd Degree since 7/22/2025, associated case
#5A0247491. The Mercedes showed as clear but ws expired as of 7/1/2024.
The driver of the 2019 Ram 1500 was identified by his WADL as Jeremy C Johnson DOB: 6/30/1972.
Jeremy said that he was driving east in the #2 lane of S Puget Dr when the vehicle in front of him
suddenly slowed down to make a left turn. Jeremy said that he hit his brakes to avoid a collision and
was struck by Unit 1. There was no airbag deployment, and the damage was to the rear bumper of
the Ram. Jeremy's DOL status showed he was clear and valid.
I completed Sector citations #6A0092291 for DWLS 3rd Degree RCW 46.20.342.1 C and
#6A0092292 for Following Vehicle Too Closely RCW 46.61.145.1 and Failure to Renew Expired
Registration Greater Than 2 Months RCW 46.16A.030.5.0. These citations should be mailed to
John'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 1/14/2026 Renton WA
PAGE 3 OF 4
REPORT NO. EG71309 CASE# 25-422 DATE AND TIME 01/14/2615:56
OF COLLISION
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