HomeMy WebLinkAbout25-80295 POLICETRAFF'c" III !�� I IIIllI111IN II II I REPORT NO. EG72209 170
27
COLLISION REP FIT 1591971
CASE 25-80295 z
INTERSTATE ❑ CITY STREET FIRE ❑RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHICI F ❑ LOCAL AOENC 4200 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 2 TOTAL#OF OBJECT 1 1 8 28
TRIBAL UNITS 02 RESERVATION STRUCK
z
3 DATE OF M M D D Y Y Y Y TIME(2400) COUNTY# MILES N E IN CITY#
cawsloN 12 - 01 - 2025 1420 17 =. S H W H OF 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
RAINIER AVE S BLOCK NO. e✓ 300 ❑
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ MILES�.❑ FEET e S ❑ W e S 3RD PL
2 0 29
MOTOR ✓ PEDAL- DAMAGE THRESHOLD MET PHONE
NIT 01 VEHICLE ❑ CYCLE. ❑ YES NO D:3608106196 0 1 30
6 LAST NAME CHOQUE FIRSTNAME FREDDY MIDDLE N 1 1 2 31
INITIAL
STREET El15818 WILDAIRE DR SE CITY YELM ST WA 2jp, 985978940 z=
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
iNTERLOCKYEs NO 1/ INTERLOCKYEs NO�/ vEs No�/
8❑ LICENSE# STATE WA SEX'M I D-MMDDYY 07 — 18 — 1965 1 2 32
9❑ ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 H USE 2 CLASS 1 NATURE OF INJURIES z❑
3
10❑ PIATNES# CLT2201 sTAT WAuN# 1G1FY6S07P4206365
- TRAILER STATE PL TRAILER STATE
11 3 5 PLATE# PLATE# FR.. ro
TRLR. TRLR. 5 1 33
12 3 5 VIN#' VIN#
>; FROM TO
VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE 5 1 34
13 3 2023 CHEV BOLT 5D DAMAGE YES NO YES❑ NO✓
REGISTERED OWNER INFO FREDDY CHOQUE 15818 WILDAIRE DR SE YELM WA 98597 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
14 r1 LIABILIT INSURANCE INSURANCE CO GEICO 4618957296 4
IN EFFECT &POLICY# 9TOP
LEwcLe CHARGE 1 5 36
LEGALLY YES❑NO CITATION# 5AO159141 INATTENTIVE DRIVING o ao oM
15❑ STANDING 8 6
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT 02 VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES 1/ NO D-2066519703
16 a
LAST NAME PHIPPS FIRST NAME SHANIA MIDDLE I T
INITIAL
17 STREET❑ NEW ADORE57 22416 88TH AVE S APT C306 CITY KENT ST WA ZIP 980311842 4❑ 37
18❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL—T�RANSPORTED � 38
INTERLOCK YEs❑No� INTERLOCK YEs I I NOF YES t l NOF,/
19 DRIVER'S STATE WA ]SEX IF D.O.B. O6 _ 07 1996 39
LICENSE# MMDDYY
20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 H U EET 2 NJAU EY 1 NATURE OF INJURIES ❑ 40
❑LICENSE I CL
21❑ PLA E# CSF8527 TATE 41
WA VIN# 1GNEC13Z82R229061 1
42
22❑ PLATE# STATE PLATE# STATE
TRLR
23❑ UIN#. N#.
43
%
RLR
'I
VEH YEAR 2002 MAKE CHEV MODEL TAHOE STYLE UT VEHICLETOWED TO BLIN TOWEDBY GOV HI 44
24❑ DAMAGE YES NO YES NO
REGISTERED OWNER INFO SHANIA PHIPPS 2241688TH AVE S APT C306 KENTWA98031 VEHICLE NO.2
SHADE IN DAMAGED AREA
2 3 4
INAEFFIECTTY NSURANCE❑ &POINSULICY#E CO I 9TOP
VE""LE ❑ ,J� CITATION# CHARGE i o BOTTOM
LEGALLY YES N J
25 s 6
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
26
C.JACOBS 1953 WA0171300
PAGE 01 OF
PART A
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT No. EG72209
COLLISION REPORT III III III III III 111
1591972 CASE# 25-80295
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'
On 12-1-25 at about 1424 1 arrived the 300 block of Rainier Ave S for a collision that occurred in the
area of S 3rd Place and Rainier Ave S. 1 contacted both vehicles and their drivers in a nearby parking
lot. Both drivers identified themselves via WADL. Driver 1, Freddy Choque told me;
He was Northbound in the 300 block of Rainier Ave S when he needed to change lanes from lane 2 to
lane 1.
He did not see unit 2 already occupying lane 1 when he began his lane change.
He collided with unit 2 during the lane change.
He was not injured.
Driver 2 told me;
She had just passed unit 1 when unit 1 suddenly changed lanes into the side of her vehicle.
She was not injured.
There were 2 adult passengers that were in unit 2 that did not want to be identified. There were no
known injuries.
This collision occurred in the city of Renton, County of King.
I declare under penalty of perjury under the laws of Washington state that the foregoing is true and
correct.
C. Jacobs/1953
I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT.
C.JACOBS 12-24-25 01:18 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
C.JACOBS 1953 1 1/26/2026 1:11:52 PM
BADGE OR ID# 1953 ORI# WA0171300 TIME POLICE DISPATCHED; 2:20 Pry TIME POLICE ARRIVED';2:24 PM
PART B PAGE IT]OF 3�
REPORT NO. EG72209 CASE# 25-80295 DATE AND TIME 12/01/2514:20
OF COLLISION
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