HomeMy WebLinkAbout25-81066 iiTFiNII IIIII III IIIII II IIII IIIII I . 27c REPORT NO EG72212oc� RA
COLLISION REPORT 1591971
INTERSTATE CITY STREET FIRE I
CASE# 25-81066 2
RESULTEDSTOLENSTATE ROUTE OTHER VEHICLE LQCAI-A`NG 4100 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 TOTAL#OF OBJECT o 5 28
TRIBAL UNITS 02 STRUCK
RESERVATION : 1 1
2
3I M M D D Y Y Y Y TIME(2400) COUNTY# MILES CITY#
eDCL s on' 12 - 27 - 2025 1754 17 =.= S 8 W e OF IN e 1070 s
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓
NE SUNSET BLVD BLOCK ST e 3700 .=
4a❑ MILE POST
❑ DISTANCE OF(REFERENCE OR CROSS STREET)
5 MILES 1.1 FEET B S B W e
0 1 29
MOTOR PEDAL- DAMAG THRESHOLD MET PHONE
UNIT 01 VEHICLE
❑ CYCLE ❑ YES No �/ D:4254443866 30
5 LAST NAME TRAN FIRST NAME HONG MIDDLE T 1 2 31
INITIAL
STREET ❑ 12150 SE 38TH PL CITY; BELLEVUE ST I WA ZIP; 980061151 2
NEW ADDRESS
7 +CDL IGNITION REQUIRED lIGNITION PRESENT MEDICAL TRANSPORTED' 3
INTERLOCK YES NOW] INTERLOCK YES Nb YES NO
8 DRIVERS# STATE WA SEXI F MMDDYY' 08 - 29 - 1967 32
9 ON DUTY STATUS' AIRBAG 2 RESTR 4 EJECT 1 N USEET 2 CLASSY 1 NATURE of INJURIES 2
10 al ENSttEI AVT5477 STATE WA VIN# 4JGBB86E49A480809 3
TRAILER STATE TRAILER STATE
11 3 5 PLATE# PLATE# FROM To
TRLR TRLR 7 1 3 33
12 VIN#' VIN#
FROM TO
VEH.YEAR 2009 MAKE MERZ MODEL ML350 STYLE VEHICLE TOWED[n TO ZBLIN TOWEDBY GOVT VEHICLE g 1 34
13� DAMAGE YES II_II NO YESII_I) NO
REGISTERED OWNER INFO KR1ST/NA NGUYEN 13718 SE 90TH PL NEWCASTLE WA 98059 VEHICLE NO. 1
SHADE IN DAMAGED AREA 35
2 LIABILITY INSURANCE INSURANCE CO 2 3 4
14 ALLSTATE 076 553 105
IN EFFECT &POLICY# 4TOP
VEn" CHARGE t 5 36
Lemur YES❑NO❑ CITATION# 7 0 80TTOM
15❑ STANDING e
EDAL-:. PEDESTRIAN ❑
PROPERTY PHONE
UNIT 02VMEOHTIOCRLE CPYCLE OWNE
16�
LAST NAME MACVEIGH FIRST NAME JAMES MIDDLE A
INITIAL
17 F1 STREET ❑
❑ 301 12TH AVE UNT/404 CITY I SEATTLE ST, WA ZIP 98122 37
NEW ADDRESS
1$❑ CDL IGNITION REQUIREO IGNITION PRESENT MEDICAL TRANSPORTED' 38
INTERLOCKYES NO INTERLOCKYEs R NO YES No
19 DRIVER'S STATE WA SEX M D-O.e. 08 08 1987 � 39
LICENSE# MMDDYY —
20 ON DUTY STATUS 3 AIRBAG RESTR EJECT HELMET 2 INJURY 5 NATURE OF INJURIES ❑ 40
USE CLASS LACERATION TO HEAD
21 PLATE# TATE VIN# 41
22❑ [TILER TAILER
PLATE# STATE PLATE# STATE 42
23 TRLR RLR 43
UIN#. 'IN#
VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN
TOWED BY GOV HI 44
24 0 6 DAMAGE YES NO YES NO
REGISTERED OWNER INFO VEHICLE NO.2
SHADE IN DAMAGED AREA
2 3 4
LIABILITY INSURANCE❑ INSURANCE CO
IN EFFECT &POLICY# 9TOP
vemae
EEGnEEY CITATION
CHARGEYES❑ N`L] to BOTTOM
25 a s
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
26
K.LANE 10008 WA0171300
PAGE 01 OF
PART A 3000-348-189(R 11/18)
STATE OF
" POLICETRAFFICN CORRECTION REPORT NO. EG72212
COLLISION REPORT III III III III III 111
1591972 CASE# 25-81066
E NA ADDITIONAL PERSONS INVOLVED(PASSENGERS AND/OR WITNESSES ONLY)
M
(LAST,FIRST,MIDDLE INITIAL) PEARMAN PAUL B
ADDRESS&PHONE# D�
1817 HARRINGTON AVE NE RENTON WA 98056 4254730095 SEXi M MM DDYVYv 07 — 13 — 1972
PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET INJURY NATURE OF INJURIES
�; POS. USE CLASS ----�
:NAME
(LAST FIRST MIDDLE INITIAL)
ADDRESS R PHONE#
SEX D.O.B. —
MMDDYYYY
PASSENGER❑WITNESS UNIT# : SEAT AIRBAG RESTR. EJECT HELMET INJURY: NATURECFINJURIES
POS. USE CIASS ----�
: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
Unit 1 (vehicle) was traveling eastbound on NE Sunset BLVD approaching the 3700 blk. Pedestrian
1 was on the south sidewalk of NE Sunset BLVD in the 3700 blk. This roadway had streetlights on it,
but this portion was particularly unlit as there were few in the area or they were not operating.
Witness 1 states that Pedestrian 1 began to cross over NE Sunset BLVD from south to north and
stated that he did not believe he saw Unit 1 approaching.
Pedestrian 1 stepped out into the path of Unit 1, and the front driver's side of Unit 1 impacted
Pedestrian 1.
Unit 1 had little to no damage with only dirt marks slid clean as a result of the collision. This indicated
that Driver 1 was traveling at a low level of speed and she stated she applied maximum braking when
she saw Pedestrian 1 walk out in front of her. The scene evidence supports this statement.
After the collision, Pedestrian 1 did fall to the ground. Pedestrian 1 sustained a laceration to the (his)
right side of his head. Pedestrian 1 was transported to Valley Medical Center for treatment.
Pedestrian 1 failed to yield the right of way to Unit 1, and crossed outside of a crosswalk into the path
of Unit 1 which was the proximate cause of the collision.
**** AUTO-POPULATED SECTION ****
THE FOLLOWING ARE DESCRIPTIONS ENTERED FOR ITEMS SELECTED AS "OTHER":
Light Condition: DARK,STREET LIGHTS ON, DARK UNLIT AREA
**** END OF AUTO-POPULATED SECTION ****
I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT.
K.LANE 12-27-25 07:02 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST.DET DATED PLACE SIGNED
APPROVED BY DATE
C.JACOBS 1953 1/26/2026 2:39:20 PM
BADGE OR ID# j 10008 ORI# WA0171300 TIME POLICE DISPATCHED 1 5:55 PM TIME POLICE ARRIVED i 6:00 PM
PAST B 3 Da-3mx—attar(t 1Mff) PAGE 2�OF F3
REPORT NO. EG72212 CASE# 25-81066 DATE AND TIME 12/27/2517:54
OF COLLISION
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