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Home My WebLink About23-4884 POLICE WASHING ON I jjjjj� �$j (II 161 F178 27 POLICE TFFITCOREPORT No. ED56519 COLLISION REP FIT 1591971 CITY STREET FIRE CASE# 1 23-4884 2 INTERSTATE RESULTED F STOLEN ❑STATE ROUTE ❑ OTHER ❑ VIRCI F F LOCALAGENCI 4100 3 HIT&RUN CODING F 2 1 COUNTY RD PRIVATE WAY INVOLVED F OBJECT 1 1 8 28 TRIBAL 1 02 STRUCK RESERVATION 1 2 3 M M D D Y Y Y Y TIME(2400) COUNTY# MILES CITY# ❑ 0009 [jE] =.= N SH E IN 3 WH OF 4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑ MILEPOST [:] � 4a S GRADY WAY B 1099 LOCK NO. DDISTANCE OF(REFERENCE OR CROSS STREET) 5❑ 1 MILES N E ON'Ds F1 H FEET ❑ S H WHF� FO ,]29 UNIT VEHIOR Z CYCLE Y MOT PEDAL- El DAMESAGE,/THRESHOLD MET IPHONE - 01 CLE [ ]NO [ ] lo 11 30 6 LAST NAME STADNIKOV FIRST NAME JOSEPH MIDDLE Y 1 [l 2]31 I I I I INITIAL STREET Ell 1803 SE 8TH ST CITY RENTON ST WA ZIP 98057 2 NEW ADDRESS I I I I I - �GNITION PRESENT MEDICAL TRANSPORTED 7 CDL IGNITION REQUIRED 3 I I:NTERLOCK YES[:]NOV I�NTERLOCK YES[:]No✓ YESF-]NO [ R DRIVES m4lsyy -F::1-F2006 I HELMET ,I I INJURY1 [NATURE OF INJURIES 2❑ 9❑ STATUS AIRBAG 6 RESTIR 9 EJECT USE CLASS I' I LICENSEI PI AT CFH1776 SLAT WA VIN# 5UXCR6C0XM9F35311 3 10 F91 I F�k 0 1 TRAILER STATE I TRAILER STATE LATE# PLATE# IROM T. F---l- —TWITI — TRLR 5 1 33 2 0 0 VIN#j VIN#j 1 1 FROM T. VEFLYEAR 2021 MAKE BMW MODEL X5 STYLE SD VEHICLE TOWED 2 TO ffBLINI TagWgYMEYER DAMAGE GOVT.V 34 13 I I YES NO YESE] ✓ Hil REGISTERED OWNER INFO JOSEPH STADNIKOV 1803 SE 8TH ST RENTON WA 98057 VEHICLE NO, 1 ❑ n SHADE]IS DAWWIEED AREA 35 14 LIABILITY INSURANCE❑ INSURANCE CO NIA IN EFFECT POLICY# VEH'CL' ❑ 36 LEGALLY YES[:]NO❑ CITATION# CHARGE 15❑ 2 1 STANDINGI an>'; MOTOR PEDAL- ❑ ❑ PROPERTY ❑IDAM VTHRrl OLD MET PHONE UNIT 02 VEHICLE CYCLE PEDESTRIAN OWNER YES NO D:2539991938 16 LAST NAME MCCAIN FIRST NAME JOHN MIDDLE L I I I I INITIAL 17❑ STREET —F110S 4 144TH ST CITY TUKWILA ST WA ZIP 98168 ❑ 37 NEW ADDRESS I I I I I I 18 CDL IGNITION GNITION REQUIRED JIGNITION PRESENT I MEDICAL TRANSPORTED 38 ERLOCK YESF-INOF,/IIINTERLOCKyEsF�NOF,/� YES F]NO FVI STATE WA ]SEXIM P� --7 39 19 DRIVERS T � 20 F1 ON DUTY STATUS AIRBAG 6 RESTR 9 EJECT 11 JHELMETJ I INJURY 17 NATURE OF INJURIES 40 [:]I I I I I I I USE CLASS SHOULDER PAIN 21[-] ILICENSE 1508LVN FATE I OR lVIN#1 IFMFK18557LA91524 ❑ 41 PLATE# 42 22❑ TRAILER STATE STATE TRAILER PLATE LE PLATE 23❑ J TRUR' �RLRJ 43 VINV IN# VFH,YEAR 2007 IMAKE FORD IMODEL Epp ISTYLE $D -FEHICLE TOWEDf G& v 'n 44 Y /JT.ffBE��jy 24❑ DAMAGE ES NO MEYER FT-T�N.,/ REGISTERED OWNER INFO 0 EDBYDRIVER VEHICLE NO.2 SHADY DArfWEA LIABILITY INSURANCE❑ INSURANCE CO NIA IN EFFECT &POLICY# VETILE C 25❑ LEGALLY F] Nu CITATION# LARGE -T(PRINT) ONE BADGE OR ID# AGENCY 26 OFFICER'S 12503 WA0171300 PAGE 01 OF PARTA3000-345-159 OR 11/181 TON POLICE T AFFIICCOLLISION REPORT CORRECTION REPORT NO. I ED56519 1591972 CASE# 1 23-4884 AWTIONAL PERSONS INVOLVED(PASSENGERS ANDIOR WITNESSES ONI tNll:: : PETERS JAZMYNE S MIDDLE INITIAL? ADDFJ,$5 3 P&VCNE 0... 1620 BENSON RD S,APT 210 RENTON WA 98055 SEX F wIMYRrvx 12 31 1988 SEAT HELMET INJURY NATURE OF INJURIK; PASSENGER ZWITNESS❑'UNIT0 2 SEA 3 AIRBAG 6 RESTR. g EJECT 1 USE CLASS ',7 PAIN IN KNEES NAME A,ST FIRST MIDDLE INITIAL) ADC E5S�a PIiCINE A D,Oyy SEX I ;x9Ixi6O YY'YY PASSENGER WITNESS UNIT# SEAT AIRIEAG REST R, EJECT HELMET INJURY NATURE GF INJURIES RD& USE CiLA.S..S, NAI,,PoE (LAa^T FIRST.N 0010E INI1AQ AD SS S.PHONE R SEXLIDDY D.C.I3. PASSENGER[] TNESS❑ UNIT a S III AIRBAG RE TR, EJECT HELMET flC SS NATURE cF INJURIES 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. J RAYGOZA 05-01-23 01:45 AM INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST.DET DATED PLACE SIGNED APPROVED BY _.. _..... _ DATE _... _ DESIRES SCOTT 10272 1 512(2023 2:55:09 PM BADGE OR ID# 12503 DRI# W 0171300 TIME POLJGE DISPATCHED I 12:09 AM TIME POLICE ARRIVED 12:09 AM PART B PAGE 2 OF 1 4 REPORT NO. ED56519 CASE# 23-4884 OF COLLISION 05/01/2300:09 OF COLLISION NARRATIVE RPD CASE#: 23-4884 On 04/30/2023 at approximately 0009 hours, I responded to 1106 Benson Rd S, in the City of Renton, King County, Washington, for a report of a motor vehicle collision. Upon arrival I identified unit 1 as a black 2021 BMW X5 WA/LIC CFH1776 VIN# 5UXCR6COXM9F35311. Unit 1 was on a curb facing north on Benson Rd S and sustained major damage all around the vehicle. Unit 1 was also engulfed in flames and was being put out by fire who was on scene. I identified the driver of Unit 1 via his WADL as Stadnikov Joseph Yuriyevich (DOB 10/01/2006). Stadnikov said he was driving northbound on Benson Rd S when he saw unit 2 driving southbound on Benson Rd S. Stadnikov told me that unit 2 was swerving and came onto his lane of travel causing him to swerve and collide with unit 2. As I spoke with Stadnikov he appeared to be dazed due to the impact of the collision and wasn't making sense. Fire evaluated Stadnikov for his injuries and he was later transported to Valley Medical Center. I was unable to get Stadnikov's insurance information due to his glove compartment being damaged by the incident. I identified unit 2 as a red Ford EPD OR/LIC 508LVN VIN#1 FMFK18557LA91524. Unit 2 was facing east and sustained major damage all around the vehicle. A unit 2 passenger later identified by her WADOL as Peters, Jazmyne Sylene DOB (12/31/1988) was stuck in the front passenger side seat and complaining of knee pain. I identified the driver of unit 2 via his WADOL as McCain, John Louis DOB (07/01/1938). McCain stated that he was driving southbound on Benson Rd S when he saw unit 1 driving northbound on Benson Rd S and swerving onto his lane. Unit 1 then collided with unit 2 causing him to lose control and coming to a stop facing east on Benson Rd S. McCain was complaining of shoulder pain and was evaluated by fire. Fire informed me that McCain might have a dislocated shoulder and was transported to Valley Medical Center. Peters was also transported to Valley Medical Center due to her injuries. I was unable to get McCain's insurance information as well due to his glove compartment being destroyed by the accident. Due to both drivers having similar stories, I was unable to determine who was at fault. Both parties were unable to provide insurance information and were both transported to Valle Medical Center. Both vehicles were towed by Gene Meyer towing and once the roadway was cleared, I left the scene. I certify (declare) under penalty of perjury under the laws of the State of Washington that the foregoing is true and correct. Electronically signed by J. Raygoza on 05/01/2023 at 0155 hours in the City of Renton. PAGE 3 OF 4 REPORT NO. ED56519 CASE# 23-4884 DATE AND TIME 05/01/23 00:09 OF COLLISION Unit 1' d ut; Unit 2 PAGE 4 OF 4