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HomeMy WebLinkAbout26-101 II III III IIIII IIII III II I SUPPLEMENTAL O EG66136 t 27iiT REPORT COLLISION REPORT 1591971 ❑ 0✓ RESULTED ❑ CASE#I 26-101 2 INTERSTATE CITY STREET FIRE 1 STOLEN STATE ROUTE ❑ OTHER ❑ VEHICLE ❑ LOCAI-AGENCY 4200 3 HIT&RUN CODING COUNTY RD PRIVATE WAY INVOLVED 2 TOTAL#OF OBJECT 1 s 28 TRIBAL UNITS 03 STRUCK RESERVATION : 1 1 2 3� M M D D Y Y Y Y TIME(2400) COUNTY# MILES CITY# DATE OF N E eDLLISION' 01 - 05 - 2026 0713 17 =.= S 8 W E OF IN M 1070 a 4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓ NE SUNSET BLVD BLOCK ST e 1500 .= 4a❑ MILE POST DISTANCE OF(REFERENCE OR CROSS STREET) 5❑ 200 00 FEET e✓ S 8 W e✓ `�NACORTES AVE NE OF11 29 MOTOR PEDAL- DAMAG THRESHOLD MET PHONE UNIT 01 VEHICLE ❑ CYCLE ❑ YES No �/ D:2069465882 0 1 30 5❑ LAST NAME BOONE FIRST NAME AUSTIN MIDDLE S 1 2 31 INITIAL STREET ❑ 29720 45TH AVE S CITY;AUBURN ST WA ZIP; 980011558 2 NEW ADDRESS 7 CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3 INTERLOCKYEs No INTERLOCK Yes No vEs NO 8 DCIENSE# STATE WA SEXI M MMDDYY' 12 - 09 - 1992 t 1 2 32 9 ON DUTY STATUS' AIRBAG 2 RESTR 9 EJECT 1 N USEET CLASSY 1 NATURE of INJURIES 2= LICENSE, CV7307J STATE WA V 1J4FJ78S9PL619477 3 10� PI ATP rt TRAILER STATE TRAILER STATE 11 0 0 PLATE# PLATE# ROM To TRLR TRLR. 7 1 3 33 12 Q Q UIN#' VIN# FROM TO VEH.YEAR 1993 MAKE JEEP MODEL CHERO STYLE 4C VEHICLE TOWED TO BLIN TOWED By GOVT VEHICLE 7 3 34 13� DAMAGE YES II_II NO `/ YESII_I) NO REGISTERED OWNER INFO OWNEDBYDRIVER VEHICLE NO. 1 SHADE IN DAMAGED AREA 35 5 LIABILITY INSURANCE INSURANCE CO 4 14 AMERICAN FAMILY 4I085-803I9-97 IN EFFECT &POLICY# 9TOP V""' CHARGE 5 36 LEDgLLy YES❑NO❑ CITATION# t a 80TTOM 15❑ STMDwc 7 e MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE UNIT 02 VEHICLE CYCLE nWNFR D:4253069616 16� LAST NAME MAC FIRST NAME BIEN MIDDLE' N INITIAL 17 STREET ❑ 254 BLAINE CT SE CITY' RENTON ST, WA ZIP 37 980568863 NEW ADDRESS I I I I I 1 ❑ 18� IGNITION REQUIRED IGNITION PRESENT MEDICALTRANSPORTED. 38 CDL INTERLOCKYES NO INTERLOCKYEs No NO 19 DRIVER'S STATE IJ WA SEX F D.O.e. 03 02 1968 39 LICENSE# MMOCSYY — HELMET INJURY: NATURE OF INJURIES 4Q 20❑ ON DUTY STATUS AIRBAG 2 RESTR 9 EJECT 1 USE CLASS 1 ❑ 21 LICEN� 761YWZ raTE WA vIN# 4T3ZF13CX2U468334 41 PLATE22❑ [TILER TAILER PLATE# STATE PLATE# STATE 42 23 TRLR RLR 43 UIN#. 'IN# VEH.YEAR 2002 MAKE TOYT MODEL SIENNA STYLE VEHICLE TOWED TO BLIN TOWED BY GOV HI 44 24 DAMAGE YES NO VES NO REGISTERED OWNER INFO VINCENT TRAN 254 BLAINE CTSE RENTON WA 98056 VEHICLE NO.2 SHADE DAMAGEAREA 3 LIABILITY INSURANCE[Z INSURANCE CO STATE FARM 588-8118-COI.47 IN EFFECT &POLICY# 9TOP LY—ve ❑ ,J—I CITATION# CHARGE t080TTOM LEGnL YES N`[_ 25 OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY 26 SULIASI TAMAIVENA 12788 WA0171300 PAGE 01 OF PART A 3000-345-189(R 11/18) STATE OF POLICETRAFFICN CORRECTION REPORT NO. EG66136 COLLISION REPORT III III III III III 111 1591972 CASE# 26-101 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 CLASS ----� :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. SULIASI TAMAIVENA 01-11-26 05:46 PM INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST.DET DATED PLAGE SIGNED APPROVED BY DATE D.SKELTON 9139 1/6/2026 4:39:54 AM BADGE OR ID# 12788 ORI# WA0171300 TIME POLICE DISPATCHED; 7:13 AM TIME POLICE ARRIVED i 7:27 AM PAST B 3 Do-3mx—attar(t 1Mff) PAGE 2�OF F5 REPORT NO. EG66136 CASE# 26-101 O OF COLLI 510N TIME 01/05/26 07:13 COLLISION NARRATIVE On 01/05/2026, at approximately 0713 hours, I was dispatched to an accident at NE Sunset BLVD and Anacortes Ave NE in the City of Renton, while I was employed as a uniformed Patrol Officer for the City of Renton, County of King, State of Washington. I spoke with the driver of Unit #1, and he advised that he was on Ne Sunset Blvd, coming to Anacortes in lane #2 (lane #1 being nearest to the curve), traveling eastbound. The driver stated that all units were following closely behind each other. He said the driver of Unit#2 had braked, and he had as well, but was unable to stop entirely due to the wet roads. He advised that he was on top of a puddle. Unable to stop, Unit 1's vehicle collided with Unit#2's rear bumper. Unit#1 vehicle did have damage to its front bumper. I spoke with the driver of Unit#2, and she advised that she was in the same lane and traveling in the same direction as Unit #1. The driver said she stopped her vehicle because Unit #3 was in front of her, which was also stopped. Unit#2 was then struck on the rear of the bumper, which caused her to move forward and hit Unit#3's truck from the rear bumper. Unit#2's vehicle met the threshold of damage to the front and rear of the car. spoke with the driver of Unit#3, who advised that he was in the same travel lane as Units #1 and #2. The driver said he was stopped at the red light before being rear-ended by Unit#2. The driver did receive minor damage. All drivers claimed no injuries. Vehicles were still drivable. All damages were documented with a photo and submitted as evidence. Each driver was given a copy of an exchange information form. I determined Unit#1 was the proximate fault, as he followed Unit#2 too closely, which did not give him enough time to stop when Unit#2 stopped. If Unit#1 had not followed closely, this accident wouldn't have occurred, as he would have had enough time to stop. This concludes my report. My Axon camera was on for this call. I certify (declare) under penalty of perjury under the laws of the State of Washington that the foregoing is true and correct. This report was electronically signed by Officer S. Tamaivena #12788, 1/5/2026, at 1005 hours, Renton, WA. PAGE 3 OF 5 SUPPLEMENTAL REPORT No. EG661 36 POLICE TRAFFIC 1 1 8 27 COLLISION REPORT CASE# 26-101 t113197 1 COMMERCIAL MOTOR CARRIER INTERSTATE INTRASTATE UNIT# USDOT ICC# VEHICLE TYPE CARGO BODY 3 TYPE 2 ❑ 1 28 CARRIER NAME 3 CARRIER L ADDRESS CITY STi ZIP 4 ❑ NAME # PLACARD GWVR NAME IF NO NUMBER SOURCE AXLES + 4a ❑ ADDITIONAL UNITS { MOTOR PEDAL- PROPERTY DAMAGETHRESHOLD MET PHONE 5 ❑ UNIT# 3 VEHICLE CYCLE C) PEDESTRIAN :.. OWNER YES NO D:4252479437 0 1 29 LAST NAME SHARP FIRST NAME I ELIJAH MIDDLE' M INITIAL STREET 30 ❑ NFW ADORFs 901 SUNSET BLVD NE APT A104 CITY RENTON ST WA ZIP 980568710 6 PRESENT MEDICALTANSPORTED'. 1 1 2 31 CDL IGNITION REtSUIRED I{iNiTiON :: .. INTERLOCK YES NO INTERLOCK vEs N YES N DRIVER'S D.O.B L LICENSE' STATE WA SEX'M MMDD' 02 25 - 2008 7 ON DUTY STATUS AIRBAG 2 RESTR. 9 EJECT 9 HELMET INJURY 1 NAruRE of INJURIES USE ;CLASS ; 8 ❑ 1 32 LICENSE D00270J TAT WA VIN 1FTYR14X1YTA42175 PLATE# 9 9] TRAILER TRAILER L PLATE# STATE PLATE# STATE 0 10 ❑ TRLR TRLR VIN.# VIN#. 11 O O vEH.vEAR2000 MAKE FORD M°DELRANGER STYLE TR VEHICLE TOWE E T ABLIN TOWED BY GovT vEHICI E FROM To DAMAGE YES NO ✓ YES NO REGISTERED OWNER INFONASIROH ABDOL 901 SUNSET BLVD NE APTA 104 RENTONWA98056 7 3 33 12 � SHADE IN DAMAGED AREA � FROM TO INSURANCE CO LIABILITY INSURANCE PROGRESS/VE 995247043 IN EFFECT &POLICY# I JTt1P--_ m 34 13 ❑ ve A" YES NGEII CITATION# CHARGE 1080TTOM ecaLLY s-rANoiNc 3 7 MOTOR PEDAL_ ' 1:1PROPERTY DAMAGE THRESHOLD MET PHONE 35 14 ❑ UNIT# VEHICLE CYCLE PEDESTRIAN OWNER YES NO 36 15 LAST NAME FIRST NAME NIT AL 16 ❑ STREET �' CITY ST' ZIP NFW ADDRFSS CDL IGNITION RE6UIRED IGNITION PRESENT MEDICAL TANSPORTED INTERLOCK YES NO INTERLOCK YEs Net YES No 17 37 RIVER'SLLIICENSE# STATE SEX MMOD' - ❑ HELMET 'INJURY NATURE OF INJURIES 38 18 ON DUTY STATUS' AIRBAG RESTR. EJECT USE CLASS. 19 ❑ ❑ 39 LICENSE TAT vIN# PLATE# 20 TRAILER I TRAILER 40 PLATE#. STATE PLATE# - STATE ❑ 21 ❑ TRLR TRLR 41 VIN# VIN#:: 42 22 VEH.YEAR MAKE I MODEL I STYLE VEHICLE TOWED DUET ABLIN TOWED BY GOVT.VEHICLE DAMAGE YES NO YES NO 23 REGISTERED OWNER INFO. SHADE IN DAMAC ED AREA 43 2 3 4 LIABILITY INSURANCE INSURANCE CO IN EFFECT &POLICY# I.. 1�TOP_.__ E. 44 vewc�e ❑ ❑ CITATION# CHARGE 70 BOTiC?M 24 I T ALL, YES NO sF__ 8 7 6 1 CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT. SULIASI TAMAIVENA 01-11-26 05:46 PM 25 INVESTIGATING OFFICER'S SIGNATURE OFFICER'S PHONE UNIT OR DIST DET DATED: PLACE SIGNED 26 OR Ib# 12788 O#RI WA0171300 APSKELTON 11612026 PAGE[4 OF 3000-345-013(R 11t18) REPORT NO. EG66136 CASE# 26-101 DATE AND TIME 01/05/2607:13 OF COLLISION K" 3 t � I� f� t q �1 tat t t � y l 4� r N � ltvti " a t, lh t � zF t. 4 '81f t {y, a s PAGE 5 OF 5