HomeMy WebLinkAbout26-343 iiTFiNII IIIII III IIIII II IIII IIIII I . 27c REPORT NO EG68752oc� RA
COLLISION REPORT 1591971
❑ 0✓ FIRERES ED I
CASE# 26-343 2
INTERSTATE CITY STREET FIRE STOLENSTATE ROUTE OTHER VEHICLE LOCAI-AGENCY 4100 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 TOTAL#OF OBJECT 1 s 28
TRIBAL UNITS 05 STRUCK
RESERVATION : 1 1
2
3� M M D D Y Y Y Y TIME(2400) COUNTY# MILES CITY#
DATE OF N E IN eDLTISION' 01 - 13 - 2026 0631 17 =.= S 8 W E OF M 1070 a
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
BLOCK NO.
S GRADY WAY
4a❑ MILE POST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ �. FEET e S 8 N e LAKE AVE S
2 0 29
MOTOR ✓ PEDAL- DAM AG THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE ❑ YEs Vl No D:2532692452 0 1 30
5 LAST NAME PORTER FIRST NAME WILLIAM MIDDLE E 1 1 2 31
INITIAL
STREET ] 29427 215TH AVE SE CITY; KENT ST I WA ZIP 980425903 2
NEW ADDRESS
7 CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
INTERLOCKYEs NO INTERLOCKYEs No YES F NO
8❑ DCIENSE# STATE WA SEXI M MMDDYY' 09 - 10 - 1961 1 2 32
9 ON DUTY STATUS' AIRBAG 2 RE
4 EJECT 1 N USE CLASSY 1 [NATURE of INJURIES 2
10 1� aiCENSE' D63037B STATE WA VIN# 1FT8W3BT9EEB65016 3�
TRAILER
11 3 5 STATE TRAILER STATE ROM TO
PLATE# PLATE#
TRLR TRLR 3 1 7 33
12 0 0 VIN#' VIN#
FROM TO
HICLE
13 2 VEH.YEAR2014 MAKE FORD MODEL F350 STYLE VEHICLE TOYED NOjyS46LIN Tv49WEBYMEYER GESr`-IVT ENp 3 7 34
DAMAGE IIII._IIII I_I
REGISTERED OWNER INFO WILLIAM PORTER 29427215TH AVE SE KENT WA 980425903 D:2532692452 VEHICLE NO. 1
SHADE IN DAMAGED AREA 35
3 4
14 LIABILITY INSURANCE NSURANCE CO PROGRESSIVE 8637215486
IN EFFECT &POLICY#VEHICLE YES OUR,
srgNOLNG ❑ ❑ 6A0095318 CHARGE IMPROPER LANE USAGE 36
NO CITATION#
15
UNIT 02 MOTCSR PEDAL- ❑ PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
VEHICLE CYCLE nWNRR
16�
LAST NAME MiNTZ FIRST NAME JAMES MIDDLE' F
INITIAL
17 F1 STREET ❑❑ 18005 113TH AVE SE CITY RENTON ST, yyq ZIP 980556578 37
NEW ADDRESS
18❑ IGNITION REQUIRED (GNITION PRESENT MEDfCALTRANSPORTED. 38
CDL INTERLOCKYEs NO INTERLOCK YES Nb YEs NO
19 DRIVERS STATE WA SEX M D.Os. 11 24 1978 � 39
LICENSE# MMDDYY
HELMET INJURY: NATURE OF INJURIES 40
20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 USE CLASS 1 ❑
21 LICENSE CHX9107 TATE WA VIN# 7FARS6H91PE010477 I El 41
22❑ [TILER TAILER
PLATE# STATE PLATE# STATE 42
23 TRLR r RLR 43
UIN#. 'IN#
VEH.YEAR 2Q23 MAKE HOND MODEL (,`R-V STYLE VEHICLE TOWED TO BLIN TOWED BY GOV HI 44
24 DAMAGE YES �/ No GENE MEYER E
REGISTERED OWNER INFO JAMES MINTZ 18005113TH AVE SE RENTON WA 980556578 VEH'�`rLE N0.2
SHADE IN DAMAGEAREA
2 3
LIABILITY INSURANCE INSURANCE CO PROGRESSIVE 991361421
IN EFFECT &POLICY# 9TOP
VEHIE ❑ NJ—I, CITATION# CHARGE to BOTTOM
CLE
L' L YES
25 a s
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
J
26
M.LEVERTON 2517 WA0171300
PAGE 01 OF
PART A 3000-345-189(R 11/18)
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EG68752
COLLISION REPORT III III III III III 111
1591972 CASE# 26-343
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 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 GLASS
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.
M.LEVERTON 01-13-26 08:14 AM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST.DET DATED PLAGE SIGNED
APPROVED BY DATE
C.JACOBS 1953 111412026 11:55:19 AM
BADGE OR ID# ; 2517 ORI#s WA0171300 TIME POLICE DISPATCHED 6:32 AM TIME POLICE ARRIVED i 6:33 AM
PAST B 3 Do-3m5—attar(t 1Mff) PAGE 2�OF F6
REPORT NO. EG68752 CASE# 26-343 O OF COLLI 510N TIME 01/13/26 06:31
COLLISION
NARRATIVE
1 gray changes lanes hit 2 blue hit 3 grya then 1 hit 4 and 4 hit 5
CC
Within the city limits of Renton/King/Wa I responded to a 5 vehicle blocking crash at the intersection
of S Grady Way and Lake Ave S. All of lane 2 was blocked, part of lane 1 and part of the east bound
to north bound left turn lane.
I contacted the driver of unit 1 ID'd by his picture WADL. He summarized the following: He told me
he as changing lanes west bound S Grady from lane 1 to lane 2. He told me he truck had some type
of steering and braking issue when he hit the back of unit 2. He did not provide much more
information that that. Later he was on the phone with his insurance company and confessed he was
the cause of the crash. He did not complain of injury and damages required a tow truck/Gene Meyer.
He was later cited ref RCW 46.61.140 improper lane change 5 car injury crash via complaint.
I contacted the driver of unit 2 who told me he was in lane 2 at slow speeds in heavy traffic when unit
1 hit the back of his car, bounced off his car and hit unit 3 and then unit 4. He did not complain of
injury and damages did require a tow truck. Gene Meyer
I contacted the driver of unit 3. She told me she did not know what had happened. She wasnt sure if
she was moving or completely stopped. She said all of a sudden she got hit and that was it. She did
not complain of injury and damages to her car did not require a tow truck.
I contacted the driver of unit 4 who told me she was in lane 2 stopped when she was hit by unit 1
forcing her vehicle forward into the back of unit 5. She did complain of shoulder pain but refused on
scene checks by Renton Fire. Damage to her vehicle required a tow truck. Gene Meyer
I contacted the driver of unit 5 who told me he was stopped in lane 2 when he was hit from behind by
unit 4. He did not complain of injury and damages did not require a tow truck.
Based on the statements provided by all 5 units involved and the positions of vehicles it looked as if
unit 1 made a lane change from lane 1 to lane 2 west bound S Grady Way he he clipped the back end
of unit 2, glanced off unit 3 and rear-ended unit 4 forcing her into unit 5. During this crash all of west
bound Grady was shut down, multiple units responded to redirect traffic and KC-Metro was notified
and diverted.
I certify (declare) under penalty of perjury under the laws of the State of Washington that the
foregoing is true and correct.
M.Leverton/2517 City of Renton/King/Wa 1/13/2026
PAGE 3 OF 6
SUPPLEMENTAL REPORT No. EG68752
POLICE TRAFFIC
1 1 8 27
µ ^'� COLLISION REPORT CASE#i 26-343
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 ST ZIP
4 ❑ NAME # PLACARD
GWVR NAME IF NO NUMBER
SOURCE AXLES +
4a ❑ ADDITIONAL UNITS
MOTOR PEDAL- PROPERTY DAMAGE THRESHOLD MET PHONE
UNIT# 3 �✓ PEDESTRIAN ❑', YES� NO D:2063976955
5 VEHICLE CYCLE OWNER
0 7 29
LAST NAME CHANG FIRST NAME ARUM MIDDLE'. N
INITIAL
0 7 STREET 30
NFW ADDRFs 2719 MORRIS AVE S CITY RENTON ST WA ZiP gg0555038
6 ❑ PRESENT MEDICALTANSPORTED' 1 1 2 31
CDL IGNITION REQUIRED 1{iNiTiON ::
INTERLOCK YES No INTERLOCK YES Na YES N
L
DRIVER'S D.O,B
LICENSE'. WA SEX..F MMDDYYY - 1986
7 ❑
ON DUTY STATUS AIRBAG 2 RESTR. 4 EJECT 9 HELMET INJURY 1 NAruRE of INJURIEs 16
USE ;CLASS
8 ❑ 1 1 2 32
LICENSE BLCO570 TAT WA VIN JTMJJREV7JD217582
PLATE#
9 � TRAILER TRAILER L
PLATE# STATE PLATE# STATE
0
10 ❑ TRLR TRLR
VIN.# VIN#.
11 0 0 VEIL YEAR2018 MAKE TOYT MODELRA V4 HV STYLE VEHICLE TOWE E T ABLIN TOWED BY GovT vFHICI E FROM To
DAMAGE YES NO ✓ YES NO
ARUM CHANG 2719 MORRIS AVE S RENTON WA 980555038 D:2063976955 g g 33
REGISTERED OWNER INFO. SHADE IN DAMAGED AREA
12
� FROM TO
INSURANCE CO <r TOK'
LIABILITY INSURANCE ALLSTATE 987 909 312
IN EFFECT &POLICY# J ""`__' `� 9 9 34
13 ❑ ve A" YES NO CITATION# CHARGE 1080TTOM
e LLY
s-rANOINc � 3 7v
DAMAGE THRESHOLD MET PHONE 35
14 UNIT# 4 MOTOR PEDAL- ❑ PEDESTRIAN ❑ PRO""' YES NO
VEHICLE CYCLE OWNER �/ D:4258917693
15 LAST NAME FIRST NAME ROSALES FARIAS LUCERO MIDDLE' 36
N
INITIAL
16 STREET ❑' 10930 SE 172ND ST APT A203 CITY RENTON ST WA ZIP 980556063
NEW ADDRFSa
CDL IGNITION REf1U1RED 1GNITION PRESENT MEDICALTANSPORTED'.
17 F] INTERLOCK YES NO INTERLOCK YEs Nt7 YES NO.
DRIVER'S STATE WA SEX F D.O.B 37
18
LICENSE# 03 - 16 - 1992
C '.2 '.1 HELMET INJURY,] NATURE OF INJURIES 38
ON DUTY❑ STATUS AIRBAG RESTR. 4 EJECT USE CLASS SHOULDER
19 ❑ LICENSE' ❑
PLATE#: CAP3000 TAT WA ufN# 1HGCR2F30HA182788 39
20 TRAILER+ TRAILER 40
PLATE# STATE PLATE# - STATE ❑
21 ❑ TRLR TRLR 41
VIN# VIN#Y
42
22 VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED DUET ABLIN TOWED BY GOUT.VEHICLE
2017 HOND ACCOR DAMAGE YES No GENE MEYER
23 REGISTERED OWNER INFOLUCERO ROSALES FARIAS 10930 SE 172ND ST APT A203 RENTON WA 980556063 D:4258917693 SHADE IN DAMAC ED AREA 43
2 3
NLIABILITY
EFFIECTNSURANCE INSURANCE CO STFARM 5689267Oi847 _`�LOI'._._ 44
❑ &POLICY# •_"_
vewcEe ❑ CITATION# CHARGE 70 BOTiC?M
24 I..EGALLY YES NO
STANDING 8 3
I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT.
M.LEVERTON 01-13-26 08:14 AM
25 INVESTIGATING OFFICER'S SIGNATURE OFFICER'S PHONE UNIT OR DIST DET DATED: PLACE SIGNED
BADGE 1 APPROVED
/1
�ORIWA0171300 A 4 PAGE 2517 OF
ORID# #
3000-345-013(R 11/18)
SUPPLEMENTAL REPORT No. EG68752
POLICE TRAFFIC
1 1 8 27
µ ^'� COLLISION REPORT CASE#i 26-343
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 ST ZIP
4 ❑ NAME # PLACARD
GWVR : NAME IF NO NUMBER
SOURCE AXLES +
4a ❑ ADDITIONAL UNITS
MOTOR PEDAL- PROPERTY DAMAGE THRESHOLD MET PHONE
UNIT# 5 �✓ PEDESTRIA1:1N vps No D:2532937486
5 VEHICLE CYCLE OWNER
0 7 29
LAST NAME GONZALEZ FIRST NAME DILAN MIDDLE. Y
INITIAL
STREET 30
NEW ADORFs 1202 E ST SE CITY AUBURN ST Wq ZiP gg002
6 ❑ PRESENT MEDICALTANSPORTED. 1 1 2 31
CDL IGNITION RE(UIRED IGNITION
INTERLOCK YES NO INTERLOCK YES NO YES N..
DRIVER'S D.O.B 2
7
LICENSE' WA SEX U MMDDv 05 - 30 - 2003
ON DUTY STATUS AIRBAG 2 RESTR. 4 EJECT 9 HELMET INJURY 1 NAruRE of INJURIES
USE ;CLASS ;
8 ❑ 1 32
LICENSE A8943269 TAT WA VIN 3MVDMBCM3PM520909
PLATE#
9 TRAILER I I TRAILER L
PLATE# STATE PLATE# STATE
10 ❑ TRLR TRLR
VIN.# VIN.#.
11 0 0 VEIL YEAR2023 MAKE MAZD MODELCX30 STYLE VEHICLE TOWE E T ABLIN TOWED BY GovT vFHICI E FROM To
DAMAGE YES NO ✓ YES NO
DILAN GONZALEZ 1202 E ST SE AUBURN WA 98002 D:2532937486 g g 33
REGISTERED OWNER INFO. SHADE IN DAMAGED AREA
12
4 FROM TO
INSURANCE CO
LIABILITY INSURANCE SAME.
IN EFFECT &POLICY# J7t1P N`- m 34
13 ❑ vewc�e YES NO CITATION# CHARGE 1080TTOM
ecaLLY
srANo1'-
MOTOR PEDAL_ ' 1:1PROPERTY
DAMAGE THRESHOLD MET PHONE 35
14 ❑ UNIT# VEHICLE CYCLE PEDESTRIAN OWNER YES NO
15 LAST NAME FIRST NAME NIIT AL
El 36
16 ❑ STREET �' CITY ST' ZIP
n>FW ADDRFSS
CDL IGNITION REQUIRED IGNITION PRESENT MEDICALTANSPORTED.
INTERLOCK VES NO INTERLOCK YES NO :YES NO
17 37
RIVERSLLIICENSE# STATE SEX M M.
_
18 ❑
HELMET 'INJURY NATURE OF INJURIES 38
ON DUTY STATUS AIRBAG RESTR. EJECT USE CLASS,
19 ❑ AN# ❑ 39
LICENSE TAT
PLATE#
20 TRAILER' TRAILER 40
PLATE#. STATE PLATE# - STATE ❑
21 ❑ TRLR TRLR 41
VIN#t 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 DAMAGED AREA 43
2 3 4
LIABILITY INSURANCE[—] INSURANCE CO
IN EFFECT I &POLICY# 7c;Q
y. 44
vewc�e ❑ ❑ CITATION# CHARGE
24 I..TF_ YES NO
STANDING 8 3 G
1 CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT.
M.LEVERTON 01-13-26 08:14 AM
25 INVESTIGATING OFFICER'S SIGNATURE OFFICER'S PHONE UNIT OR DIST DET DATED: PLACE SIGNED
26 ORID# 2517 O#RI WA0171300 APJACOBS 1%14/2026 PAGE OFF
3000-345-013(R 11/18)
REPORT NO. EG68752 CASE# 26-343 DATE AND TIME 01/13/2606:31
OF COLLISION
J
t
�u RP i 1 ini'
Y
avG ti IE�1
9?.
c
`a n
4 d
k
S�
Y..
C
�` av
z
s �y
€
i
s
1
t
\ t
i d
t �
n
;
ak
v
PAGE 6 OF e