HomeMy WebLinkAbout26-360 IT si " II IIIII III IIIII II IIII IIIII I . 27c REPORT NO EG68797OLCERA
COLLISION REPORT 1591971
❑ ❑✓ FIRERES ED ❑ CASE# 26-360 2
INTERSTATE CITY STREET FIRE
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VEHICLE ❑ LOCAL AGENC'Y 4200 3[--�
COUNTY RD ❑ NVOLVED CODING
PRIVATE WAY
2❑ TRIBAL TOTAL 1
UNITS#OF 02 SO BJECT TRUCK 1 8 28
RESERVATION 2
3� M M D D Y Y Y Y TIME(2400) COUNTY# MILES CITY#
DATE OF'. N E IN COLLISION' 01 - 13 - 2026 1249 17 =.= S 8 W E OF M 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION [Z NON INTERSECTION BLO❑
FACTORYAVEN MILE POST
e 200 .�
4a❑ MILE POST
❑ DISTANCE OF(REFERENCE OR CROSS STREET)
5 �. FEET e S 8 W e N 2ND ST
0 3 29
MOTtlR PEDAL- DAMAG THRESHOLD MET PHON
UNIT 01 E
VEHICLE ❑ CYCLE ❑ YES No �/ D:2062717138 1 4 30
6 LAST NAME HANSON FIRST NAME MARK MIDDLE P 1 1 2 31
INITIAL
STREET ❑ 23217 26TH AVE S CITY DES MOINES ST WA ZIP 981988718 2
NEW ADDRESS
7 CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
INTERLOCKYES NO✓ INTERLOCKYES NO✓ YES F NO✓
SEXMMMOC — 288 DRIVER'S STATE WA 32
LICENSE#
9 ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 N USEET 2 1 INJURY
CLASS 1 NAruRE of INJURIES 2
10 LI ENSE'ti� A6134C STATE WA VN# 1BAKCCPA3FF311289 3
TRAILER STATE TRAILER ,STATE
11 2 5 PLATE# PLATE# ROM TO
TRLR TRLR 1 7 33
12 0 Q VIN# VIN#
FROM TO
VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED By GOVT VEHICLE
13 4 2015 BLB C60DL BU DAMAGE YES�NO ✓� YES❑ NO✓ m 34
REGISTERED OWNER INFO RENTON SCHOOL DISTRICT 300 SW 7TH ST RENTON WA 98057 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
14❑ LIABILITY INSURANCE NSURANCE CO RENTON SCHOOL DISTRICT SELF-INSURED 4
IN EFFECT &POLICY# 9TOP
VEHICLE CHARGE t S 36
Lemur YES❑NO❑ CITATION# 7 o BOTTOM
15❑ sTnNowc B 7 a
rL� MOTOR ✓ PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT VEHICLE ❑ CYCLE' ❑ ❑ OWNFR YEs�/ No D:2063566674
16❑
LAST NAME DUBOIS FIRST NAME WILLIAM MIDDLE I E
INITIAL
2 STREET ❑
17 ❑ 226 VASHON AVE SE CITY RENTON ST, yyq ZIP 98059 4 37
NEW ADDRESS
18❑ CDL IGNITION REQUIRED IGNTION PRESENT MEDICAL TRANSPORTED 38
INTERLOCKYES No✓ INTERLOCK YES No✓ ES No;✓
19 F] DRIVER' # STATE I SEXIM MMDOYY 09 19 1998 39
HELMET INJURY' NATURE OF INJURIES 40
20❑ ON DUTY STATUS' AIRBAG g RESTR g EJECT 9 USE 9 CLASS 0 ❑
21 LICEN PLATE� CLE6418 rarE WA vIN# WAUFFAFL6AN037734 41
22❑ [TILER AILER
PLATE# STATE PATE# STATE ❑ 42
23 TRLR kRLR 43
UIN#. 'IN#.
VEH.YEAR 2010 MAKE gl/DI MODEL q4 STYLE $D VEHICLE TOWED TO BLIN
TOWED BY GOV HI 44
24 DAMAGE YES NO✓ YES NO✓
REGISTERED OWNER INFO WILLIA.DUBOIS 226 VASHON AVE SE RENTON WA 98059 D:2063566674 VEHICLE NO.2
SHADE IN DAMAGED AREA
2 3 4
LIABILITY INSURANCE INSURANCE CO NATIONAL GENERAL 2011689751
IN EFFECT &POLICY# t 9TOP
veeicLe ❑ ,J—I CITATION# CHARGE tO BOTTOM
Lecnttr YES N`[
25 a
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
26
D.NELSON 12421 WA0171300
PAGE 01 OF
PART A 3000-345-159(R 11/18)
POLIICFETRAFFICN CORRECTION REPORT NO. EG68797
COLLISION REPORT III III III III III 111
1591972 CASE# 26-360
ADDITIONAL PERSONS INVOLVED(PASSENGERS AND/OR WITNESSES ONLY)
NAME MIDDLE INITIAL} TRIBBLE JACQUELINE M
(LAST,FIRST
ADDRESS&PHONE#
1750 22ND AVE S APT E647 SEATTLE WA 981444620 2065510825 SEX' F MMoovvvv 12 - 14 - 1992
PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET INJURY NATURE OF INJURIES
Q Q 1 POS. 9 2 4 1 USE 2 CLASS '1 �_ ---�
'NAME
(LAST FIRS,MIDDLE INITIAL)
ADDRESS&PHONE#
' D.O.B.
SEX MMDD -F L----------�
YYYY
PASSENGER DWITNESSD UNIT# SEAT AIRBAG RESTR. EJECT HELMET NJURY NATURE OF INJURIES
POS. : USE CLASS ----�
'.NAME
(LAST,FIRST,MIDDLE INITIAL)
ADDRESS&PHONE#
SEX' D.O.B.M -T L----------�
MDDYYYY
PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET INJURY NATURE OF INJURIES
❑ Q' POS. USE CLASS r— ----�
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.
D.NELSON 01-14-26 07:07 AM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST.DET DATED PLACE SIGNED
APPROVED BY DATE
C.JACOBS 1953 111412026 1:36:30 PM
BADGE OR ID# 12421 ORI# ( WA0171300 TIME POLICE DISPATCHED'; 12:50 PM TIME POLICE ARRIVED 12:52 PM
PART PAGE 27 OF 57
REPORT NO.` EG68797 CASE# 26-360 O COLLI COLLISION TIME
OF 01/13/26 12:49
COLLI
NARRATIVE
26-360 ACC
On 1/13/2026 1 was working as a uniformed patrol officer and driving a marked patrol vehicle for the
City of Renton. I was dispatched to a report of a school bus versus a parked vehicle near N 2nd St
and Factory Ave N Renton/King/WA. Injuries were initially reported.
I arrived on scene with RRFA, they checked on all occupants of the bus and advised there was no
injuries.
The driver of the 2015 Blue Bird C60DL WA/XMTA6134C #309 (Unit 1) was identified by his WADL
as Mark P Hanson DOB: 3/28/1968. Mark said that he was driving south on Factory Ave N and was
attempting to turn west on N 2nd St. He said that as he was turning, he struck the parked vehicle.
There was damage to the rear passenger side wheel well of the bus, it was drivable.
All the students on the bus were seat belted in and were not injured. I was provided a seating chart
from the school district personnel on scene. Photographs of this seating chart were uploaded to Axon
Evidence.
The 2010 Audi A4 WA/CLE6418 was parked on the north side of N 2nd St facing west when it was
struck. There was damage to the driver side rear quarter panel. It was unoccupied at the time of the
collision.
I provided the owner of the Audi as well as Renton school district employees with an exchange of
information.
Photographs of the damage were uploaded to Axon Evidence.
Nothing further.
I certify under penalty of perjury under the laws of the State of Washington that the foregoing is true
and correct.
D. Nelson #191 1/13/2026 Renton WA
PAGE 3 OF 5
SUPPLEMENTAL REPORT NO. EG68797POLICE TRAFFIC
1 27
COLLISION REPORT CASE# 26-360
1 COMMERCIAL MOTOR CARRIER INTERSTATE INTRASTATE ✓
UNIT# 1 USDOT 1 208334 ICC# VEHICLE TYPE 1 CARGO BODY 1
TYPE
2 ❑ 1 28
CARRIER NAME. RENTON SCHOOL DISTRICT
3 ❑ CARRIER KOHLWES EDUCATION CENTER 300 SW 7TH ST L
ADDRESS
CITY RENTON ST WA ZIP 98055
4 NAME # PLACARD. -�
NAME IF NO NUMBER
SOURCE' 3 AXLES 02 GVWR 33000 +
4a ❑ ADDITIONAL UNITS
5 U UNIT
N�T.µ MOTOR PEDAL- PROPERTY DAMAGE THRESHOLD MET PHONE
'# VEHICLE ❑ : CYCLE ❑ PEDESTRIAN OWNER :❑ YES NO
MIDDLE; 29
LAST NAME FIRST NAME fNITIAL
STREET 30
NFW ADDRFs'P CITY ST ZIP
6 1 PRESENT MEDICAL TANSPORTED 1 31
CDL IGNITION REQUIRED IGNITION
INTERLOCK YES NO INTERLOCK YES NO YES N
G
7
LICENSE STATE I SEX MMDD g Y
ON DUTY STATUS: AIRBAG RESTR. EJECT HELMET I INJURY NAruREofINJURIES
USE GLASS
8 ❑ VIN.#LICENSE 1 32
PLATE# rAT
9 TRAILER TRAILER 2
PLATE# STATE PLATE# STATE
10 ❑ TRLR TRLR
.VIN.# .VIN.#.
11 VEH.YEAR MAKE MODEL STYLE VEHICLE TOWE E T ABLIN TOWED BY GDVr.VFHICI F FROM TO
DAMAGE YES NO YES NO
RED OWNER INFO. m 33
REGISTEREDSHADE IN DAMAGED AREA
12
LIABILITY INSURANCE❑ INSURANCE CO 4 FROM TO
TO
IN EFFECT &POLICY# 34
13 YES NO CITATION# CHARGE
10 8C)1`l OM
ecauv
DAMAGE THRESHOLD MET PHONE 35
sTnNoiNc
MOTOR PEDAL- ' PROPERTY 1:1
14 ❑ UNIT# VEHICLE CYCLE PEDESTRIAN OWNER YES NO
15 LAST NAME FIRST NAME ❑INITMIDDL
ALE 36
16 ❑ STREET CITY ST ZIP
NFW ADDRESS"
GDL IGNITION REOUIRED .IGNITION PRESENT ME171CALTANSPORTED
INTERLOCK YES NO INTERLOCK YES NO .YES NO
17 37
DRIVERS
STATE SEX M�DDWY
18 ❑
HELMET INJURY NATURE OF INJURIES 38
ON DUTY STATUS AIRBAG RESTR. EJECT USE CLASS
19 ❑ ❑ 39
LICENSE viN
PLATE# TAT #
20 ❑ TRAILER TRAILER ❑ 40
PLATE#. STATE PLATE# STATE
21 ❑ TRLR TRLR 41
VIN#1 VIN#;
42
22 VEH.YEAR MAKE I MODEL I STYLE VEHICLE TOWED DUE T SABLIN 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# tK-99
5 44
vewc�e ❑ ❑ CITATION# CHARGE 24 IEG_ VES NOSTIWDING3 3 6
I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT.
D.NELSON 01-14-26 07:07 AM
25 INVESTIGATING OFFICER'S SIGNATURE OFFICER'S PHONE UNIT OR DIST DET DATED: PLACE SIGNED
26 ORID# 12421 O#RI WA0171300 APJACOBS 1%14/2026 PAGE OFF
3000-345-013(R 11/18)
REPORT NO. EG68797 CASE# 26-360 DATE AND TIME i 01/13/26 12:49
OF COLLISION
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