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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 r � } r � g � ti ate« i S yd t { le k PAGE 5 OF 5