HomeMy WebLinkAbout26-102 iiTFiNII IIIII III IIIII II IIII IIIII I . 27c REPORT NO EG69110oc� RA
COLLISION REPORT 1591971
❑ ❑✓ RESULTED ❑ CASE# 26-102 2
INTERSTATE CITY STREET FIRE
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VEHICLE ❑ LOCAL ACENC'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
COUISION' 01 - 05 - 2026 0816 17 =.= S 8 W E IN OF M 1070 a
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION �✓ NON INTERSECTION ❑
BLOCK NO. e .�
4a
NE 4TH ST MILE POST
❑
❑ DISTANCE OF(REFERENCE OR CROSS STREET)
5 . FEET S 8 W e DUVALL AVE NE
2 0 29
MOTtlR PEDAL- DAMAG THRESHOLD MET PHON
UNIT 01 E
VEHICLE ❑ CYCLE ❑ YES No �/ D:8163510048 0 1 30
6 LAST NAME STUCK FIRST NAME LARRY MIDDLE J t 1 2 31
INITIAL
STREET ❑ 12423 169TH AVE SE CITY RENTON ST WA ZIP 980596501 2
NEW ADDRESS
7 CDL IGNITIQN REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
INTERLOCKYES NO INTERLOCKYEs N YES F NO
8� LICIENS# STATE WA SEX M MMDCSYY' 07 - 24 - 1949 1 2 32
9[�] ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 N USEET INJURY
CLASS 1 NAruRE of INJURIES 2
10 LI ENSE' AZC3188 STATE WA VN# 4A4AP3AU6FE029929 3
TRAILER STATE TRAILER ,STATE
11 3 5 PLATE# PLATE# ROM TO
TRLR TRLR 3 7 33
1 3
( FROM TO
2 5 VIN# vI.
VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWEDBY GOVT VEHICLE
13 4 2015 MITS OUTLAN DAMAGE YES DNO ✓ YEs❑ No 3 7 34
REGISTERED OWNER INFO MARIA STUCK 12423169TH AVE SE RENTON WA 98059 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
3
14❑ LIABILITY INSURANCE INSURANCE CO ALLSTATE 817 625 872 4
IN EFFECT &POLICY# 4TOP _
YEs
IALLNG ❑NO CITATION#❑ 6A0003808 CHARGE IMPROPER LANE USAGE B o ooTrob 36
15 STM
MOTCYR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT 02 VEHICLE ❑ CYCLE' ❑ ❑ nWNFR YE:
No D:4257576464
16�
LAST NAME EUBANK FIRST NAME LORRAINE MIDDLE'
INITIAL
STREET ❑
17 '❑ 13421 162ND AVE SE CITY RENTON ST, Wq ZIP 98059 37
NEW ADDRESS
18❑ CDL IGNITION REQUIRED3 (GNTION PRESENT MEDICAL TRANSPORTED' 38
INTERLOCKYES NO INTERLOCK YES 11--hl vEs NDI
19 DRIVER'S STATE WA SEXI F D.O.B. 01 18 1987 39
LICENSE# MMDDYY -
HELMET INJURY' NATURE OF INJURIES 40
20❑ ON DUTY STATUS' AIRBAG 2 RESTR 4 EJECT 1 USE CLASS 1 ❑
21 LICEN� 851VMM rarE WA vIN# USE
41
PLATE 22❑ PLTL ATE# STATE TILER PATE# STATE ❑ 42
43
23 TRLR kRLR
UIN#. 'IN#.
VEH.YEAR 2006 MAKE pJJ$$ MODEL 350Z STYLE VEHICLE TOWED TO BLIN
TOWED BY GOV HI 44
24 DAMAGE YES NO YES NO
REGISTERED OWNER INFO JOHN EUBANK 2140 DEER PARK RD PORTANGELES WA 98362 VEHICLE NO.2
SHADE IN DAMAGED AREA
2 3 4
LIABILITY INSURANCE INSURANCE CO PROGRESSIVE 927190955
IN EFFECT &POLICY# t
vAaLE IL—JI CITATION# CHARGE
25 wLY YES❑ N
M
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
26
C.ARNOLD 12509 WA0171300
PAGE 01 OF
PART A 3000-345-159(R 11/18)
POLIICFETRAFFICN CORRECTION REPORT NO. EG69110
COLLISION REPORT III III III III III 111
1591972 CASE# 26-102
ADDITIONAL PERSONS INVOLVED(PASSENGERS AND/OR WITNESSES ONLY)
'NAME
(LAST,FIRST MIDDLE INTTIAL)
ADDRESS&PHONE#
SEX' D.O.B. - [----------�
MMDDYYYY
PASSENGER F-1 WITNESS Ej UNIT# SEAT AIRBAG RESTR. EJECT HELMET INJURY NATURE OF INJURIES--�
POS. USE CLASS
'NAME
(LAST FIRS,MIDDLE INITIAL)
ADDRESS&PHONE#
SEX' D.O.B. - L----------�
MMDDYYYY
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. - L----------�
MMDDYYYY
PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET INJURY NATURE OF INJURIES
❑ Q POS. USE CLASS �____ ----j
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.
C.ARNOLD 01-05-26 09:53 AM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST.DET DATED PLACE SIGNED
APPROVED BY DATE
1/15/2026 1:57:27 PM
C.JACOBS 1953
BADGE OR ID# 12509 ORI# ( WA0171300 TIME POLICE DISPATCHED'; 9:18 AM TIME POLICE ARRIVED 9:20 AM
PART B 3 Do-3mx-,ao(Burls) PAGE 27 OF 47
REPORT No.` EG69110 CASE# 26-102 O COLLI COLLISION TIME
OF 01/05/26 09:16
COLLI
NARRATIVE
CC 26-102
On 1/5/2026 at 0917 hours I was dispatched to a motor vehicle collision at the intersection of NE 4th
St and Duvall Ave NE in the City of Renton, King County, Washington.
Pre-Collision
Driver 2 stated that she was traveling West in the #1 lane of NE 4th St approaching Duvall Ave NE.
Driver 1 stated that he was traveling West on NE 4th St in the #2 lane approaching Duvall Ave NE.
Collision
Driver 2 stated that as she approached the intersection, Unit 1 merged from the #2 lane to the #1 lane
where she was at and the front passenger side wheel of Unit 1 collided with the front drivers side
bumper of Unit 2.
Driver 1 stated that he did not see Unit 2 and that he merged from the #2 lane to the #1 lane where
the front passenger side wheel area of Unit 1 collided with the front drivers side bumper of Unit 2.
Injuries
None reported
Vehicle Disposition
Both vehicles were operational
Proximate Cause
I determined that Driver 1 is the proximate cause of this collision because a vehicle shall be driven as
nearly as practicable entirely within a single lane and shall not be moved from such lane until the
driver has first ascertained that such movement can be made with safety.
Had Driver 1 not moved his vehicle from his lane while there was a hazard in lane #1, this collision
would not have happened.
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 Officer C. Arnold #12509 at 09:48 on 1/5/2026 in the City of Renton, King
County, Washington.
PAGE 3 OF 4
REPORT NO. EG69110 CASE# 26-102 DATE AND TIME i 01/05/26 09:16
OF COLLISION
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PAGE 4 OF 4