HomeMy WebLinkAbout26-451 )STATE
TFcN 0 6 27i t
Oc� RA EG69228
COLLISION REPRT 1591971
❑ 0✓ RESULTED ❑ CASE 26-451 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
GDUISION' 01 - ?5 - 2026 18?1 17 =.= S 8 W E IN OF M ?070 a
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION
NE 4TH ST BLOCK NO. e 4500 .�
4a❑ MILE POST
❑ DISTANCE OF(REFERENCE OR CROSS STREET)
5 0 . FEET S 8 W e DUVALL AVE NE
OF 2 29
MOTOR ✓ PEDAL- DAMAG THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE ❑ YES �/No D:2533307388 0 1 30
LAST NAME HERRING FIRST NAME BURNIS MIDDLE
5 INITIAL 1 2 31
STREET ❑✓ 3020 S 54TH ST CITY TACOMA ST WA ZIP; 98409 2
NEW ADDRESS
7 CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED. 3
INTERLOCK YES ✓NO INTERLOCK YEs Na✓ YES D NO;✓
8 LICIENS# STATE WA SEK'M MMDDYY' 02 — 28 — 1981 1 2 32
9 ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT, ? HELMET INJURY 7 NATURE OF INJURIES 2
USE CLASS C/O BACK PAIN
LICENSE CHM0885 STATE WA VN# KNDPUCAG9P7112975 3
10 19� PI ATP tt
11[-j- TRAILER STATE TRAILER ,STATE ROM TO
11 3 5 PLATE# PLATE#
rRLR rRLR, 3 7 33
12 3 5 vIN# vI.
( FROM TO
VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN pyEN�I GOVT VEHICLE 3 7 34
13 4 2023 KlA SPORTA UT DAMAGE YES NO " "'"' R$TOW YES NO✓
REGISTERED OWNER INFO OWNEDBYDRIVER VEHICLE NO. 1
SHADE IN DAMAGED AREA 35
LIABILITY INSURANCE❑ INSURANCE CO 3 4
14 ✓ SRISTOL WEST G01619096401
IN EFFECT &POLICY# i 4TOP 5
vEn ' CHARGE 7o BOTTOM 36
LEGALLY yes❑NO❑ CITATION# 5
15❑ sTANowc B 7 e
MOTOR PEDAL- PROPERTY DAM THR OLD MET PHONE
UNIT 02 Q ❑ PEDESTRIAN ❑ D:4252081658
VEHICLE CYCLE (7WNPR 'AM NO
16�
LAST NAME WILLIARMS FIRST NAME JANIQUA MIDDLEI L
❑
17 STREET
INITIAL
❑
?4121 SE 177TH ST#K203 CITY RENTON ST, WA ZIP 98058 4 37
NEW ADDRESS
1g❑ CDL IGNITION REQUIRED IGNTION PRESENT MEDIGALTRANSPORTED: 38
INTERLOCKYEs No✓ INTERLOGKYEs NOF,-/Jl ves Now
19 DRIVER' # STATE WA SEX,F MD,033 Y 04 29 1999 39
20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 H U ET INJURY�Y 1 NATURE OF INJURIES 40
21 LICENSLATE E CSK1996 rare WA vIN# 4S4BRBCC4E3305096 41
22❑ PLATE# STATE[TILER I 1AILERPATE# STATE ❑ 42
23 TRLR kRLR 43
UIN#. 'IN#.
TOWED BY GOV HI 44
VEH.YEAR 2014 MAKE $UBq MODEL OUTBAC STYLE UT IVE DAMIAGE TOWED,� No BLIN BANKERS TOW YES NO✓
24
REGISTERED OWNER INFO OWNED BY DRIVER VEHICLE NO.2
SHADE IN DAMAGED AREA
2 3 4
LIABILITY INSURANCE INSURANCE CO GEICO 6221500926
IN EFFECT &POLICY# t R
vemcteLEGALLY YES❑ N`LJ,.I—ICITATION# CHARGEtO 25
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
26
RYAN KARLO RIVERA 12649 WA0171300
PAGE 01 OF
PART A 3000-345-159(R 11/18)
POLIICFETRAFFICN CORRECTION REPORT NO. EG69228
COLLISION REPORT III III III III III 111
1591972 CASE# 26-451
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.
RYAN KARLO RIVERA 01-15-26 09:46 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST.DET DATED PLACE SIGNED
APPROVED BY DATE
QUINT TIBEAU 7691 1 111612026 12:10:42 AM
BADGE OR ID# 12649 ORI# ( WA0171300 TIME POLICE DISPATCHED'; 6:13 PM TIME POLICE ARRIVED 6:24 PM
PART B 3 Do-3mx-,ao(Burls) PAGE 27 OF 47
REPORT NO. EG69228 CASE# 26-451 OF COLLISIONS 01/15/26 18:11
OI;COLLISICiN
NARRATIVE
On 01/15/2026, 1 was working uniformed patrol in a marked police car as 3R23. At approximately
1813 hours, officers were dispatched to a blocking collision at the intersection of NE 4th St/Duvall
Ave NE, which is located within the city limits of Renton, County of King, Washington. Dispatch
advised that there was a collision at the location involving 2 vehicles. Dispatch reported no injuries
and that the vehicles were partially blocking.
As I was driving to the dispatch location, dispatch was provided both involved vehicles and stated that
they were waiting east of the intersection just south of NE 4th St for contact.
When I arrived, I located both Unit 1 and Unit 2 as listed above. Unit 1 had pulled into the QFC
parking lot, and Unit 2 was partially blocking one of the south entrances to the QFC parking lot.
I was able to speak to the driver and sole occupant of Unit 2. 1 identified her at this time as listed
above. My conversation with her is summarized as follows:
The driver of Unit 2 stated she was headed westbound on NE 4th St, approaching Duvall Ave NE in
the #1 lane. The #1 lane of westbound NE 4th St is a right turn lane to head northbound onto Duvall
Ave NE. The Driver of Unit 2 mentioned she was traveling at relatively low speeds to prepare to turn
right to head northbound on Duvall Ave NE. She mentioned that Unit 1 was in the adjacent#2 lane of
westbound NE 4th St, paralleling her. The driver of Unit 2 then described that Unit 1 abruptly cut in
front of her, traveling from lane #2 to lane #1, resulting in Unit 1 hitting the front driver's side of Unit 2.
The driver of Unit 2 mention that she did not see him use his turn signal.
The driver of Unit 2 mentioned she was wearing her seatbelt and that she was not injured.
looked around Unit 2. 1 saw that the front driver's side bumper area had significant dents, scratches,
and was slightly pushing against the front driver's side tire. I also saw that there was no airbag
deployment. The driver of Unit 2 also did not have a dash camera.
Officer J. Turner was able to speak to the driver of Unit 1. He had identified the driver and sole
occupant of Unit 1 as listed above. Officer J. Turner relayed the following:
The driver of Unit 1 explained that he was driving westbound in an unknown lane on NE 4th St. The
driver of Unit 1 mentioned he was attempting to make a right turn into the nearby QFC parking lot
from NE 4th ST. He then said that Unit 2 had side-swiped him.
It should be noted that traveling westbound on NE 4th St would place QFC on the right-hand side of
traffic. There are 3 westbound lanes on NE 4th St where the vehicles were traveling. Lane #1 is a
right-turn-only lane to head northbound onto Duvall Ave NE. Lane #2 and Lane #3 are both continued
straight past Duvall Ave NE westbound. In order to make a successful turn into the QFC parking lot
from westbound NE 4th St, a driver should be in the right-most lane (the #1 lane) of westbound NE
4th St.
The driver of Unit 1 mentioned he was wearing his seatbelt. He did mention a complaint of back pain,
but declined to be evaluated by the aide at this time.
I briefly took a look around Unit 1. 1 saw that he had large dents and scratches along the front
passenger side wheel well and door panel area. There were also no airbags that had deployed inside
Unit 1. Unit 1 also had no dash camera.
Banker's tow was called for both vehicles as they appeared to be disabled. Both drivers of each unit
remained on scene until the tows arrived.
Associated photos were taken and uploaded to Evidence.com to be added to the case file.
Based on the totality of the circumstances, it appears that Unit 1 is the proximate cause of the
collision.
This concludes my report.
I certify (declare) under penalty of perjury under the laws of the State of Washington that the
foregoing is true and correct.
Signature: Ryan Rivera (#12649) Date and Place: 01/15/2026 @ Renton, WA
PAGE 3 OF 4
REPORT NO. EG69228 CASE# 26-451 DATE AND TIME i 01/15/26 18:11
OF COLLISION
v
1�
�v
5
z ,
e ��i�f ICY
�J1�
z
C
s
4 a
f #
�S
3 l
Asa
yf��zzz{
5�g
PAGE 4 OF 4