HomeMy WebLinkAbout26-259 II III III IIIII IIII III II I SUPPLEMENTAL
O EG67766 t 27iiT REPORTNO.Poc� RA
COLLISION REPORT 1591971
❑ 0✓ RESULTED ❑ CASE#I 26-259 2
INTERSTATE CITY STREET FIRE
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VEHICLE ❑ LOCALAGENCY 4200 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 TOTAL#OF OBJECKT 1 s 28
TRIBAL UNITS 02 STRUC ❑
RESERVATION : 1 2
3� M M D D Y Y Y Y TIME(2400) COUNTY# MILES CITY#
DATE OF N E
eDL�Is[oN' 01 - 09 - 2026 1518 17 =.�� S WE IN
OF 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓
BENSON RD S BLOCK NO. e 1000 .�
4a❑ MILE POST
❑ DISTANCE OF(REFERENCE OR CROSS STREET)
5 50 00 FEET e✓ S 8✓ W e MAIN AVE S
2 0 29
F
MOTOR PEDAL- DAMAG THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE ❑ YES No �/ D:7372228080 0 1 30
6❑ LAST NAME LONGO FIRST NAME ASHLYN MIDDLE M 1 2 31
INITIAL
STREET ❑ 1906 E 14THAVE CITY; ELLENSBURG ST WA ZIP; 989265128 2
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
INTERLOCKYES NO INTERLOCK YES Np YES NO
8 DRIVER # STATE WA SEXI F MMDDYY' 02 - 26 - 2006 1 2 32
9 ON DUTY STATUS' AIRBAG 2 RESTR 9 EJECT 1 N USE ET CLASSY 1 [NATURE of INJURIES 2❑
LICENSE, CUZ1775 STATE WA VIN#; 1C3CDFBB6ED914468 3
10 Fq I PI ATF tt
TRAILER TRAILER
11 0 0❑ STATE STATE PLATE# PLATE# ROM To
TRLR zRLR 1 1 33
12 0 0 VIN#' vIN#
FROM TO
VEH.YEAR 2014 MAKE DODG MODEL DART STYLE VEHICLE TOWED[n TO ZBLIN TOWEDBY GOVT VEHICLE g 1 34
13� DAMAGE YES II_II NO YESII_I) NO
REGISTERED OWNER INFO CHANCE RANSIER PO BOX 215 CLEELUMWA98922 VEHICLE NO. 1
SHADE IN DAMAGED AREA 35
14 LIABILITY INSURANCE❑ NSURANCE CO NONE NONE 4
IN EFFECT &POLICY
srnNowc ❑ ❑ CHARGE FAIL TO OBEY LANE CONTROL $ t a oorro�m z 36
Yes NO CITATION#
15❑
MOTCYR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT O2 VEHICLE CYCLE nWNFR YES�/ NO D:2066889719
16�
LAST NAME FERNANDO FIRST NAME NATHAN MIDDLE M
INITIAL
17F1 STREET ❑ 37
NEW ADORE SS❑ 25933 185TH PL SE CITY' COVINGTON ST, WA ZIP 980428400
18❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED' ❑ 38
INTERLOCKYES No INTERLOCK YES NO vEs NO
19 DRIVER'S
MMDDYYj I —
:
20❑ ON DUTY STATUS AIRBAG 2 RESTR g EJECT 1 HELMET INJURY NATURE OF INJURIES 40 USE CLASS 1 ❑
21 LICENSE CPB2201 TATE WA VIN# 1HGEJ8145XL094261 41
22❑ PLAILER TE# STATE PLATE# STATE 42
23 TRLR r RLR 43
UIN#. 'IN#
VEH.YEAR 1999 MAKE HOND MODEL CIVIC STYLE VEHICLE TOWED TO BLIN
TOWED BY GOV HI 44
24❑ DAMAGE YES NO�/ VES NO�/
REGISTERED OWNER INFO SOKHOEUN DAM 25933185TH PL SE COVINGTON WA 98042 VEHICLE NO.2
SHADE IN DAMAGED AREA
2 3 4
LIABILITY INSURANCE INSURANCE CO PROGRESSIVE 995565730
IN EFFECT &POLICY# I
Y 1— ❑ ,J—I CITATION CHARGE U�o
L,—�Y YES N
25 OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
26
SULIASI TAMAIVENA 12788 WA0171300
❑
PAGE 01 OF
PART A 3000-348-189(R 11/18)
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EG67766
COLLISION REPORT III III III III III 111
1591972 CASE# 26-259
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 CLASS ----�
: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 CLASS
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.
SULIASI TAMAIVENA 01-14-26 08:26 AM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST.DET DATED PLAGE SIGNED
APPROVED BY DATE
D.SKELTON 9139 111112026 3:56:25 AM
BADGE OR ID# 12788 ORI# WA0171300 TIME POLICE DISPATCHED 1 3:24 PM TIME POLICE ARRIVED i 3:31 PM
PAST B 3 Do-3mx—attar(t 1Mff) PAGE 2�OF 4
REPORT NO. EG67766 CASE# 26-259 O OF COLLI 510N TIME 01/09/26 15:18
COLLISION
NARRATIVE
On 01/09/2026, at approximately 1516 hours, I was dispatched to an accident at Benson Road South
and Main Avenue South in the City of Renton, while I was employed as a uniformed Patrol Officer for
the City of Renton, County of King, State of Washington. The reporting party advised that both parties
are now at Renton Ave S and Beacon.
I spoke with Unit#1, and she advised that she doesn't know this area and doesn't even remember
which street she was on. Unit#1 stated she was at fault and that whatever Unit#2 says is correct.
She also mentioned that she thought she was in the correct lane, but saw at the last minute that she
wasn't, and tried to move to the right lane, to which she hit Unit#2's vehicle. Her explanation was that
she is not from this area.
Unit#1 did not claim any injuries. Through my observation, she had damage to the right top tire
fender. The vehicle was still drivable.
I spoke with Unit#2, and he advised that he was on Benson RD S in lane #1, the only straight-of-
travel lane, and that lane #2 was a left-turn-only lane, attempting to cross into Main Ave S traveling
northbound. He said Unit#1 vehicle was in lane #2. While driving in his lane, he said Unit#1's vehicle
had crossed into his lane, hitting the left side of his vehicle near the driver's and passenger's door.
Unit#2 vehicle sustained damage to the left side, more specifically between the driver and passenger
doors. He estimated the damage at over 2k. He claimed no injuries, and the vehicle was still drivable.
I took photos of all the damages and uploaded them as evidence. Both were provided with exchange
information forms with a case number.
I believe the proximate cause of this accident was Unit#1, as the driver failed to change lanes safely
and with caution. If she had turned safely with caution, I believe this accident would have been
preventable. As a result of her actions, she will receive a citation for failing to change lanes safely
(RCW 46.61.140)
This concludes my report.
My Axon camera was on for this call.
I certify (declare) under penalty of perjury under the laws of the State of Washington that the
foregoing is true and correct. This report was electronically signed by Officer S. Tamaivena #12788,
1/10/2026, at 0536 hours, Renton, WA.
PAGE 3 OF 4
REPORT NO. EG67766 CASE# 26-259 DATE AND TIME 01/09/26 15:18
OF COLLISION> '
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