HomeMy WebLinkAbout26-252 IT si " II IIIII III IIIII II IIII IIIII I . 27c REPORT NO EG71312OLCERA
COLLISION REPORT 1591971
FIRE CASE#
26-252 2
INTERSTATE CITY STREET RESULTED ❑
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VEHICLE ❑ LOCALAGENCY 4250 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY ❑✓ INVOLVED
2 OF OBJECT 1 1 s 28
TRIBAL UNITS 02 STRUCK
RESERVATION : 2
3� M M D D Y Y Y Y TIME(2400) COUNTY# MILES CITY#
DATE OF N E
cDLLISION' 01 - 09 - 2026 1220 17 =.= S 8 W e OF M 1070 a
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓
N 10TH PL BLOCK NO. e 815 .�
4a❑ MILE POST
DISTANCE OF(REFERENCE OR CROSS STREET)
5 1❑ 100 00 FEET e✓ S 8 W e LOGAN AVE N
1 5 29
MOTOR PEDAL- DAMAG THRESHOLD MET E
UNIT 01 VEHICLE ❑ CYCLE ❑ YES NO ✓ PHON 30
6 LAST NAME UNKNOWN FIRST NAME MIDDLE t 1 2 31
INITIAL
STREET ❑ CITY', ST ZIP 2
NEW ADDRESS
7 CDL IGN(TIUN REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
INTERLOCKYEs NO✓ INTERLOCKYES NO✓ YES NOW
8❑ LCEENSE# SRVERSTTATE SEX U MMDDYY' —�— 32
9 ON DUTY STATUS' AIRBAG 9 RESTR 9 EJECT 1 HELM
USEET 9 CLASSY 0 NATURE OF INJURIES 2
LICENSE, CFJ2600 sTATs WA VIN# 7FARS6H59PE030554 3
10 Fq I as ATP tt
TRAILER STATE TRAILER STATE
11 0 0 PLATE# PLATE# ROM To
TRLR zRLR 0 0 33
12= UIN#' VIN#
FROM TO
VEH.YEAR 2023 MAKE HOND MODEL CRV STYLE VEHICLE TOWED TO BUN TOWED By GOVT VEHICLE g 9 34
13 DAMAGE YES NO ✓ YES_ NO✓
REGISTERED OWNER INFO MARTIN CHAN 8519 S 112TH ST SEATTLE WA 98178 VEHICLE NO. 1
SHADE IN DAMAGED AREA 35
14❑ LIABILITY INSURANCE❑+�NICLICY
SURANCE CO UNKIN EFFECT Enic� CHARGE 36Lemur yes❑NOTATION# t a 80TTOM
15❑ STANDING s 7 e
MOTOR PEDAL-:. PROPERTY DAM THR OLD MET PHONE
IUNIT02 ❑ ❑ PEDESTRIAN Q✓ D:2532699136
VEHICLE CYCLE OWNER YES✓ NO
16�
LAST NAME SMALL FIRST NAME LARITA MIDDLE A
INITIAL
17 F1 STREET ❑
❑ 20729 235TH AVE SE CITY MAPLE VALLEY ST, WA ZIP 98038 g 37
NEW ADDRESS
1$❑ CDL IGNITION REQUIRED (GNI I iON PRESENT MEDICAL TRANSPORTED 38
INTERLOCKYES NO INTERLOCK YES NO vEs NO
19 DRIVER'S STATE WA SEX F D.02. Fol 17 1983 39
LICENSE# MMDDYY I -
6 INJURY 40
NATURE OF INJURIES 3
20❑ ON DUTY STATUS 3 AIRBAG RESTR EJECT HELMET 2 6 ❑
USE CLASS PAIN TO LEFT TOE
21 I LICENSE PLATE# TATE VIN# 4� 41
22❑ [TILER TAILER
PLATE# STATE PLATE# STATE 42
23 TRLR RLR 43
UIN#. 'IN#
VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN
TOWED BY GOV HI 44
24 1 7 DAMAGE YES NO YES NO
REGISTERED OWNER INFO VEHICLE NO.2
SHADE IN DAMAGED AREA
2 3 4
LIABILITY INSURANCE❑ INSURANCE CO
IN EFFECT &POLICY# 9TOP
vewae ❑ , CITATION# CHARGE to BOTTOM
EEGnEEy YES N.I—I
25 a s
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
WA0171300
26
D.NELSON 12421
PAGE 01 OF
PART A 3000-348-189(R 11/18)
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EG71312
COLLISION REPORT III III III III III 111
1591972 CASE# 26-252
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.
D.NELSON 01-21-26 03:37 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST.DET DATED PLAGE SIGNED
APPROVED BY DATE
RAYMOND GORAJEWSKI 12399 1/23/2026 6:42:56 AM
BADGE OR ID# 12421 ORI# WA0171300 TIME POLICE DISPATCHED 12:30 PM TIME POLICE ARRIVED i 12:40 p�q
PAST B 3 Do-3mx—attar(t 1Mff) PAGE 2�OF 4
REPORT NO. EG71312 CASE# 26-252 O OF COLLI 510N TIME 01/09/26 12:20
COLLISION
NARRATIVE
25-252 ACCHR
On 1/9/2026 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 hit and run with minor injury that had just occurred in
the parking lot of Ulta Beauty located at 815 N Landing Way Renton/King/WA. Larita A Smalls DOB:
1/17/1983 was calling to report that a vehicle had run over her toe before leaving the scene.
Larita was requesting phone contact, I called her and asked what happened. She told me that she
was standing in the driver side rear door of her vehicle trying to get something out of her backseat.
She said that the vehicle next to her was backing out and as it backed out it ran over the tip of her
toe. She said that she told the driver he had just run over her foot, and he replied, "so what?" before
driving off in an unknown direction.
Larita said that she had gauze on the tip of her toe, but she was not going to see any medical
attention.
Larita was able to get the license plate of the suspect vehicle WA/CFJ2600. This plate returned to a
2023 Honda CR-V registered to a Martin K Chan DOB: 12/10/1956 to a Seattle address.
Larita described the suspect driver as a Asian male, 50-60 years old with short black hair.
Larita said that she would be able to recognize the suspect driver again if seen and did want to
pursue charges.
On 1/14/2026 1 performed a LINX check of Martin Chan and the Honda CRV and did not recieve a
result.
I performed an area check of Ulta and nearby businesses and was not able to locate any exterior
cameras.
I completed a photo montage and forwared to Det. Lane for possible viewing.
After numerous attempts to set up a meeting with Larita she eventaully stopped taking Det. Lane's
phone calls.
This case is closed
I certify under penalty of perjury under the laws of the State of Washington that the foregoing is true
and correct.
D. Nelson #191 1/9/2026 Renton WA
PAGE 3 OF 4
REPORT NO. EG71312 CASE# 26-252 DATE AND TIME 01/09/26 12:20
OF COLLISION
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PAGE 4 OF 4