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Home My WebLink About26-412 IT si " II IIIII III IIIII II IIII IIIII I . 27c REPORT NO EG71311OLCERA COLLISION REPORT 1591971 ❑ 0 RESULTED I $ 26-412 2 INTERSTATE CITY STREET FIRESTOLENSTATE ROUTE OTHER VEHICLE LOL`CODICENC'Y 4200 3 HIT&RUN CODING COUNTY RD PRIVATE WAY INVOLVED 2 TOTAL#OF OBJECT 1 s 28 TRIBAL UNITS 03 STRUCK RESERVATION : 1 1 2 3� M M D D Y Y Y Y TIME(2400) COUNTY# MILES CITY# DATE OF N E eDLLISION' 01 - 14 - 2026 1229 17 =.= S 8 W E IN M 1070 a 4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑ BLOCK NO. e .� 4a S 43RD ST MILE POST ❑ ❑ DISTANCE OF(REFERENCE OR CROSS STREET) 5 C------ 1.1 FEET e S 8 W e TALBOT RD S 0 1 29 MOTOR PEDAL- DAM AG THRESHOLD MET PHONE UNIT 01 VEHICLE ❑ CYCLE ❑ YEs Vl No D:2064093222 0 8 30 5 LAST NAME MCLEAN FIRST NAME CHARLES MIDDLE E 1 1 2 31 INITIAL STREET Q 4214 SW 100TH ST CITY; SEATTLE ST I WA ZIP; 98146 2 NEW ADDRESS 7 CDL IGN(TIUN REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3 INTERLOCKYES NO INTERLOCKYEs N YES F No 8❑ DRIVER'CENS # STATE WA SEXI M MMDDYY' 03 — 11 — 1994 1 2 32 9 ON DUTY STATUS' AIRBAG 2 RESTR 4 EJECT 1 N USEE7 INJUR CLASSY 14 NATURE of INJURIES 2 LICENSE, CHD3125 STATE WA VIN#; 1N4BL4DV5PN370893 3 10 Fl I PI ATP rt TRAILER STATE TRAILER STATE ROM To 11 3 5 PLATE# PLATE# TRLR TRLR 3 1 7 33 12 0 0 VIN#' VIN# FROM TO 13 3 VEH.YEAR2023 MAKE NISS MODEL ALTIMA STYLE VEHICLE TOYED NO�iS46LIN T�VyED.6LRS CLE 9 9 34 DAMAGE IIII._IIII HHttVVii((tt REGISTERED OWNER INFO EAN HOLDINGS LLC 500 NACRES AVE SW STE 300 RENTON WA 98057 VEHICLE NO. 1 SHADE IN DAMAGED AREA 35 2 3 4 3 LIABILITY INSURANCE INSURANCE CO 14 Z ALLSTATE 817624217 IN EFFECT &POLICY# 4TOP VEHICLE CHARGE t 5 36 Lemur yes[:]NO[:] CITATION# 7 0 80TTOM 15❑ srnNowc e MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE UNIT VEHICLE CYCLE nWNFR YES NO �/ D:2067872354 16� LAST NAME SELLERS FIRST NAME ' G/NA MIDDLE M INITIAL STREET ❑ 17 ❑ 2012 S 279TH PL CITY FEDERAL WAY ST, WA ZIP 98003 37 NEW ADORE SS : 1 g❑ IGNITION REt]UIREO IGNITION PRESENT MEDICAL TRANSPORTED' ❑ 38 CDL INTER(_OCKYEs No INTERLOCK YES NO yEs No 19 DRIVERS ' MMDDYYj I — : 20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 HELMET INJURY NATURE OF INJURIES 40 USE CLASS 1 ❑ 21 LICENSLATE E CER3372 TATE WA VIN# KNMAT2MT3JP517054 41 22❑ [TILER TAILER PLATE# STATE PLATE# STATE 42 23 TRLR RLR 43 UIN#. 'IN# VEH.YEAR 201$ MAKE pJJSS MODEL ROGUE STYLE VEHICLE TOWED TO BLIN TOWED BY GOV HI 44 24 DAMAGE YES NO NO REGISTERED OWNER INFO OWNED BY DRIVER VEHICLE N0.2 SHADE IN DAMAGED AREA 2 3 4 LIABILITY INSURANCE INSURANCE CO PROGRESSIVE 961265782 IN EFFECT &POLICY# t STOP VEHICLE ,.I—I CITATION# CHARGE to BOTTOM L'EILY YES[Z N 25 s e OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY J 26 C.ARNOLD 12509 WA0171300 PAGE 01 OF PART A 3000-348-189(R 11/18) STATE OF POLICETRAFFICN CORRECTION REPORT NO. EG71311 COLLISION REPORT III III III III III 111 1591972 CASE# 26-412 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 CLASS 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. C.ARNOLD 01-14-26 02:04 PM INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST.DET DATED PLACE SIGNED APPROVED BY DATE RAYMOND GORAJEWSKI 12399 1/23/2026 6:54:13 AM BADGE OR ID# 12509 ORI# WA0171300 TIME POLICE DISPATCHED I 12:31 PM TIME POLICE ARRIVED i 12:35 PM PAST Ba as-mx-at s gtxtrrasp PAGE F2 OF 57 REPORT NO. EG71311 CASE# 26-412 O OF COLLI 510N TIME 01/14/26 12:29 COLLISION NARRATIVE RTF 26-412 On 1/14/2026 at 1231 hours I was dispatched to a motor vehicle collision at the intersection of Talbot Rd S and S 43rd St in the City of Renton, King County, Washington. Pre-Collision Driver 3 stated that he was stopped for a red light behind Unit 2 facing East of S 43rd St at Talbot Rd S in the lefthand turn lane (#4). Driver 2 stated that she was stopped at a red light facing East on S 43rd St in front of Unit 3 in the lefthand turn lane (#4). Driver 1 stated that he was traveling West on S Carr Rd approaching Talbot Rd S in the #2 lane. Collision Driver 2 and 3 both stated that Unit 1 crossed over the intersection Westbound and upon entering S 43rd St, Unit 1 crossed over the center line. Driver 2 was unsure of what hit her vehicle, but upon further investigation it appears that the drivers side mirror of Unit 1 collided with the front drivers side door of Unit 2. Driver 3 stated that the drivers side door and front quarter panel of Unit 1 collided with and scraped along the drivers side of Unit 3. Driver 1 stated that he had a medical emergency and lost consciousness prior to entering the intersection. Driver 1 showed me that he has some sort of mobile EKG or heart monitor due to this being a frequent problem. Driver 1 stated that this is not the first time this has happened, and that he was in a collision in 2024 due to the same circumstances. Unit 1 appears to have slightly corrected to the right after it's collision with Unit 3. Following this, the front drivers side tire of Unit 1 appears to have collided with a raised median that begins just after where Unit 3 was positioned. This caused the front drivers side wheel to be broken off. Injuries None reported, Driver 1 refused Fire. Vehicle Disposition Unit 1 was rendered inoperable and was towed from the scene. Proximate Cause I determined that Driver 1 is the proximate cause of this collision due to a medical emergency. Had Driver 1 not had a medical emergency, this collision would not have happened. I completed a DOL license retest form to evaluate Driver 1's ability to safely operate a motor vehicle. 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 13:54 on 1/14/2026 in the City of Renton, King County, Washington. PAGE 3 OF 5 SUPPLEMENTAL REPORT No. EG71 31 1 POLICE TRAFFIC 1 1 8 27 µ ^'/ COLLISION REPORT CASE#i 26-412 t113197 1 COMMERCIAL MOTOR CARRIER INTERSTATE INTRASTATE UNIT# USDOT ICC# VEHICLE TYPE CARGO BODY: TYPE 2 ❑ 1 28 CARRIER NAME 3 CARRIER L ADDRESS CITY ST ZIP 4 ❑ NAME # PLACARD GWUR : NAME IF NO NUMBER SOURCE AXLES + 4a ❑ ADDITIONAL UNITS MOTOR PEDAL- PROPERTY DAMAGE THRESHOLD MET PHONE UNIT# 3 �✓ PEDESTRIA1:1N ves No D:2062515489 5 VEHICLE CYCLE OWNER INITIAL 0 8 29 LAST NAME HATFIELD FIRST NAME JACOB MIDDLE. L STREET 30 NEW ADDRF 9525 384TH AVE SE CITY SNOQUALMIE ST WA ZIP 980659201 6 PRESENT MEDICALTANSPORTED.. 1 2 31 CDL IGNITION REQUIRED IGNITION .. INTERLOCK YE$. NO INTERLOCK YESLl-0 1 xEs N . L DRIVER'S WA SEX M D.O" 04 LICENSE MMDDv - 14 - 1980 ON DUTY STATUS AIRBAG 2 RESTR. ¢ EJECT 9 HELMET INJURY 1 NAruREOFINJURIES USE CLASS 8 ❑ 1 32 LICENSE D05488J TAT WA VIN 5TFDY5F14MX024256 PLATE# 9 TRAILER TRAILER L PLATE# STATE PLATE# STATE 0 10 ❑ TRLR TRLR VIN#. VIN#. 11 0 0 VEH.YEAR2021 MAKE TOYT MODELTUNDRA STYLE VEHICLE TOWE E T ABLIN TOWED BY GovT.vEHICI E FROM TO DAMAGE YES NO ✓ YES NO REGISTERED OWNER INFOOWNED BYDRIVER 9 9 33 SHADE IN DAMAGED AREA 12 � 3 4 FROM TO LIABILITY INSURANCE INSURANCE CO THE C/NCINNATi INS.CO.EBA O6fi 63 33 IN EFFECT &POLICY# 1 _JTt1P__- 5 m 34 13 ❑ vewc�e YESZ NO❑ CITATION# CHARGE 10,10TFf1M .. Ecauv o I. sTnNoiNc MOTOR PEDAL_ ' 1:1PROPERTY : DAMAGE THRESHOLD MET PHONE 35 14 ❑ UNIT# VEHICLE CYCLE PEDESTRIAN OWNER YES NO 36 15 LAST NAME FIRST NAME NIT AL 16 ❑ STREET CITY ST ZIP NEW ADDRESS" CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TANSF'ORTED. INTERLOCK YES NO INTERLOCK YES NO 'YES NOD 37 11 LDICENSE# STATE SEX M�D°B _ C 18 ❑ ❑ HELMET '.INJURY NATURE OF INJURIES 38 ON DUTY STATUS AIRBAG RESTR. EJECT USE CLASS. 19 ❑ ❑ 39 LICENSE TAT AN# PLATE# 20 TRAILER TRAILER 40 PLATE#. STATE PLATE# STATE ❑ 21 ❑ TRLR TRLR 41 VIN# VIN#Y 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 DAMAC ED AREA � 43 2 3 4 LIABILITY INSURANCE INSURANCE CO IN EFFECT I &POLICY# .. t. E 44 24 YES❑ NO CITATION# CHARGE K-99 STF_ G 3 3 G 1 CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT. C.ARNOLD 01-14-26 02:04 PM 25 INVESTIGATING OFFICER'S SIGNATURE OFFICER'S PHONE UNIT OR DIST DET DATED: PLACE SIGNED 26 OR Ib# 12509 O#RI WA0171300 APPROVED 1/223/2026 PAGE OF� 3000-345-013(R 11/18) REPORT NO. EG71311 CASE# 26-412 DATE AND TIME 01/14/2612:29 OF COLLISION> ' k s ks� $Yi„ (k�4 �1 5 k I �'I f k ' ��, yy5 •kk k, )�� 1 rklk ka k mot„ k e� k '~ k r k PAGE 5 OF 5