HomeMy WebLinkAbout25-80492 ("7—
STATECE TRAFFicNREPORT NO. EG72002 1 1 027
,tne COLLISION REP F 1591971
CASE# 25-80492 2
INTERSTATE CITY STREET FIRE ❑
RESULTED
1 2 STATE ROUTE OTHER STOLEN
VFHICLF ❑ LOCALAGENCY 4100 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 TRIBAL f UNITS#OF OBRIJCK 1 8 2$
03 WOOD SIGN PECT OST
':.RESERVATION '. `.. z
3 M M D D Y Y Y Y TIME(2400) COUNTY# MILES CITY#
COLT s oN 12 - 08 - 2025 0740 17 �. S e W 8 OF IN 8 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓
S.GRADY WAY BLOCK NO. 8✓ 600 .�
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ 300 00 FEET e✓ S e W 8 TALBOT RD S
OF 4 29
MOTOR ✓ PEDAL- DAM ETHRESHOLD MET PHONE
UNIT 01 VEHICLE CYCLE YES �/NO D:2062291229 0 1 30
5 LAST NAME COLES FIRST NAME ! WILLIAM MIDDLE M
INITIAL 1 F
2 31
STREET 0 14103 SE 4TH ST APT B
NEW ADDRESS CITY BELLEVUE ST WA ZIP, 980076618 z
7 CDL fGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
INTERLOCK YES NO✓ INTERLOCKYEs N ✓ YES ND'✓
81-1 LICENSE# STATE WA SEX'M MMD]YY 03 - 29 - 1962 1 2 32
9 ON DUTY STATUS' AIRBAG 2 RES7R 4 EJECT 1 N USE ET EL12 CLASSINJURY 7NATURE OF IN
BACK PAIN JURIES z
10 PI LICEN
#' CKX1772 STATE WA VIN# 1G6KD57YO8U140207 3
TRAILER STATE TRAILER STATE
11 3 5 PLATE# PLATE# ROM TO
TRLR TRLR 3 5 33
12 3 5 VIN# VIN#
FROM TO
❑ VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN T Y GOVT.VEHICLE 7 3 34
13 3 2008 CADI DTS 4D DAMAGE YES ✓ NO � �MEYERS YEs NO✓
REGISTERED OWNER INFO pyILLIAMCOLES14f03SE4THSTAPTB BELLEVUEWA98007 VEHICLE NO. 1 ❑
SHADE INDAMAGED AREA 35
14 LIABILITY INSURANCE U INSURANCE CO GEICO 4610660062
IN EFFECT &POLICY# 9T0P_ _
—1— CHARGE 1 S 36
E AL,V YES❑NO❑ CITATION# 5AO159142 INATTENTIVE DRIVING o eorroM
1 5❑ srAnomc 8 7 6
MOTOR PEDAL PROPERTY DAM THR OLD MET PHONE
UNIT 02 ✓ ❑ PEDESTRIAN ❑ ❑ D:4259032321
VEHICLE CYCLE OWNER YES✓ NO
16F1
LAST NAME JOHNSON FIRST NAME ; ERIC MIDDLE I D
INITIAL
17❑ STREET 24256 26TH PL S APT B CITY' DES MOINES ST' WA ZIP 981984070 4❑ 37
NEW ADDRESS
18� .,. I ✓ IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED' 4 38
[COL INTERLOCK YES No NTERLOCK YES Na✓ YES ND;✓
19❑ 1 DRIVERS LICENSE# STATE WA SEX'M MMODYY 07 _ 28 _ 1966 39
20❑ ON DUTY❑ STATUS AIRBAG 6 RESTR 4 EJECT ':1 HEL MET 2 GIJASRSY 1 NATURE OF INJURIES 40
❑21❑ LICENSE'CTZ5991 TATE WA VIN# WVW 41
TR7AN2KE000397 1
PLATE#
42
22 PLATE#TAILER STATE PLATE#TRAILER STATE
43
23
TRLR I kRLR
VIN#. IN#
44
VEH.YEAR 2019 MAKE VOLK MODEL gRTEON STYLE 4D DAMIAGE TOWEDYES✓ NOO BLIN TOWED BY GO GENE MEYERS YES N HI O✓
24
REGISTERED OWNER INFO ERIC JOHNSON 2425626TH PL SAPTB DES MOINES WA 98198 VEHICLE NO.2
SHAD DAMAGED AREA
LIABILITY INSURANCE ✓ INSURANCE CO DIRECT INS 2030911430 3 4
IN EFFECT &POLICY# 4TOP - 5
vEeia.E ❑ „I�1 CITATION# CHARGE 7060T70M
LEfALLY YES N
25 s
7.FFIS NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
26
OBS 7 1953 WA0171300
PART A . PAGE 01 OF
3000-345-159(R 11(1S1
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EG72002
COLLISION REPORT III III III III III 111
1591972 CASE# 25-80492
E NA ADDITIONAL PERSONS INVOLVED(PASSENGERS AND/OR WITNESSES ONLY)
M
(LAST,FIRST,MIDDLE INITIAL) JOHNSON ADRIANA D
ADDRESS&PHONE#
24256 26TH PL S APT B DES MOINES WA 98198 SEXi F MMDDD B. 02 - 26 - 2014
PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET INJURY NATUREOFINJURIES
❑ 2 POS. 3 6 4 1 USE 1 2 CLASS 1 ----�
:NAME
(LAST FIRST MIDDLE INITIAL)
ADDRESS R 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
On 12-8-25 at about 0744 1 arrived in the 600 block of S Grady Way for a 2-vehicle collision. I
contacted both vehicles still in the roadway. Driver 1 was out of the vehicle, both occupants of unit 2
were still seated in the vehicle. Both drivers identified themselves via WADL and gave me all the
required documents. Driver 1, William Coles told me;
He was making a left turn from S Grady way to the parking lot of 600 S Grady Way.
Lanes 2 and 3 left space for him to turn so he began his turn, then unit 2 collided with his passenger's
side, pushing unit 1 into a stop sign.
His back hurt but he was otherwise fine.
Driver 2 told me;
He was driving eastbound towards Talbot Rd S when unit 1 pulled from in between traffic and in front
of unit 2. The vehicles collided in lane 1.
No complaints of injury.
Both vehicles were removed from the roadway via tow truck. I cited Coles for inattentive driving with
collision via complaint.
This incident occurred in the city of Renton, County of King.
I declare under penalty of perjury under the laws of Washington state that the foregoing is true and
correct.
C. Jacobs/1953
I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT.
C.JACOBS 12-24-25 01:18 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST.DET DATED PLACE SIGNED
APPROVED BY DATE
C.JACOBS 1953 1/26/2026 8:12:55 AM
BADGE OR ID# 1953 ORI# WA0171300 TIME POLICE DISPATCHED; 7:41 AM TIME POLICE ARRIVED i 7:44 AM
PART B 3000-345.160(R1Vt8) PAGE F2 --]OF 47
4( � SUPPLEMENTAL REPORT NO. EG72002POLICE TRAFFIC
1 27
}_ COLLISION REPORT CASE#, 25-80492
1 COMMERCIAL MOTOR CARRIERT '. INTERSTATE INTRASTATE G
UNIT# USDOT ICC# VEHICLE TYPE CARGO BODY
.TYPE
2 ❑ 1 28
CARRIER
NAME
3 CARRIER 7
ADDRESS
CITY Ts—Ti
ZIP
4 NAME # PLACARD
+
GWVR ❑ NAME IF NO NUMBER
SOURCE AXLES
4a ❑ ADDITIONAL UNITS
5 ❑ U N CT 3 MOTOR � PEDAL- : � PEDESTRIAN F PROPERTY Z:.. YES ENO THRESHOLD MET PHONE
VEHICLE CYCLE. OWNER :.�-
29
FIRST NAME MIDDLE'.
LAST NAME RENTON CITY OF INITIAL
STREET 30
NFW AnnRFGs 1055 S.GRADY WAY I
CITY RENTON I
ST WA ZIP 1 98057
6 PRESENT MEDICAL TANSPORTED 1 31
CDL IGNITION REOt1IRED IGMT7ON
INTERLOCK YES NO {INTERLOCK YES Ni yEs N
DRIVER'S STATE I SEX,U MDDDYBVY -�-
LICENSE,
7
ON DUTY❑ STATUS AIRBAG RESTR. EJECT HELMET INJURY NATURE OF INJURIES
USE CLASS
8 ❑ 1 32
LICENSE TAT viN
PLATE#
9 TRAILER TRAILER
PLATE# STATE PLATE# STATE
10 TEL TRLR
ViN.#. VIN.#.
11 VEH.YEAR MAKE MODEL STYLE VEHICLE TOWS E T ABLIN TOWED BY anl/T.VFHICI F FROM To
DAMAGE YES NO YES NO
REGISTERED OWNER INFO. m 33
SHADE.IN DAMAGED AREA
12
4 FROM TO
LIABILITY INSURANCE❑ INSURANCE CO 9,FC1P
IN EFFECT &POLICY# 34
0
13 vewcle YES[j NO CITATION# CHARGE
1 BOTTOM
LEGALLY
14 ❑ sTL]N�T � El PEDESTRIAN: � ❑ 8 T 6
MOTOR PEDAL- PROPERTY
DAMAGETHRESHOLD MET PHONE ❑ 35
VEHICLE CYCLE OWNER YES NO
15 LAST NAME FIRST NAME :.NEW A NIT ALE 36
'.
❑
16 ❑ STREET CITY ST' ZIP
ODR FSS
GDL IGNITION REWIRED IGNITION PRESENT MEDICAL TANSPORTED
INTERLOCK YES[]NO[] INTERLOCK YES No YES NO
1Y 37
LIICIVERS ENSE# STATE SEX MMDD'WY' - -
18 ❑
ON DUTY� STATUS' AIRBAG' RESTR. EJECT ' HELMET I INJURY, NATURE of INJURIES 38
USE :CLASS
19 ❑ LICENSE TA VIN 39
PLATE# #
20 TRAILER TRAILER � 40
PLATE# STATE PLATE# STATE
41
21 TRLR TRLR
VIN# VIN#
42
22 VEH.YEAR MAKE I MODEL STYLE VEHICLE TOWED DUE TO DISABLINITOWED BY GOVT.VEHICLE
DAMAGE YES NO YES NO
23 REGISTERED OWNER INFO, SHADE IN DAMAGED AREA 43
LIABILITY INSURANCE
INSURANCE CO 2 3 4
IN EFFECT &POLICY# 1GQl
44
vEG Le ❑ ❑ CITATION# CHARGE
24 SIANDIY vES NO
srnNUlNc S T 6
I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT.
C.JA COBS 12-24-25 01:18 PM
25 INVESTIGATING OFFICER'S SIGNATURE OFFICER'S PHONE UNIT OR DIST DET DATED: PLACE SIGNED
APPROVED BY DATE
26 BADGE
1953 0#RL WA0171300 JACOBS 1/26/2026 PAGE F3 —1 OF 4F
3000-345-013 IR 111181
REPORT NO. EG72002 CASE# 25-80492 DATE AND TIME 12/08/25 07:40
OF COLLISION
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