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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 \ it s � , 'e m 4 S J h y 1 t ;S i E v tk? i i; Z i t Yr PAGE 4 OF 4