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Home My WebLink About26-617 IT si " II IIIII III IIIII II IIII IIIII I . 27c REPORT NO EG72218OLCERA COLLISION REPORT 1591971 ❑ 0 RESULTED I $ 26-617 2 INTERSTATE CITY STREET FIRESTOLENSTATE ROUTE OTHER VEHICLE LOCAI-AGENCY 4200 3 HIT&RUN CODING COUNTY RD PRIVATE WAY INVOLVED 2 TOTAL#OF OBJECT 1 8 28 TRIBAL UNITS 03 STRUCK RESERVATION : 1 1 2 3� M M D D Y Y Y Y TIME(2400) COUNTY# MILES CITY# eaCL s on' 01 - 22 - 2026 1109 17 =.= S 8 W e OF IN e 1070 s 4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑ BLOCK NO. e .� 4a PARKAVEN MILE POST ❑ ❑ DISTANCE OF(REFERENCE OR CROSS STREET) 5 MILES 1.1 FEET e S 8 W e N 10TH PL 0 1 29 MOTOR ✓ PEDAL- DAM AG THRESHOLD MET PHONE UNIT 01 VEHICLE ❑ CYCLE ❑ YES ✓NO 1 4 30 5 LAST NAME DOUGLAS FIRST NAME SHERICA MIDDLE M 1 2 31 INITIAL STREET ] 1300 NE RESERVE TRL APT 304 CITY; JENSEN BEACH ST FL ZIP; 349576468 2 NEW ADDRESS 7 CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3 INTERLOCKYEB No INTERLOCKYES Na YES F NO 8 DCIENSE# STATE FL SEX F MMD4YY' 03 - 05 - 1982 t 32 9 ON DUTY STATUS' AIRBAG 2 RESTR 4 EJECT 1 HELM USEET CLASSY 1 NAruRE of INJURIES 2 10 LI ENSE BYOHM STATE FL VIN# JTHCK262282023998 3 TRAILER STATE TRAILER STATE 11 3 0 PLATE# PLATE# ROM To TRLR TRLR 7 1 5 33 12 0 Q VIN#' VIN# FROM TO HICLE 13 2 VEH.YEAR 2008 MAKE LEXS MODEL IS 250 STYLE VEHICLE TO YED NOIyS46LIN diW9YMEYER GESr`-IVT ENp m 34 DAMAGE IIII._IIII I_I REGISTERED OWNER INFO SHERICA DOUGLAS 1300 NE RESERVE TRL APT 304 JENSEN BEACH FL 349576468 VEHICLE NO. 1 SHADE IN DAMAGED AREA 35 2 3 4 14 LIABILITY INSURANCE ElNSURANCE CO IN EFFECT &POLICY# 4TOP vEnic�E CHARGE 7o 80TTOM 5 36 15 srnNowc YES❑NO❑ CITATION# 6AO095328,6AO095328 INATTENTIVE DRIVING,OP MOT VEH UN# MOTOR PEDAL- ❑ PEDESTRIAN PROPERTY DAM THR OLD MET PHONE 1 T 02 VEHT,O,E CYCLE nWNFR YES�/ NO 16❑ LAST NAME UNKNOWN FIRST NAME MIDDLE' INITIAL 17❑ STREET ❑ CITY, ORTING ST ZIP ❑ 37 NEW ADDRESS 18❑ CDL IGNITION REQUIRED IGNITION PRESENT MED[CALTRANSPORTED: 38 INTERLOCK YES No fNTERLOGK YES R no YEs No 19 LICENSE# STATE SEX U MMDDDYY -� 39 HELMET INJURY: NATURE OF INJURIES 40 20❑ ON DUTY❑ STATUS AIRBAG 9 RESTR 9 EJECT 1 USE 9 CLASS 0 ❑ 21 PLATE# D47888C TATE WA VIN# 1GCGTDE36G1389649 41 22❑ PLATE# STATE[TILER I PLATE# STATE 42 23 TRLR RLR 43 UIN#. 'IN# VEH.YEAR 2016 MAKE CHEV MODEL COLORA STYLE VEHICLE TOWED TO BLIN TOWED BY GOV HI 44 24 DAMAGE YES NO VES NO REGISTERED OWNER INFO ALYSSA VERLENNICH 6702 81ST ST SW LAKEWOOD WA 984992517 D:6125169503 VEHICLE NO.2 SHADE IN DAMAGEAREA 2 3 LIABILITY INSURANCE INSURANCECO LIBERTY MUTA05261 2344 7190 IN EFFECT &POLICY# t 9TOP VEHICLE ❑ CITATION11 CHARGE to BOTTOM L'—LY YES N 25 a OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY J 26 M.LEVERTON 2517 WA0171300 PAGE 01 OF PART A 3000-345-189(R 11/18) STATE OF POLICETRAFFICN CORRECTION REPORT NO. EG72218 COLLISION REPORT III III III III III 111 1591972 CASE# 26-617 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. M.LEVERTON 01-23-26 10:12 AM INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST.DET DATED PLAGE SIGNED APPROVED BY DATE C.JACOBS 1953 1 1/26/2026 2:37:17 PM BADGE OR ID# ; 2517 ORI# WA0171300 TIME POLICE DISPATCHED 11:32 AM TIME POLICE ARRIVED i 11:33 AM PAST B 3 Do-3mx—attar(t 1Mff) PAGE 2�OF F5 REPORT NO. EG72218 CASE# 26-617 O OF COLLI 510N TIME 01/22/26 11:09 COLLISION NARRATIVE wht/1 hitd parked sil/2 blk/3 CC Within the city limits of Renton/King/Wa I responded to a 3 vehicle crash near the intersection of Park Ave N at N 10th PI. When I arrived I found a sedan that appeared to have rear-ended a parked car forcing that parked vehicle into another parked vehicle. I contacted the driver of unit 1 ID'd by her matching picture FLDL. She told me she was making a right turn from N 10th PL onto southbound Park Ave N and was distracted by an object inside her vehicle while making this turn and drove into the back of a lawfully unoccupied parked vehicle. The impact pushed unit 2 into unit 3 another lawfully parked unoccupied vehicle. Unit 1 did not complain of injury and damages required a tow truck. She told me she was here working for Boeing. When asked for a local address she was vague and merely said she stays at a hotel, but lives in Florida. Unit 1 driver was unable to provide valid proof of insurance for her vehicle and told me she did not have insurance. I was able to contact both unit 2 and 3. Both of them had lawfully parked their vehicles in marked parking stalls on Park Ave N and were attending other activities when they realized unit 1 had crashed into their cars. A tow truck was required to separate unit 1 from unit 2. 1 provided information exchanges for all three units. I cited unit 1 ref RCW 46.30.020 no valid insurance and RMC 10-12-25 Driver inattention 3 vehicle crash via complaint to her Florida address. I certify (declare) under penalty of perjury under the laws of the State of Washington that the foregoing is true and correct. M.Leverton/2517 City of Renton/King/Wa 1/23/2026 PAGE 3 OF 5 SUPPLEMENTAL REPORT No. EG7221 8 POLICE TRAFFIC 1 1 8 27 COLLISION REPORT CASE#i 26-617 013197 1 COMMERCIAL MOTOR CARRIER INTERSTATE INTRASTATE UNIT# USDOT ICC# VEHICLE TYPE CARGO BODY 3 TYPE 2 ❑ 1 28 CARRIER NAME 3 CARRIER L ADDRESS CITY STi ZIP 4 ❑ NAME # PLACARD GWVR NAME IF NO NUMBER SOURCE AXLES + 4a ❑ ADDITIONAL UNITS { MOTOR PEDAL- PROPERTY DAMAGE THRESHOLD MET PHONE 5 ❑ UNIT�T 3 VEHICLE CYCLE C) PEDESTRIAN OWNER :� YES NO 1 4 29 LAST NAME UNKNOWN FIRST NAME MIDDLE'. INITIAL STREET 30 CITY ORTING ST ZiP NEW ADDRFfi . 6 ❑ CDL GNITION REQUIRED PRESENT MEDICAL TANSPORTED 1 31 I 1{iNiTION :: INTERLOCK YES D NO INTERLOCK YES No YES N DRIVER'S STATE I SEX U M�DDW —F� LICENSE! 7 ONDUTYqSTATUS AIRBAG 9 RESTR. 9 EJECT 1 HELMET 9 INJURY 0 NATUREDFINJURIES USE CLASS 8 ❑ 1 32 LICENSE CEJ0345 TAT WA VIN KM8K2CAAXMU737292 PLATE# 9 TRAILER I I TRAILER L PLATE# STATE PLATE# STATE 0 10 ❑ TRLR TRLR VIN.# VIN#. 11 0 0 VEH.YEAR2021 MAKE HYUN MODELKONA STYLE VEHICLE TOWE E T ABLIN TOWED BY GOVT.VFHICI E FROM TO DAMAGE YES NO ✓ YES NO KEVIN WILSON 1206 SIGAFOOS AVE NW ORTING WA 98360 m 33 REGISTERED OWNER INFO. SHADE IN DAMAGED AREA 12 4 FROM TO LIABILITY INSURANCE❑ INSURANCE CO TP IN EFFECT &POLICY# "__`;10 m 34 1080TTO 13 vewc�e YES N0[jj CITATION# CHARGE ecauv sTnNoiNc 3 7 35 MOTOR PEDAL_ ' 1:1PROPERTY : DAMAGE THRESHOLD MET PHONE 14 ❑ UNIT# VEHICLE CYCLE PEDESTRIAN OWNER YESF-1 NO 36 15 LAST NAME FIRST NAME NIT AL 16 ❑ STREET �' CITY ST ZIP NEW ADDRESa CDL IGMTION RE6UIRED IGNITION PRESENT MEDICAL TAN SPORTED INTERLOCK YES[]AI INTERLOCK YEs NO .YES NO ❑ 17 5 37 LIICENSE# SE L X M D.00.B —= 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 ❑ [4 41 VIN# 42 TRLR TRLR UIN#Y 22 VEH.YEAR MAKE I MODEL I STYLE VEHICLE TOWED DUET ABLIN 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# 7c;Q S. 44 vewc�e ❑ ❑ CITATION# CHARGE 24 I..TF_ YES NO STIWDING 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. M.LEVERTON 01-23-26 10:12 AM 25 INVESTIGATING OFFICER'S SIGNATURE OFFICER'S PHONE UNIT OR DIST DET DATED: PLACE SIGNED 26 BADGE GRID# 2517 O#RI WA0171300 APJACOBS 1/226/2026 PAGE F OFF 3000-345-013(R 11/18) REPORT NO. EG72218 CASE# 26-617 DATE AND TIME 01/22/26 11:09 OF COLLISION kM , 6 Yi Jv sa 40, Ar W WWI! i I� z 1 L aar� auras � ��• hi4 �r C 'r } yr l rrkint r S 1 ti s Z.tgx <c S t t<'' �1+i ct��ti.tt�st hrs�yysc�ss tkkx k tv;A/s sr} fr t t t t ttkt r{vft t 4 1 f 1 ,s' tt �l 4, PAGE 5 OF 5