HomeMy WebLinkAbout26-512 iiTFiNII IIIII III IIIII II IIII IIIII I . 27c REPORT NO EG72335oc� RA
COLLISION REPORT 1591971
❑ 0 RESULTED I
$ 26-512 z
INTERSTATE CITY STREET FIRESTOLENSTATE ROUTE OTHER VEHICLE LOL`CODIGENC'Y 4200 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 TOTAL#OF OBJECT 1 s 28
TRIBAL UNITS 02 STRUCK
RESERVATION : 1 1
2
3� M M D D Y Y Y Y TIME(2400) COUNTY# MILES CITY#
DATE OF N E IN eDL�ISION' 01 - 18 - 2026 1329 17 =.= S 8 W E OF M 1070 a
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓
NE 4TH ST BLOCK NO. e 3200 .�
4a❑ MILE POST
❑ DISTANCE OF(REFERENCE OR CROSS STREET)
5 1.1 FEET e✓ S B W
0 3 29
MOTOR PEDAL- DAMAG THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE ❑ YES No �/ D:2062941711 0 1 30
6❑ LAST NAME TANG FIRST NAME LULU MIDDLE t 1 2 31
INITIAL
STREET ❑ 11117 SE 218TH PL CITY; KENT I ST WA ZIP; 98031 2
NEW ADDRESS
7 CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED. 3
INTERLOCKYEs No INTERLOCKvEs NO YES NO
8 DRIVERS# STATE WA SEXI F MMDDYY' 10 - 26 - 1949 1 2 32
-NJUR
9� ON DUTY STATUS' AIRBAG 2 RESTR 4 EJECT 1 HELMET
2 CLASSY 1 [NATURE of INJURIES 2
10 ENSrtEI ACY0185 STATE WA VIN# 4T1BK3DB9BU399238 3
1� PI
TRAILER STATE TRAILER STATE
11 0 0 PLATE# PLATE# ROM To
TRLR TRLR. 1 1 7 33
12 0 0 VIN#' vIN#
FROM TO
13 4 VEH.YEAR2011 MAKE TOYT MODEL AVALON STYLE SD VEHICLE TOYED NO�iS46LIN T�VyED.6LRS GESIT` CLE 3 7 34
DAMAGE IIII._IIII HHttVVii((tt u
REGISTERED OWNER INFO OWNED BY DRIVER VEHICLE R 1
SHADE IN DAMAGED AREA 35
4 LIABILITY INSURANCE INSURANCE CO 4
14 GE/CO 0710860800
IN EFFECT &POLICY# 9TOP
vEnic�E CHARGE 5 36
Lemur YES❑NO[ CITATION# t a 80TTOM
15❑ STMDING 7 e
UN# MOTOR PEDAL- E] PEDESTRIAN1:1 PROPERTY DAM THR OLD MET PHONE
1 T 02 VEHT,O,E CYCLE nWNFR
16�
LAST NAME LAM FIRST NAME PHUC MIDDLE' D
INITIAL
17 F1 STREET ❑
❑ 4210 NE 7TH ST CITY RENTON ST, WA ZIP 98059 q 37
NEW ADDRESS
1$❑ CDL IGNITION REQUIRED (GNITION PRESENT MEDICAL TRANSPORTEDI 38
INTEtLOCKYEs No (NTERLOC(£YES uz YEs NO
19 DRIVER'S
MMDDYY —
20❑ ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 R USEET 2 CLASSY 1 NATURE OF INJURIES 40
21 LICENSE 698ZUV TATe WA VIN# JTEDK3EHXA2156219 41
22❑ PLATE# STATE PLATE# STATE 42
23 TRLR RLR 43
UIN#. 'IN#
VEH.YEAR 2010 MAKE TOYT MODEL H/GHlAN STYLE UT VEHICLE TOWED TO BLIN
TOWED BY GOV HI 44
24 DAMAGE YES NO NO
REGISTERED OWNER INFO OWNED BY DRIVER VEHICLE
NO.2
SHADFY DAMAGED AREA
3 4
LIABILITY INSURANCE INSURANCECO STATE FARM 5863185BI547
IN EFFECT &POLICY# 9TOP
vewae YES❑ N,J—I CITATION11 CHARGE t080TTOM
LEGnLLY
25 a e
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
J
26
PHILIP DAVIS 12018 WA0171300
PAGE 01 OF
PART A 3000-345-189(R 11/18)
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EG72335
COLLISION REPORT III III III III III 111
1591972 CASE# 26-512
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 NJURY 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
26-512
On 1-18-26 around 1331 hrs 1 dispatched to a non-injury collision in the 3200 block of NE 4th St,
Renton, King Co, WA. Initial information was both vehicles were stopped in lane 2 of the 3200 block
awaiting police arrival.
On arrival 1 observed unit 1, ACY0185MA, to have damage to the driver side front fender and the
front bumper was on the ground. The driver of unit 1, Lulu, advised the following. She was in lane 2,
right turn lane, of southbound Monroe Ave NE at the intersection of NE 4th St. Lulu made the right
turn into lane 2 of westbound NE 4th St then felt the collision with unit 2. Lulu was uninjured and her
vehicle was privately towed.
observed unit 2, 689ZUV/WA, to have damage to the front passenger fender. The driver of unit 2,
Phuc, advised the following. He was driving west in lane 1 of NE 4th St through a green light at the
intersection for Monroe Ave NE. Unit 1 turned onto NE 4th St and collided with his vehicle. Phuc was
uninjured and his vehicle was drivable.
Both drivers advised they stayed in their respective lanes of travel.
I declare under penalty of perjury under the laws of the State of Washington that the foregoing is true
and correct.
Electronically signed by P Davis 12018 on January 18, 2026 at 14:46 hours in Renton, King Co, WA.
I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT.
PHILIP DAVIS 01-18-26 02:56 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST.DET DATED PLACE SIGNED
APPROVED BY DATE
S.WOODWARD 11528 1/27/2026 4:43:59 AM
BADGE OR ID# 12018 ORI# WA0171300 TIME POLICE DISPATCHED 1:31 PM TIME POLICE ARRIVED i 1:34 PM
PAST B 3 Da-3mx—attar(t 1Mff) PAGE 2�OF F3
REPORT NO. EG72335 CASE# 26-512 DATE AND TIME 01/18/2613:29
OF COLLISION
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