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HomeMy WebLinkAbout26-671 iiTFiNII IIIII III IIIII II IIII IIIII I . 27c REPORT NO EG74227oc� RA COLLISION REPORT 1591971 ❑ 0 El $ 26-671 2 INTERSTATE CITY STREET STATE ROUTE OTHER LOCAI-A`NG 4150 3 C©DINGCOUNTY RD PRIVATE WAY 2 TOTAL#OF OBJECT 1 1 8 28 TRIBAL UNITS 02 STRUCK RESERVATION : 2 3� M M D D Y Y Y Y TIME(2400) COUNTY# MILES CITY# eaCL s o v' 01 - 23 - 2026 1527 17 =.= S 8 W e OF IN e 1070 3 4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑ RAINIER AVE S BLOCK NO. e 641 .� 4a❑ MILE POST ❑ DISTANCE OF(REFERENCE OR CROSS STREET) 5 �. FEET e S 8 W e SW 7TH ST 2 0 29 MOTOR PEDAL- DAM AG THRESHOLD MET PHONE UNIT 01 VEHICLE ❑ CYCLE ❑ YES ✓NO 0 7 30 6 LAST NAME UNKNOWN FIRST NAME MIDDLE t 1 2 31 INITIAL STREET ❑) CITY', ST ZIP 2 NEW ADDRESS 7� +CDL IGN(TIUN REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3 INTERLOCKYEs No INTERLOCKYEs No YES NO 8❑ LCEENSE# SRVERISTTATE SEX U MMDDYY' —=— 1 2 32 9 ON DUTY STATUS' AIRBAG 9 RESTR 9 EJECT 1 HELM USEET 9 CLASSY 0 NATURE OF INJURIES 2 LICENSE, 3 10� PI ATP# STATE V(N TRAILER STATE TRAILER STATE 11 3 5 PLATE# PLATE# ROM To TRLR zRLR 1 5 33 12 0 0 VIN#'. VIN#: FROM TO VER YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED By GOVT VEHICLE 9 9 34 13� DAMAGE YES�NO� YES❑ NO REGISTERED OWNER INFO (NEW] VEHICLE NO. 1 SHADE IN DAMAGED AREA 35 14❑ LIABILITY INSURANCE❑ INSURANCE CO 3 4 IN EFFECT &POLICY# 9TOP ic CHARGE t 5 36 Lemur yes❑NO❑ CITATION# HARE t a 80TTOM 15❑ STM ING s 7 e MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE UNIT VEHICLE CYCLE nWNFR YES'/ NO D:4255660062 16� LAST NAME GOMEZ RUIZ FIRST NAME MARIO MIDDLE N INITIAL ❑ 37 17 STREET ❑ 4702 DAV/S AVE S APT GG103 CITY' RENTON ST, WA ZIP 980556263 g NEW ADDRESS 1$❑ IGNITION REQUIRED IGNITION PRESENT MEDICALTRANSPORTED' 38 CDL INTERLOCKYEs NO NTERLO"K YES NO YEs No 19[� DRIVER'S ' MMDDYY — HELMET INJURY: NATURE OF INJURIES 40 20❑ ON DUTY� STATUS AIRBAG 2 RESTR 4 EJECT '1 7 ❑ USE CLASS COLLAR BONEISHOULDER 21[ LICENSE I PATE# CPB8207 rare WA vIN# 1 C3CCCAB2FN631564 41 22❑ [TILER TAILER PLATE# STATE PLATE# STATE 42 23 TRLR RLR 43 UIN#. 'IN# VEH.YEAR 2015 MAKE CHRY MODEL 200 STYLE VEHICLE TOWED TO BLIN TOWED BY GOV HI 44 24 DAMAGE YES �/ No GENE MEYER REGISTERED OWNER INFO MARIO GOMEZ RUIZ 4702 DAVIS AVE S APT GG103 RENTON WA 980556263 D:4255660062 VEHICLE NO.2 SHADE IN DAMAGED AREA 2 3 4 LIABILITY INSURANCE INSURANCE CO PROGRESSIVE 863978103 IN EFFECT &POLICY# I STOP VEHICLE ,.I—I CITATION11 CHARGE to BOTTOM LE —Y YES[Z N 6 25 OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# JAGENCY 26 M.LEVERTON 2517 WA0171300 PAGE 01 OF PART A 3000-345-189(R 11/18) STATE OF POLICETRAFFICN CORRECTION REPORT NO. EG74227 COLLISION REPORT III III III III III 111 1591972 CASE# 26-671 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 CIASS ----� :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 GLASS 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 01-28-26 06:46 AM INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST.DET DATED PLAGE SIGNED APPROVED BY DATE C.JACOBS 1953 1 2/2/2026 2:55:24 PM BADGE OR ID# ; 2517 ORI# WA0171300 TIME POLICE DISPATCHED 3:34 PM TIME POLICE ARRIVED i 3:38 PM PAST B 3 Do-3mx—attar(t 1Mff) PAGE 2�OF 4 REPORT NO. EG74227 CASE# 26-671 O OF COLLI 510N TIME 01/23/26 15:27 COLLISION NARRATIVE unit 1 grey 2 wht/stop RTF Within the city limits of Renton/King/Wa I responded to a 2 vehicle hit and run blocking at the 600 block of Rainer Ave S. I located unit 2 in lane one southbound. I asked him to move his vehicle to clear the roadway and during this attempt it looked like his front left wheel/tire was going to come off and he lost his ability to steer. I requested a tow truck. Unit 2 told me that he was stopped in traffic when out of nowhere an unknown vehicle crashed into the side of his car and fled south on Rainer Ave S, then west on 7th. He could not provide any additional information about the car or suspect driver. He did not complain of injury and damages required a tow truck. There was no camera footage available to assist with locating additional information reference the suspect vehicle. Information/Insurance only 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 1/28/2026 PAGE 3 OF 4 REPORT NO. EG74227 CASE# 26-671 DATE AND TIME 01/23/26 15:27 OF COLLISION> ' $ 8 at r � t ro ;u a• a { C tit �r a 3 4Ji ter tiYz e y r Y y ti r� > u 4 > r M1' 4`ix S. � ibC r ,y PAGE 4 OF 4