HomeMy WebLinkAbout26-1267 )STATE
TFcN 5 0 27i t
Oc� RA EG77800
COLLISION REPRT 1591971
CASE# 26-1267 2
INTERSTATE CITY STREET FIRE ❑
RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VEHICLE ❑ LOCAL AGENCY 4200 3
COUNTY RD ❑ NVOLVED CODING
PRIVATE WAY
2❑ TRIBAL TOTAL 1
UNITS#OF 02 SO BJECT TRUCK 1 8 28
RESERVATION 2
3� M M D D Y Y Y Y TIME(2400) COUNTY# MILES CITY#
DATE OF'. N E
GDLLISION' 02 - 13 - 2026 1631 17 =.= S 8 W E IN OF M 1070 a
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION
S CARR RD BLOCK NO. e 500 .�
4a❑ MILE POST
❑ DISTANCE OF(REFERENCE OR CROSS STREET)
5 50 00 FEET e✓ S 8 Nl a TALBOT RD S
0 1 29
MOTtlR PEDAL- DAMAG THRESHOLD MET PHON
UNIT 01 E
VEHICLE ❑ CYCLE ❑ YES No �/ D:4255722995 0 9 30
6 LAST NAME CLAY FIRST NAME SHANNON MIDDLE G 1 1 2 31
INITIAL
STREET ❑ 22111 108TH AVE SE TRLR 7 CITY KENT ST WA ZIP 98031 2
NEW ADDRESS
7 CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
INTERLOCKYEs NO✓ INTERLOCKYEs NO✓ YES ND;✓
8❑ DRIVERCENS # STATE WA SEx F MMor YY' 09 - 12 - 1970 1 2 32
9 ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 N USEET 2 1 INJURY
CLASS 1 NAruRE of INJURIES 2
LICENSE, CUV4839 STATE WA VN# 2B3LA43T09H590203 3
10[9� PI ATP tt
11[-j- TRAILER STATE TRAILER STATE
11 3 5 PLATE# PLATE# FROM To
TRLR TRLR 7 3 33
12 3 5 VIN# vI.
;:... FROM TO
VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED By GOVT VEHICLE 9 9 34
13 2 2009 DODG CHARG $D DAMAGE YES�NO ✓� YES NO✓
REGISTERED OWNER INFO OWNEDBYDRIVER VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
14❑ LIABILITY INSURANCE❑ NSURANCE CO 3 4
IN EFFECT &POLICY# 4TOP _
srg NOLNG Yes❑NO❑ CITATION# 6AO044131 CHARGE OP MOT VEH W/OUT INSURANCE B o ooTrofi 36
15
rL� MOTOR ✓ PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT VEHICLE ❑ CYCLE' ❑ ❑ nWNFR D:2067955576
16�
LAST NAME KLEINBECK FIRST NAME JONATHAN MIDDLEI p
INITIAL
STREET ❑
17 ' 2❑ 5814 188TH AVE SE CITY COVINGTON ST, WA ZIP 98042 4 37
NEW ADDRESS
18❑ CDL . IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED' 38
INTERLOCKYEs XYEs Nio✓ YEs NO I✓
19 DRIVER'S STATE WA SEX I M I DO,B. 01 23 1989 39
'..LICENSE# MMDDYY -
20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 H U ET 2 INJCLA 1 RY NATURE OF INJURIES � 40
21 LICENSLATE E B3587C rarE WA vIN# 4UZAEJFD3KCKC4197 41
22❑ PLATE# STATE PATE# STATE 42
❑
23 TRLR kRLR 43
UIN#. 'IN#.
VEH.YEAR 2019 MAKE FRHT MODEL BUS STYLE BU VEHICLE TOWED TO BLIN
TOWED BY GOV HI 44
24 DAMAGE YES NO✓ YES NO✓
REGISTERED OWNER INFO COMMUNITY CONNECTIONS KING COUNTY 5004TH AVE RM 620 SEATTLE WA 98104 VEHICLE NO,2
SHADE IN DAMAGED AREA
2 3 4
LIABILITY INSURANCE INSURANCECO PHILADELPHIA INSURANCE COMPANY PHPK2555920.002
IN EFFECT &POLICY# t 9TOP
vewaE ,.I—I CITATION# CHARGE tO BOTTOM
LEGntty YES N`.LJ
25 a 7 a
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
J
26
GREGORY BILLS 12495 WA0171300
PAGE 01 OF
PART A 3000-345-159(R 11/18)
POLIICFETRAFFICN CORRECTION REPORT NO. EG77800
COLLISION REPORT III III III III III 111
1591972 CASE# 26-1267
ADDITIONAL PERSONS INVOLVED(PASSENGERS AND/OR WITNESSES ONLY)
'NAME
(LAST,FIRST MIDDLE INTTIAL)
ADDRESS&PHONE#
SEX' D.O.B. — [----------�
MMDDYYYY
PASSENGER F-1 WITNESS Ej UNIT# SEAT AIRBAG RESTR. EJECT HELMET INJURY NATURE OF INJURIES--�
POS. USE CLASS
'NAME
(LAST FIRS,MIDDLE INITIAL)
ADDRESS&PHONE#
SEX' D.O.B. — L----------�
MMDDYYYY
PASSENGER DWITNESSD UNIT# SEAT AIRBAG RESTR. EJECT HELMET NJURY NATURE OF INJURIES
POS. : USE CLASS ----�
'.NAME
(LAST,FIRST,MIDDLE INITIAL)
ADDRESS&PHONE#
SEX D.O.B. — L----------�
MMDDYYYY
PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET INJURY NATURE OF INJURIES
❑ Q POS. USE CLASS �____ ----j
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.
GREGORYBILLS 02-13-2605:31 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST.DET DATED PLACE SIGNED
APPROVED BY DATE
P.KORDEL 9676 2/14/2026 10:30:16 AM
BADGE OR ID# 12495 ORI# ( WA0171300 TIME POLICE DISPATCHED'; 4:34 PM TIME POLICE ARRIVED 4:37 PM
PART B 3 Do-3mx-,ao(Rtlras) PAGE 27 OF 47
REPORT NO.` EG77800 CASE# 26-1267 O COLLI COLLISION TIME
OF 02/13/26 16:31
COLLI
NARRATIVE
On 02/13/2026 at 1634 hours I was dispatched to Talbot Rd S / S Carr Rd, in the City of Renton, King
County, Washington. I was responding to a report of a collision.
While en route, dispatch advised the following: two vehicle collision, blocking S Carr Rd, metro bus
and a Dodge Charger involved.
At approximately 1637 hours, I arrived on scene. I saw both vehicles pulled off the road and no longer
blocking. In this report, Unit 1 refers to a black 2009 Dodge Charger (WA/CUV4839) driven by
Shannon G. Clay (DOB 09/12/1970, WA DL). Unit 2 refers to a 2019 Freightliner Bus (WA/B3587C)
driven by Jonathan P. Kleinbeck (DOB 01/23/1989, WA DL).
I spoke to both drivers. Neither were injured, and Kleinbeck confirmed no passengers on the bus
were injured. Both drivers gave the same account:
The bus, Unit 2, was stopped in the right eastbound lane of S Carr Rd at the bus stop to pickup and
drop off passengers. It had been stopped for several moments when Unit 1 rear-ended the bus. Clay
said she was distracted by traffic and trying to change lanes and did not notice the bus stopped. The
collision was at slow speeds, resulting in only minor scratches and paint transfer to each vehicle.
Kleinbeck provided insurance for the bus, but Clay said she did not have insurance. I told Clay she
would receive a citation in the mail for driving without insurance. I completed a SECTOR exchange of
information form and provided it to both parties.
This concludes my involvement in this case.
I certify under penalty of perjury under the laws of the State of Washington that the foregoing is true
and correct.
Electronically signed by Ofc. Gregory Bills #12495, 02/13/2026 at 1717 hours in Renton, Washington.
PAGE 3 OF 4
REPORT NO. EG77800 CASE# 26-1267 DATE AND TIME i 02/13/26 16:31
OF COLLISION
fitPtJ jf,
t.
ti
Fr
g,
r
.�„, � •�e, dF t�F �ra jF�}7�t�ei � i�"Y�
iy
l
t s
1 Fr 1
t
1
PAGE 4 OF 4