HomeMy WebLinkAbout26-627 iiTFiNII IIIII III IIIII II IIII IIIII I . 27c REPORT NO EG79068oc� RA
COLLISION REPORT 1591971
❑ 0 RESULTED I
$ 26-627 2
INTERSTATE CITY STREET FIRESTOLENSTATE ROUTE OTHER VEHICLE LOL`CODICENC'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 eDLLISION' 01 - 22 - 2026 1811 17 =.= S 8 W E OF M 1070 a
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION BLO❑
SOUTHGRADYWAY MILE POST
e 200 .�
4a❑ MILE POST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ MILES�. FEET e S 8 E e RAINER AVE SOUTH
1 2 29
MOTOR ✓ PEDAL- DAM AG THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE ❑ YEs Vl No D:3607919176 0 1 30
5❑ LAST NAME ORDUNA FIRST NAME ALEXANDRA MIDDLE K 1 2 31
INITIAL
STREET ❑ 2701 FISHTRAP LOOP NE CITY; OLYMPIA ST WA ZIP; 985069609 2
NEW ADDRESS
7 CDL IGN(TIUN REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED. 3
INTERLOCKYEe NO✓ INTERLOCKVES NO✓ YEs ND�/
8 DRIVERS# STATE WA SEXI F MMDDYY' O6 — 25 — 2005 1 2 32
9� ON DUTY STATUS' AIRBAG 2 RESTR 4 EJECT 1 HELMET
2 CLASSY 1 [NATURE of INJURIES 2
LICENSE, CVK4770 STATE WA VIN# 2HGES165X5H510997 3
10 Fl I as ATP tt
5 TRAILER STATE TRAILER STATE
11 2 5 PLATE# PLATE# ROM To
TRLR 7 3 33
12 2 5 TVINRLRRLR vIN#
FROM TO
VEH.YEAR 2005 MAKE HOND MODEL civic STYLE VEHICLE TOWED TO BLIN TOWED By GOVT VEHICLE 7 $ 34
13� DAMAGE YES II_II NO ✓ YESII_I) NO✓
REGISTERED OWNER INFO ALEXANDRA ORD.2701 FISHTRAP LOOP NE OLYMPIA WA 98506 VEHICLE NO. 1
SHADE IN DAMAGED AREA 35
4 LIABILITY INSURANCE INSURANCE CO 2 3 4
14 PROGRESSIVE 864613839
IN EFFECT &POLICY# 4TOP
VEnicLE❑ CITATION# t 7
5 36
Le , CHARGE
15 STMDwc e
MOTCYR ✓ PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT 02 VEHICLE CYCLE nWNFR D:2068025397
16�
LAST NAME VITHAYATH/L FIRST NAME JANCY MIDDLE S
INITIAL
17
STREET ❑ 37
NEW ADORE SS❑ 19227138TH AVE SE CITY' RENTON ST, WA ZIP 980587772
1$❑ IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED' ❑ 38
CDL INTERLOCKYEs ND✓ INTERLOCK YES xz ,/ YEs NO'✓
19 DRIVER'S
MMDDYY I —
HELMET INJURY: NATURE OF INJURIES 40
20❑ ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 USE 2 CLASS 1 ❑
21 LICENSLATE E APH8654 TATE WA VIN# 2HKYF18447H522366 41
22❑ [TILER TAILER
PLATE# STATE PLATE# STATE 42
23 TRLR RLR 43
UIN#. 'IN#
VEH.YEAR 2007 MAKE HOND MODEL PILOT STYLE VEHICLE TOWED TO BLIN
TOWED BY GOV HI 44
24 DAMAGE YES NO✓ VES NO✓
REGISTERED OWNER INFO JANCY VITHAYATHIL 19227138TH AVE SERENTONWA98058 VEHICLE NO.2
SHADFY DAGED AREA
4
LIABILITY INSURANCE INSURANCE CO GEICO 6113-92.05.39
IN EFFECT &POLICY# 9TOP
Ve—L ,J—I CITATION# CHARGE t080TTOM
LEGntY YES❑ N`[
25 s e
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
J
26
DAVID DOUGHERTY 13183 WA0171300
PAGE 01 OF
PART A 3000-345-189(R 11/18)
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EG79068
COLLISION REPORT III III III III III 111
1591972 CASE# 26-627
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.
DAVID DOUGHERTY 01-22-26 08:19 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST.DET DATED PLAGE SIGNED
APPROVED BY DATE
M.BRAUN 2194 2/19/2026 4:01:38 AM
BADGE OR ID# j 13183 ORI# WA0171300 TIME POLICE DISPATCHED 1 6:11 pry] TIME POLICE ARRIVED i 6:Y9 pM
PAST B 3 Do-3mx—attar(t 1Mff) PAGE 2�OF 4
REPORT NO. EG79068 CASE# 26-627 O OF COLLI 510N TIME 01/22/26 18:11
COLLISION
NARRATIVE
Case 26-627
1 was working as a fully uniformed City of Renton Police Officer in a fully marked City of Renton,
Police Car as unit#3R13. All events took place in the City of Renton, County of King, State of
Washington unless otherwise noted.
This report is a summary of events that occurred and is not an exact sequencing of events.
Statements have been paraphrased and summarized. At the time of this call my body worn camera
was activated.
On 1/22/2026, at 1811 hours, I was dispatched to a hit and run collision at South Grady Way and
Rainer Ave South. The reporting party and victim was identified as Jancy S Vithayathil (DOB
06/20/1965). She stated that an unknown white sedan collided with her while she was driving on
South Grady Way. Jancy had relocated to the Discount Tire Parking lot on South Grady Way.
The driver of the white sedan called in as I had just been dispatched to the call. The driver was
identified as Alexandra K Orduna (DOB 06/25/2005). Alexandra stated she believed she had hit a
vehicle and stated that her driver's side mirror was damaged. I asked Alexandra to meet Jancy and I
at the Discount Tire so I could complete an accident investigation.
I arrived at Discount Tire and saw Jancy's Silver, 2007 Honda Pilot (WA plate APH8654). I observed
that there was damage on the right front fender of the vehicle. 1 took photos of the damage that I later
uploaded to evidence.com. 1 then saw Alexandra's White, 2005 Honda Civic (WA plate CVK4770). 1
observed that her left drivers side mirror was damaged and that there was damage to left front fender.
I took photos of the damage that 1 later uploaded to evidence.com.
I identified Alexandra as the Unit 1 driver based on the damage to both cars and what Alexandra
stated had occurred. Alexndra was in the merging lane to get onto southbound 167 and was
attempting to merge into the eastbound lane of South Grady Way when she collided with the side of
Jancy's vehicle.
I completed an exchange of information form and provided to copies to both Jancy and Alexandra.
Neither were injured in the collision. Nothing further at this time.
I certify (declare) under penalty of perjury under the laws of the State of Washington that the
foregoing is true and correct.
Electronically signed by D. Dougherty on 1/22/2026 at 2017 hours, In the City of Renton, WA.
PAGE 3 OF 4
REPORT NO. EG79068 CASE# 26-627 DATE AND TIME 01/22/26 18:11
OF COLLISION
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