HomeMy WebLinkAbout26-1268 IT si " II IIIII III IIIII II IIII IIIII I . 27c REPORT NO EG79872OLCERA
COLLISION REPORT 1591971
INTERSTATE ❑ CITY STREET FIRE I
CASE# 26-1268 2
RESULTED STOLENSTATE ROUTE OTHER VEHICLE LOCAI-A`NG 4100 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
eDLLISION' 02 - 13 - 2026 1801 17 =.= S 8 W❑ INOF 1070 a
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓
140TH WAY SE BLOCK NO. e 15200 .�
4a❑ MILE POST
❑ DISTANCE OF(REFERENCE OR CROSS STREET)
5 50 1.1 00 FEET e✓ S 8 W e SE 151STlN
1 2 29
MOTOR ✓ PEDAL- DAM AG THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE ❑ YEs Vl No D:2065307562 0 1 30
5 LAST NAME FISH AGUILAR FIRST NAME HECTOR MIDDLE t 1 2 31
INITIAL
STREET ❑ 10765 14 AV SW
NEW ADDRESS CITY I $EATTlE ST WA ZIP; 98146 2
7 CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
INTERLOCKYES No✓ INTERLOCKYEs No✓ YES NO✓
8❑ DRIVERCENS # STATE WA SEXI U MMDDYY' 10 - 17 - 1967 1 2 32
9 ON DUTY STATUS' AIRBAG 6 RESTR 4 EJECT 1 N UET SE LA SY 1 [NATURE of INJURIES 2❑
10 LI ENSE' D08544G STATE WA VIN# 3C6TRVAG4HE546371 3
TRAILER TRAILER
11 4 0 STATE STATE PLATE# PLATE# ROM To
TRLR rRLR 7 1 33
12 4 0 VIN#' vIN#
FROM TO
LE
13 4 VEH.YEAR 2017 MAKE RAM MODEL pROMA STYLE VEHICLE TO YED NO fiS46LIN diW9YMEYER YESr`-IVT ENp✓ 1 5 34
DAMAGE IIII._IIII I_I
REGISTERED OWNER INFO HECTOR FISH AGUILAR 10765 14TH AVE SW APT 69 SEATTLEWA 98146 VEHICLE NO. 1
SHADE IN DAMAGED AREA 35
3 14 LIABILITY INSURANCE❑ INSURANCE CO PROGRESSIVE 008046480 4
IN EFFECT &POLICY# 9TOP _
srnNoiNc ❑NO❑ CITATION# 6AO073361 CHARGE FLO STOP/YIELD ENTERING ta6orro6 z 36
Yes
15❑
MOTOR ✓ PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT 02 VEHICLE CYCLE nWNFR YES�/ NO D:9253226360
16�
LAST NAME BRANTINGHAM FIRST NAME AARON MIDDLE' R
INITIAL
STREET ❑ 37
17 ❑ 20918 30TH DRIVE SE CITY BOTHELL ST, WA ZIP 980210000
NEW ADDRESS
18❑ CDL IGNITION REQUIRED? IGNITION PRESENT MEDICAL TRANu.PORTE6 ❑ 38
INTERLOCK YES NO✓ INTERLOCK YES ND✓ vEs NO✓
19 DRIVER'S STATE WA sEX M D.o.e. 07 04 1998 39
LICENSE# MMDDYY -
20❑ ON DUTY❑ STATUS AIRBAG 6 RESTR 4 EJECT 1 HELMET I INJURY', 7 NATURE OF INJURIES ❑ 40
USE CLASS RIGHT ARM
21 LICENSE
LATE# CGH3502 rare WA vIN# 1G1ZE5SX8LF012794 41
22❑ PLATE# STATE PLATE# STATE 42
23 TRLR RLR 43
UIN#. 'IN#
VEH.YEAR 202Q MAKE CHEV MODEL MALJB(J STYLE VEHICLE TOWED TO BLIN TOWED BY GOV HI 44
24 DAMAGE YES �/ No GENE MEYER vEs No✓
REGISTERED OWNER INFO AARON BRANTINGHAM 2091830TH DR SE BOTHELL WA 98021 VEHICLE NO.2
SHADFjy DAMAGED AREA
3 4
LIABILITY INSURANCE INSURANCE CO USAA 0608759187101
IN EFFECT &POLICY# 9TOP
1— ❑ ,J—I CITATION# CHARGE t080TTOM
L,—LY YES N
25 e
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
26
HANSEN HSU 12651 WA0171300
❑
PAGE 01 OF
PART A 3000-345-189(R 11/18)
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EG79872
COLLISION REPORT III III III III III 111
1591972 CASE# 26-1268
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 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 CLASS
NARRATIVE
Unit 2 traveling southbound along 15200 block of 140th Way SE. Unit 1 merging into traffic, entering
onto 140th Way SE from the driveway of the Preserve at Cedar River at 15205 140th Way SE, turning
left, attempting to head northbound. Unit 1 failed to yield right of way when merging into traffic
causing major disabling front end damage to both units. Unit 2 driver sustained right arm injuries from
air bag deployment. Unit 2 driver treated on scene by Renton Fire. No other injuries reported. Unit 1
driver cited for failure to yield ROW and was proximate cause of collision.
I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT.
HANSEN HSU 02-13-26 09:39 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST.DET DATED PLACE SIGNED
APPROVED BY DATE
CASEY PROCTER 12123 2/22/2026 11:03:50 AM
BADGE OR ID# 12651 ORI# WA0171300 TIME POLICE DISPATCHED 1 6:02 PM TIME POLICE ARRIVED i 6:15 PM
PAST B 3 Da-lmx—attar(txIMR) PAGE 2�OF F3
REPORT NO. EG79872 CASE# 26-1268 DATE AND TIME 02/13/26 18:01
OF COLLISION
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