HomeMy WebLinkAbout26-1288 )STATE
TFcN 6 0 27i t
Oc� RA EG79875
COLLISION REPRT 1591971
CASE# 26-1288 2
INTERSTATE CITY STREET FIRE ❑
RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VEHICLE ❑ LOCAL ACENC'Y 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
coulsloN' 02 - 14 - 2026 2010 17 =.= S 8 W e IN OF M ?070 a
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION �✓ NON INTERSECTION BLO❑
MAPLE VALLEY HWY MILE POST
e 1800 .�
4a❑ MILE POST
❑ DISTANCE OF(REFERENCE OR CROSS STREET)
5 . FEET S 8 W e PRIV DR 1820 MVH
0 1 29
MOTtlR PEDAL- DAM AG THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE ❑ YEs Vl No D:2064122574 0 4 30
5 LAST NAME PALMER FIRST NAME BRYSON MIDDLE K 1 1 2 31
INITIAL
STREET ❑ 13514 SE 186TH PL CITY RENTON ST WA ZIP 980588027 2
NEW ADDRESS
7 CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
INTERLOCKYES NO Z/ INTERLOCKYEs N �/ YES No,/
8 LICIENS# STATE WA SEX M MMDCSYY' 11 1 2 32
9 ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 N USEET INJURY
CLASS ? NAruRE of INJURIES 2
LICENSE, CSD0334 STATE WA VN# 1N4BA41E37C838173 3
10 as ATP tt
TRAILER STATE TRAILER ,STATE
11 0 0 PLATE# PLATE# FROM TO
rRLR TRLR 3 7 33
1 4
( FROM TO
2 Q VIN# VIN#
VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWEDBY GOVT VEHICLE
13 4 2007 N/33 MAJOMA SD DAMAGE YES DNO ✓ YES❑ NO 7 1 34
REGISTERED OWNER INFO BRYSON PALMER 13514 SE 186TH PL RENTON WA 980588027 D:2064122574 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
3 14 LIABILITY INSURANCE[%,/] INSURANCE CO STATE FARM 5721356FO847A001 4
IN EFFECT &POLICY# 4TOP _
srgNOLNG ❑NO❑ CITATION# 6AO073362 CHARGE FAIL TO OBEY TRAFFIC CONTROL o ooTrob 36
Yes
15
PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT 02 VEHIC6E ❑ CYCLE' ❑ E
❑ nWNFR YES,/ No D:3603481237
16�
LAST NAME RU►Z FIRST NAME ANTHONY MIDDLE D
INITIAL
STREET ❑ 37
17 ❑ ?332?209THAVESE CITY', MONROE ST, WA ZIP 982729726
NEW ADDRESS
18❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED' 38
INTERLOCKYEs No�/ INTERLOCK YES No,/
19 DRIVER'S STATE WA SEX M I D.O.B. 1 05 01 2003 ❑ 39
LICENSE# MMDDYY —
HELMET INJURY' NATURE OF INJURIES 40
20❑ ON DUTY STATUS' AIRBAG 2 RESTR 4 EJECT 1 USE CLASS ? ❑
21 PLATE# CDP3232 rare W/a vIN# JM1 DE1 KZSC0147420 41
22❑ PLATE# STATE PAAILER
TE# STATE ❑ 42
23 TRLR kRLR 43
UIN#. 'IN#.
VEH.YEAR 2012 MAKE MAZD MODEL MAZDA2 STYLE $D VEHICLE TOWED TO BLIN
TOWED BY GOV HI 44
24 DAMAGE YES NO�/ YES NO
REGISTERED OWNER INFO A.HARCROYV 228002711 AVE NE ARLtNGTON WA 98223 VEHICLE NO,2
SHADE IN DAGED AREA
2 4
LIABILITY INSURANCE INSURANCE CO CONTA101311666
IN EFFECT &POLICY# 9TOP
vewaE ❑ CITATION11 CHARGE tO BOTTOM
A Y YES N J
25 s 6
OFFICER'S NAME(PRINT)
26 OFFICER PHONE BADGE OR ID# JAGENCY
HANSEN HSU 12651 WA0171300
PART A PAGE 01 OF
3000-345-159(R 11/181
POLIICFETRAFFICN CORRECTION REPORT NO. EG79875
COLLISION REPORT III III III III III 111
1591972 CASE# 26-1288
ADDITIONAL PERSONS INVOLVED(PASSENGERS AND/OR WITNESSES ONLY)
NAME PALMER LIBERTY
(LAST,FIRST MIDDLE INITIAL}
ADDRESS&PHONE#
16123 SE PETROVITSKY RD RENTON WA 980589508 SEX' F MMDDYYYv 10 - 19 - 2002
PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET INJURY NATURE OF INJURIES
El I 1 POS. 3 2 4 1 USE CLASS 1 ---�
'NAME
LAsr F RST,MIDDLE INITIAL) HARCROW ANISA D
ADDRESS&PHONE# D C,B
22800 27TH AVE NE ARLINGTON WA 982237625 SEX' F MMDDVVYv 04 _ 30 _ 2001
SEAT HELMET INJURY
NATURE OF INJURIES
PASSENGER �WITNESS UNIT# i 2 POS. 3 AIRBAG 2 RESTR. 4 EJECT 1 USE CLASS 1
'.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 �____ ----�
NARRATIVE
Unit 1 traveling westbound along 1800 block of Maple Valley Hwy. Unit 2 traveling eastbound along
1800 block of Maple Valley Hwy. Unit 2 making left turn north into private driveway at a clearly
established intersection with operational traffic signals at 1820 MVH. Unit 1 driver admits to running
red light at the same intersection and was the proximate cause of the collision. Unit 1 sustains non
disabling reportable front end damage. Unit 2 sustains non disabling reportable passenger side
damage. No injuries reported. Unit 1 driver cited for failure to obey traffic control device.
I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT.
HANSEN HSU 02-14-26 09:04 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST.DET DATED PLACE SIGNED
APPROVED BY DATE
CASEY PROCTER 12123 2/22/2026 11:06:44 AM
BADGE OR ID# 12651 ORI# ( WA0171300 TIME POLICE DISPATCHED'; 8:14 PSI TIME POLICE ARRIVED 8:Y0 PM
PART IS 3 Da-3m5-,aR(R11r1s) PAGE 27 OF 37
REPORT NO. EG79875 CASE# 26-1288 DATE AND TIME 02/14/26 20:10
OF COLLISION
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