HomeMy WebLinkAbout26-1624 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 0 27c
COLLISION REP FIT 1591971
SASE 26-1624 z
INTERSTATE ❑ CITY STREET FIRE ❑
RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHICI F ❑ LOCAL AGENCI 4Y00 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2❑ TOTAL#OF OBJECT ❑2$
TRIBAL UNITS 02 STRUCK' META!SIGN POST
RESERVATION
z
3❑ DATE OF M M D D Y Y Y Y TIME(2400) COUNTY# MILES N E IN CITY#
CowsloN 02 - 27 - 2026 1715 17 ❑-= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
TALBOT RD S BLOCK NO. e✓ 5000 ❑
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ ❑ FEET e S ❑ W e S 50TH PL
0 3 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
,/No D:2532872733 30
6� LAST NAME HERRERA FIRSTNAME ENCHY MIDDLE R 1 1 2 31
INITIAL
STREET ❑✓ 530 S 50TH PL#F CITY RENTON ST WA 2Ip, 98055 z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
INTERLOCK YES[:]NO INTERLOCKYEs NO YES R NO
8❑ LRIIVER #
ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 HELMET
2 CLASS 1 NATURE OF INJURIES z❑
3
10❑ P1 aT�S� CUV4721 sTArI WAvrN# 1 FMCU9J9XDU602239
TRAILER STATE TRAILER STATE
11 3 5 PLATE# PLATE# FROM TO
TRLR. TRLR. 5 3 33
12❑ VIN#j VIN#
RomM TO
34
13 VEH.YEAR2013 MAKE FORD MODEL ESCAPE STYLE VEHICLE TOWED0NOOffBLIN TSIgWgYMEYER vOs❑ENo /
DAMAGE IILLJJII (S�IV6
REGISTERED OWNER INFO ENCHY HERRERA 530 S SOTH PL UNIT F RENTON WA 98055 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
14❑ LIABILITY INSURANCE❑ INSURANCE CO 3
IN EFFECT &POLICV# � STOP
❑ VEHICLE CHARGE 36
15 2 VE-LNG res No clTAnoN# 6AO107334 OP MOT VEH W/OUT INSURANCE I o R TTOM
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR PHONE
UNIT 02 VE OLD MET HICLE El "DAL-
❑ ❑ OWNER ❑ YES 1/ NO D:4254307500
16❑
LAST NAME RENTON FIRST NAME CITY OF MIDDLE
INITIAL
17❑ STREET ❑', 1055 S GRADY WAY CITY' RENTON ST WA ZIP 98056 37
NEW ADDRESS ❑
18� CDL IGNITION REQUIRED IGNITION PR-E-1SENT MEDICAL TRANSPORTED ❑ 38
INTERLOCKYES�NOR INTERLOCK YEs It I NOF YES
t t- l No❑
19 LLIICENS # STATE SEX U MMDDYY -❑_ 39
HELMET INJURY NATURE OF INJURIES 40
20❑ ON DUTY STATUS' AIRBAG RESTR EJECT USE CLASS ❑
❑21❑ LICENSE TArE vIN# 41
PLATE#
42
22❑ PR TRAILER LATE# STATE PLATE# STATE
23❑ 43
TRLR RLR
UIN It 'IN#.
VEH YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN
TOWED BY Gov HI 44
L4❑ DAMAGE YES NO YES NO
REGISTERED OWNER INFO VEHICLE NO.2
SHADE IN DAMAGED AREA
2 3 4
INAEFFIECTTY NSURANCE❑ &POINSULICY#E CO 1GQ
5
VEHICLE ❑ C[:] CITATION# CHARGE
LEGALLY YES N`LJ
25 s � a
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# JAGENCY
26
K.LANE 10008 WA0171300
PART A PAGE 01 OF C7
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EG82518
COLLISION REPORT III III III III III 111
1591972 CASE# 26-1624
ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY)
NAME
(LAST FIRST,MIDDLE INITIAL)_
ADDRESS&PHONE#
SEX D.O.B. - -
MMDDYYYY.
PASSENGER❑WITNESS UNIT# SEAT AIRBAG RESTR. EJECT ' HELMET INJURY NATURE OF INJURIES
POS. USE CLASS
NAME
'(LAST,FIRST MIDDLE INITIAL)
ADDRESS&PHONE# D D B
SEX MMDDYYYY
PASSENGER ❑WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET INJURY NATURE OF INJURIES
POS. USE CLASS
NAME
(LAST FIR57 MIDDLE INITIAL)
AppRESS R PHONE#
SEX D.O.B.
MMDDYYYY. -
PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET NJURY NATURE OF INJURIES
❑ ❑ POS. USE CLASS ----�
NARRATIVE'
Unit 1 was traveling northbound on Talbot RD S approaching S 50th PL intending to turn right onto
eastbound S 50th PL. Unit 1 did not negotiate this turn or manage speed effectively and entered the
turn traveling too fast. Unit 1 went up and over the north curb, striking Unit 2 (a city street sign) and
becoming immobilized on a rockery/ditch.
Unit 1 towed by Gene Meyer.
Driver 1 advised they did not have insurance for the vehicle.
Driver 1 cited for operating a motor vehicle without insurance.
I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT.
K.LANE 02-27-26 06:15 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY E
DAT
C.JACOBS 1953 3/3/2026 10:00:39 AM
BADGE OR ID# 10008 ORI# WA0171300 TIME POLICE DISPATCHED 5:22 Pry TIME POLICE ARRIVED 5:25 PM
PART I PAGE IT]OF 3�
REPORT NO. EG82518 CASE# ' 26-1624 DATE AND TIME 02/27/26 17:15
OF COLLISION
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