HomeMy WebLinkAbout26-1682 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 1 27c
COLLISION REP FIT 1591971
SASE 26-1682 2
INTERSTATE ❑ CITY STREET FIRE ❑
RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHICI F ❑ LOCAL AOENC 4Y00 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 1 TOTAL#OF OBJECT 1 1 8 28
TRIBAL UNITS 03 STRUCK
RESERVATION
z
3❑ DATE OF M M D D Y Y Y Y TIME(2400) COUNTY# MILES N E IN CITY# ❑
cowsloN 03 - 1-- 2026 1013 17 ❑.= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓
SE 166TH ST BLOCK NO. e✓ 12707
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ 1.❑ FEET e S ❑ W e 0 4 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
�/No D:2069539038 1 4 30
6� LAST NAME HATAMl FIRSTNAME SOHILA MIDDLE 1 2 31
INITIAL
STREET ❑✓ 12621 SE 166TH ST CITY RENTON ST WA ZIP 98058 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 H U SE
ICNLJAUSSY 1 NATURE OF INJURIES z❑
3
10❑ P1 aT�S� CLX8122 sTArI WAurN# 1 NXBR30E06Z727776
TRAILER STATE TRAILER STATE
11 2 5 PLATE# PLATE# FROM TO
TRLR. A'RLA2 1 3 33
12 0 0 VIN#' VIN#'
2006 TOYT COROL nIG❑ FROM 34
VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE
13 4 DAMAGE YES NO YES[:] NO✓
REGISTERED OWNER INFO HAMED JILANI 12210 SE PETROVITSKYRDAPTH RENTON WA 98058 VEHICLE NO. 1
❑ ❑
SHADE IN DAMAGED AREA 35
14❑ LIABILI INSURANCE INSURANCE CO PROGRESSIVE 995822366 3 4
IN EFFECT &POLICY# STOP
15❑ vEHLEGALLY Ia.E 5 36
YEs�No M CITATION# 6A0190245 CHARGE DRIVING WITH WHEELS OFF )o BorroM
STANDING 8 7 6
1.' MOTOR PEDAL- PROPERTY DAM THR OLD ME
UNIT 02 VEHICLE CYCLE ❑ PEDESTRIAN
16❑ ❑ OWNER ❑ YES✓ ETPHON
NO
LAST NAME UNKNOWN FIRST NAME MIDDLE
INITIAL
STREET
17❑ NEW ADDRESS❑' CITY ST ZIP ❑ 37
18❑ CDL IGNITION REQUIRED IGNITION PR—E-1SENT MEDICAL—T�RANSPORTED � 38
INTERLOCKYES�NOR INTERLOCK YEs It I NOF YES
t l NO❑
19 LLIICENS# STATE SEX U MMDDYY —�_ 39
WELMET INJURY NATURE OF INJURIES 40
20❑ ON DUTY STATUS' AIRBAG 9 RESTR 9 EJECT ''1 USE 9 CLASS 0 ❑
21❑ LICENSE D056756 TAre I WA VIN1i 1FTCR15U1PP674133
❑ 41
PLATE#
42
22❑ PIR ILER LATE# STATE pLATE# STATE
23❑ 43
TRLR RLR
UIN#. 'IN#.
VEH YEAR 1993 MAKE FORD MODEL RANGER STYLE VEHICLETOWED TO BLIN TOWEDBY GOV!TN
�44
24❑ DAMAGE YES NO✓ YES NO✓
REGISTERED OWNER INFO JACKSON CAPUTO 520428TH AVE SELACEYWA98503 VEHICLE NO.2
SHADE IN DAMAGED AREA
2 3 4
INAEFFIECTTY NSURANCE❑ &POINSULICY#E CO I STOP 5
VE""LE ❑ ,J� CITATION# CHARGE i o BOTTOM
LEGALLY YES N J
25 $
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
26
C.ARNOLD 12509 WA0171300
PAGE 01 OF
PART A
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EG82588
COLLISION REPORT III III III III III 111
1591972 CASE# 26-1682
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
PM 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 FIRST 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'
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.
C.ARNOLD 03-02-26 02:04 PM
NVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
M.LEVERTON 2517 3/3/2026 2:29:48 PM
BADGE OR ID# 12509 OR]#` WA0171300 TIME POLICE DISPATCHED 10:19 AM TIME POLICE ARRIVED',10:45 AM
PART I PAGE IT]OF 5�
REPORT NO. EG82588 CASE# 26-1682 OF COLLISION
03/02/26 10:13
OF CbLLI510N
NARRATIVE
CC 26-1682
On 3/2/2026 at 1019 hours I was dispatched to a motor vehicle collision at 12707 SE 166th St in the
City of Renton, King County, Washington.
Pre-Collision
Driver 1 stated that she was facing South on SE 165th St preparing to turn left onto SE 166th St.
Unit 2 and 3 were parked off of the roadway within their respective driveways and unoccupied.
Collision
Driver 1 stated that when she began to turn left, a vehicle came from an unknown direction and Driver
1 hit the accelerator instead of the brake. Driver 1 stated that she lost control and took a wide lefthand
turn, leaving the roadway and the front passenger side bumper of Unit 1 collided with the rear drivers
side bumper of Unit 2, then proceeding East towards Unit 3 where the front bumper of Unit 1 collided
with the front drivers side door of Unit 3, causing substantial damage.
Injuries
None reported.
Vehicle Disposition
Unit 1 was severely damaged but was able to be driven from the scene. Unit 2 and 3 remained at
their respective addresses.
Proximate Cause
I determined that Driver 1 is the proximate cause of this collision because it shall be unlawful to
operate or drive any vehicle or combination of vehicles over or along any pavement or gravel or
crushed rock surface on a public highway with one wheel or all of the wheels off the roadway thereof.
Had Driver 1 stayed on the roadway, this collision would not have happened.
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 Officer C. Arnold #12509 at 11:24 on 3/2/2026 in the City of Renton, King
County, Washington.
**** AUTO-POPULATED SECTION ****
THE FOLLOWING ARE DESCRIPTIONS ENTERED FOR ITEMS SELECTED AS "OTHER":
Location Character: PRIVATE DRIVEWAY/YARD
**** END OF AUTO-POPULATED SECTION ****
PAGE 3 OF 5
SUPPLEMENTAL REPORT NO. EG825588
r`I POLICE TRAFFIC 1 1 8 27
COLLISION REPORT CASE# 26-1682
1 COMMERCIAL MOTOR CARRIER INTERSTATE INTRASTATE G
UNIT'# USL70r ICC# VEHICLE TYPE CARGO BODY
TYPE
2 ❑ 1 28
CARRIER
NAME
3 CARRIER
ADDRESS `
CITY ST' ZIP'
4 ❑ NAME # PLACARD: :❑
GWVR NAME IF NO NUMBER
SOURCE AXLES +
4a ❑ ADDITIONAL UNITS
MOTOR PEDAL- PROPERTY DAMAGE THRESHOLD MET PHONE
5 UNIT# 3 VEHICLE tSJ CYCLE I_) PEDESTRIAN OWNER YES IN
1 4 29
LAST NAME : UNKNOWN FIRST NAME MIDDLE
INITIAL
STREET 30
NEW AnnRFrtP. CITY ST ZIP
6 1
CDL GNITIttN REQUIRED GNITION PRESENT MEDICAL TANSPORTED 1 31
INTERLOCK YES No INTERLOCK YES❑N0� vES N
DRIVER'S STATE I SEX U M��DYSYv' -� 2
LICENSE
7
ON DUTY STATUS AIRBAG 9 RESTR. 9 EJECT 1 HELMET 9 INJURY 0 NATURE OF INJURIES
F�
USE CLASS
8 ❑ 1 32
LICENSE I CNK1864 [TAT WA VIN# SAJAJ4FX7LCP57754
PLATE#
9 TRAILER TRAILER
PLATE# STATE PLATE# STATE
10 ❑ TRLR TRLR
VIN.#. VIN.#.
11 0 0 VEH.YEAR2020 MAKE JAGU MODELXE STYLE VEHICLE TOVVE E T SABLIN TOWED BY anvi vEH1C P FROM TO
DAMAGE YES 'E YES NO
REGISTERED OWNER INFOMARCO WILSON 12707 SE 166TH ST RENTON WA 980585543 D:2069419474 m 33
12 SHADE IN DAMAGED AREA
7GQ
j4 FROM TO
LIABILITY INSURANCE[] INSURANCE CO
IN EFFECT &POLICY# tVEHICLE 34
13 ❑ LEGALLY YES❑ NO❑ CITATION# CHARGE
STANDING S} 8 dg
14 ❑ UNIT Tr Vd 1RE O CYDCLE OWNER
YES AGE NOHRESHOLD MET PHONE El
35
PEDESTRIAN
15 LAST NAME FIRST NAME INITIALMIDDLE
TIAL
❑
STREET
16 TRENEW "F ' CITY ST ZIP
CDL IGNITION REdUiRED IGNITION PRESENT MEDICALTANSPORTED
NTERLOCK YES NO NTERLOCK YES NO 'YES NO ❑
17 5 37
LICENSE# STATE SEX MMDDDYBYY
18 ❑ ON DUTY� STATUS AIRBAG RESTR. ; EJECT HELMET INJURY NATURE of INJURIES 38
USE ICLASS
19 ❑ VIN# 39
LICENSE
PLATE# rnr
20 ❑ TRAILER TRAILER ❑ 40
PLATE# STATE PLATE# STATE
21 ❑ [441
TRLR TRLR
VIN# YIN#i
42
22 VEH.YEAR MAKE I MODEL STYLE I VEHICLE TO DUET SABLIN TOWED BY GOVT.VEHICLE
DAMAGE YES NO YES NO
23 REGISTERED OWNER INFO SHADE IN DAMAGED 3 4 4 AREA F 43
z
LIABILITY INSURANCE INSURANCE CO '
VEHICLE
EFFECT &POLICY# I 970P - 4 44
24 LEHIcLE YES❑ NO❑ CITATION# CHARGE iq 60TiOM
LeGALIv
E:l
STANDING S 7 6
1 CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT.
C.ARNOLD 03-02-26 02:04 PM
25 INVESTIGATING OFFICER'S SIGNATURE OFFICER'S PHONE UNIT OR DIST DET DATED: PLACE SIGNED
26 OI BADGE 12509 O#I',WA0171300 APPROVED BY
3/33/2026 PAGE F41 OF F
3000-345-013(R 11118)
REPORT NO. EG82588 CASE# ' 26-1682 DATE AND TIME 03/02/26 10:13
OF COLLISION
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PAGE 5 OF 5