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HomeMy WebLinkAbout26-1458 IT si " II IIIII III IIIII II IIII IIIII I . 27c REPORT NO EG84699OLCERA COLLISION REPORT 1591971 CASE# 26-1458 2 INTERSTATE CITY STREET FIRE I RESULTED STOLENSTATE ROUTE OTHER VEHICLE LOCAI-A`NG 4200 3 HIT&RUN ©DING 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' 02 - 21 - 2026 1317 17 =.= S 8 W E OF M 1070 a 4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑ 152ND AVE SE BLOCK NO. e 15200 .� 4a❑ MILE POST ❑ DISTANCE OF(REFERENCE OR CROSS STREET) 5 �.� FEET e S 8 W e MAPLEVALLEYHWY 0 1 29 MOTOR PEDAL- DAMAG THRESHOLD MET PHONE UNIT 01 VEHICLE ❑ CYCLE ❑ vEs No �/ D:2533322615 N:2533357214 0 8 30 5 LAST NAME HORBACHUK FIRST NAME HELEN MIDDLE V 1 2 31 INITIAL STREET ] 27880 257TH AVE SE CITY; MAPLE VALLEY ST WA ZIP 980382029 2 NEW ADDRESS 7 CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED' 3 INTERLOCKYES NO INTERLOCKYES NC YEs NO 8 DRIVERI # STATE WA SEXI F MMDDYY' 03 - 27 - 2008 1 2 32 9 ON DUTY STATUS' AIRBAG 1 RESTR 4 EJECT 1 HELMET 2 CLASSY 1 [NATURE of INJURIES 2 LICENSE, CKW2047 STATE WA VIN#; JF1ZCAC17L8703762 3 10 Fl I as ATP rt STATE STATE TRAILER TRAILER 11 0 0 PLATE# PLATE# FROM To TRLR TRLR 3 1 7 33 12 0 0 VIN#' VIN# FROM TO VEH.YEAR 2020 MAKE SUBA MODEL BRZ STYLE CP VEHICLE TOWED TO BLIN TOWED BY GOVT VEHICLE g 9 34 13 DAMAGE YES YES❑ NO REGISTERED OWNER INFO NELYA HORSACHUK 17880257TH AVE SE MAPLE VALLEY WA 98038 VEHICLE NO. 1 SHADE IN DAMAGED AREA 35 4 LIABILITY INSURANCE INSURANCE CO 4 14 PROGRESSIVE 978764310 IN EFFECT &POLICY# 9TOP CHARGE 5 36 LvEnemur yes❑NO❑ CITATION# t a 80TTOM 15❑ STANDING s 7 e MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE UNIT 02 VEHICLE CYCLE nWNFR YES NO �/ D:9136176667 16� LAST NAME Yl FIRST NAME JASON MIDDLE S INITIAL STREET ❑ 37 17 ❑ 24040 SE 258TH WAY CITY MAPLE VALLEY ST, WA ZIP 980385010 4 NEW ADDRESS 18❑ CDL IG DICAL IGNITION REQUIRED (GNI'I`iON PRESENT ME TRANSPORTED: 38 INTERLOCKYE , ND INTERLOCK YES NO Es No 19 DRIVER'S STATE WA SEXIM D.02. 11 39 LICENSE# MMDDYY 12 — 1977 20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 HELMET 2 INJURY 7 NATURE A INJURIES 40 USE CLASS NECK PAIN 21 LICEN� BYF5063 rArE WA vIN# 7SAYGDEEXTF411957 41 PLATE22❑ [TILER TAILER PLATE# STATE PLATE# STATE 42 23 TRLR RLR 43 UIN#. 'IN# VEH.YEAR 2026 MAKE TESL MODEL Y STYLE UT VEHICLE TOWED TO BLIN TOWED BY GOV HI 44 24 DAMAGE YES NO NO REGISTERED OWNER INFO OWNED BY DRIVER VEHICLE NQ.2 SHADE IN DAMAGEAREA 2 3 LIABILITY INSURANCE INSURANCECO STATE FARM 4829904AI547 IN EFFECT &POLICY# t STOP vemae E VEHICLE YES� N.I,—I CITATION# CHARGE to BOTTOM V 25 s s OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY J 26 KEITH PETTY 12809 WA0171300 PAGE 01 OF PART A 3000-345-189(R 11/18) STATE OF POLICETRAFFICN CORRECTION REPORT NO. EG84699 COLLISION REPORT III III III III III 111 1591972 CASE# 26-1458 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. KEITH PETTY 02-21-26 02:39 PM INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST.DET DATED PLAGE SIGNED APPROVED BY DATE J.TRADER 4553 311112026 11:30:10 AM BADGE OR ID# 1Y809 ORI#s WA0171300 TIME POLICE DISPATCHED I 1:17 PM TIME POLICE ARRIVED i 1:Y7 PM PAST B 3 Do-3mx—attar(t 1Mff) PAGE 2�OF F5 REPORT NO. EG84699 CASE# 26-1458 O OF COLLISION TIME 02/21/26 13:17 NARRATIVE 26-1458 On 02/21/2026 at approximately 1317 hours, I was dispatched to the intersection of 152nd Vae SE and Maple Valley Hwy in the City of Renton, County of King, State of Washington for an accident with unknown injuries. Upon arrival I contacted the parties involved and confirmed there were no injuries needing medical attention. Unit 1 was a white 2020 Subaru BRZ (CKW2047/WA) VIN/JFIZCAC17L8703762, driven by Helen V Horbachuk (DOB 03/27/2008) identified by her WADL. Unit 2 was a gray 2026 Tesla Model Y (BYF5063/WA) VIN/7SAYGDEEXTF411957, driven by the owner Jason Seungup Yi (DOB 11/12/1977) identified by his WADL. Jason stated he was on maple Valley Hwy stopped at the intersection waiting for the signal to turn green, when unit 1 collided into the back of his vehicle. The accident caused his neck to feel stiff but denied needing medical attention at the scene. Unit 2 stated she was traveling west bound on Maple Valley Hwy and had misjudged the distance it was going to take to stop at the intersection and collided into the back of unit 2. Each vehicle was able to drive away on its own. The damage did not appear to be over $1000 on either vehicle. This report is a summary of the events that occurred and is not an exact sequencing of events. Statements have been paraphrased and summarized "I certify (or declare) under penalty of perjury under the laws of the State of Washington that the foregoing is true and correct." Electronically signed: K.Petty, Date: 02/21/26at 1428 hours, Place: Renton, King County, WA PAGE 3 OF 5 REPORT NO. EG84699 CASE# 26-1458 O OF COLLISION TIME 02/21/26 13:17 NARRATIVE PAGE 4 OF 5 REPORT NO. EG84699 CASE# 26-1458 DATE AND TIME 02/21/2613:17 OF COLLISION> ' k � { u �Ilvfl''4t� fill I �Ni 1 f t' I ry `'w r Y I a �' �4 't. f �I i If ! r' (I .1 ii P 4 t,' l g Y s a �a i t, a sr I �Pt 4f WtV U� t 1 5Y a �5 s� PAGE 5 OF 5