HomeMy WebLinkAbout26-1545 iiTFiNII IIIII III IIIII II IIII IIIII I . 27c REPORT NO EG84701oc� RA
COLLISION REPORT 1591971
CASE# 26-1545 2
INTERSTATE CITY STREET FIRE ❑
RESULTED
LVED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VEHICLE ❑ LOCALANG 4200 3
COUNTY RD NT&RUN CODING
PRIVATE WAY
2 TOTAL#OF OBJECT 3 4 28
TRIBAL UNITS 03 STRUCK
RESERVATION : 1 1
2
3� M M D D Y Y Y Y TIME(2400) COUNTY# MILES CITY#
EDGEson' 02 - 25 - 2026 1406 17 =.= S 8 W e IN e 1070 s
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓
BLOCK NO.
780 LOGAN AVE N
4a❑ MILE POST
❑ DISTANCE OF(REFERENCE OR CROSS STREET)
5 100 00 FEET e✓ S 8✓ E e N 8TH ST
OF11
29
MOTOR PEDAL- DAM AG THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE ❑ YEs Vl No D:2533275875 0 7 30
5 LAST NAME LEVISON FIRST NAME WILLAM MIDDLE L 1 1 2 31
INITIAL
STREET ❑ 801 RAINIER AVE N UNITY E225 CITY; RENTON ST I WA ZIP 98057 2
NEW ADDRESS
7 CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
INTERLOCK YES NO�/ INTERON Km Na�/ YES NO
�/
8 DCIENSE# STATE WA SEXI M MMDDYY' 05 - ?9 - 1993 1 2 32
9 ON DUTY STATUS' AIRBAG 6 RESTR 4 EJECT 1 JHELM
USEET 2 CLASSY ? NATURE of INJURIES 2
10 PI ATLAS#EI BHY7589 STATE WA VIN# 1 FAHP2E89HG 146401 3
TRAILER STATE TRAILER STATE
11 3 5 PLATE# PLATE# ROM To
TRLR zRLR 1 1 5 33
12 0 0 VIN#' VIN#
FROM TO
13 4 VEH.YEAR2017 MAKE FORD MODEL TAURUS STYLE SD VEHICLE TOYED NO�iS46LIN T�VyED.6LRS GESI�TEND 9 9 34
DAMAGE IIII._IIII HHttVVii((tt u
REGISTERED OWNER INFO WILLIAM LEVISON 801 RAINIER AVE N UNITY E225 RENTON WA 98057 D:2533275875 VEHICLE NO. 1
SHADE IN DAMAGED AREA 35
4 LIABILITY INSURANCE INSURANCE CO 14 ALLSTATE 807343050
IN EFFECT &POLICY#V""' CHARGE 36
LEGALLY YES❑NO❑ CITATION# <14,
15 STANDING
MOTDR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT 02 VEHICLE CYCLE nWNFR D:2066174698
16�
LAST NAME TRAN FIRST NAME TUAN MIDDLE' M
INITIAL
17F1 STREET ❑ 37
❑ ?045464TH AVE S CITY' SEATTLE ST, WA ZIP 98?782313 4
NEW ADDRESS
1$❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 38
INTERLOCKYES No INTERLOCK YES NO YES NO
19 DRIVER'S STATE WA SEX M I D,CLB F04 23 1993 39
LICENSE# MMDDYY -
20❑ ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 R USEET 2 CLASSY ? NATURE OF INJURIES 40
21 LICENSLATE E CTC3432 TATe WA VIN# SALE27EU5S2450778 41
22❑ [TILER TAILER
PLATE# STATE PLATE# STATE 42
23 TRLR RLR 43
UIN#. 'IN#
VEH.YEAR 2025 MAKE LNDR MODEL DEFENDS STYLE 4W VEHICLE TOWED TO BLIN
TOWED BY GOV HI 44
24 DAMAGE YES NO VES NO
REGISTERED OWNER INFO TUAN TRAN 10454 64THAVES SEATTLE WA 98178 D:2066174698 VEHICLE NO.2
SHADE IN DAMAGEAREA
2 3
LIABILITY INSURANCE INSURANCECO STATE FARM 4530413F1947B
IN EFFECT &POLICY# I STOP
VEHICLE ,.I—I CITATION11 CHARGE to BOTTOM
LEGALLY YES[Z N
25 s
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
26
E.CHANG 10065 WA0171300
PAGE 01 OF
PART A 3000-345-189(R 11/18)
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EG84701
COLLISION REPORT III III III III III 111
1591972 CASE# 26-1545
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 CLASS 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
RTF
On 02-25-2026 at about 1426 hours, I was sent to a collision which occurred at 780 Logan Ave N,
with in the City of Renton, King County, Washington.
Upon arrival all drivers were identified via a WADL photo.
Both unit 2 and 3 said they were stopped in traffic in lane 2 southbound Logan Ave N.
The driver of unit 1 said he was not paying attention and rear-ended unit 2 which pushed unit 2 in to
unit 3.
There were no injuries.
Unit 1 was the only vehicle which was towed away from the scene.
I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT.
E.CHANG 03-03-26 05:18 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST.DET DATED PLACE SIGNED
APPROVED BY DATE
J.TRADER 4553 3/11/2026 11:27:27 AM
BADGE OR ID# 10065 ORI# WA0171300 TIME POLICE DISPATCHED 1 2:23 Pry] TIME POLICE ARRIVED i 2:36 PM
PAST B 3 Da-3mx—attar(txIMR) PAGE 2�OF 4
SUPPLEMENTAL REPORT No. EG84701
POLICE TRAFFIC
1 1 8 27
COLLISION REPORT CASE# 26-1545
t113197
1 COMMERCIAL MOTOR CARRIER INTERSTATE INTRASTATE
UNIT# USDOT ICC# VEHICLE TYPE CARGO BODY:
TYPE
2 ❑ 1 28
CARRIER
NAME
3 CARRIER L
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 CYCLE CI PEDESTRIAN :.. OWNER YES NO
D:2065017675
0 7 29
LAST NAME PON FIRST NAME TRISHIA MIDDLE. C
INITIAL
STREET 30
NEW AnnRFs 6125 KENNEDY AVE SE UNIT A CITY AUBURN I ST WA ZiP gg092
6 ❑ 1 1 2 31
CDL IGNITION REQUIRED :1GNi71ON PRESENT MEDICAL TANSPORTED'.
:NTER�.00K YES N( �/ INTERLOCK YES NO Z/ YES N..�/
L
DRIVER'S STATE WA SEX F D'O' p1
7
LICENSE'; MMDDYY - 04 - 1993
ON DUTY STATUS AIRBAG 1 RESTR. 4 EJECT 9 HELMET 2 INJURY 1 NAruREofINJURIEs
USE ;CLASS
8 ❑ 1 32
LICENSE CBN8455 TAT WA VIN 5FNYF6H37NB035873
PLATE#
9 TRAILER TRAILER L
PLATE# STATE PLATE# STATE
0
10 ❑ TRLR TRLR
VIN.# VIN#.
11 0 0 VEIL YEAR2022 MAKE HOND MODELPILOT STYLE SW VEHICLE TOWE E T ABLIN TOWED BY GOVT.VEHICI E FROM TO
DAMAGE YES NO �/ YES
REGISTERED OWNER INFO.TRISHIA PON 6125 KENNEDY AVE SE UNIT A AUBURN WA 98092 D:2065017675 SHADE IN DAMAGED AREA 9 9 33
12 2 3 4
FROM TO
INSURANCE CO
LIABILITY INSURANCE PROGRESS/VE 957204935
IN EFFECT � &POLICY# � _J7t1P_ m 34
13 YES NO[jj CITATION# CHARGE 35
1080TTOM
ecauv
sTnNoiNc �
MOTOR PEDAL_ ' 1:1PROPERTY DAMAGE THRESHOLD MET PHONE
14 ❑ UNIT# VEHICLE CYCLE PEDESTRIAN OWNER YES NO
36
15 LAST NAME FIRST NAME NIT AL
16 ❑ STREET �' CITY ST' ZIP
NEW ADDRESS
CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TANSPORTED.
INTERLOCK YES NO INTERLOCK YEs N6 YES NO ❑
17 4 37
LIRIVER'SICENSE# STATE SEX Moog
L _ C---�
18 ❑ ❑
HELMET 'INJURY: NATURE OF INJURIES 38
ON DUTY STATUS' AIRBAG RESTR. EJECT USE CLASS.
19 ❑ LICENSE TAT ViN# 39
PLATE#
20 TRAILER' TRAILER 40
PLATE# STATE PLATE# STATE ❑
21 ❑ ❑ 41
TRLR TRLR
VIN# VIN#:'
42
22 VEH.YEAR MAKE I MODEL I STYLE VEHICLE TOWED DUET ABLIN TOWED BY GOVT.VEHICLE
DAMAGE YES NO YES NO
23 REGISTERED OWNER INFO. SHADE IN DAMAC ED AREA 43
2 3 4
LIABILITY INSURANCE INSURANCE CO
IN EFFECT I &POLICY#
..
)
E 44
24 YES❑ NO CITATION# CHARGE OM
SWG 8 3 G
1 CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT.
E.CHANG 03-03-26 05:18 PM
25 INVESTIGATING OFFICER'S SIGNATURE OFFICER'S PHONE UNIT OR DIST DET DATED: PLACE SIGNED
26 OR 1b# 10065 O#RI WA0171300 APTRADER 31111/2026
PAGE OF
3000-345-013(R 11/18)
REPORT NO. EG84701 CASE# 26-1545 DATE AND TIME 02/25/2614:06
OF COLLISION
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