HomeMy WebLinkAbout26-1497 ("7—
STATE.w, TFFiNCERA �I I ��� III I I Iil I I�I1 II{ II I 0 27c .
,one COLLISION REP F 1591971
FIRE
CASE# 26-1497 2
INTERSTATE CITY STREET
RESULTED ❑
1 2 S OLEN STATE ROUTE OTHER VFTHICI F LOCAL AGENCY 42UD S[�
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 TRIBAL UN 75 TOTAL#t7F STRUCK OBJECT 1 28
01 TREE OR STUMP
RESERVATION 2
3 M M D D Y Y Y Y TIME I2400) COUNTY# MILES CITY#
coAT sloN 02 - 23 - 2026 0741 17 �. e W 8 OF IN 8 1070 3
S
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓
BLOCK OLYMPIAAVENE MILEPOST T 8
4a 2310
❑ MILEPOST .�
❑ DISTANCE OF(REFERENCE OR CROSS STREET)
5 �.= FEET e S e W B
0 1 29
♦� MOTOR PEDAL- DAM ETHRESHOLD MET PHONE
UNIT 01 VEHICLE � CYCLE � YES �NO D:4255722287 �30
6 LAST NAME WANG FIRST NAME BAIXUE MIDDLE 1 2 31
INITIAL
STREET E:1' 3519 NE 23RD CT CITY RENTON WA
NEW ADDRESS ST ZIP 980562451 z
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
INTERLOCKYEs No INTERLOCKYEs No YES NO
LDICENS #
STATE WA SEX'F MMDDW 03 - 24 - 1991 32
9 ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 HELMET INJURY 7 NATURE OF INJURIES 2
USE CLASS CUT UNDER LIP
10 LICn NStt CTX7081 srArE WA WIN# JTJGKCEZXT2071357 3
11 2 5 PLATE# STATE TRAIPLATE# STATE ROM To
rRLR TRLR.. 5 1 33
12 VIN# VIN#
FROM TO
13 4 VEH.YEAR2026 MAKE LEXS MODEL NX STYLE VEHICLE TOWED 2NO ll—IN TvR&LBYMEYERS Govv ENOL� m 34
❑ DAMAGE II1I._IIII -IIJJ
REGISTERED OWNER INFO OWNED BY DRIVER VEHICLE NO. 1
SHADE 1N DAMAGED AREA ❑ 35
INSURANCE CO 2 3 4
14 LIABILITY INSURANCE STATE FARM 5924163-E01.47
IN EFFECT &POLICY# i 4TOP
V""Lt CHARGE ❑ 36
ecnu Y YES❑NO❑ CITATION# 10 ftOTTOM
1S❑ sT-- a
MOTOR PEDAL- PROPERTY DAM THR OLD MET PHONE
UNIT 02 ❑ ❑ PEDESTRIAN ❑
VEHICLE CYCLE'. OWNER YES NO
16❑
LAST NAME FIRST NAME MIDDLE
INITIAL
17
STREET
CITY' ST' ZIP ❑ 37
❑ {I��I
NEW ADDRESS
18❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED ❑ 38
INTERLOCK YES No INTERLOCK YES NO YES No
19❑ LICENSE# STATE SEX MMDDYY - _ ❑ 39
20❑ ON DUTY STATUS AIRBAG RESTR EJECT HELMET I INJURY NnruREOFINJURIES ❑ 40
USE CLASS
21 LICENSE❑ TATE'PLATE# ❑ 41
ViN
42
22 AILER TRAILER
PLATE# STATE PLATE STATE
23 TRLR 43
RLR
VIN# IN#
VEH.YEAR MAKE MODEL STYLE VEHICLE TOWEDfUf TO BLIN TOWED BY GO HI 44
24 DAMAGE YES NO YES NO
REGISTERED OWNER INFO VEHICLE NO.2
SHADE IN DAMAGED AREA
LIABILITY INSURANCE INSURANCE CO 3 4
IN EFFECT &POLICY# t 4TOP 5
venue YES❑ N J
.1-1 CITATION# CHARGE tOBOTTQM
�ecn��v
25 s e
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
26
C.ARNOLD 12509 WA0171300
PART A . PAGE 01 OF
9000-345-159(R 11(181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EG84705
COLLISION REPORT III III III III III 111
1591972 CASE# 26-1497
ADDITIONAL PERSONS INVOLVED(PASSENGERS AND/OR WITNESSES ONLY)
'.NAME
(LAST,FIRST,MIDDLE INITIAL)
ADDRESS&PHONE
SEXi D.O.B. -
MMDDYYYY
PASSENGER❑WITNESS❑;UNIT# SEAT AIRBAG RESTR. EJECT HELMET INJURY NATURECFINJURIES
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 CIASS ----�
: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
CC 26-1497
On 2/23/2026 at 0742 hours I was dispatched to a single vehicle collision at 2310 Olympia Ave NE in
the City of Renton, King County, Washington.
Pre-Collision
Driver 1 stated that she was driving North on Olympia Ave NE at around the 2300 block.
Collision
Driver 1 stated that as she entered the 2300 block, she lost control of her vehicle due to slippery
roads and Unit 1 left the roadway on the East side where it collided with a tree. There was minimal
damage to the tree which was located on the East side of the roadway at 2310 Olympia Ave NE.
Injuries
Driver 1 had a small cut below her bottom lip and refused medical treatment.
Vehicle Disposition
Unit 1 was rendered inoperable and was towed from the scene.
Proximate Cause
This report is for insurance purposes as there was minimal damage to the tree and the property
owner did not wish to identify themselves for this case.
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 08:14 on 2/23/2026 in the City of Renton, King
County, Washington.
I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT.
C.ARNOLD 02-23-26 10:15 AM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST.DET DATED PLACE SIGNED
APPROVED BY DATE
C.JACOBS 1953 311112026 10:28:52 AM
BADGE OR ID# 12509 ORI# WA0171300 TIME POLICE DISPATCHED; 7:42 Aryl TIME POLICE ARRIVED i 7:59 AM
PART B 3000-345.160(R1Vt8) PAGE F2 _-]OF F3
REPORT NO. EG84705 CASE# 26-1497 DATE AND TIME 02/23/2607:41
OF COLLISION
1� iz,S
z
i
w
s V
tt
)� S
S
{� ti
t
S
1y
s it St
�SSSt }
t
Yg
t! ger ,
p �
PAGE 3 OF 3