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Home My WebLink About26-1807 ("7— STATETFF' "CERA II I �� III I I III I I IIII III II I 1 27c . COLLISION REP F 1591971 FIRE CASE 26-1807 2 INTERSTATE CITY STREET RESULTED ❑ 1 2 S OLEN STATE ROUTE OTHER VFTHICI F LOCAL AGENCY 4200 3[� HIT 8 RUN CODING COUNTY RD PRIVATE WAY INVOLVED 2 TRIBAL UN 75 TOTAL#OF STRUCK 1 8 OBJECT 2$ RESERVATION 1 2 3 M M D D Y Y Y Y TIME I2400) COUNTY# MILES CITY# coATL s ory 03 - O6 - 2026 2002 17 �. S e W 8 OF 8 1070 3 4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑ BLOCK AIRPORT WAY 8✓ .� 4a❑ MILEPOST DISTANCE OF(REFERENCE OR CROSS STREET) 5❑ FEET e S e W 8 RA/NER AVE S OF 4 29 k, MOTOR PEDAL- DAM ETHRESHOLD MET PHONE UNIT 01 VEHICLE CYCLE YES NO D:2064689949 0 1 30 6� LAST NAME GOMEZLUNA FIRST NAME DEVIN MIDDLE' A 1 1 2 31 INITIAL STREET E:1 15821 8TH AVE SW CITY BURIEN WA NEW ADDRESS S7 ZIP 981662901 z 7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL-1 NO OftTED 3 INTERLOCKYEs No,/ INTERLOCKYEs NOW YES Na,/ $❑ LDICENS STATE WA SEX'M MM flYY 07 - 05 - 2006 1 2 32 9 ON DUTY STATUS AIRBAG 6 RESTR 4 EJECT 1 H U5 E7 2 CLASS 1 NATURE OF INJURIES 2 LICEN st CKF1172 srArE WA WIN# 2HGES26762H514712 10 1❑ PI 3 11 3 5 PLATE# STATE PLATE# STATE ROM To RA TRLR TRLR. 3 5 33 12 3 5 VIN#' v1N# FROM TO 13 4 VEH.YEAR2002 MAKE HOND MODEL CIVIC STYLE SD VEHICLE TOWED 2NOn fBLIN tIHNK RS GOVT,VEHIICL✓ ] 3 34 ❑ DAMAGE II1I�_IIII tlAlVt(t ccJllu—'II REGISTERED OWNER INFO DEVIN GOMEZ WNA 158218TH AVE SW BURIEN WA 98166 VEHICLE NO. 1 ❑ SHADE 1N DAMAGED AREA 35 4 LIABILITY INSURANCE INSURANCE CO 4 14 PROGRESSIVE 866127379 IN EFFECT &POLICY# STOP VEHICLE 5 ❑ 36 EGALI V YES[:]NO[:] CITATION# CHARGE lO BOTTOM 15❑ sTAnowG e w' MOTOR PEDAL PEDESTRIAN PROPERTY DAM THR OLD MET PHONE UNIT 02 VEHICLE CYCLE OWNER YES 1/ NO D:7038983988 16� LAST NAME NGHIEM FIRST NAME THANH MIDDLE T INITIAL 17❑ STREET El 14814 NE 16TH ST CITY' BELLEVUE ST', WA ZIP 980074202 4 NEW ADDRESS ❑ 37 18 CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED � 3$ INTERLOCK YES ND INTERLOCK Es Ho✓ YES No,� 19 F DRIVER'# ON DUTY[:]I I STATUS AIRBAG 6 RESTR 4 EJECT 1 H EL 2 SE CLAY NATURE OF INJURIES 40 ❑SS 21❑ LICENSE CPC1025 TATE'W 41 A v)N# 2HGFA16999H344455 1 PLATE# 42 22 PLATE#TRAILER STATE PLATE TRAILER STATE 23� 43 TRLR RLR VIN#. '[N#, TOWED BY GO HI 44 VEH.YEAR 2009 MAKE HOND MODEL CIVIC STYLE $D DAMIAGETOWED✓ ND BLIN BANKERS YES NO�/ 24 REGISTERED OWNER INFO THANH NGHIEM 14814 NE 16TH ST BELLEVUE WA 98007 VEHICLE NO.2 SHADE IN DAMAGED AREA LIABILITY INSURANCE ✓ INSURANCECO STATE FARM 5873158BOB47 2 3 4 IN EFFECT &POLICY# 4TOP 5 VEHICLE ❑ CE] CITATION# CHARGE tOBOTTOM LEGALLY YES N 6 25 7KEN 'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY 26 PETERSON 12808 WA0171300 PART A . PAGE 01 OF 9000-345-159(R 11(181 STATE OF POLICETRAFFICN CORRECTION REPORT NO. EG85553 COLLISION REPORT III III III III III 111 1591972 CASE# 26-1807 E NA ADDITIONAL PERSONS INVOLVED(PASSENGERS AND/OR WITNESSES ONLY) M (LAST,FIRST,MIDDLE INITIAL) HOLLEY GERALDINEL ADDRESS&PHONE# D� 7930 SE 34TH ST APT 107 MERCER ISLAND WA 980403555 SEXi F MMDDYYYY 12 — 07 — 1930 PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET INJURY NATURE OF INJURIES El UNIT 3 POS. 3 2 4 1 USE 2 CLASS 1 ----� :NAME (LAST FIFS7 MIDDLE INITIAL) ADDRESS R PHONE# SEX D.O.B. - MMDDYYYY PASSENGER❑WITNESS UNIT# : SEAT NJURY: AIRBAG RESTR. EJECT HELMET NaruREOFINJURIES POS. USE CLASS ----� :NAME (LOST,FIRST,MIDDLE INITIAL) ADDRESS&PHONE# SEX/ MMDDY D.O.B. YYY PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET INJURY NATURE OF INJURIES ❑ ❑ POS. I USE CLASS NARRATIVE I was dispatched to a vehicle collision on 03/06/26 at the intersection of Rainer Ave S and Airport Way, in city Renton, King County WA. Unit 1 CKF1172 Driver: Devin A. Gomez Luna (DOB 07/05/2006) Unit 2 CPC1025 Driver: Thanh T. Nghiem (DOB 02/20/2003) Unit 3 BTY5953 Driver: Johannes Christoffersen (DOB 04/12/1931) Upon arriving I saw three vehicles collided in the intersection of Airport Way and Rainer Ave S. I spoke to Unit 1 who told me that he was sitting at the intersection of Airport Way facing West. He said that his light was green he turned to go South on Rainer Ave S when colliding with unit 2. Unit 2 told me that he was traveling East on Renton Ave Ext and entering through the intersection of Rainer Ave S and Airport Way when he was struck in the middle of the intersection by Unit 1. Unit 2 told me that he had a green light and was in lane 2. Unit 3 told me that he was traveling East on Renton Ave Ext and when entering through the intersection of Rainer Ave S and Airport Way when he was struck in the middle of the intersection by Unit 2. He stated that he was in lane 1 far right lane. Spoke to all drivers and the passengers who stated no injuries. Information exchange were given to all drivers. I certify (declare) under penalty of perjury under the laws of the State of Washington that the foregoing is true and correct. Electronically signed: Officer Kevin L. Peterson Date and Place: 03/07/2026, 0030 hours at Renton, WA I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT. KEVIN PETERSON 03-07-26 12:30 AM INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST.DET DATED PLACE SIGNED APPROVEQ BY DATE HANSEN HSU 12651 1 311312026 4:44:57 PM BADGE OR ID# 12808 ORI# WA0171300 TIME POLICE DISPATCHED 1 8:04 Pry/ TIME POLICE ARRIVED i 8:10 PM PART B 30e0-345.160(R1Vt8) PAGE 0 OF 47 SUPPLEMENTAL REPORT No. EG85553 1 $ 27 FIC �.V�='t P CL ION REPORT CASE# 26-1807 1 COMMERCIAL MOTOR CARRIERT '.. INTERSTATE INTRASTATE L UNIT# USDOT ICC# VEHICLE TYPE CARGO BODY TYPE 2 ❑ 1 28 CARRIER NAME 3 CARRIER ADDRESS 1 7 1 CITY ST ZIP 4 NAME ?# .PLACARD GWVR ❑ NAME IF NO NUMBER SOURCE AXLES + 4a ❑ ADDITIONAL UNITS MOTOR PEDAL- PROPERTY DAMAGE THRESHOLD MET PHONE (� PEDESTRIAN �/ D:2066416213 5 UNIT� 3 VEHICLE I�I CYCLE L-1 � OWNER � YES NO 0-1 29 LAST NAME CHRISTOFFERSEN FIRST NAME JOHANNES MIDDLE N INITIAL 30 STREET pj NEwAnnew 9103 FORTUNA DR APT 9203 CITY MERCER ISLAND ST WA ZIP 980403100 6 1 1 2 31 COIL IGNITION RE IGNITION : PRESENT MEDICALTANSFORTED INTERLOCK YES NO�/ 1NTERLO11 YES N �/ yEs N DRIVER'S D.O.B LICENSE; STATE yyq SEX M MMDDYYY 04 - 12 - 1931 7 ON DUTY� STATUS AIRBAG, 2 RESTR.1 4 1 EJECT 1 1 HELMET 2 INJURY 1 ATURE OF INJ NURIES USE CLASS 8 ❑ 1 32 LICENSE;BTY5953 TA WA WIN JF2SKASCOLH541220 PLATE# 9 TRAILER TRAILER PLATE# STATE PLATE# STATE 10 ❑ TRLR TRLR VIN..#. VIN.#. 11 3 5 VEH.YEAR2020 I MAKE SUBA MODELFORESTE STYLE VEHICLE TOWE E T ABLIN TOWED BY arn/r.vEHlci F FROM TO DAMAGE YES NO `/ YES NO REGISTERED OWNER INFOfOHANNES CHRISTOFFERSEN 9103 FORTUNA DR APT 9203 MERCER ISLAND WA 98040 SHADE.IN DAMAGED AREA 7 3 33 12 2 3 4 FROM TO LIABILITY INSURANCE INSURANCE CO MUTUAL OF ENUMCLAW AB30075852 ❑ IN EFFECT &POLICY# 9FC1P m 34 Q 1080TTOM 13 vewcLe AA YES NO CITATION# CHARGE sTnNDiNc 6 El 14 ❑ UNIT' MOTOR PEDAL_ PEDESTRIAN PROPERTY ❑ : DAMAGETHRESHOLD MET PHONE ❑ 35 VEHICLE CYCLE OWNER YES NO 15 LAST NAME FIR87NAME MIDDLE INITIAL TIAL ❑ 16 ❑ NEW STREETAnnRFSS CITY ST' ZIP CDL IGNITION RF.OUIRED IGNITION PRESENT MEDICAL 7ANSPORTED INTERLOCK YES N INTERLOCK YES[:]NO YEs NO' 17 4 37 DRIVER'S STATE I SEX D.O.B 18 ❑ LICENSE'.,# MMDDYY ON DUTY STATUS AIRBAG RESTR. EJECT HELMET I INJURY NATURE OF INJURIES ❑ 38 USE CLASS 19 ❑ LICENSE: TA VIN# 39 PLATE# 20 TRAILER TRAILER 40 PLATE#, STATE PLATE# STATE 21 ❑ ❑ 41 TRLR TRLR UIN#i U[IN#; 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 DAMAGED AREA 43 2 3 4 LIABILITY INSURANCE INSURANCE CO IN EFFECT � &POLICY# �KU9 1 44 24 YES[:] NO[] CITATION# CHARGE srnNOlNc S L 6 I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT, KEVIN PETERSON 03-07-26 12:30 AM 25 INVESTIGATING OFFICER'S SIGNATURE OFFICER'S PHONE UNIT OR DIST DET DATED: PLACE SIGNED 47 APPROVED BY DATE 26 OBADE IDG# 12808 #1 WA0171300 HSU 31,312026 PAGE F OF 3000-345-013(R 11/181 REPORT NO. EG85553 CASE# 26-1807 DATE AND TIME 03/06/2620:02 OF COLLISION ml yy� f � R } � t r j 7 d�14 t t { 41 ss t � t} i, 1 nt 1 b t' 1� } } PAGE 4 OF 4