HomeMy WebLinkAbout26-2065 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 5 27c
COLLISION REP FIT 1591971
CASE 26-2065 z
INTERSTATE ❑ CITY STREET FIRE ❑RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHIC;I F ❑ LOCAL AGENC 4100 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 1 TOTAL#OF OBJECT 1 1 8 28
TRIBAL UNITS OZ 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 1705 17 ❑-= S 8 IN e 1070 3
4❑ oN (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
NE 3RD STREET BLOCK NO. e✓ 1800 ❑
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ ❑ FEET e S ❑ VV e BLA/NEAVE NE
0 1 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
,/No D:4258644955 0 11
30
6� LAST NAME STANTON FIRSTNAME RODNEY MIDDLE T 1 1 2 31
INITIAL
STREET ❑ 77 SOUTH WASHINGTON STREET CITY SEATTLE ST WA ZIP 98104 z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
iNTERLOCKYEs 1/ I NO NTERLOCKYEs NO Z YEs No�/
8❑ LRIIVER # STATE WA SEX'M MI D Y' 05 - 04 - 1973 1 2 32
9 ON DUTY❑ STATUS AIRBAG 2 RESTR 9 EJECT 1 HELMETU SE CLASS 1 NATURE OF INJURIES z❑
3
10 9❑ P1 aTES� CTA9248 sTArI WAurN# KMHWF35H75A104362.
TRAILER STATE TRAILER STATE
11 0 0 PLATE# PLATE# FROM TO
TRLR. TRLR 3 7 33
12 0 0 VIN#' VIN#
>; FROM TO
VEH.YEAR 2005 MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE 7 3 34
13 4 HYUN SONATA SD DAMAGE YES NO YES[:] NO✓
REGISTERED OWNER INFO DIANNE GOEBE 2442064THAVES MC141 KENTWA 98032 D:4258644955 VEHICLE NO. 1
❑ ❑
SHADE IN DAMAGED AREA 35
14 ❑ INSURANCE CO 3 4
LIABILITY INSURANCE
IN EFFECT &POLICY# � 9TOP 5
VE"'CLE CHARGE 10 BOTTOM 36
LEGALLY YES❑NO❑ CITATION# 6AO112356,6AO112356, NO VALID OPER LICENSE WITH
15❑ STANDING 6
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT U2 VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES 1/ No D:4253899455
16 a
LAST NAME ANDERSON FIRST NAME AUSTIN MIDDLE U
INITIAL
17 STREET NEW ADDREs7 219 SUNSET BLVD N CITY RENTON ST WA ZIP 98057 4❑ 37
18� CDL IGNITION REQUIRED IGNITION PtR-E-S1ENT MEDICAL TRANSPORTED 38
INTERLOCK YEs❑NO� INTERLOCK YEs I I NOF YEs I'✓ NO❑
19[—] DRIVER #
❑ ON DUTY STATUS AIRBAG,4 RESTR y EJECT 1 HELMET INJURY 6 NATURE OF INJURIES ❑ 40
USE CLASS HEAD AND NECK PAIN
❑21❑ PLATE# CMA1620 TArE 41
WA VIN# 5J6RE4H306L021330 1
42
22❑ PLATE# STATE PLATE# STATE
TRLR
23❑ UIN#. IN#.
43
RLR
'
I
VEH YEAR 2011 MAKE yOND MODEL CR-V SE STYLE UT jVEHl DAMAGE TO WED NOO✓ BLIN TOWED BY 44
Yr
GOV H YES NO 1/
24❑ REGISTERED OWNER INFO OWNED SY DRIVER VEHICLE N0.2
SHADE IN DAMAGED AREA
2 3 4
LIABILITY
INSURANCE 8 POINSURGY#E CO PROGRESSIVE INS 9869304447IN STOP
VEHICLE ❑ NC[-] CITATION# CHARGE �BOTTOM
LEGALLY YES N J 6
25=
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# FVA0171300
NCY
26
YUSUF JIBRIL 12490
PART A PAGE 01 OF
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EG86107
COLLISION REPORT III III III III III 111
1591972 CASE# 26-2065
ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY)
NAME MIDDLE INITIAL) BRADFORD DEAN K
(LAST FIRST,
ADDRESS&PHONE#
14825 SE 145TH P RENTON WA 98056 4252265980 SEX M MMDOYyry -�-
PASSENGER [:]WITNESS UNIT# SEAT AIRBAG RESTR. EJECT ' HELMET INJURY NATURE OF INJURIES
POS. USE CLASS
NAME
'(LAST,FIRST,MIDDLE INITIAL)
ADDRESS&PHONE# DOB
SEX' MMDDYVYV
PASSENGER ❑WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET INJURY NATURE OF INJURIES
POS. USE CLASS
NAME
(LAST FIR57 MIDDLE INITIAL)
AppRESS&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.
YUSUF XBR/L 03-15-26 07:13 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST.DET DATED PLACE SIGNED
APPROVED BY DATE
NICOLAS SANGDER 11350 1 3/16/2026 12:15:26 AM
BADGE OR ID# 12490 OR]# ! WA0171300 TIME POLICE DISPATCHED 5:08 Pry] TIME POLICE ARRIVED',5:12 PM
PART I PAGE IT]OF 4]
REPORT NO. EG86107 CASE# 26-2065 OF COLLISION
03/15/26 17:05
OF CbLLI510N
NARRATIVE
On 03/15/2026 at approximately 1712 hours, I responded to an injury collision at NE 3rd St and
Blaine Ave NE in Renton.
Dispatch advised that one driver was complaining of a neck and head pain injuries and that Renton
Fire Authority medics were responding. Upon arrival, all vehicles involved were located at the 1800
block of NE 3rd street.
Unit 1: A grey Hyundai Sonata (WA- CTA9248) sustained damage to the front left bumper and
remained drivable. The driver of Unit 1 reported no injuries.
Unit 2: A brown Honda CRV (WA- CMA1620) sustained damage to the left side of the vehicle and the
side airbags deployed. The driver complained of head and neck pain. The driver was transported by
medics to Valley Medical Center. Unit 2 was not drivable.
The following is based on the drivers, the witness statements, and the evidence observed at the
scene: The collision occurred at the 1800 block of NE 3rd street.
Unit 1 was traveling westbound on NE 3rd street in lane 2. Unit 2 was traveling eastbound on NE 3rd
St in lane 2. Unit 1 crossed the double yellow centerline into eastbound lane and collided head-on
with unit 2.
The driver of Unit 1 stated he was distracted while attempting to pick up a soda that had fallen onto
the vehicle floor. As a result, he lost control of the vehicle, crossed the centerline, and collided with
unit 2.
Record check on Unit 1's driver revealed that he did not have a valid driver license and no valid proof
of insurance for the vehicle. The driver of unit 1 was issued a citation for operating motor vehicle with
no valid license, operating vehicle with no proof of insurance, and distracted driving. Unit 1 was
impounded to Gene Meyer Tow lot since there was no one with a valid driver license to operate the
vehicle.
Unit 2 was not drivable, and it was towed to Gene Meyer's Tow lot.
All drivers were provided with exchange information, including the case number.
PAGE 3 OF 4
REPORT NO. EG86107 CASE# ' 26-2065 DATE AND TIME 03/15/26 17:05
OF COLLISION
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PAGE 4 OF 4