HomeMy WebLinkAbout26-2015 iiTFiNII IIIII III IIIII II IIII IIIII I . 27c REPORT NO EG86100oc� RA
COLLISION REPORT 1591971
INTERSTATE CITY STREET FIRE I
CASE# 26-2015 2
RESULTED STOLENSTATE ROUTE OTHER VEHICLE LQCAI-A`NG 4100 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY ❑ INVOLVED
2❑ TRIBAL i UNITS TRUCK
#OF 02 SO"" TRAFFIC SIGNAL POLE 1 1 8 28
i RESERVATION : 2
3� M M D D Y Y Y Y TIME(2400) COUNTY# MILES CITY#
eaCL s o v' 03 - 13 - 2026 1750 17 =.[� S 8 W e OF 8 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
N 4TH ST BLOCK NO. e 400 .�
4a❑ MILE POST
❑ DISTANCE OF(REFERENCE OR CROSS STREET)
5 �. FEET e S 8 W e WILLIAMS AVE N
0 1 29
MOTOR ✓ PEDAL- DAM AG THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE ❑ YEs Vl No D:4254964713 2 0 30
5 LAST NAME LESMES FIRST NAME LUIS MIDDLE E 1 1 2 31
INITIAL
STREET ] 4710 S 124TH ST
'NEW ADDRESS CITY I $EATTLE ST: WA ZIP: 98178 2
7 +CDL IGN(TIUN REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
INTERLOCKYES No,/ INTERLOCKyEs NO✓ YEs NO✓
8❑ DCIENSE# STATE WA SEXI M MMDDYY' 10 — 25 — 1966 1 2 32
9 ON DUTY❑ STATUS' AIRBAG 6 RESTR 4 EJECT 1 HELMET 2 INJURY 6 NATURE of INJURIES 2
USE ,CLASS HEAD/NECK PAIN
10 LI ENSE BLE9365 STATE WA VIN#, 3N1AB6AP4CL608711 3
TRAI STATE TRAILER LE STATE
11 2 5 ,LATE# PLATE# FROM To
TRLR TRLR 3 7 33
12 2 5 VIN#' VIN#
FROM TO
HICLE
13 1 VEH.YEAR 2012 MAKE NISS MODEL SENTRA STYLE $D VEHICLE TO YED NO fiS46LIN diW9YMEYER YESr`-IVT ENp✓ 3 7 34
DAMAGE IIII._IIII I_I
REGISTERED OWNER INFO LUIS LESMES 4710S 124TH ST SEATTLEWA 98178 D:4254964713 VEHICLE NO. 1
SHADE IN DAMAGED AREA 35
1 LIABILITY INSURANCE INSURANCE CO 4
14 STATE FARM 435 6502 F23 47D
IN EFFECT &POLICY# <5,
TOPVEn" CHARGE 36
Lec Lr YES❑NO❑ CITATION# 0TFOM15 sTnNowc 6
EDAL-
MOTOR ✓ P PEDESTRIAN PROPERTY DAM THR HONE
OLD MET P
UNIT 02 VEHICLE ❑ CYCLE ❑ ❑ nWNFR YEs✓ No D:2062653345
16�
LAST NAME JOHNSON FIRST NAME CAMI MIDDLE L
INITIAL
STREET ❑
17 ❑ 27920 215TH PL SE CITY MAPLE VALLEY ST, WA ZIP 98038 q 37
NEW ADDRESS
1$❑ CDL IGNITION REQUIRED IGNI I iON PRESENT MEDICAL TRANSPORTED 38
INTERLOCKYEs No✓ INTERLOCK YES No✓ vEs No✓
19 DRIVER'S STATE WA SEX F D.o.e. 03 04 1985 39
LICENSE# MMDDYY —
20❑ ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 R USEET 2 CLASSY 1 NATURE OF INJURIES 40
21 LICENSE CCM8715 TATE WA VIN# 1GNKVJKD8EJ147448 41
22❑ PLAILER TE# STATE PLATE# STATE 42
23 TRLR RLR 43
UIN#. 'IN#
VEH.YEAR 2014 MAKE CHEV MODEL TRAVERS STYLE UT VEHICLE TOWED TO BLIN TOWED BY GOV HI 44
24 DAMAGE YES �/ No GENE MEYER vEs No✓
REGISTERED OWNER INFO CAMI JOHNSON 27920215TH PL SE MAPLE VALLEY WA 98038 D:2062653345 VEHICLE NO.2
SHADFY DAMAGED AREA
3 4
LIABILITY INSURANCE INSURANCECO STATE FARM 4077899 F2247B
IN EFFECT &POLICY# 9TOP
1— ❑ ,J—I CITATION11 CHARGE t080TTOM
LEGALLY YES N
25 e
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
26
JAREN JOKELA 12805 WA0171300
PAGE 01 OF
PART A 3000-345-189(R 11/18)
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EG86100
COLLISION REPORT III III III III III 111
1591972 CASE# 26-2015
E NA ADDITIONAL PERSONS INVOLVED(PASSENGERS AND/OR WITNESSES ONLY)
M
(LAST,FIRST,MIDDLE INITIAL) SAMUELSON JAY
ADDRESS&PHONE
2068196541 SEXi M MpDDYBVYY
PASSENGER WITNESS UNIT SEAT AIRBAG RESTR. EJECT HELMET INJURY NATURE OF INJURIES
1:10 POS. USE CLASS ----�
:NAME
(LAST FIRST MIDDLE INITIAL)
ADDRESS&PHONE#
SEX MMDDYYYY D.O.B. —
PASSENGER❑WITNESS UNIT# : SEAT AIRBAG RESTR. EJECT HELMET INJURY: NATURE CFINJURIES
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.
JAREN JOKELA 03-13-26 07:33 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST.DET DATED PLAGE SIGNED
APPROVED BY DATE
N/COLAS SANGDER 11350 3/15/2026 11:24:21 PM
BADGE OR ID# 12805 ORI# WA0171300 TIME POLICE DISPATCHED 5:52 PM TIME POLICE ARRIVED i 5:57 PM
PAST B 3 Do-3mx—attar(t 1Mff) PAGE 2�OF F5
REPORT NO. EG86100 CASE# 26-2015 DATE OF COLLI r�510NN + 03/13/26 17:50
L1
NARRATIVE
Renton Case #26-2015
On 03/13/2026 at 1752 hours I was dispatched to N 4th St/Williams Ave N, in the City of Renton, King
County, Washington. I was responding to the call of an unknown injury two-car motor vehicle
accident. This incident was captured on my body worn video camera. This report is a summation of
events that occurred and is not an exact sequence of events.
At approximately 1757 hours, I arrived on scene located both involved vehicles. Unit 1 vehicle was
blocking westbound lanes of travel on N 4th ST, just west of Williams Ave N and Unit 2 was partially
off the roadway on the northwest corner of the intersection and had collided with a traffic signal pole.
I identified Unit 1 as a blue 2012 Nissan Sentra (WA LIC #BLE9365) being driven by the sole
occupant, identified by his WA DOL photo as Luis E Lesmes (DOB 10/256/1966).
1 observed significant damage to the front of Unit 1 vehicle, with most of the impact affecting the front
right of the vehicle. No vehicle airbags had been deployed. Unit 1 vehicle was later removed from the
scene by Gene Meyers Towing.
Unit 1 driver provided me with his WADL, registration and proof of insurance.
I identified Unit 2 as a white 2014 Chevrolet Traverse (WA LIC #CCM8715) being driven by Unit 2
driver, identified by her WA DL as Cami L Johnson (DOB 03/04/1985).
1 observed significant damage to the front end of Unit 2 vehicle. As a result of the initial collision with
Unit 1 vehicle, Unit 2 vehicle was pushed partially off the roadway causing it to strike a traffic signal
pole (POLE #318130). No vehicle airbags had been deployed in Unit 2 vehicle.
Renton Fire arrived on location and evaluated both involved drivers. Unit 2 driver did not make any
complaints of pain and appeared to be uninjured. Unit 1 driver complained of head/neck/back pain
and had minor swelling to the right side of his head. Unit 1 driver was later transported by Renton Fire
to Valley Medical Center to receive additional medical treatment.
Unit 2 driver stated that prior to the collision, she was traveling westbound on N 4th ST in the number
2 lane of travel, as she approached Williams Ave N. Just east of the intersection, Unit 2 driver stated
that she was struck by Unit 1 vehicle, who was traveling in the number 3 lane of travel, causing her to
lose control and crash into the traffic signal pole.
Unit 1 driver stated that he was traveling westbound on N 4th St, when he was struck by Unit 2
vehicle who was also traveling westbound on N 4th St directly next to him.
In speaking with a witness of the collision, verbally identified as Jay Samuelson, he stated that he
observed Unit 2 vehicle traveling southbound on Williams Ave N and attempt to turn westbound onto
N 4th St. In the process of turning onto N 4th St, Unit 2 collided with Unit 1 who was traveling
westbound on N 4th St.
After speaking with all involved parties/witness', all with differing recollections, it is unclear as to how
the collision occurred and what was the proximate cause.
I took photographs of both involved vehicles and the sustained vehicle damage. All photos were later
uploaded to Axon Evidence.
All parties involved were provided with a business card and case number.
PAGE 3 OF 5
REPORT NO. EG86100 CASE# 26-2015 DATE OF COLLI r�510NN + 03/13/26 17:50
L1
NARRATIVE
Both involved vehicles were removed from the scene by Gene Meyers Towing.
I then cleared the scene.
This ends my report.
I certify under penalty of perjury under the laws of the State of Washington that the foregoing is true
and correct.
Electronically signed by Ofc. Jaren Jokela #12805, 03/13/2026 at 1931 hours in Renton, Washington.
PAGE 4 OF 5
REPORT NO. EG86100 CASE# 26-2015 DATE AND TIME 03/13/2617:50
OF COLLISION
3, �t
t..
I
t
t`l
S}br �S
llS
t
ttit�
3 h� 3E sXF
h
i
tl Y�
a �,Z
ix
S �
� 4
tY K
t t L h
a
t
� t
t
t su 1't
4" t
t
PAGE 5 OF 5