HomeMy WebLinkAbout26-2514 j ITFC II IIIII III IIIII II IIII IIIII I . 27I
OOLCERAF EG90709
COLLISION REPRT 1591971
CASE# 26-2514 2
INTERSTATE CITY STREET FIRE ❑
RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VEHICLE ❑ LOCAL AGENCY 4200 3
COUNTY RD ❑ NVOLVED CODING
PRIVATE WAY
2❑ TRIBAL TOTAL 1
UNITS#OF 02 SO BJECT TRUCK 1 8 28
RESERVATION 2
3� M M D D Y Y Y Y TIME(2400) COUNTY# MILES CITY#
DATE OF'. N E
coulsloN' 04 - 01 - 2026 0551 17 =.= S 8 W E OF IN M 1070 a
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION �✓ NON INTERSECTION ❑
BLOCK NO.
GARDEN AVE N
4a❑ MILE POST
❑ DISTANCE OF(REFERENCE OR CROSS STREET)
5 �. FEET e S 8 W e N LANDING WAY
1 2 29
MOTtlR PEDAL- DAM AG THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE ❑ YEs Vl No D:2535694742 0 1 30
6 LAST NAME WHITE FIRST NAME GRADY MIDDLE M 1 1 2 31
INITIAL
STREET ❑ 28207 73RD AVE E
NEW ADDRESS CITY; GRAHAM gT WA ZIP 983389380 2
7 CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
INTERLOCKYEs No INTERLOCKYEs NO YES NO
8❑ LICIENS# STATE WA 8EK'M MMOCSYY' 12 1 2 32
9 ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 N USEET INJURY
CLASS 1 NAruRE of INJURIES 2
10 LI ENSE'ti� D44496C STATE WA VN# 1FTBR1YG4NKA61966 3
11[-j- TRAILER STATE TRAILER ,STATE ROM TO
11 3 0 PLATE# PLATE#
rRLR TRLR 5 7 33
12 3 Q VIN# VIN#
( FROM TO
VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED By GOVT VEHICLE
13 2 2022 FORD TRANSI DAMAGE YES�No ✓� ves❑ 5 1 34
REGISTERED OWNER INFO CLIMA TE PROS LLC 805 W THORNDALE A VE ITASCA IL 60143 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
3 4
14 LIABILITY INSURANCE NSURANCE CO SAME.
IN EFFECT &POLICY# 4TOP
VEHICLE CHARGE t 5 36
Lemur YES❑NO❑ CITATION# 7 o BOTTOM
15❑ sTnNowc 7 e
rL� MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT VEHICLE ❑ CYCLE' ❑ ❑ nWNFR D:2536865584
16�
LAST NAME ACUNA FIRST NAME AVERY MIDDLE' M
INITIAL
17 F1 STREET ❑'❑ 872135 TH ST W CITY UNIVERSITY PLACE ST 37
, WA ZIP 984662103
NEW AbbRESS
18❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICALTRANSPORTEDI 38
INTERLOCKYEs No jNTERLOCKYEs No YEs No
19[ DRIVER'S STATE WA SEX M I D.O.E. 1 05 16 1995 ❑ 39
LICENSE# MMDDYY —
HELMET INJURY' NATURE OF INJURIES 40
20❑ ON DUTY STATUS' AIRBAG 2 RESTR 4 EJECT 1 USE CLASS 1 ❑
21 LICENSLATE E CBF6575 TATE WA VIN# 2HGFC1E54HH702603 41
22❑ [TILER AILER
PLATE# STATE PATE# STATE ❑ 42
23 TRLR kRLR 43
UIN#. 'IN#.
VEH.YEAR 2Q17 MAKE HOND MODEL CIVIC STYLE VEHICLE TOWED TO BLIN
TOWED BY GOV HI 44
24 DAMAGE YES NO YES NO
REGISTERED OWNER INFO AVERYAC.IA 72135THSIW UNIVERSITY PLACE WA 1.662103 D:2536865584 VEHICLE NO.2
SHADE IN DAGAREA
2
LIABILITY INSURANCE INSURANCE CO PROGRESSIVE 976123305
IN EFFECT &POLICY# t 9TOP 5
veeicLe ❑ ,J—I CITATION# CHARGE tO BOTTOM
Lecnttr YES N`[
25 a ' 6
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
26
M.LEVERTON 2517 WA0171300
PAGE 01 OF
PART A 3000-345-159(R 11/18)
POLIICFETRAFFICN CORRECTION REPORT NO. EG90709
COLLISION REPORT III III III III III 111
1591972 CASE# 26-2514
ADDITIONAL PERSONS INVOLVED(PASSENGERS AND/OR WITNESSES ONLY)
'NAME
(LAST,FIRST MIDDLE INTTIAL)
ADDRESS&PHONE#
SEX' D.O.B. - [----------�
MMDDYYYY
PASSENGER F-1 WITNESS Ej UNIT# SEAT AIRBAG RESTR. EJECT HELMET INJURY NATURE OF INJURIES--�
POS. USE CLASS
'NAME
(LAST FIRS,MIDDLE INITIAL)
ADDRESS&PHONE#
SEX' D.O.B. - L----------�
MMDDYYYY
PASSENGER DWITNESSD UNIT# SEAT AIRBAG RESTR. EJECT HELMET NJURY NATURE OF INJURIES
POS. : USE CLASS ----�
'.NAME
(LAST,FIRST,MIDDLE INITIAL)
ADDRESS&PHONE#
SEX D.O.B. - L----------�
MMDDYYYY
PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET INJURY NATURE OF INJURIES
❑ Q POS. USE CLASS �____ ----j
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.
M.LEVERTON 04-01-26 09:59 AM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST.DET DATED PLACE SIGNED
APPROVED BY DATE
M.LEVERTON 2517 4/1/2026 12:23:33 PM
BADGE OR ID# 2517 ORI# ( WA0171300 TIME POLICE DISPATCHED'; 5:52 AM TIME POLICE ARRIVED 6:15 AM
PART B 3 Do-3mx-,ao(Burls) PAGE 27 OF 47
REPORT No.` EG90709 CASE# 26-2514 O COLLI COLLISION TIME
OF 04/01/26 05:51
COLLI
NARRATIVE
wht/1 gate closed merge left turn blk/2 slowly going around
RTF
Within the city of Renton/King/Wa I responded to a 2 vehicle collision at Garden Ave N and N Landing
Way.
I contacted the driver of unit 1 who told me he was northbound on Garden Ave N and turning into the
"job site" parking lot of the old Fry's lot, but the gate was closed so he started to merge from the
driveway apron back into the roadway where he contacted unit 2. He did not complain of injury and
minor damages did not require a tow truck.
I contacted the driver of unit 2 who told me he was directly behind unit 1. He was familiar with the job
site at this is an area he drive by regularly. He said he saw unit 1 pulling into the job site and partially
blocking the northbound lane. He knew there was a gate there. He said at about 5 mph he
negotiated he way around the back end of unit 1 about the same time unit 1 was merging back into
the roadway where he was contacted by unit 1. He did not complain of injury and minor damages did
not require a tow truck.
Information/Insurance only
I certify (declare) under penalty of perjury under the laws of the State of Washington that the
foregoing is true and correct.
M.Leverton/2517 City of Renton/King/Wa 4/1/2026
PAGE 3 OF 4
REPORT NO. EG90709 CASE# 26-2514 DATE AND TIME i 04/01/26 05:51
OF COLLISION
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