HomeMy WebLinkAbout26-1253 iiTFiNII IIIII III IIIII II IIII IIIII I . 27c REPORT NO EG91267oc� RA
COLLISION REPORT 1591971
ASE# 26-1253 2
INTERSTATE CITY STREET FIRE ❑
RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VEHICLE ❑ LOL`CO A`NG 4200 3[--�
COUNTY RD INVOLVED
CODING
2❑ TOTAL 1
PRIVATE WAY
TRIBAL 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' 02 - 13 - 2026 0758 17 =.= S 8 W E IN OF M 1070 a
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION �✓ NON INTERSECTION ❑
BLOCK NO.
MEADOW AVE N
4a❑ MILE POST
❑ DISTANCE OF(REFERENCE OR CROSS STREET)
5 �. FEET e S 8 W e N 4TH ST
0 4 29
MOTOR PEDAL- DAM AG THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE' ❑ YES ✓NO D:2067004590 0 1 30
6 LAST NAME TRBAS FIRST NAME JOSEPH MIDDLE C 1 1 2 31
INITIAL
STREET ❑' 4204 175TH ST SW CITY LYNNWOOD ST WA ZIP 980377442 2
NEW ADDRESS
7 CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
INTERLOCKves N INTERLOCKYEs NO YEs Nb
8 DCIENS # STATE WA SEX M MMOCSYY' 03 - 14 - 1984 1 2 32
9 ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 H USEELMET CLASS ,1 NAruRE of NJURIES 2
10 LI ENSE' ASX1721 STATE WA vN# 1GNFK26309R102982 3
11[-j— TRAILER STATE TRAILER ,STATE
11 2 5 PLATE# PLATE# FROM TO
rRLR TRLR 5 7 33
12 3 0 VIN# VIN#
( FROM TO
VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO NO
7 v GOVT VEHICLE 3 7 34
13 1 2009 CHEV SUBUR DAMAGE YES ONO MEYER YEs❑ No
REGISTERED OWNER INFO ,/OSECHITO TRIAS4204175THSTSW LYNNWOOD WA 98037 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
14 LIABILITY INSURANCE[—,/] INSURANCE CO SAME. 3 4
IN EFFECT &POLICY# 4TOP _
srgNOLNG ❑ CITATION# 6AO095350 CHARGE INATTENTIVE DRIVING s o ooTrob 36
ves NO
15
MOTOR PEDAL- PROPERTY DAM THR OLD MET PHONE
UNIT(�2 Q ❑ PEDESTRIAN ❑ D:2067791428
VEHICLE CYCLE OWNER NO
16�
LAST NAME KUMARI FIRST NAME KULVINDER MIDDLE' N
INITIAL
❑
17 F1 STREET' 2232 SE 3RD ST CITY RENTON ST, W 37
q ZIP 980568858
NEW ADDRESS❑
18❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICALTRANSPDRTED. ❑ 38
INTERLOCKYEs No fNTERLOCK YES No vEs ND
19 DRIVER'S STATE WA SEXI F I D.O.E. 03 03 1975 39
LICENSE# MMDDYY -
HELMET INJURY' NATURE OF INJURIES 40
20❑ ON DUTY STATUS' AIRBAG 2 RESTR 4 EJECT 1 USE CLASS 1 ❑
21 LICENSE I PLATE# BQG4399 rare WA vIN# 2T1BU4EE8AC411372 41
22❑ PLATE# STATE PATE# STATE ❑ 42
23 TRLR kRLR 43
UIN#. 'IN#.
VEH.YEAR 2010 MAKE TOYT MODEL COROLL STYLE VEHICLE TOWED 70 BLIN TOWED BY GOV HI 44
24 DAMAGE vEs�/ No GENE MEYER
REGISTERED OWNER INFO KULVINDER KUMARI 2232 SE 3RD ST RENTON WA 98056 VEHICLE NO.2
SHADE IN DAMAGED AREA
2 3 4
LIABILITY INSURANCE INSURANCE CO SAME.
IN EFFECT &POLICY# t STOP
1-1— YES❑ N J
,.I—I CITATION# CHARGE to BOTTOM
E—LY
25 rFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# JAGENCY
26
LEVERTON 2517 WA0171300
PAGE 01 OF
PART A 3000-345-159(R 11/18)
POLIICFETRAFFICN CORRECTION REPORT NO. EG91267
COLLISION REPORT III III III III III 111
1591972 CASE# 26-1253
ADDITIONAL PERSONS INVOLVED(PASSENGERS AND/OR WITNESSES ONLY)
'NAME
(LAST,FIRST MIDDLE INITIAL)
ADDRESS&PHONE#
SEX' D.O.B. - [----------�
MMDDYYYY
PASSENGER F-1 WITNESS El 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
tan/1 It blu/2 wb
CC
Within the city limits of Renton/King/Wa I responded to a 2 vehicle blocking crash near the
intersection of N 4th St at Meadow Ave N.
I located and contacted the driver of unit 2 facing northbound on Garden Ave N blocking that lane.
She told me she was west on N 4th St in lane 3 when unit 1 turned left from Meadow Ave N and into
the side of her car. She did not complain of injury and damages did require a tow truck.
I contacted the driver of unit 1 ID'd by matching picture WADL. Unit 1 told me he wasnt paying close
enough attention to his merge/left turn and made contact with unit 2 as he was passing his location.
He did not complain of injury and damages required a tow truck.
I cited unit 1 via complaint ref RMC 10-12-25 Driver Inattention 2 vehicle crash.
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 2/17/2026
I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT.
M.LEVERTON 02-17-26 01:33 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST.DET DATED PLACE SIGNED
APPROVED BY E
DAT
C.JACOBS 1953 41212026 1:15:26 PM
BADGE OR ID# Y517 ORI#' f WA0171300 TIME POLICE DISPATCHED'; 7:58 AM TIME POLICE ARRIVED 7:59 AM
PART B 3aaa-345-,aa(R11Y1s) PAGE 27OF 37
REPORT NO. EG91267 CASE# 26-1253 DATE AND TIME 02/13/26 07:58
OF COLLISION
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