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HomeMy WebLinkAbout26-1925 IT si " II IIIII III IIIII II IIII IIIII I . 27c REPORT NO EG91279OLCERA COLLISION REPORT 1591971 INTERSTATE ❑ CITY STREET FIRE I CASE# 26-1925 2 RESULTED STOLENSTATE ROUTE OTHER VEHICLE LOCALANG 4100 3 HIT&RUN CODING COUNTY RD PRIVATE WAY INVOLVED 2 TOTAL#OF OBJECT 1 s 28 TRIBAL UNITS 03 STRUCK ❑ RESERVATION : 1 1 2 3� M M D D Y Y Y Y TIME(2400) COUNTY# MILES CITY# DATE OF N E IN eDL�ISION' 03 - 11 - 2026 1212 17 =.= S 8 W❑ OF M 1070 a 4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑ BLOCK NO. BENSON DR S 4a❑ MILE POST ❑ DISTANCE OF(REFERENCE OR CROSS STREET) 5 MILES 1.1 FEET e S 8 W e S 16TH ST 0 1 29 MOTOR PEDAL- DAM AG THRESHOLD MET PHONE UNIT 01 VEHICLE ❑ CYCLE ❑ YEs Vl No D:5592147418 0 7 30 6 LAST NAME TRAN FIRST NAME RICHARD MIDDLE K 1 1 2 31 INITIAL STREET ] 12631 SE 165TH ST CITY; RENTON ST WA ZIP; 980585547 2 NEW ADDRESS 7 CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED. 3 INTERLOCK YES ND INTERLOCKVEs Na YES NOD 8 DCIENSE# STATE WA SEXI M MMDDYY' 04 - 20 - 2007 1 2 32 9 ON DUTY STATUS' AIRBAG 2 RESTR 4 EJECT 1 N USEET CLASSY 1 NATURE of INJURIES 2❑ LICENSE, CKF4869 STATE WA V JTHCK262975008931 3 10� PI ATP rt IN# TRAILER STATE TRAILER STATE 11 4 0 PLATE# PLATE# FROM To TRLR TRLR 5 1 33 12 0 Q VIN#' VIN# FROM TO VT VEHICLE 13 2 VEH.YEAR 2007 MAKE LEXS MODEL IS STYLE VEHICLE TO YED NO IyS46LIN diW9YMEYER GESr`] - 9 9 34 DAMAGE IIII._IIII I_I REGISTERED OWNER INFO TAI TRAN 12631 SE 165TH ST RENTON WA 98058 VEHICLE NO. 1 SHADE IN DAMAGED AREA 35 3 14 LIABILITY INSURANCE❑ INSURANCE CO AMERICAN FAM BX13842787 4 IN EFFECT &POLICY# 9TOP _ srnNowc ❑ ❑ 6AO095367 CHARGE FOLLOW VEHICLE TOO CLOSELY t a oorrob z 36 Yes NO CITATION# 15❑ UNIT 02 MGTOR PEDAL- ❑ PEDESTRIAN1:1 PROPERTY DAM THR OLD MET PHONE VEHICLE CYCLE CIWNFR 16� LAST NAME RAMOS FIRST NAME YOHANA MIDDLE' INITIAL 17 F1 STREET ❑❑ 4338 S CEDAR ST APT 203 CITY TACOMA ST, yyq ZIP 984096611 37 NEW ADDRESS 18❑ CDL IGNITION REQUIRED (GNITION PRESENT MEDICAL TRANSPORTED ❑ 38 INTERLOCKYES No INTERLOCK YES NO vEs NO 19 DRIVER'S STATE WA SEX,F I D.O.B. 1 09 01 1990 � 39 LICENSE# MMDDYY — 20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 7 HELMET INJURY NATURE OF INJURIES ❑ 40 USE CLASS NECK 21 LICENSE CUA0654 TATe WA VIN# 5YFBU4EE8DP154847 41 22❑ [TILER TRAILER PLATE# STATE PLATE# STATE 42 23 TRLR RLR 43 UIN#. 'IN# VEH.YEAR 201$ MAKE TOYT MODEL COROLL STYLE VEHICLE TOWED TO BLIN TOWED BY GOV HI 44 24❑ DAMAGE YES NO VES NO REGISTERED OWNER INFO YOHANA RAMOS 4338 S CEDAR ST APT 203 TACOMA WA 984096611 D:7702469227 VEHICLE NO.2 SHADE DAMAGEAREA 3 LIABILITY INSURANCE INSURANCE CO NEW SOUTH 2O30770594 IN EFFECT &POLICY# 9TOP VEHICLE ❑ CITATION11 CHARGE t080TTOM L'—LY YES NN"Lv=I1 25 OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY J 26 M.LEVERTON 2517 WA0171300 ❑ PAGE 01 OF PART A 3000-345-189(R 11/18) STATE OF POLICETRAFFICN CORRECTION REPORT NO. EG91279 COLLISION REPORT III III III III III 111 1591972 CASE# 26-1925 ADDITIONAL PERSONS INVOLVED(PASSENGERS AND/OR WITNESSES ONLY) '.NAME (LAST,FIRST,MIDDLE INITIAL) ADDRESS&PHONE# SEXi D.O.B. — MMDDYYYY PASSENGERQ WITNESS� UNIT SEAT AIRBAG RESTR. EJECT ; HELMET INJURY NATURE OF INJURIES POS. ' USE GLASS 1 ----� :NAME (LAST FIRST MIDDLE INITIAL) ADDRESS&PHONE# SEX D.O.B. — MMDDYYYY PASSENGER❑WITNESS UNIT# : SEAT AIRBAG RESTR. EJECT HELMET INJURY: NATURECFINJURIES 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. M.LEVERTON 03-11-26 02:46 PM INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST.DET DATED PLAGE SIGNED APPROVED BY DATE C.JACOBS 1953 4/2/2026 1:21:17 PM BADGE OR ID# ; 2517 ORI# WA0171300 TIME POLICE DISPATCHED'; 12:13 PM TIME POLICE ARRIVED i 12:15 PM PAST B 3 Do-3mx—attar(t 1Mff) PAGE 2�OF REPORT NO. EG91279 CASE# 26-1925 O OF COLLISION TIME 03/11/26 12:12 NARRATIVE blk/3 rear blu/2 stop blk/1 stop lane 1 nb CC Within the city limits of Renton/King/Wa I responded to a 3 car blocking crash at Benson Dr S at S 16th St. When I arrived I located 3 vehicle in lane one facing/blocking northbound. I contacted the driver of unit 1 ID'd by his picture WADL. He told me traffic was stopping/had stopped in front of him and although he applied the brake pedal hard he slid into unit 2 shoving her into unit 3. He told me he thought he brake pedal may have not been working. He gave me permission to check, and his pedal seems to be fine. When I checked his brake pedal there was a large black water bottle on the floor. I asked if this impeded he braking ability and he told me no. I contacted the driver of unit 2 who had just stopped for traffic in front of her when she was hit by unit 1 and shoved into unit 3. She did complain of injury and was checked on scene by Renton Fire. She was not transported from the scene. Damages to her vehicle did not require a tow truck. I contacted the driver of unit 3 who was stopped for traffic when the chain reaction collision took place. He did complain of injury. He was checked and released by Renton Fire onscene. Damages to his vehicle did not require a tow truck. I cited unit 1 Ref RCW 46.61.145 Following too close causing a 3 vehicle injury crash via complaint. 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 3/11/2026 PAGE 3 OF 5 SUPPLEMENTAL REPORT No. EG91279 POLICE TRAFFIC 1 1 8 27 µ ^'� COLLISION REPORT CASE# 26-1925 t113197 1 COMMERCIAL MOTOR CARRIER INTERSTATE INTRASTATE UNIT# USDOT ICC# VEHICLE TYPE CARGO BODY TYPE 2 ❑ 1 28 CARRIER NAME 3 CARRIER L ADDRESS CITY ST ZIP 4 ❑ NAME # PLACARD GWUR NAME IF NO NUMBER SOURCE AXLES + 4a ❑ ADDITIONAL UNITS MOTOR PEDAL- PROPERTY DAMAGE THRESHOLD MET PHONE 5 ❑ UNIT# 3 VEHICLE ( CYCLE ❑ PEDESTRIAN OWNER ❑'. YES NO 0 7 29 I NNITIAITIAL E LAST NAME NAGRA FIRST NAME MANJINDER I ' S STREET 01 30 NEW ADnRFj 17320 126TH AVENUE CT E CITY PUYALLUP ST WA II ZIP 983746822 6 [2 PRESENT MEDICALTANSPORTED. 1 1 2 31 CDL A- REQUIRED {GNiTION INTERLOCK Yes NO INTERLOCK YES NO vEs N.. L DRIVER'S WA SEX M MDDY 10 7 LICENSE; MMDDvv - 18 - 1985 HELMET INJURY NATURE OF INJURIES ON DUTY STATUS AIRBAG 2 RESTR. 4 EJECT 1 USE CLASS `7 NECK LICENSE I CGZ9426 TAT WA VIN 7SAYGAEEOPF766964 32 PLATE# 9 Fq] STATE TRAILER TRAILER L PLATE# PLATE# STATE 0 10 ❑ TRLR TRLR VIN.# VIN#. 11 0 0 VEIL YEAR2023 MAKE TESL MODELMODEL Y STYLE VEHICLE TOWE E T ABLIN TOWED BY GovT vEHICI F FROM To DAMAGE YES NO ✓ YES NO REGISTERED OWNER INFOGURBACHAN MAAN 17320126TH AVENUE CT E PUYALLUPWA98374 SHADE IN DAMAGED AREA 9 9 33 12 z 3 4 FROM TO INSURANCE CO LIABILITY INSURANCE ALLSTATE 864 264 021 IN EFFECT &POLICY# I 1:0i f.-- m 34 13 ❑ vewc�e YES NO[jj CITATION# CHARGE 1080TTOM ecauv s-rnNoiNc � MOTOR PEDAL_ ' 1:1PROPERTY : DAMAGE THRESHOLD MET PHONE 35 14 ❑ UNIT# VEHICLE CYCLE PEDESTRIAN OWNER YES NO 36 15 LAST NAME FIRST NAME NIT AL 16 ❑ STREET �' CITY ST' ZIP NEW ADDRESS CDL IGNITION REQUIRED IGNITION PRESENT MEDICALTANSPORTED INTERLOCK YES NO INTERLOCK YES1:1 NO .YES NO ❑ 17 37 LICENSE#RIVERS —F SEX MD.r30.6 — l 18 ❑ ❑ HELMET 'INJURY NATURE OF INJURIES 38 ON DUTY STATUS' AIRBAG RESTR. EJECT USE CLASS. 19 ❑ ❑ 39 LICENSE TAT AN# PLATE# 20 TRAILER+ TRAILER 40 PLATE#. STATE PLATE# - STATE ❑ 21 ❑ TRLR TRLR 41 VIN# VIN#Y 42 22 VEH.YEAR MAKE I MODEL I STYLE VEHICLE TOWED DUE T SABLIN TOWED BY GOVT.VEHICLE DAMAGE YES NO YES NO 23 REGISTERED OWNER INFO. SHADE IN DAMAC ED AREA 43 2 3 4 LIABILITY INSURANCE INSURANCE CO IN EFFECT I &POLICY# .. t. E 44 24 YES❑ NO CITATION# CHARGE K-99 STF_ G 3 3 G 1 CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT. M.LEVERTON 03-11-26 02:46 PM 25 INVESTIGATING OFFICER'S SIGNATURE OFFICER'S PHONE UNIT OR DIST DET DATED: PLACE SIGNED BADGE 1 APPROVED 1 �ORIWA0171300 A 2122 PAGE 2517 OF ORID# # 3000-345-013(R 11t18) REPORT NO. EG91279 CASE# 26-1925 DATE AND TIME 03/11/26 12:12 OF COLLISION a s i 1\ i sl t Y e PAGE 5 OF 5