HomeMy WebLinkAbout26-2104 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 5 27c
COLLISION REP FIT 1591971
CASE 26-2104 z
INTERSTATE ❑ CITY STREET ❑ FIRE ❑RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHIC;I F ❑ LOCAL AOENC 4I00 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 3 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# ❑
COLLISION.. 03 - 1-- 2026 1000 17 ❑.= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓
GARDEN AVE N BLOCK NO. e✓ 1000
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ ❑ FEET e S ❑ W e 0 1 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
,/No D:4253878183 1 51
30
6� LAST NAME LANG FIRSTNAME VALERIE MIDDLE P 1 2 31
INITIAL
STREET ❑, 1610710TH ST SE CITY SNOHOMISH ST WA 2jp, 982904324 z=
NEW ADDRESS
]❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
INTERLOCK YES[:]NO INTERLOCKYEs NO YES R NO
8❑ LRIIVER #
ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 H USE 2 1 CLASS NATURE OF INJURIES 2❑
3
10 9❑ P1 ATE 14 CTM9356 STATE WA u N# 1 HGCY2F53PA011424
TRAILER STATE TRAILER STATE
11 0 0 PLATE# PLATE# FROM ro
TRLR. YRLR. 5 1 33
12 0 0 VIN#' VIN#
:: FROM TO
VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE Q 0 34
13 2 2023 HOND ACCOR DAMAGE YES NO YES[:] No✓
REGISTERED OWNER INFO VALERIE LAN.1111110TH ST SE SNOHOMISH WA 98290 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
14 LIABILITY INSURANCE INSURANCE CO GEICO 6119 09 34 63
IN EFFECT &POLICY# 9TOP
VEHICLe CHARGE
5 36
LEGALLY
YES❑NO❑ CITATION# 1 o BOTTOM
15❑ NDING 8 6
MOTOR PEDAL- ❑ PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT 02 VEHICLE ❑ CYCLE ❑ OWNER ❑ YES 1/ NO D:2063041060
16 a
LAST NAME MURPHY FIRST NAME JOHN MIDDLE I R
INITIAL
17❑ STREET ❑', 19635 MILITARY RD S CITY' SEATAC ST WA ZIP 981885453 37
NEW ADDRESS ❑
18� CDL IGNITION REQUIRED IGNITION PtR-E-S1ENT MEDICALt-T�RANSPORTED 38
INTERLOCKYES�NOR INTERLOCK YEs I I NoF YES t l NO❑
19 DRIVER'S STATE WA SEX M I D.O.B. 05 _ 30 _ 1970 0 39
LICENSE# MMDDYY
HELMET {NJURY NATURE OF INJURIES 40
20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 USE 2 CLASS 1 ❑
21❑ LICENSE BMN4244 TATe WA VINt USE
❑ 41
PLATE#
42
22❑ PILER LATE# STATE pLATE# STATE
23❑ 43
TRLR RLR
UIN#. 'IN#.
VEH YEAR 2007 MAKE CADI MODEL ESCALAD STYLE VEHICLETOWED TO BLIN TOWEDBY GOV HI 44
L4❑ DAMAGE YES NO YES NO
REGISTERED OWNER INFO VIP WAXING AND CARPET CLEANIN 19635 MILITARY RD S SEATACWA98188 VEHICLE NO.2
SHADE IN DAMAGEbAREA
2 3 Cd
LIABILITY
INSURANCE INSU&PORGY#E CO TRUCORDIA NPP8640422IN 1GV'""LE
TOP❑ ,J� CITATION# CHARGE OTTOM
LEGALLY YES N`L J
25
7CA
NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
J
26LAN 12007 WA0171300
PART A PAGE 01 OF
3000-345-159 fR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EG91288
COLLISION REPORT III III III III III 111
1591972 CASE# 26-2104
ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY)
NAME MIDDLE INITIAL) SHAW ATTIKUS J
(I.P.ST FIRST,
ADDRESS&PHONE#
17600 134TH AVE SE APT D207 RENTON WA 980586835 SEX M MMDOYyry 05 - 13 - 2008
PASSENGER RV WITNESS❑ UNIT# 2 POS 3 AIRBAG;2 RESTR. 4 EJECT ? 1 HE
USE
ET 2 INJUSS
RY( ,1 NATURE OF INJURIES
NAME
(LAST,FIRST,MIDDLE INITIAL)
ADDRESS&PHONE# DOB
SEX MMDDYYYY
PASSENGER ❑WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET NJURY NATURE OF INJURIES
POS. USE CLASS
NAME
(LAST FIRST 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.
C.CATALAN 03-19-26 10:24 AM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
C.JACOBS 1953 1 4/2/2026 1:30:25 PM
BADGE OR ID# 1Y007 ORI# WA0171300 TIME POLICE DISPATCHED 10:02 AM TIME POLICE ARRIVED',10:32 AM
PART I PAGE IT]OF 4�
REPORT NO. EG91288 CASE# 26-2104 OF COLLISION
03/17/26 10:00
OF CbLLI510N
NARRATIVE
On March 17, 2026, at approximately 1000 hours, I was dispatched to a two-vehicle collision at
Lowes, 1000 Garden Ave N, within the City Limits of Renton, County of King, State of Washington.
Upon my arrival, 1 confirmed there were no complaints of injury requiring immediate medical response
at the time of report. There, I was able to collect each involved party's information and independent
summary of the events leading up to the collision.
The driver of Unit#1, identified as Valerie Lang, said he was traveling northbound through the
parking lot of Lowes. While approaching Unit#2 which was parked closer to the Lowes building,
Valerie failed to see Unit#2 reversing. Unit#1 and Unit#2 collided in lane parking lot aisle causing
substantial damage to the front passenger side fender, doors, and rear quarter panel of Unit#1.
The driver of Unit#2, identified as John Murphy, said he was accompanied by his front passenger
and was slowly reversing out of a parking stall. As he backed, Unit 1 struck his rear bumper and tow
hitch, causing substantial damage.
Officer Chang reviewed the properties surveillance footage and told me that Unit#1 was traveling too
fast through the parking lot. He said Unit#2 was "crawling" (reversing) when the collision occurred.
Officer Chang told me it was obvious that Unit#1 was traveling too fast.
Since this collision occurred in a parking lot, this will only be an informational report only. No
infractions were given.
Both Unit#1 and Unit#2 were driven away without further issues. An exchange of information was
provided for all involved parties.
I certify (declare) under penalty of perjury under the laws of the State of Washington that the
foregoing is true and correct.
C. Catalan 03/19/2026 Renton
PAGE 3 OF 4
REPORT NO. EG91288 CASE# ' 26-2104 DATE AND TIME 03/17/26 10:00
OF COLLISION
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