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HomeMy WebLinkAbout26-2535 POLICETRAFF'c" III !�� I IIIllI111IN II II I REPORT NO. EG91295 170 27 COLLISION REP FIT 1591971 CASE 26-2535 z INTERSTATE ❑ CITY STREET FIRE ❑RESULTED 1 STOLEN STATE ROUTE ❑ OTHER ❑ VFHIC;I F ❑ LOCAL AOENC 4900 3 HIT&RUN CODING COUNTY RD PRIVATE WAY INVOLVED 2 3 TOTAL#OF OBJECT 1 1 8 28 TRIBAL UNITS 03 STRUCK RESERVATION z 3❑ DATE of M M D D Y Y Y Y TIME(2400) COUNTY# MILES N E IN CITY# ❑ COLLISION.. 04 - 01 - 2026 1417 17 ❑.❑ S 8 W H OF e 1070 3 4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓ DUVALL AVE NE BLOCK NO. e✓ 450 4a❑ MILEPOST DISTANCE OF(REFERENCE OR CROSS STREET) 5❑ ❑ FEET e S ❑ W e 2 0 29 MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE UNIT 01 VEHICLE ❑ CYCLE El ✓NO D:4259192297 0 11 30 6� LAST NAME ROS FIRSTNAME SREYMOM MIDDLE N 1 2 31 INITIAL STREET ❑, 3921 NE 11TH PL CITY RENTON ST WA ZIP 980563538 z NEW ADDRESS 7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3 iNTERLOCKYEs NO INTERLOCKYEs NO YES R NO 8❑ LRIIVER # ON DUTY❑ STATUS AIRBAG 6 RESTR 4 EJECT 1 H USEET ICNLJU:SY 0 NATURE OF INJURIES z❑ 3 10 9❑ PI ATE 14 AWR3227 STATE WA VIN# 1 HGCR2F86FA091873 TRAILER STATE TRAILER STATE 11 3 5 PLATE# PLATE# FROM TO FT -R TPILF1 1 5 33 12 3 5 VIN#j VIN# FROM TO VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN T /g[ GOVT.VEHICLE 1 $ 34 13 201$ HOND ACCOR DAMAGE YES NOBS YES : No✓ REGISTERED OWNER INFO SREYMOM ROS 3921 NE 11TH PL RENTON WA 980563538 D:4259192297 VEHICLE NO. 1 ❑ SHADE IN DAMAGED AREA 35 3 4 14 LIABILITY INSURANCE INSURANCE CO STATE FARM 402 544 OC 28478 IN EFFECT &POLICY# 9TOP ❑ LEGALLY CHARGE 1 5 36 15 2 YEs No clTAnoN# IMPROPER LANE USAGE o aorrom MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE UNIT 02 VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES V NO D:2067954585 16 a LAST NAME NELSON FIRST NAME KOLEDEN MIDDLE I T INITIAL 17❑ STREET ❑', 23501 112TH AVE SE APT B101 CITY KENT ST WA ZIP 980313422 37 NEW ADDRESS ❑ 18� CDL ., IGNITION REQUIRED IGNITION PtR-E-S1ENT MEDICAL TRANSPORTED 38 INTERLOCKYES�NOR INTERLOCK YEs I I NOF YES t l No❑ 19[ LDI IVE STATE WA SEX DDY M M D.C.B. 07 1 25]_ 2003 0 39 WELMET INJURY1 NATURE OF INJURIES 40 20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 USE CLASS ❑ 21❑ LICENSE D94557D TATe I WA VIN1t 1FT8W3BT5NEE46603 ❑ 41 PLATE# ❑ 42 22❑ TRAILER 62O71AA STATE WA TRAILER STATE PLATE# PLATE# 43 23❑ VIN# 4ZEDT1220H1137972 IN VEH YEAR 2022 MAKE FORD MODEL F350 STYLE VEHICLETOWED TO BLIN TOWEDBY GOV HI 44 24❑ DAMAGE YES NO YES NO REGISTERED OWNER INFO KOLEDEN NELSON 23501112TH AVE SEAPT B101 KENTWA980313422 D:2067954585 VEHICLE NO.2 SHADEDAMAGEDAREA 3 4 LIABILITY INSURANCE INSU&PORGY#E CO PROGRESSIVE 937688929IN I STOP 5 'EwCLE ❑ Nu J ,J� CITATION# CHARGE LEGAL 25 to BOTTOM LY YES s � a OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY J 26 M.LEVERTON 2517 WA0171300 PART A PAGE 01 OF 3000-345-159 OR 11/181 STATE OF POLICETRAFFICN CORRECTION REPORT NO. EG91295 COLLISION REPORT III III III III III 111 1591972 CASE# 26-2535 ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY) NAME (LAST FIRST,MIDDLE INITIAL) ADDRESS&PHONE# SEX D.O.B. - - MMDDYYYY. PASSENGER❑WITNESS UNIT# SEAT AIRBAG RESTR. EJECT ' HELMET INJURY NATURE OF INJURIES POS. USE CLASS NAME '(LAST,FIRST MIDDLE INITIAL) ADDRESS&PHONE# D D B SEX MMDDYYYY PASSENGER ❑WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET INJURY NATURE OF INJURIES POS. USE CLASS NAME (LAST FIR57 MIDDLE INITIAL) AppRESS R 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. M.LEVERTON 04-02-26 07:27 AM INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED APPROVED BY E DAT C.JACOBS 1953 4/2/2026 2:04:34 PM BADGE OR ID# 2517 OR]#' WA0171300 TIME POLICE DISPATCHED! 2:18 Pry TIME POLICE ARRIVED',2:20 PM PART I PAGE IT]OF 5� REPORT NO. EG91295 CASE# 26-2535 OF COLLISION 04/01/26 14:17 OF CbLLI510N NARRATIVE 2/wht-trlr lane 2 1 blk/lane one into lane 2 unit 2 rotates now facing nb continues and hits unit 3 blue lane 2 CC Within the city limits of Renton/King/Wa I responded to a 3 vehicle crash at near the 450 block of Duvall Ave NE. I contacted the driver of unit 2 who told me he was southbound lane 2 on Duvall Ave NE when unit 1 in lane one going the same direction made a sudden lane change across the front of his truck and trailer striking his front passenger bumper and fender. He said unit 1 rotated around the front of his truck. Unit 1 told me he tried to brake and avoid unit 1 but she was so close that contact was inevitable. Unit 1 did not complain of injury and damages did not require a tow truck. I contacted the driver of unit 1 ID'd by her matching picture WADL. She told me she signaled and changed lanes but in the same space/area of unit 2. She did not provide any additional information and at this point was being checked by Renton Fire. Damages did require a tow truck. I contacted the driver of unit 3 who told me he was behind unit 2 and although he applied his brakes to avoid unit 1-unit 2 collision he told me that unit 1 after spinning out post contact with unit 2 continued north and drove into the driver side of his truck. He did complain of injury and was checked by Renton Fire. Damages did not require a tow truck. I cited unit 1 via complaint Ref RCW 46.61.140 improper lane use/improper lane change causing a 3 vehicle injury 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 4/2/2026 PAGE 3 OF 5 SUPPLEMENTAL REPORT NO. EG91 2955 r`) POLICE TRAFFIC 1 1 8 27 COLLISION REPORT CASE# 26-2535 1 COMMERCIAL MOTOR CARRIER INTERSTATE INTRASTATE G UNIT'# USDOT ICC# VEHICLE TYPE CARGO BODY ;TYPE 2 ❑ 1 28 CARRIER NAME 3 CARRIER ADDRESS ` CITY ST ZIP—1 I ' 4 ❑ NAME # PLACARD: :❑ GWVR NAME IF NO NUMBER SOURCE AXLES + 4a ❑ ADDITIONAL UNITS MOTOR PEDAL- PROPERTY DAMAGE THRESHOLD MET PHONE 5 ❑ UNIT# 3 VEHICLE t_"J CYCLE _) PEDESTRIAN � OWNER � YES� NO D:2064452774 0 1 Zg LAST NAME MICUS FIRST NAME : JACKSON MIDDLE'.. M INITIAL STREET 30 NEW AnDRFrtP 14004 144TH AVE SE CITY RENTON ST WA ZIP 980595530 6 CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TAN5PORTED 1 1 2 31 INTERLOCK YEs No NTERLOCK YES�NO� YEs N DRIVER'S LICENSE STATE I WA SEX M MMDDYYv 10 - 31 - 2008 7 HELMET :INJURY' NATURE OF INJURIES ON DUTY STATUS AIRBAG 2 RESTR. 4 EJECT 1 USE CLASS 7 NECK 8 ❑ 32 LICENSE BYL4308 TAr WA VIN# 1GKEK13K1SJ757249 PLATE# 9 9] TRAILER TRAILER PLATE# STATE PLATE# STATE 10 ❑ TRLR TRLR VIN.#. VIN.#. 11 3 5 VEH.YEAR199 Jr MAKE GMC I MODEL YUKON I STYLE VEHICLE TOWS E T SABLIN TOWED BY anvi vEH1Ci P FROM TO DAMAGE YES NO YES NO 33 REGISTERED OWNER INFORICHARD MICUS 14004144TH AVE SE RENTON WA 98059 1 5 12 SHADE IN DAMAGED AREA 7 j 4 FROM TO LIABILITY INSURANCE INSURANCE CO COUNTRY P46A4228927 q"i"Olx IN EFFECT &POLICY# 1 VEHICLE 34 CITATION# CHARGE 10 BOTTUM 13 LEG LEY YES NO STANDING❑ dRD PROPERTY Y ❑ 35GNHROE VEHICLE CYCLE OWNER O14 UNIT� j PHONE 15 LAST NAME FIRST NAME INITIAL 36 MIDDLE ❑ STREET"[-] 16 NEW nnR CITY ST ZIP CDL IGNITION REdUiRED IGNITtGN PRESENT MEDICALTANSPORTED NTERLOCK YES No INTERLOCK YEs NO YEs NO El 17 37 LICENSE# STATE SEX MMDDDYBYY -� II 18 ❑ ON DUTY� STATUS AIRBAG RESTR. ; EJECT HELMET INJURY NATURE of 1NJURIEs 38 USE (CLASS 19 ❑ 39 LICENSE rnr VIN# PLATE# 20 ❑ TRAILER' STATE TRAILER STATE ❑ 40 PLATE#< PLATE# 21 ❑ TRLR TRLR 41 VIN# YIN#i 42 22 VEH.YEAR MAKE I MODEL STYLE I VEHICLE TO DUET SABLIN TOWED BY GOVT.VEHICLE DAMAGE YES NO YES NO 23 REGISTERED OWNER INFO_ SHADE IN DAMAGED AREA 43 3 4 71 LIABILITY INSURANCE INSURANCE CO ' VINE EFFECT &POLICY# i 970P - 4 E:l 44 24 VEHICLE YES❑ NO❑ CITATION# CHARGE iq 60TiOM LEGALLv STANDING 8 7 6 1 CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT. M.LEVERTON 04-02-26 07:27 AM 25 INVESTIGATING OFFICER'S SIGNATURE OFFICER'S PHONE UNIT OR DIST DET DATED: PLACE SIGNED APPROVED BY DATE 26 OI BADGE 2517 O#I WA0171300 JACOBS 4/2/2026 PAGE F41 OF F 3000-345-013(R 11118) REPORT NO. EG91295 CASE# ' 26-2535 DATE AND TIME 04/01/26 14:17 OF COLLISION t' a. k �v �y o- � u N, i t x. PAGE 5 OF 5