HomeMy WebLinkAbout26-2583 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 0 27c
COLLISION REP FIT 1591971
CASE 26-2583 z
INTERSTATE ❑ CITY STREET FIRE ❑RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHIr.I F ❑ LOCAL AOENC 4200 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 1 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# ❑
cawsloN 04 - 1-- 2026 1004 17 ❑.= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓
SUNSET BLVD N BLOCK NO. e✓ 200
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:2068175527 0 7 30
6� LAST NAME DURHAM FIRSTNAME RENATE MIDDLE A 1 1 2 31
INITIAL
STREET ❑, 403 RAINIER AVE CITY ENUMCLAW ST I WA 2jp, 980223435 z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
iNTERLOCKYEs NO INTERLOCKYEs NO YES NO
8❑ LRIIVER #
ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 H USEET ICNLJAURY 1 NATURE OF INJURIES z❑
3
10 1❑ P1 ATNES# C24770G sTAr WAv N# 1 FTFX1 CF2GKE32728
0 TRAILER STATE TRAILER STATE
11 3 0 PLATE# PLATE# FROM TO
FT -R TPILF1 1 5 33
12 0 0 VIN#' VIN#
FROM TO
VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE J 9 34
13 2 2016 FORD F150 DAMAGE YES NO YES[:] No✓
REGISTERED OWNER INFO BOWENSCARFF FORD-LINCOLN 1157 CENTRAL AVE N KENT WA98032 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
14 LIABILI INSURANCE INSURANCE CO SAME. 3 4
IN EFFECT &POLICY# 9TOP
VErIICLE CHARGE 5 36
LEGALLY Yes❑NO❑ CITATION# 10 BOTTOM
15❑ �STA""
G 8 6
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES NO 1/ D:2533357813
16 a
LAST NAME TRAN FIRST NAME BANG MIDDLE M
INITIAL
17❑ STREET ❑', 2910 SE 3RD CT CITY' RENTON ST WA ZIP 980565817 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 DRIVER'S STATE WA SEX M D.C... 04 10 _ 1970 39
LICENSE# MMDDYY
WELMET INJURY1 NATURE OF INJURIES 40
20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 USE CLASS ❑
21❑ LICENSE I C78740K TAre WA vIN1i 3TMLU4EN0FM164996
❑ 41
PLATE#
42
22❑ PILER LATE# STATE pLATE# STATE
23❑ UIN#. 43
TRLR RLR
'IN#.
VEH YEAR 2015 MAKE TOYT MODEL TACOMA STYLE VEHICLETOWED TO BLIN TOWEDBY GOV HI 44
24❑ DAMAGE YES NO YES NO
REGISTERED OWNER INFO BANG TRAN2910 SE3RD CT RENTON WA 980565817 D:2533357813 VEHICLE NO.2
SHADE IN DAMAGED AREA
2 3 4
LIABILITY
INSURANCE INSU&PORGY#E CO ALLSTATE 954 015 441IN 1 GD
VE""LE CITATION# CHARGELEGAL25
LY YES Nu
❑ s e
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
J
26
M.LEVERTON 2517 WA0171300
PART A PAGE 01 OF C7
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EG91595
COLLISION REPORT III III III III III 111
1591972 CASE# 26-2583
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'
lan2 2 sb gry 2 stop wht/1 rear
RTF
Information/Insurance only
Within the city limits of Renton/King/Wa I responded to a 2 vehicle collision at about the 200 block of
Sunset Blvd N.
I contacted the driver of unit 2 who told me he was stopped in the middle lane southbound Sunset
Blvd N when he was hit from behind by unit 1. He did not complain of injury and the minor damages
did not require a tow truck.
I contacted the driver of unit 1 who told she was approaching the rear of unit 2 and could see other
traffic moving and drove into the back of unit 2. who was still stopped . She did not complain of injury
and the 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 4/3/2026
I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT.
M.LEVERTON 04-03-26 10:41 AM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY E
DAT
M.LEVERTON 2517 4/3/2026 11:29:01 AM
BADGE OR ID# 2517 ORI# WA0171300 TIME POLICE DISPATCHED 10:05 AM TIME POLICE ARRIVED 10:13 AM
PART I PAGE IT]OF 3�
REPORT NO. EG91595 CASE# ' 26-2583 DATE AND TIME 04/03/26 10:04
OF COLLISION
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