HomeMy WebLinkAbout26-2642 IT si " II IIIII III IIIII II IIII IIIII I . 27c REPORT NO EG92619OLCERA
COLLISION REPORT 1591971
INTERSTATE ❑ CITY STREET FIRE I
CASE# 26-2642 2
RESULTEDSTOLENSTATE ROUTE OTHER VEHICLE LOCAI-AGENCY 4100 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2❑ TRIBAL UN TS#OF OBJESTRUCT
1 1 8 28
03 RETAINING WALL
i KI
RESERVATION : 1
2❑3� M M D D Y Y Y Y TIME(2400) COUNTY# MILES CITY#
BOLL s oN' 04 - 06 - 2026 0755 17 =.= S 8 W❑ IN OF e 1070 s
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
BLOCK NO. e .�
4a
N 3RD ST MILE POST
❑
❑ DISTANCE OF(REFERENCE OR CROSS STREET)
5 1. FEET e S 8 W e FACTORYAVE N
0 1 29
MOTOR ✓ PEDAL- DAM AG THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE ❑ YEs Vl No D:2062764997 0 1 30
6 LAST NAME SHERROD FIRST NAME MICHAEL MIDDLE D 1 1 2 31
INITIAL
STREET ] 235 MEADOW AVE N CITY; RENTON ST WA ZIP; 980575724 2
NEW ADDRESS
7 CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
INTERLOCKYEs No INTERLOCKYEs NO YES NO
8 DCIENSE# STATE WA SEXI M MMDOYY' 07 - 28 - 1964 1 2 32
9 ON DUTY STATUS' AIRBAG 6 RESTR 4 EJECT 1 HELMET INJURY 7 [NATURE of INJURIES 2❑
USE CLASS BICEP AND THUMB PAIN
LICENSE, C97674Y STATE WA VIN#, 1GTCS19W3W8506291 3
10 Fl I PI ATP rt
❑ TRAILER TRAILER
11 STATE STATE 3 0 PLATE# PLATE# ROM To
TRLR TRLR 7 3 33
12 2 5 VIN#' VIN#
FROM TO
VT VEHICLE
13 1 VEH.YEAR 1998 MAKE GMC MODEL SONOM STYLE VEHICLE TOWED NO�iS46LIN Tv4 EBYMEYERS GOSE] - 5 1 34
DAMAGE IIII._IIII I�I
REGISTERED OWNER INFO OWNED BY DRIVER VEHICLE R 1
SHADE IN DAMAGED AREA 35
3 14 LIABILITY INSURANCE� INSURANCE CO BRISTOL WEST G01 7905152 00 4
IN EFFECT &POLICY# 9TOP
srn Nowc Yes❑NO❑ CITATION# 6AO190282 CHARGE VEH ENTER INTERSEC STEADY RED s t a oorrob z 36
15❑
MOTCYR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT 02 VEHICLE CYCLE nWNFR D:2067478974
16�
LAST NAME VIRADET FIRST NAME SOUTHIMA MIDDLE
INITIAL
17 F1 STREET ❑❑ 12841 4TH AVE S CITYBUR/EN ST, WA ZIP 981682649 37
NEW ADDRESS
1$❑ CDL IGNITION REdUIRED IGNITION PRESENT MEDICAL TRANSPORTED ❑ 38
INTERLOCKYEs Nfl INTERLOCK YES NO YES NO
19 DRIVER'S STATE WA SEX F D.O.e. 10 11 2002 39
LICENSE# MMDDYY —
20❑ ON DUTY❑ STATUS AIRBAG'6 RESTR 4 EJECT 1 HELMET INJURY', 6 NATURE OF INJURIES ❑ 40
USE CLASS ARM AND LEG PAIN
21 LICENSE I PLATE# CL W7264 rare WA vIN# 5YJ3E1EA7RF741573 41
22❑ PLATE# STATE PLATE# STATE 42
23 TRLR RLR 43
UIN#. 'IN#
VEH.YEAR 2024 MAKE TESL MODEL MODEL 3 STYLE VEHICLE TOWED TO BLIN TOWED BY GOV HI 44
24 DAMAGE YES �/ No GENE MEYERS E
REGISTERED OWNER INFO OWNED BY DRIVER VEHICLE N0.2
SHADE IN DAMAGED AREA
2 3 4
LIABILITY INSURANCE INSURANCECO STATE FARM 5594629-E20.47B-001
IN EFFECT &POLICY# 1 STOP
1—
L YES❑ N.I—I, CITATION11 CHARGE to BOTTOM
LE
,— 6
25 OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
26
C.ARNOLD 12509 WA0171300
❑
PAGE 01 OF
PART A 3000-345-189(R 11/18)
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EG92619
COLLISION REPORT III III III III III 111
1591972 CASE# 26-2642
E NA ADDITIONAL PERSONS INVOLVED(PASSENGERS AND/OR WITNESSES ONLY)
M
(LAST,FIRST,MIDDLE INITIAL) NICKSIC CLAIRE M
ADDRESS&PHONE# D O
16537 119THAVE SE RENTON WA 98058 2067158409 SEXi F MMDDYYYY 03 — 21 — 1994
PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET INJURY NRE OF INJURIES
POS. ' USE :CLASS � ATU ----�
:NAME
(LAST EIRS7 MIDDLE INITIAL}
ADDRESS R PHONE#
SEX MMDDYYYY D.O.B. —
PASSENGER❑WITNESS UNIT# : SEAT AIRBAG RESTR. EJECT HELMET INJURY: NATURE CFINJURIES
POS. USE CLASS ----�
:NAME
(LOST,FIRST,MIDDLE INITIAL)
ADDRESS&PHONE#
SEX I 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.
C.ARNOLD 04-06-26 10:50 AM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST.DET DATED PLAGE SIGNED
APPROVED BY DATE
C.JACOBS 1953 4/7/2026 3:50:25 PM
BADGE OR ID# 12509 ORI# WA0171300 TIME POLICE DISPATCHED 7:55 AM TIME POLICE ARRIVED i 7:58 AM
PAST B 3 Do-3mx—attar(t 1Mff) PAGE 2�OF F5
REPORT NO. EG92619 CASE# 26-2642 DATE OF COLLI r�510NN + 04/06/26 07:55
L1
NARRATIVE
CC 26-2642
On 4/6/2026 at 0755 hours I was dispatched to a motor vehicle collision at the intersection of Factor
Ave N and N 3rd St in the City of Renton, King County, Washington.
Pre-Collision
Driver 2 stated that she was traveling North on Factory Ave N at N 3rd St, proceeding across the
intersection with a green light.
Driver 1 stated that he was traveling East on N 3rd St approaching Factory Ave N in the #1 lane.
Collision
Driver 2 stated that as she crossed into the intersection, Unit 1 ran the red light and the front bumper
of Unit 1 collided with the drivers side door area of Unit 2.
Driver 1 stated that he had a green light and that when he entered the intersection, Unit 2 entered as
well and the front bumper of Unit 1 collided with the drivers side doors of Unit 2. Unit 1 then rolled into
a brick retaining wall on the NE side of the intersection.
Per a witness, Unit 2 had a green light. The witness was positioned behind Unit 2 at the time of the
collision.
Video footage from Unit 2 showed that she had a green light at the time of the collision, and was the
second vehicle to cross the intersection.
Injuries
Driver 1 complained of bicep and thumb pain. Driver 2 complained of left arm pain. Driver 2 was
medically transported to Valley Medical Center.
Vehicle Disposition
Both vehicles were towed by Gene Meyers
Proximate Cause
I determined that Driver 1 is the proximate cause of this collision because vehicle operators facing a
steady circular red signal alone shall stop at a clearly marked stop line, but if none, before entering
the crosswalk on the near side of the intersection or, if none, then before entering the intersection
control area and shall remain standing until an indication to proceed is shown.
Had Driver 1 stopped for the red light, this collision would not have happened.
Driver 1 was cited reference RCW 46.61.055.
1 certify (declare) under penalty of perjury under the laws of the State of Washington that the
foregoing is true and correct.
Electronically signed by Officer C. Arnold #12509 at 10:11 on 4/6/2026 in the City of Renton, King
County, Washington.
PAGE 3 OF 5
SUPPLEMENTAL REPORT No. EG9261 9 1 27
POLICE
ION REPORT �! CASE# 26-2642
013197
1 COMMERCIAL MOTOR CARRIER INTERSTATE INTRASTATE
UNIT# USDOT ICC# VEHICLE TYPE CARGO BODY 3
TYPE
2 ❑ 1 28
CARRIER
NAME
3 CARRIER L
ADDRESS
CITY ST ZIP
4 ❑ NAME # PLACARD
GWVR NAME IF NO NUMBER
SOURCE AXLES ' +
4a ❑ ADDITIONAL UNITS
{ MOTOR PEDAL- PROPERTY DAMAGE THRESHOLD MET PHONE
5 ❑ UNIT�T 3 VEHICLE CI CYCLE C) PEDESTRIAN :.. OWNER YES NO
LAST NAME UN/( FIRST NAME MIDDLE 29INITIAL
STREET 30
NEW AnDIRFRPI 1500 N 3RD ST CITY RENTON I ST WA ZiP gg057
6 PRESENT MEC7ICALTANSPORTED. 1 31
CDL IGNITION REOUIREb I{iNiTiON :: ..
INTERLOCK YES NO .;INTERLOCK YESLl- YES N
L
DRIVER'S I STATE I SEX U MMDDYB -C-1-
LICENSE
7
ON DUTY STATUS AIRBAG RESTR. EJECT HELMET INJURY' NATUREDFINJURIEs
USE CLASS
8 ❑ 1 32
LICENSE TAT VIN.
PLATE#
9 TRAILER I I TRAILER L
PLATE# STATE PLATE# STATE
0
10 TRLR TRLR
VIN.#. VIN#.
11 VEH.YEAR MAKE MODEL STYLE VEHICLE TOWE E T ABLIN TOWED BY GOVT.VFHICI F FROM TO
DAMAGE YES NO YES NO
m 33
REGISTERED OWNER INFO.� SHADE IN DAMAGED AREA
12
LIABILITY INSURANCE❑ INSURANCE CO 4 FROM TO
7t)P
IN EFFECT &POLICY# 34
13 YES NO CITATION# CHARGE
1080TTOM
ecauv
sTnNoiNc 3. 7 G.
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
NFW ADDRESS
CDL IGNITION REQUIRED IGNITION PRESENT MEDICALTANSF'ORTED.
INTERLOCK YES NO INTERLOCK YES NO :YES NO
17 37
LDICENSE# STATE SEX M�D°B _ C
18 ❑ ❑
HELMET NJURY NATURE OF INJURIES 38
ON DUTY STATUS AIRBAG RESTR. EJECT USE CLASS.
19 ❑ ❑ 39
LICENSE TAT vIN#
PLATE#
20 TRAILER TRAILER 40
PLATE#. STATE PLATE# STATE ❑
21 ❑ TRLR TRLR 41
VIN#�, VIN#:'
42
22 VEH.YEAR MAKE I MODEL I STYLE VEHICLE TOWED DUET ABLIN TOWED BY GOVT.VEHICLE
DAMAGE YES NO YES NO
23 REGISTERED OWNER INFO. SHADE IN DAMAGED AREA 43
2 3 4
LIABILITY INSURANCE INSURANCE CO
IN EFFECT I &POLICY# 7c;Q
S. 44
vewc�e ❑ ❑ CITATION# CHARGE
24 I..EG_ YES NO
STIWDING 8 3 G
1 CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT.
C.ARNOLD 04-06-26 10:50 AM
25 INVESTIGATING OFFICER'S SIGNATURE OFFICER'S PHONE UNIT OR DIST DET DATED: PLACE SIGNED
26 BADGE OR ID# 12509 O#RI WA0171300 APJACOBS 4n/2026
PAGE OF
�
3000-345-013(R 11/18)
REPORT NO. EG92619 CASE# 26-2642 DATE AND TIME 04/06/2607:55
OF COLLISION
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PAGE 5 OF 5