HomeMy WebLinkAbout26-2640 IT si " II IIIII III IIIII II IIII IIIII I . 27c REPORT NO EG92620OLCERA
COLLISION REPORT 1591971
INTERSTATE CITY STREET FIRE ❑
CASE# 26-2640 2
RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VEHICLE ❑ LOCCODIGENC'Y 4100 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 TOTAL#OF OBJECT 28
TRIBAL UNITS 01 STRUCK
RESERVATION : 1 1
2
3� M M D D Y Y Y Y TIME(2400) COUNTY# MILES CITY#
eaCL s on' 04 - 06 - 2026 0629 17 =.= S 8 W e OF e 1070 s
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
BLOCK NO. e .�
4a
NE 3RD ST MILE POST
❑
❑ DISTANCE OF(REFERENCE OR CROSS STREET)
5 F--1 MILES. FEET e S 8 W e MONTEREYDR NE
OF 3 29
MOTOR PEDAL- DAMAG THRESHOLD MET PHONE
UNIT 01 VEHICLE
❑ CYCLE ❑ YES No �/ D:4254459979 30
6 LAST NAME ZAPPONE FIRST NAME SHOSHANA MIDDLE L 1 1 2 31
INITIAL
STREET ] 169 MONTEREYDR NE CITY; RENTON ST WA ZIP; 98056 2
NEW ADDRESS
7 CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
INTERLOCKYEs No INTERLOCKYES Eq MEDICAL
�/ NO
8 DRIVER # STATE WA SEXI F MMDDYY' 01 - 28 - 1989 t 32
9 ON DUTY STATUS' AIRBAG 1 RESTR 13 EJECT 2 HELMET INJURY 5 NATURE OF INJURIES 2
USE CLASS POSSIBLE BROKEN FEMUR
LICENSE, 2KO948 STATE WA yIN#, JS1GN7FA6P7100589 3
10 as ATP rt
TRAILER STATE TRAILER STATE
11 3 5 PLATE# PLATE# 3 ROM
TRLR zRLR. 5 3 33
12 VIN#' VIN#
FROM TO
VEH.YEAR 2023 MAKE SUZI MODEL GSX- STYLE VEHICLE TOWED TO BLIN TOWED By GOVT VEHICLE m 34
13� DAMAGE YES II_II NO `/ YESII_I) NO
REGISTERED OWNER INFO OWNEDBYDRIVER VEHICLE NO. 1
SHADE IN DAMAGED AREA 35
14❑ LIABILITY INSURANCE❑ NSURANCE CO 4_
IN EFFECT &POLICY# 9TOP
ic CHARGE t 5 36
Lemur YES[:]".[:] CITATION# 7 0¢OTTOM
15❑ STM LNG s 7 e
MOTOR PEDAL-:. PROPERTY DAM THR T OLD ME PHONE
UNIT 0' PEDESTRIAN
VEHICLE CYOLE' OWNERYES NO
16❑
LAST NAME FIRST NAME MIDDLE'
INITIAL
17❑ STREET ❑ CITY ST ZIP ❑ 37
NEW ADDRESS
1$❑ CDL IGNITION REQUIRED IGNITION PRESENT MED[CALTRANSPORTED 38
INTERLOCKYEs No INTERLOCK YES No vEs NQ
19 DRIVER'S
# STATE SEX MMDDYY —= 39
HELMET INJURY NATURE OF INJURIES 4Q
20❑ ON DUTY STATUS AIRBAG RESTR EJECT USE CLASSLICENSE
❑
21 PLATE# TATE VIN# 41
22❑ [TILER TAILER
PLATE# STATE PLATE# STATE 42
23 TRLR RLR 43
UIN#. 'IN#
VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN
TOWED BY GOV HI 44
24 DAMAGE YES NO YES NO
REGISTERED OWNER INFO VEHICLE NO.2
SHADE IN DAMAGED AREA
2 3 4
LIABILITY INSURANCE❑ INSURANCE CO
IN EFFECT &POLICY# 9TOP
vemae ❑ ,.I—I CITATION# CHARGE to BOTTOM
EEGnEEY YES NC
25 a s
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
26
C.ARNOLD 12509 WA0171300
PAGE 01 OF
PART A 3000-348-189(R 11/18)
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EG92620
COLLISION REPORT III III III III III 111
1591972 CASE# 26-2640
E NA ADDITIONAL PERSONS INVOLVED(PASSENGERS AND/OR WITNESSES ONLY)
M
(LAST,FIRST,MIDDLE INITIAL) ALARCON STEPHENA
ADDRESS&PHONE# D O
824 CHELAN PL NE RENTON WA 98056 6822589121 SEXi M MMDDYYYY 10 — 24 — 1997
PASSENGER WITNESSZ UNIT# SEAT AIRBAG RESTR. EJECT HELMET INJURY NATURE OF INJURIES
POS. ' USE CLASS ----�
:NAME
(LAST FIRST MIDDLE INITIAL)
ADDRESS R 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
CC 26-2640
On 4/6/2026 at 0630 hours 1 was dispatched to a single vehicle collision at NE 3rd St and Monterey
Dr NE in the City of Renton, King County, Washington.
Pre-Collision
Driver 1 stated that she was facing North on Monterey Dr NE preparing to perform a righthand turn to
proceed East on NE 3rd St.
Collision
Driver 1 stated that as she accelerated, the tires of Unit 1 lost their traction, and Unit 1 fell over,
ejecting Driver 1 from Unit 1.
Injuries
Driver 1 sustained a possible broken right leg (femur), and was transported to Overlake Hospital.
Vehicle Disposition
Unit 1 was operable and was ridden back to it's residence by Driver 1's husband.
Final Disposition
This was a single vehicle collision that was documented for informational purposes only. Photos
taken were uploaded to evidence.com.
I 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 07:31 on 4/6/2026 in the City of Renton, King
County, Washington.
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 07:36 AM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST.DET DATED PLACE SIGNED
APPROVED BY DATE
C.JACOBS 1953 1 4/7/2026 3:51:09 PM
BADGE OR ID# 12509 ORI# WA0171300 TIME POLICE DISPATCHED 6:30 AM TIME POLICE ARRIVED i 6:32 AM
PAST B 3 Da-3mx—attar(t 1Mff) PAGE 2�OF F3
REPORT NO. EG92620 CASE# 26-2640 DATE AND TIME 04/06/2606:29
OF COLLISION
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