HomeMy WebLinkAbout26-2833 iiTFiNII IIIII III IIIII II IIII IIIII I . 27c REPORT NO EG93865oc� RA
COLLISION REPORT 1591971
CASE# 26-2833 2
INTERSTATE CITY STREET FIRE I
RESULTED STOLENSTATE ROUTE OTHER VEHICLE LOCCODIGENC'Y 4200 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY ❑ INVOLVED
2❑ TRIBAL UN TS#OF 02 STRUCKCK 1 1 8 28
STREET LIGHT POLE
i RESERVATION : 2
3� M M D D Y Y Y Y TIME(2400) COUNTY# MILES CITY#
DATE OF N E IN eOL�ISION' 04 - 11 - 2026 0849 17 =.= S 8 W E OF M 1070 a
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
SGRADYWAY BLOCK NO. e 300 .�
4a❑ MILE POST
❑ DISTANCE OF(REFERENCE OR CROSS STREET)
5 . FEET e S 8 W e SHATTUCKAVES
OF 4 29
MOTOR ✓ PEDAL- DAM AG THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE ❑ YEs Vl No D:4257548155 0 1 30
6 LAST NAME BOROVEC FIRST NAME KERRY MIDDLE L 1 1 2 31
INITIAL
STREET ❑ 201 UNION AVE SE UNIT 68 CITY; RENTON ST WA ZIP; 98059 2
NEW ADDRESS
7 CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
INTERLOCKYEs NO✓ INTERLOCKVEs Na✓I YES F NO✓
8 DRIVER # STATE WA SEXI M MMDOYY' 11 - 15 - 1946 1 2 32
9 ON DUTY❑ STATUS' AIRBAG 2 RESTR 4 EJECT 1 N USEET CLASSY 1 NATURE of INJURIES 2
10 LICENSE AA V8625 srATE WA yIN 3C8FY68B43T510837 3
TRAILER STATE TRAILER STATE ROM To 11 3 5 PLATE# PLATE#
TRLR zRLR. 3 5 33
12 3 5 VIN# vIN#
FROM TO
13 4 VEH.YEAR2003 MAKE CHRy MODEL PT STYLE UT VEHICLE TOYED NO�iS46LIN T�VyED.6LRS GES❑END 5 34
DAMAGE IIII._IIII HHttVVii((tt
REGISTERED OWNER INFO OWNED BY DRIVER VEHICLE R 1
SHADE IN DAMAGED AREA 35
2 3 4
4 LIABILITY INSURANCE INSURANCE CO
14 Z HARTFORD 55PHG982843
IN EFFECT &POLICY# 4TOP
VEHICLE CHARGE 5 36
Lemur yes❑NO❑ CITATION# 7 o BOTTOM
15❑ sTnNowc 7 e
MOTOR ✓ PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT VEHICLE ❑ CYCLE ❑ ❑ nWNRR vEs✓ NO D:2532045794
16�
LAST NAME BUTLER FIRST NAME RAYNA MIDDLE p
INITIAL
STREET ❑
17 ❑ 12905 RIDGE CIRCLE E CITY BONNEY LAKE ST, WA ZIP 98391 37
NEW ADORE SS
1$❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDfCAL TRANSPORTED' 38
INTERLOCKYES No�/ INTERLOCK YES NO�/ YES No✓
19 DRIVERS ' STATE WA SEX F D.O.B. 10 21 1996 � 39
LICENSE# MMDDYY
HELMET INJURY NATURE OF INJURIES 40
20❑ ON DUTY❑ STATUS AIRBAG 6 RESTR 4 EJECT 1 USE CLASS 1 ❑
21 LICENSE CFJ6990 rarE WA vIN# 3KPF44AC9PE525588 41
22❑ STATE PLAAILER TE# STATE 42
PLATE#
23= TRLR RLR 43
UIN#. 'IN#
TOWED BY GOV HI 44
VEH.YEAR 202$ MAKE KJA MODEL FORTE STYLE 4D DAMIAGE
24 TOVYESS V NO BLIN BANKERS ves No✓
REGISTERED OWNER INFO OWNED BY DRIVER VEHICLE Np.2
SHADE IN DAGF,,AREA
2
LIABILITY INSURANCE[Z INSURANCE CO SAFECO H2584891
IN EFFECT &POLICY# 1 9TOP
vewae ❑ ,o CITATION11 CHARGE tO BOTTOM
EEGnEEy YES N
2rO 8
OFFICER'S NAME(PRINT)
26 OFFICER PHONE BADGE OR ID# JAGENCY
D.MYERS 10433 WA0171300
PART A PAGE 01 OF
3000-348-189(R 11/18)
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EG93865
COLLISION REPORT III III III III III 111
1591972 CASE# 26-2833
ADDITIONAL PERSONS INVOLVED(PASSENGERS AND/OR WITNESSES ONLY)
'.NAME
(LAST,FIRST,MIDDLE INITIAL)
ADDRESS&PHONE
SEXi D.O.B. —
MMDDYYYY
PASSENGERQ WITNESS UNIT# SEAT AIRBAG RESTR. EJECT ; HELMET INJURY NATURE OF INJURIES
POS. ' USE CLASS 1 ----�
:NAME
(LAST FIRST MIDDLE INITIAL)
ADDRESS&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
On 04-11-2026 at approximately 0950 hours, I was dispatched to a traffic collision in the intersection
of S Grady Way and Shattuck Ave S in the City of Renton, County of King, State of Washington.
I contacted the driver of Unit #1 who told me he was traveling westbound on S Grady Way and was
stopped to make a left turn into the parking lot of McDonalds on Shattuck Ave S. There was flashing
yellow light for traffic control when he made the left turn and he did not see Unit#1 traveling
eastbound on S Grady Way. He made his turn hitting the driver side of Unit#1.
I contacted the driver of Unit#2 who told me she was traveling eastbound on S Grady Way in the left
lane. Unit#1 hit the driver side area of her vehicle causing her to spin into the traffic control light on
the southeast corner of the intersection. The damage to both sides of her vehicle were caused by
todays collision.
I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT.
D.MYERS O4-11-26 06:18 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST.DET DATED PLACE SIGNED
APPROVED BY DATE
P.KORDEL 9676 1 411212026 3:38:26 PM
BADGE OR ID# j 10433 ORI# WA0171300 TIME POLICE DISPATCHED 9:50 AM TIME POLICE ARRIVED 9:53 AM
PAST B 3 Da-3m5—attar(txIMR) PAGE 2�OF F3
REPORT NO. EG93865 CASE# 26-2833 DATE AND TIME 04/11/2609:49
OF COLLISION
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