HomeMy WebLinkAbout26-3197 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 2 27c
COLLISION REP FIT 1591971
CASE 26-3197 z
INTERSTATE ❑ CITY STREET FIRE ❑RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHIC;I F ❑ LOCAL AOENC 4Y00 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 1 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 - 1-- 2026 1534 17 ❑.= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓
8715 S 133RD PL BLOCK NO. e✓ 8700
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ ❑ FEET e S ❑ W e 1 5 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
,/No D:2065191555 0 11
30
6� LAST NAME NGUYEN FIRSTNAME LONG MIDDLE H 1 2 31
INITIAL
STREET ❑, 8715 S 133RD PL TTLE WA
NEW ADDRESS ST zIP', 96178 2
CITy SEA
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
INTERLOCK YES[:]NO 1/ INTERLOCKYEs NO�/ YES R No�/
8❑ LRIIVER #
ON DUTY❑ STATUS AIRBAG 1 RESTR 4 EJECT 1 HELMET USE 2 1 CLASS NATURE OF INJURIES z❑
3
LICENSE CNJ0922 STATE WA VIN# WVWD67AJ8EW005026
10 9❑ Pr ATF�
TRAILER STATE TRAILER STATE
11 2 5 PLATE# PLATE# FROM ro
TRLR. TRLR O 0 33
12 2 5 VIN#j VIN#
FROM TO
VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED By GOVT.VEHICLE 7 $ 34
13 2 2014 VOLK GOLF HB DAMAGE YES NO YES[:] NO✓
REGISTERED OWNER INFO OWNEDBYDRIVER VEHICLE NO. 1
SHADE IN DAMAGED AREA ❑ 35
14 LIABILITY INSURANCE Z INSURANCE CO FARMERS 9874303840 3
IN EFFECT &POLICY# 9TOP
VE—LE CHARGE 36
LEGALLv YES❑NO❑ CITATION# 10 BOTTOM
15❑ STANDING 8
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT a2 VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES 1/ NO D:2062148247
16 a
LAST NAME SESSOMS FIRST NAME DEREK MIDDLE A
INITIAL
17❑ STREET ❑' 8625 S 133RD PL CITY' SEATTLE ST WA ZIP 98178 37
NEW ADDRESS ❑
18� CDL IGNITION REQUIRED IGNITION PtR—E—S1ENT MEDICAL TRANSPORTED 38
INTERLOCK YES❑No� INTERLOCK YEs I I NOF YEs t l NOF,/
19 LDIIVER # STATE WA SEX M MMDDW 01 21 1996 0 39
HELMET {NJURY 1 NATURE OF INJURIES 40
20❑ ON DUTY STATUS AIRBAG 1 RESTR 4 EJECT 1 USE 2 CLASS ❑
21❑ LICENSE I CAX5975 TATe WA vIN# WVWMP7AN3CE509281
❑ 41
PLATE#
42
22❑ PLATE# STATE PLATE# STATE
TRLR
23❑ VIN#. IN#. 43
RLR
'
GI
VEH YEAR 2012 MAKE VOLK MODEL CC STYLE $D DAMAGE TOWED NOO✓ BLIN TOWED BY ov HyES NO 1/ 44
24❑ ES
REGISTERED OWNER INFO OWNED SY DRIVER VEHICLE N0.2
SHADEDAMAGED AREA
3 4
LIABILITY
INSURANCE INSU PORGY#E CO ALLSTATE 820958089IN STOP 5
--E ❑ ,J� CITATION# CHARGE
25 to BOTTOM
LEGALLY YES N`L J
s � a
=AS
I OQ
NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
26 SWAN 7 12965 WA0171300
PAGE 01 OF
PART A
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EG97519
COLLISION REPORT III III III III III 111
1591972 CASE# 26-3197
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
PM 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.
NICHOLAS SWAN 04-25-26 07:28 AM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
S.WOODWARD 11528 4/26/2026 4:40:56 AM
BADGE OR ID# 12965 OR]# WA0171300 TIME POLICE DISPATCHED 3:34 PM TIME POLICE ARRIVED 3:41 PM
PART I PAGE IT]OF
REPORT NO. EG97519 CASE# 26-3197 OF COLLISION
04/24/26 15:34
OF CbLLI510N
NARRATIVE
#26-3197
Unless otherwise noted, all events took place in the City of Renton, in the County of King, in the State
of Washington.
This incident was captured on my body worn video camera and in-car cameras. This report is a
summary of events that occurred and is not an exact sequencing of events.
On 04/25/2026 at approximately 1534 hours I was dispatched to a non injury, blocking accident at
8715 S 133rd PL in the city of Renton, King County, WA.
Unit#1 was a white 2014 Volkswagen Golf with WA LIC CNJ0922 (VIN: WVWDB7AJ8EW005026).
The driver of unit 1 was the sole occupant of the vehicle, was wearing their seatbelt, and had no
injuries.
Unit#2 was a grey 2012 Volkswagen CC with WA LIC CAX5975 (VIN: WVWMP7AN3CE50928). The
driver of unit 2 was the sole occupant of the vehicle, was wearing their seatbelt, and had no injuries.
Unit#2 stopped partially on the sidewalk and partially in the front yard of 8714 S 133rd PL. No
damage was done to the landscaping.
Roadway conditions were dry with clear skies at the time the collision occurred. Unit#1 was able to
remove it self from the roadway. Unit#2 was also able to remove itself from the roadway.
Driver#1 of Unit#1 was backing out of their driveway at 8715 s 133rd PL. There was a vehicle
parked to the west of them. As they were backing out of the driveway and beyond the vehicle
blocking their view to the west, they were struck in the rear passenger corner by unit#2. This collision
caused their rear bumper cover to come completely off along with other various trim pieces.
Unit#2 had just left their residence approximately 2 houses to the west. Unit#2 stated that as he was
driving east on S 133rd PL at approximately 22mph, unit#1 backed out of their driveway into the
roadway and the two vehicles collided in unit#2's front passenger corner. This then caused him to
swerve across the street, on to the side walk, and into the front yard of 8714 S 133rd PL. This
collision caused damage estimated to be above $1,000 to the front bumper and front passenger
quarter panel of the vehicle.
Pictures of the collision were uploaded to Axon from my department issued cell phone.
Both drivers had insurance for their vehicles. An exchange of information was provided to each of
them.
At the conclusion of my investigation, I determined that Unit#1 was the proximate cause of the
collision as they did not ensure the roadway was clear prior to entering from their driveway.
If Unit#1 had not entered the occupied roadway, then this collision would not have occurred.
This concludes my report.
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 N. Swan on 04/25/2026 at 0713 hours, in the City of Renton, WA.
PAGE 3 OF 5
SUPPLEMENTAL REPORT NO. EG97519
r`) POLICE TRAFFIC 1 27
COLLISION REPORT CASE# 26-3197
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 I_J CYCLE _) PEDESTRIAN � OWNER � YES NO
D:2062284615
MIDDLE.. 29
LAST NAME HUYNH FIRST NAME LOAN-ANH INITIAL
STREET _—] H 30
NEW AnnRFrtP 8714 S 133RD PL CITY SEATTLE ST WA ZIP 98178
6
CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TANSPORTED 1 31
INTERLOCK YEs No zERLOCK YES E]Na� YEs N
DRIVER'S STATE I SEX F MDYSYv' -� 2
LICENSE
7F-ION DUTY STATUS AIRBAG RESTR. EJECT HELMET INJURY NATURE OF INJURIES
F�
USE CLASS
8 ❑ ' 1 32
LICENSE+ rar V1N.#
PLATE#
9 TRAILER TRAILER
PLATE# STATE PLATE# STATE
10 ❑ TRLR TRLR
VIN.#. VIN.#.
11 VEH.YEAR MAKE I MODEL STYLE I VEHICLE TOWS E T SABLIN TOWED BY anvi vEHIG E FROM TO
DAMAGE YES NO YES NO
REGISTERED OWNER INFO. m 33
12 SHADE IN DAMAGED AREA
FROM TO
((ABILITY INSURANCE❑ INSURANCE CO
IN EFFECT &POLICY# tGQ
VEHICLE 34
13 ❑ LEGALLY YES[:] NO❑ CITATION# CHARGE
STANDING S} 8 7 6
14 ❑ UNIT Tr Vd IRE O CYDCLE OWNER
YES AGE NOHRESHOLD MET PHONE El
35
PEDESTRIAN
15 LAST NAME FIRST NAME MIDDLE': INITIAL36
STREETIAL
❑
16 NEn+AnnREs.�' CITY'. ST ZIP
CDL IGNITION REdUiRED IGNITtGN PRESENT MEDICALTANSPORTED
INTERLOCK YES No INTERLOCK YEs NO YEs NO El
17 37
LICENSE# STATE SEX MMDDDYBYY
18 ❑ ON DUTY� STATUS AIRBAG RESTR. ; EJECT HELMET INJURY NATURE of INJURIES 38
USE (CLASS
19 ❑ vIN# 39
LICENSE
PLATE# rnr
20 ❑ TRAILER' TRAILER ❑ 40
PLATE# STATE PLATE# STATE
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 '
VEHICLE
EFFECT &POLICY# I 970P - 4 44
24 VEHICLE YES NO❑ CITATION# CHARGE iq 60TiOM
E:l
C=DLv
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.
NICHOLAS SWAN 04-25-26 07:28 AM
25 INVESTIGATING OFFICER'S SIGNATURE OFFICER'S PHONE UNIT OR DIST DET DATED: PLACE SIGNED
APPROVED
E 26 � BADGE O#I'WA0171300 OA PAGE OF
3000-345-013(R 11118)
REPORT NO. EG97519 CASE# ' 26-3197 DATE AND TIME 04/24/26 15:34
OF COLLISION
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