HomeMy WebLinkAbout26-2942 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 0 27c
COLLISION REP FIT 1591971
CASE 26-2942 z
INTERSTATE ❑ CITY STREET FIRE ❑RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHICI F ❑ LOCAL AOENC 4900 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 2 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 1342 17 ❑.= S 8 IN e 1070 3
4❑ oN (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓
BENSON DR S BLOCK NO. e✓ 3401
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:7652621629 0 9 30
6 LAST NAME KABURU FIRSTNAME HARUN MIDDLE G 1 1 2 31
INITIAL
STREET ❑, 12936 SE 185TH ST CITY RENTON ST WA ZIP 980587921 z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
iNTERLOCKYEs NO INTERLOCKYEs NO YES R NO
8❑ LRIIVER #
ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 HELMETU E ICNLJAUSSY 1 NATURE OF INJURIES z❑
3
10� P1 aT�S� CUX4193 sTATI WAVIN# 3N10E2P2FL407612
TRAILER STATE TRAILER STATE
11 4 0 PLATE# PLATE# FROM TO
TRLR. YRLR. 5 1 33
12 0 0 VIN#' VIN#
>; FROM TO
❑ VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN T GOVT.VEHICLE 9 9 34
13 2 2015 NISS VERSA DAMAGE vEs ONO f �LAWkkRS vEs❑ No
REGISTERED OWNER INFO HARUN KABURU 12936 SE 185TH ST RENTON WA 980587921 D:7652621629 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
14 LIABILI INSURANCE INSURANCE CO NATIONAL GENERAL 2031414877 4
IN EFFECT &POLICY# TOPVEHICLE CHARGE 36
LEGALLYYES❑NO❑ CITATION# 6A0254800 FOLLOW VEHICLE TOO CLOSELY <1�3
orrow
15❑ STANDING 7 6
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT VEHICLE ❑ CYCLE i ❑ ❑ OWNER ❑ YES 1/ No D:9152414353
16 a
LAST NAME BASTIDAS MARTINEZ FIRST NAME ANTHONY MIDDLE I J
INITIAL
17❑ STREET ❑', 5277 45TH AVE SW CITY SEATTLE ST WA ZIP 981361105 37
NEW ADDRESS ❑
18� CDL IGNITION REQUIRED IGNITION PtR-E-S1ENT MEDICAL t-T�RANSPORTED 38
INTERLOCKYES�NOR INTERLOCK YYEEsI I I No� YES t l NO❑
19 D IVEW # STATE WA SEX M M.C.B. O6 _ 13 _ 1995 0 39
20 ON DUTY STATUS AIRBAG 3 RESTR 4 EJECT 1 HELMET INJURY 7 NATURE OF INJURIEs 40
USE CLASS FINGER
21❑ LICENSE CUR5074 TATE WA VIN1i 2T1BU4EE9BC701329
❑ 41
PLATE#
42
22❑ PILER LATE# STATE PLATE# STATE
23❑ UIN#. 43
TRLR RLR
'IN#.
VEH YEAR 2011 MAKE TOYT MODEL COROLL STYLE VEHICLE TOWED TO BLIN TOWEDBY GOV HI 44
24❑ 981361105
DAMAGE YES NO BANKERS YES NO
REGISTERED OWNER INFO ANTHONY BASTIDAS MARTINEZ 527745TH AVE SW SEATTLE WA 9 8 13 6 110 5 D:9152414353 VEHICLE NO.2
SHADE IN DAGELLAREA
z Cdd
LIABILITY INSURANCE❑ INSURANCE CO
IN EFFECT &POLICY# 1GD
EHIGLEYES NuCITATION# 6A0254801 CHARGE OP MOT VEH W/OUT INSURANCE
LEGALLY
25 s � e
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
26
M.LEVERTON 2517 WA0171300
PART A PAGE 01 OF
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EG99594
COLLISION REPORT III III III III III 111
1591972 CASE# 26-2942
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.
M.LEVERTON 04-15-26 02:49 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY E
DAT
C.JACOBS 1953 4/23/2026 1:50:13 PM
BADGE OR ID# 2517 OR]#' WA0171300 TIME POLICE DISPATCHED! 1:43 PM TIME POLICE ARRIVED',1:47 PM
PART I PAGE IT]OF 5�
REPORT NO. EG99594 CASE# 26-2942 OF COLLISION
04/15/26 13:42
OF CbLLI510N
NARRATIVE
gry/2 It 3401 wht rear 2 2 pushed across wht/3 t bone 2
CC
Within the city limits of Renton/King/Wa I responded to an unknown if injury crash/blocking crash at
the 3401 block of Benson Dr S.
When I arrived and located a sedan in the driveway of 3401, a white van on the sidewalk facing
southbound and a small white car blocking all of lane 2 northbound and a portion of lane 1.
I contacted the driver of unit 2 who told me he was preparing to make a left turn into the driveway of
3401 for a delivery when he was hit from behind by unit 1. The impact from unit 1 shoved unit 2
across the southbound lanes at the same time unit 3 was passing by. Unit 3 was unable to avoid unit
2 and they contacted in lane 1 southbound. Unit 2 was bleeding from his finger. I requested Renton
Fire respond to care for his injury. His vehicle was towed for damages. Unit 2 was unable to provide
valid proof of insurance, even though he was driving as an Amazon delivery driver. I cited unit 2 via
complaint Ref RCW 46.30.020, fail to provide valid proof of insurance.
I contacted the driver of unit 3 who told me he was southbound and when unit 2 was hit from unit 1 it
pushed unit 1 across his lane where he had no chance to avoid confact. He did not complain of injury
and damages did require a tow truck.
I contacted the driver of unit 1 ID'd by his picture WADL. He told me that unit 2 stopped suddenly and
he couldn't not avoid contact with him. He told me he skidded and crashed into the back of unit 2. He
did not complain of injury and damages did require a tow truck. I cited unit 1 Ref RCW 46.61.145
Following Too Close 3 car injury crash via complaint.
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 4/15/2026
PAGE 3 OF 5
SUPPLEMENTAL REPORT NO. EG995594
r`I POLICE TRAFFIC 1 1 8 27
COLLISION REPORT CASE# 26-2942
1 COMMERCIAL MOTOR CARRIER INTERSTATE INTRASTATE G
UNIT'# USL70r !CC# VEHICLE TYPE CARGO BODY
TYPE
2 ❑ 1 28
CARRIER
NAME
3 CARRIER
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# 3 VEHICLE tSJ CYCLE I_) PEDESTRIAN OWNER YEs NO
D:5107786024
OF 1 29
LAST NAME RAINGARD FIRST NAME STEPHANE MIDDLE ',, G
INITIAL
STREET 30
NFW AnDRFrtP 2207 E TERRACE ST APT A CITY SEATTLE ST WA ZIP 981226056
6
CDL IGNITIttN REQUIRED IGNITION PRESENT MEDICAL TANSPORTED 1 1 2 31
INTERLOCK YEs No NTERLOCK YEs[:]NO[:] YEs N
DRIVER'S
LICENSE STATE I WA SEX M MMDDYYv 10 - 23 - 1967
7
ON DUTY� STATUS AIRBAG' $ RESTR. Q EJECT 1 HELMET I INJURY 1 1 NATURE OF INJURIES
USE CLASS
8 ❑ 1 32
LICENSE BQG5691 TAr Wq VIN# 1GNDM19X55B126613
PLATE#
9 9] TRAILER TRAILER
PLATE# STATE PLATE# STATE
10 ❑ TRLR TRLR
VIN.#. VIN.#.
11 4 0 VEH.YEAR MAKE MODEL STYLE VEHICLE TOWS E T SABLI anvi vEH1Ci P FROM TO
2005 CHEV ASTRO THE
DAMAGE YES�NO YES NO
REGISTERED OWNER INFO STEPHANE RAINGARD 2207 E TERRACE ST APT A SEATTLE WA 981226056 D:5107786024 1 5 33
12 � SHADE IN DAMAGED AREA
j 4 FROM TO
LIABILITY INSURANCE INSURANCE CO PROGESSIVE 989 q"i"Olx
IN EFFECT &POLICY#
VEHICLE 10 6QTTUM 34
13 ❑ LEGALLY YES❑ NO❑ CITATION# CHARGE
STANDING } MOTOR
l:9 7 6
14 ❑ UNIT Tr Vd IRE O CYCLE � OWNERRTY YESAGE NOHRESHOLD MET PHONE ❑ 35
PEDESTRIAN
15 LAST NAME FIRST NAME INITIAL
36
MIDDLE ❑
STREET"[-]
16 NFW nnR CITY ST ZIP
CDL IGNITION REdUiRED IGNITION PRESENT MEDICALTANSPORTED
NTERLOCK 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 ICLASS
19 ❑ 39
LICENSE rnr VIN#
PLATE#
20 ❑ TRAILER TRAILER El40
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 '
VINE
EFFECT &POLICY# i 970P - 4 E:l
44
24 VEHICLE YES❑ NO❑ CITATION# CHARGE iq 60TiOM
LECALLv
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.
X LEVERTON 04-15-26 02:49 PM
25 INVESTIGATING OFFICER'S SIGNATURE OFFICER'S PHONE UNIT OR DIST DET DATED: PLACE SIGNED
APPROVED BY DATE
26 OI BADGE 2517 O#I',WA0171300 JACOBS 412312026 PAGE F41 OF F
3000-345-013(R 11118)
REPORT NO. EG99594 CASE# ' 26-2942 DATE AND TIME 04/15/26 13:42
OF COLLISION
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PAGE 5 OF 5