HomeMy WebLinkAbout26-3138 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 5 27c
COLLISION REP FIT 1591971
CASE 26-3138 z
INTERSTATE ❑ CITY STREET FIRE ❑RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHIr.I F ❑ LOCAL AOENC 4Y00 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 2 TOTAL#OF OBJECT 1 1 8 28
TRIBAL UNITS OZ 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 1529 17 ❑-= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
BLOCK NO. e✓ --- ----� ❑
SE CARR RD MILEPOST
4a❑
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ ❑ FEET e S ❑ VV e 105TH PL SE
0 4 29
MOTOR PEDAL- DAM THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El YES NO �/ D:2069201840 0 7 30
6� LAST NAME BENNING FIRSTNAME LARONDA MIDDLE R 1 2 31
INITIAL
STREET ❑ 425 S 46TH PL UNIT A CITY RENTON ST WA 21p 980556381 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 1 RESTR 4 EJECT 1 H U SE
ICNLJAUSSY 1 NATURE OF INJURIES z❑
3
10❑ PI ATFBit C4476C sTATI WAvIN#' 1 BABNBSA5LF359111
TRAILER STATE TRAILER STATE
11 3 5 PLATE# PLATE# FROM To
TRLR. TRLR 3 5 33
12 0 0 VIN#j VIN#
FROM TO
VEH.YEAR 2020 BLUE T3RE40 MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED By GOVT.VEHICLE J 9 34
13 4 DAMAGE YES NO YES[:] NO✓
REGISTERED OWNER INFO RENTONSCHOOL DISTRCIT 300 SW 7TH ST RENTON WA 98057 VEHICLE NO. 1
❑ ❑
SHADE IN DAMAGED AREA 35
4 3 4
14 INSURANCE INSURANCE CO SCHOOLS INSURANCE ASSOCIATION OF WA SlAW252634033
IN EFFECT
IN EFFEE CT &POLICY# 9TOP
VEHlcl.e CHARGE 5 36
E�ALLv YES❑NO❑ CITATION# 6A0254412 INATTENTIVE DRIVING o eorrom
15❑ STANDING 8 7
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES NO %/ D:5413033678
16 a
LAST NAME TORRES FIRST NAME ELSA MIDDLE R
INITIAL
17 STREET ❑ 1050 JAMES ST UNIT 301 CITY SEATTLE ST WA ZIP 981042493 37
NEW ADDRESS I I I I I ❑
18� CDL IGNITION REQUIRED IGNITION PtR—E—S1ENT MEDICALt—T�RANSFORTED ❑ 38
INTERLOCK YEs❑No� INTERLOCK YEs I I No� YEs t l No❑
19[ LDI IVEW # STATE WA SEX IF M D.C.B.
11 23 _ 2000 39
HELMET I {NJURY NATURE OF INJURIES 40
20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 USE CLASS 1 ❑
21❑ LICENSE I WC12150 TATe OR vIN1t 1G11C5SA4DF215374
❑ 41
PLATE#
42
22❑ PLATE# STATE PLATE# STATE
23❑ 43
TRLR RLR
UIN#. 'IN#.
TOWED BY Gov HI 44
VEH YEAR 2013 MAKE CHEV MODEL MALIBU STYLE DAMAGE TOWED NOO✓ BLIN YES
NO
24❑ REGISTERED OWNER INFO OWNED SY DRIVER VEHICLE N0.2
SHADE IN DAMAGED AREA
2 3 4
LIABILITY
INSURANCE INSU PORGY#ECO ALLSTATE 942871926IN I STOP 5
VE""LE CITATION# CHARGE
LEG
25 i o BOTTOM
ALLY YES N�
❑ s
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
J
26
C.ARNOLD 12509 WA0171300
PAGE 01 OF
PART A
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EG99688
COLLISION REPORT III III III III III 111
1591972 CASE# 26-3138
ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY)
NAME MIDDLE INITIAL) WANG AVERY
(LAST FIRST,
ADDRESS&PHONE#
RENTON SEX X MMDDYYYY 08 - 04 - 2016
PASSENGER WITNESS UNIT# SEAT AIRBAG' RESTR. EJECT ' HELMET INJURY NATURE OF INJURIES
❑✓ 1 POS. 11 1 9 1 USE CLASS 1
NAME
(LAST,FIRST,MIDDLE INITIAL) ANDERSON REESE
ADDRESS&PHONE# DOB
RENTON SEX' MMDDYYYv 01 _ O6 _ 2017
SEAT HELMET INJURY NATURE OF INJURIES
PASSENGER WITNESS UNIT# 1 POS 11 AIRBAG 1 RESTR, 9 EJECT 1 USE CLASS 1
NAME
(LAST FIRST,MIDDLE INITIAL) ASMERONNE KABERON
AooREss PHONE# RENTON SEX' 12 _ 24 _ 2017
D.O.B.
MMDDYYYY
PASSENGER WITNESS UNIT# ! 1 SEAT 11 AIRBAG 1 RESTR. 9 EJECT 1 HELMET NJURY 1 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.
C.ARNOLD 04-22-26 04:43 PM
NVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
C.JACOBS 1953 1 5/4/2026 9:29:57 AM
BADGE OR ID# 12509 ORI# WA0171300 TIME POLICE DISPATCHED 3:30 PM TIME POLICE ARRIVED',3:47 PM
PART I PAGE IT]OF 9�
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EG99688
COLLISION REPORT III III III III III 111
1591972 CASE# 26-3138
ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY)
NAME MIDDLE INITIAL) ALTAR ZINEDINE
(LAST FIRST,
ADDRESS&PHONE#
RENTON SEX i X MMDOYyry 02 - 15 - 2017
PASSENGER WITNESS UNIT# SEAT AIRBAG' RESTR. EJECT ' HELMET INJURY NATURE OF INJURIES
❑✓ 1 POS. 11 1 9 1 USE CLASS 11
NAME
(LAST,FIRST,MIDDLE INITIAL) ALTAR RAYA
ADDRESS&PHONE# DOB
RENTON SEX' MMDDYYYv 08 _ 03 _ 2020
SEAT HELMET I INJURY NATURE of INJURIES
PASSENGER Z WITNESS UNIT# 1 POS. 11 AIRBAG 1 RESTR. 9 EJECT 1 USE CLASS 1
NAME
(LAST FIRST,MIDDLE INITIAL) ISLAN TAFS/A
AppRESS R PHONE# RENTON _
SEX M -
MDDYYYY
PASSENGER WITNESS UNIT# ! 1 SEAT 11 AIRBAG 1 RESTR. 9 EJECT 1 HELMET NJURY 1 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.
C.ARNOLD 04-22-26 04:43 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
C.JACOBS 1953 1 5/4/2026 9:29:57 AM
BADGE OR ID# 12509 ORI# WA0171300 TIME POLICE DISPATCHED 3:30 PM TIME POLICE ARRIVED',3:47 PM
PART I PAGE 3�OF 9�
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EG99688
COLLISION REPORT III III III III III 111
1591972 CASE# 26-3138
ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY)
NAME MIDDLE INITIAL) KABENON ASMERON
(LAST FIRST,
ADDRESS&PHONE#
RENTQN SEX'X MMDDYYYY
PASSENGER WITNESS UNIT# SEAT AIRBAG' RESTR. EJECT ' HELMET INJURY NATURE OF INJURIES
❑✓ 1 POS. 11 1 9 1 USE CLASS 1
NAME
(LAST,FIRST,MIDDLE INITIAL) ;MAN JAMIYAN
ADDRESS&PHONE# DOB
RENTQN SEX MMDDYYYY - _
SEAT HELMET INJURY NATURE OF INJURIES
PASSENGER WITNESS UNIT# 1 POS 11 AIRBAG 1 RESTR, 9 EJECT 1 USE CLASS 1
NAME
(LAST FIRST,MIDDLE INITIAL) CASTLEBERRY AVA
AooREss&PHONE# RENTON SEX' 07 M _ 13 _ 2016
D.O.B.
MDDYYYY
PASSENGER WITNESS UNIT# ! 1 SEAT 11 AIRBAG 1 RESTR. 9 EJECT 1 HELMET NJURY 1 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.
C.ARNOLD 04-22-26 04:43 PM
NVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
C.JACOBS 1953 1 5/4/2026 9:29:57 AM
BADGE OR ID# 12509 ORI# WA0171300 TIME POLICE DISPATCHED 3:30 PM TIME POLICE ARRIVED',3:47 PM
PART I PAGE 4�OF 9�
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EG99688
COLLISION REPORT III III III III III 111
1591972 CASE# 26-3138
ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY)
NAME MIDDLE INITIAL) LUNCEFORD LORELA!
(LAST FIRST,
ADDRESS&PHONE#
RENTON SEX X MMDDYYYY 10 - 13 - 2016
PASSENGER WITNESS UNIT# SEAT AIRBAG' RESTR. EJECT ' HELMET INJURY NATURE OF INJURIES
❑✓ 1 POS. 11 1 9 1 USE CLASS ',1
NAME
(LAST,FIRST,MIDDLE INITIAL) GOODE MILALANI
ADDRESS&PHONE# DOB
RENTON SEX' MMDDYvvv 10 _ 11 _ 2019
SEAT HELMET INJURY NATURE OF INJURIES
PASSENGER WITNESS UNIT# 1 POS 11 AIRBAG 1 RESTR. 9 EJECT 1 USE CLASS 1
NAME
(LAST FIRST,MIDDLE INITIAL) SULTAN/ EFAF
AppRESS&PHONE# RENTON _
SEX -
MMDDYYYY
PASSENGER WITNESS UNIT# ! 1 SEAT 11 AIRBAG 1 RESTR. 9 EJECT 1 HELMET NJURY 1 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.
C.ARNOLD 04-22-26 04:43 PM
NVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
C.JACOSS 1953 1 5/4/2026 9:29:57 AM
BADGE OR ID# 12509 ORI# WA0171300 TIME POLICE DISPATCHED 3:30 PM TIME POLICE ARRIVED',3:47 PM
PART I PAGE IT]OF 9�
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EG99688
COLLISION REPORT III III III III III 111
1591972 CASE# 26-3138
ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY)
NAME MIDDLE INITIAL) KHUN KHASLEY
(LAST FIRST,
ADDRESS&PHONE#
RENTON SEX X MMDDYYYY 12 - 25 - 2017
PASSENGER WITNESS UNIT# SEAT AIRBAG' RESTR. EJECT ' HELMET INJURY NATURE OF INJURIES
❑✓ 1 POS. 11 1 9 1 USE CLASS 1
NAME
(LAST,FIRST,MIDDLE INITIAL)
ADDRESS&PHONE# DOB
SEX: MMDDYYYV
PASSENGER ❑WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET NJURY NATURE OF INJURIES
POS. USE CLASS
NAME
(LAST FIR57 MIDDLE INITIAL)
AppRESS&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.
C.ARNOLD 04-22-26 04:43 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
C.JACOSS 1953 5/4/2026 9:29:57 AM
BADGE OR ID# 12509 ORI# WA0171300 TIME POLICE DISPATCHED 3:30 PM TIME POLICE ARRIVED',3:47 PM
PART I PAGE IT]OF 9�
REPORT NO. EG99688 CASE# 26-3138 OF COLLISION
04/22/26 15:29
OF CbLLI510N
NARRATIVE
CC 26-3138
On 4/22/2026 at 1530 hours I was dispatched to a motor vehicle collision at the intersection of SE
Carr Rd and 105th PI SE in the City of Renton, King County, Washington.
Pre-Collision
Driver 2 stated that she was facing East on SE Carr Rd in the #2 lane stopped for traffic.
Driver 1 stated that she was facing West on SE Carr Rd in the lefthand turn lane preparing to perform
a lefthand turn onto 105th PI SE to proceed South.
Collision
Driver 2 stated that while stopped, Unit 1 turned behind her and upon doing so, the rear driver's side
of Unit 1 scraped along the rear driver's side bumper of Unit 2.
Driver 1 stated that she was focused on traffic that was allowing her to begin her left-hand turn. Driver
1 stated she miscalculated her turn and upon performing her lefthand turn, the rear drivers side of
Unit 1 collided with the rear driver's side bumper of Unit 2.
Injuries
None reported.
Vehicle Disposition
Both vehicles were operational.
Proximate Cause
I determined that Driver 1 is the proximate cause of this collision because tt shall be a traffic
infraction, subject to RCW 7.80.120(1)(a), for any person to drive a motor vehicle on any public
highway, street, alley, or road in an inattentive manner in the City of Renton. "Inattentive manner" in
this section means a lack of: 1) attentiveness required to safely operate the vehicle under the
prevailing conditions, including, but not limited to, the nature and condition of the roadway, the
weather conditions, the presence of pedestrians, the presence of other traffic, or by the driver
focusing or directing the driver's attention to something other than driving the motor vehicle; or 2)
attentiveness that would permit the driver of a motor vehicle to observe anything resting on, or
traveling on, or entering the roadway in time to take appropriate action as circumstances require.
Had Driver 1 been more attentive, this collision would not have happened.
Driver 1 was cited reference RMC 10-12-25.
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 16:31 on 4/22/2026 in the City of Renton, King
County, Washington.
PAGE 7 OF 9
SUPPLEMENTAL REPORT NO. EG99688
r`) POLICE TRAFFIC 1 27
COLLISION REPORT CASE# 26-3138
1 COMMERCIAL MOTOR CARRIER INTERSTATE INTRASTATE ✓ G
UNIT'# 1 USDOT ICC# ' VEHICLE TYPE 1 CARGO 6ODY 1
;TYPE
2 ❑ 1 28
CARRIER RENTON SCHOOL DISTRICT
NAME
3 CARRIER
ADDRESS 300 SW 7TH ST
CITY RENTON ST WA ZIP'', 98057
4 ❑ NAME # PLACARD: :❑
SOURCE 3 AXLES 02 1
GwvR 30000 + NAME IF NO NUMBER
4a ❑ ADDITIONAL UNITS
MOTOR PEDAL- PROPERTY DAMAGE THRESHOLD MET PHONE
5 ❑ UNIT# VEHICLE I_J CYCLE _) PEDESTRIAN � OWNER � YES NO
i MIDDLE'... 29
LAST NAME FIRST NAME INITIAL
STREET 30
NFW AnnRFrtP. CITY ST ZIP
6 2
CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TANSPORTED 1 31
INTERLOCK YES No NTERLOCK YES E]NO� vES N
LLIICIENSE STATE I SEX M��DYRYY' 2
7 F-1
ON DUTYl STATUS AIRBAG' RESTR. EJECT HELMET INJURY NATURE OF INJURIES
USE CLASS
8 ❑ ' 1 32
LICENSE+ rar VIN.#
PLATE#
9 TRAILER TRAILER
PLATE# STATE PLATE# STATE
10 ❑ TRLR TRLR
VIN.#. VIN.#.
11 VEH.YEAR MAKE MODEL STYLE VEHICLE TOWS T SABLIN TOWED BY anvi vEHIG P FROM TO
DAMAGE Y EES NO YES NO
REGISTERED OWNER INFO. m 33
12 SHADE IN DAMAGED AREA
FROM TO
((ABILITY INSURANCE❑ INSURANCE CO
IN EFFECT &POLICY# t 9 1"01?
VEHICLE 1 o BarroM 34
13 ❑ LEGALLY YES❑ NO❑ CITATION# CHARGE
STANDING S} 8 7 6
14 ❑ UNIT Tr Vd 1 RE O CYCLE OWNER
YES AGE NOHRESHOLD MET PHONE El
35
El PEDESTRIAN
15 LAST NAME FIRST NAME MIDDLE INITIAL
TIAL
❑
STREET
16 STREET"[—] CITY ST ZIP
CDL IGNITION REQUIRED IGNITtGN PRESENT MEDICALTANSPORTED
NTERLOCK YES NO NTERLOCK 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 TRR 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 3 4 4 AREA F 43
z
LIABILITY INSURANCE INSURANCE CO '
VINE
EFFECT &POLICY# i 970P - 4 E:l
44
24 LEHIcLE YES❑ NO❑ CITATION# CHARGE iq 60TiOM
LeGALLv
STANDING S 7 6
1 CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT.
C.ARNOLD 04-22-26 04:43 PM
25 INVESTIGATING OFFICER'S SIGNATURE OFFICER'S PHONE UNIT OR DIST DET DATED: PLACE SIGNED
APPROVED BY DATE
26 OI BADGE 12509 O#I',WA0171300 JACOBS 5/4/2026 PAGE F81 OF F
3000-345-013(R 11118)
REPORT NO. EG99688 CASE# ' 26-3138 DATE AND TIME 04/22/26 15:29
OF COLLISION
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PAGE 9 OF 9