HomeMy WebLinkAbout26-3624 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 0 27c
COLLISION REP FIT 1591971
CASE 26-3624 z
INTERSTATE ❑ CITY STREET FIRE R�RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHIr.I F ❑ LOCAL AOENC 4900 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 1 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'. 05 - 11 - 2026 0717 17 �. S 8 W H OF e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
140TH WAY SE
BLOCK NO. e✓ --- ----� ❑
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5 .❑ FEET e S ❑ W e SE 158TH ST
❑ �
0 1 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
✓NO D:2063759887 0 81
30
6� LAST NAME PALMER FIRSTNAME SHARONDA MIDDLE K 1 1 2 31
INITIAL
STREET ❑ 15538 SE 175TH CT CITY RENTON ST WA ZIP 980589012 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 H U SE
ICNLJAUSSY 1 NATURE OF INJURIES z❑
3
10❑ pl ATFBit BZT9195 sTArI WA VIN# KL1TD56668B041539
TRAILER STATE TRAILER STATE
11 4 0 PLATE# PLATE# ROM TO
TRLR. TRLR. 5 1 33
12 0 0 VIN#' VIN#
>; FROM TO
❑ VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN T GOVT.VEHICLE J 9 34
13 4 2008 CHEV AVEO DAMAGE YES NO �LII� RS vEs❑ No✓
REGISTERED OWNER INFO AMBER BAKER 5005 GLENWOODAVE EVERETT WA 98203 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
3 4
14 LIABILI INSURANCE❑ INSURANCE CO
IN EFFECT &POLICY# 9TOP
E LE CHARGE 5 36
L
LEGAGA LLY YES❑NO CITATION# 6A0254434 FOLLOW VEHICLE TOO CLOSELY o BOTTom
15❑ NDING 8 6
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT 02 VEHICLE ❑ CYCLE ❑ ❑ OWNER El YESNO ,/ D:9162624667
16 a
LAST NAME URBANO FIRST NAME EDMON MIDDLE A
INITIAL
17❑ STREET ❑', 17532 150TH CT SE UNIT M3 CITY RENTON ST WA ZIP 980588733 37
NEW ADDRESS ❑
18� CDL IGNITION REQUIRED IGNITION PR—E-1SENT MEDICAL TRANSPORTED ❑ 38
INTERLOCK YEs❑NOR INTERLOCK vEs It I NOF YES
t t- l NO❑
19 DRIVER'S STATE WA SEX M D.C.B. 07 30 _ 1984 39
LICENSE# MMDDYY
WELMET INJURY1 NATURE OF INJURIES 40
20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 USE CLASS ❑
21❑ LICENSE D47751F TAre I WA VIN1t 5TFCZ5ANOMX281224
❑ 41
PLATE#
42
22❑ PLATE# STATE PLATE# STATE
23❑ UIN#. 43
TRLR RLR
'IN#.
GI
VEH YEAR 2021 MAKE 7'Oy7- MODEL TACOMA STYLE DAMAGE TOWED NOO✓ BLIN TOWED By ov HyES NO 44
24❑ ES
REGISTERED OWNER INFO OWNED SY DRIVER VEHICLE N0.2
SHADE IN DAMAGED AREA
2 3 4
LIABILITY
INSURANCE INSU&PORGY#E CO STATE FARM 602 0566-C31-47IN 1 GD
VE""LE CITATION# CHARGE
LEGALLY YES Nu
25❑ s e
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
J
26
C.ARNOLD 12509 WA0171300
PART A PAGE 01 OF C7
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EH03721
COLLISION REPORT III III III III III 111
1591972 CASE# 26-3624
ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY)
NAME MIDDLE INITIAL) WILSON TR/N►TYE
(/AST FIRST,
ADDRESS&PHONE# D O.B.
15538 SE 175TH CT RENTON WA 980589012 SEX F MMDDYyry 05 - 03 - 2009
SEAT HELMET NJURY NATURE OF INJURIES
PASSENGER Z WITNESS❑'UNIT# 1 POS, ! 7 AIRBAG RESTR. 4 EJECT 1 USE CLASS i7 8lTLOWER LIP
NAME
(LAST,FIRST,MIDDLE INITIAL) k CHRISTIAN DARREN D
ADDRESS&PHONE# D O B
15538 SE 175TH CT RENTON WA 980589012 SEX: M MMDDYVYv 01 _ 14 _ 2012
SEAT HELMET INJURY NATURE OF INJURIES
PASSENGER WITNESS UNIT# 1 POS 3 AIRBAG 2 RESTR. 4 EJECT 1 USE CLASS 1
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 05-11-26 02:28 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
C.JACOSS 1953 1 511812026 7:55:52 AM
BADGE OR ID# 12509 ORI# WA0171300 TIME POLICE DISPATCHED 7:17 AM TIME POLICE ARRIVED 7:26 AM
PART I PAGE IT]OF 4�
DATE AND
TIME
REPORT NO. EH03721 CASE# 26-3624 OF COLLISION05/11/2607:17
NARRATIVE
CC 26-3624
On 5/11/2026 at 0717 hours I was dispatched to a motor vehicle collision at the intersection of 140th
Way SE and SE 158th St in the City of Renton, King County, Washington.
Pre-Collision
Driver 2 stated that he was stopped facing North on 140th Way SE just South of SE 158th St in the #2
lane at a red light.
Driver 1 stated that she was proceed North on 140th Way SE approaching SE 158th St in the #2 lane.
Collision
Driver 2 stated that while stopped, Unit 1 approached from behind and the front bumper of Unit 1
collided with the rear bumper of Unit 2.
Driver 1 stated that her left rear passenger sneezed and this startled her. Driver 1 stated that she
looked down and when she looked up she was unable to stop in time to avoid a collision. Driver 1
stated that the front bumper of Unit 1 collided with the rear bumper of Unit 2.
Following this, the engine compartment of Unit 1 caught fire. RFA was called to the scene and the fire
was extinguished.
Injuries
Driver 1 informed me that the LR passenger sustained a minor injury when she bit her lip at the time
of collision. The LR passenger was GOA prior to my arrival.
Vehicle Disposition
Unit 1 was rendered inoperable and was towed from the scene by Bankers.
Proximate Cause
I determined that Driver 1 is the proximate cause of this collision because the driver of a motor
vehicle shall not follow another vehicle more closely than is reasonable and prudent, having due
regard for the speed of such vehicles and the traffic upon and the condition of the highway. Had
Driver 1 been following at a distance that was reasonable and prudent, this collision would not have
happened.
Driver 1 was cited reference RCW 46.61.145.
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 07:59 on 5/11/2026 in the City of Renton, King
County, Washington.
PAGE 3 OF 4
REPORT NO. EH03721 CASE# 26-3624 DATE AND TIME 05/11/26 07:17
OF COLLISION
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