HomeMy WebLinkAbout26-3468 POLICETRAFF'c" III !�� I IIIllI111IN II II I REPORT NO. EH05302 170
27
COLLISION REP FIT 1591971
CASE 26-3468 z
INTERSTATE ❑ CITY STREET FIRE ❑RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHICI F ❑ LOCAL AGENC 4100 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 TOTAL#TRIBAL OF OZ OBJECT 1 1 8 28
UNITS
RESERVATION I I
STRUCK
z
3❑ DATE of M M D D Y Y Y Y TIME(2400) COUNTY# MILES N E IN CITY# ❑
cowsloN 05 - 1-- 2026 1533 17 ❑.= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓
RAINIER AVE S BLOCK NO. e✓ 700
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ ❑ FEET e S ❑ W e 2 0 29
MOTOR PEDAL- DAM THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El YES NO �/ D:2063718184 0 11
30
6� LAST NAME NGUYEN FIRSTNAME THI MIDDLE H 1 2 31
INITIAL
STREET ❑, 650 DUVALL AVE NE APT J1034 CITY RENTON ST WA ZIP 980595751 z=
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
iNTERLOCKYEs NO INTERLOCKYEs NO YES R NO
8❑ LDRIVER # STATE WA SEX'F MID
.O B 08 1- 10 - 1980 2 32
9 ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 H USEET ICNLJAUSSY 1 NATURE OF INJURIES z❑
3
LICENSE CWt4267 sTArI WAvIN# JTM6CRAV5TJ003068
10 F91 PI ATE#
TRAILER STATE TRAILER STATE
11 3 5 PLATE# PLATE# FROM TO
TRLR. A'RLR. 1 5 33
12 3 5 VIN#j VIN#
FROM TO
VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE 1 $ 34
13 3 2026 TOYT RAV4 DAMAGE YES NO YES[:] No
✓
REGISTERED OWNER INFO OWNEDBYDRIVER VEHICLE NO. 1
SHADE IN DAMAGED AREA ❑ 35
14 LIABILITY INSURANCE INSURANCE CO PROGRESSIVE 986964006 3 4
IN EFFECT &POLICY# 9TOP
❑ LEGALLY LE CHARGE I 5 36
15 2 YEs No clTAnoN# 6A0254420 IMPROPER LANE USAGE o aorrob
MOTOR PEDAL- :PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES NO ,/ D:2068830232
16 a
LAST NAME PAEZ MIRANDA FIRST NAME LEOBARDO MIDDLE
INITIAL
17❑ STREET ❑', 1259 W SMITH ST APT E102 CITY' KENT ST WA ZIP 980325203 37
NEW ADDRESS ❑
18� CDL IGNITION REQUIRED IGNITION PtR-E-S1ENT MEDICAL TRANSPORTED 38
INTERLOCKYES�NOR INTERLOCK YEs I I NOF YES
F% No❑
19 LDI IVER # STATE WA SEX M M D.O.B. 09 _ 01 1982 39
—NATURE OF INJURIES
H USE
ET LASS 6
Y RIGHT SIDE ABDOMINAL AND ARM PAIN 40
20 ON DUTY STATUS AIRBAG,2 RESTR 4 EJECT 1
21❑ LICENSE D17669E TAre I WA VIN# 2FTHF25H4RCA80890
❑ 41
PLATE#
42
22❑ PLATE# STATE PLATE# STATE
TRLR
23❑ VIN#. N#. 43
RLR
'I
VEH YEAR 1994 MAKE FORD MODEL F250 STYLE VEHICLETOWED TO BLIN TOWEDBY GOV HI �44
24❑ DAMAGE YES NO YES NO
REGISTERED OWNER INFO MARGARITA PEREZ 1259 W SMITH ST,APT E102 KENT WA 98032 VEHICLE NO.2
SHADEDAMAGEDAREA
3 4
INAEFFITY ECTNSURANCE❑ &POINSULICY#E CO IGQI
'E""LE ❑ ,J� CITATION# CHARGE
LEGALLY YES N`L J
25 s � a
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
26
C.ARNOLD 12509 WA0171300
PART A PAGE 01 OF C7
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EHO5302
COLLISION REPORT III III III III III 111
1591972 CASE# 26-3468
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.
C.ARNOLD 05-04-26 04:26 PM
NVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
C.JACOBS 1953 5/22/2026 11:09:04 PM
BADGE OR ID# 12509 ORI# WA0171300 TIME POLICE DISPATCHED; 3:34 PM TIME POLICE ARRIVED',3:38 PM
PART I PAGE IT]OF 4�
REPORT NO. EH05302 CASE# 26-3468 OF COLLISION
05/04/26 15:33
OF CbLLI510N
NARRATIVE
CC 26-3468
On 5/4/2026 at 1534 hours I was dispatched to a motor vehicle collision at around the 700 block of
Rainier Ave S in the City of Renton, King County, Washington.
Pre-Collision
Driver 2 stated that he was traveling South in the #3 lane of Rainier Ave S at around the 700 block.
Driver 1 stated that she had just turned right onto Rainier Ave S from Hardie Ave SW into the #1 lane.
Driver 1 stated that she merged from the #1 lane to the #2 lane, then prepared to merge from the #2
lane to the #3 lane.
Collision
Driver 2 stated that as he entered the 700 block, Unit 1 merged from the #2 lane and into Unit 2 as he
was traveling within lane #3. Driver 2 stated that he was unable to avoid this collision. Driver 2 stated
that the front drivers side mirror and front drivers side fender of Unit 1 collided with the front
passenger side of Unit 2.
Driver 1 stated that she was trying to get to the lefthand turn lane at Rainier Ave S and S Grady Way.
Driver 1 stated that she merged from the #2 lane to the #3 lane and the front drivers side mirror and
front drivers side fender of Unit 1 collided with the front passenger side of Unit 2.
Injuries
Driver 2 complained of right abdominal/arm pain and was transported via ambulance to Valley
Medical Center.
Vehicle Disposition
Both vehicles were operational.
Proximate Cause
I determined that Driver 1 is the proximate cause of this collision because a vehicle shall be driven as
nearly as practicable entirely within a single lane and shall not be moved from such lane until the
driver has first ascertained that such movement can be made with safety.
Had Driver 1 done this, this collision would not have happened. Driver 1 was cited refence RCW
46.61.140.
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 16:20 on 5/4/2026 in the City of Renton, King
County, Washington.
PAGE 3 OF 4
REPORT NO. EH05302 CASE# ' 26-3468 DATE AND TIME 05/04/26 15:33
OF COLLISION
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