HomeMy WebLinkAbout26-3667 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 5 27c
COLLISION REP FIT 1591971
CASE 26-3667 z
INTERSTATE ❑ CITY STREET ❑ FIRE ❑RESULTED
1 STOLEN
STATE ROUTE � OTHER ❑ VFHIC;I F ❑ LOCAL AGENC 4200 3
HIT 8 RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 TOTAL#TRIBAL OF 02 OBJECT 1 1 8 28
UNITS ! ❑
RESERVATION ' STRUCK z
3 M M D D Y Y Y Y TIME(2400) COUNTY# MILES CITY#
cDt�usloN' 05 - 12 - 2026 1600 17 ❑.= E IN e 1070 3
S 8
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓
MAPLE VALLEY HWY BLOCK NO. e
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ 100 00 FEET e MILES S ❑ W e I-405
0 1 29
UNITMOTOR ❑ PEDAL- El DAMAGE THRESHOLD MET PHONE
VEHICLE CYCLE. YES ,/NO D:2064969138 0 7 30
6 LAST NAME GREWELL FIRSTNAME SOPHIA MIDDLE R 1 1 2 31
INITIAL
STREET ❑ 32518 3RD AVE CITY BLACK DIAMOND ST WA ZIp, 98010 z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
iNTERLOCKYEs NOV INTERLOCKYEs NO�/ YES R No,/
8❑ LRIIVER #
ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 HELMET U E 2 1 INJURY 1 CLASS NATURE OF INJURIES z❑
3❑
10 9❑ P1 ATNFS14 CKF7522 STATE WA VIN# 1NXBU40E89Z157082
----� TRAILER STATE TRAILER STATE
11 3 5 PLATE# PLATE# FROM ro
TRLR. TRLR. 7 3 33
12 3 5 VIN# VIN#
FROM TO
❑ VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE g 9 34
13 4 2009 TOYT COROL SD DAMAGE YES NO YES❑ NO./
REGISTEREDOWNER WFO JEFFERY GREWELL 32518 3RD AVE BLACK DIAMOND WA98010 VEHICLE NO. 1 Y ❑
SHADE IN DAMAGED AREA 35
❑ LIABILITY INSURANCE❑ INSURANCE CO 2 3 4
14 PROGRESSIVE 86929384
IN EFFECT &POLICY# 9TOP
V 'CE CHARGE 5 36
LECALLv YES❑NO❑ CITATION# 10 BOTTOM
15❑ STANDING 8 7 6
MOTOR PEDAL- PROPERTY DAM THR OLD MET PHONE
UNIT 0 ❑✓ ❑ PEDESTRIAN ❑ ❑ D:2066790118
VEHICLE CYCLE : OWNFR YES�/ NO
16 2
LAST NAME WILLIS FIRST NAME BETH MIDDLE A
INITIAL
17 STREET I❑ S❑' 21329 52ND WAYS CITY' KENT ST WA ZIP 98032 4❑ 37
NEW ADOREs
18❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED � 38
INTERLOCK YEs❑No� INTERLOCK YEs❑NOF YES
❑NOF,/
19 DRIVER'S STATE I WA ]SEX IF I D.O.B. 02 _ 01 1977 39
LICENSE# MMDDYY
20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 H U EET 2 NJAU EY 1 NATURE OF INJURIES 40
❑ 41
21❑ LICENSE I PLA E# BSK6131 TATe WA VIN1 1GNEVGKW9LJ137333 1
42
22❑ ILER El
PLATE# STATE PILER LATE# STATE
23❑ VIN#. 43
TRLR RLR
'IN#.
VEH YEAR 2020 MAKE CHEV MODEL TRAVERS STYLE 1/7' VEHICLE TOWED TO BLIN
TOWED BY Gov HI 44
L4❑ DAMAGE YES NO YES NO�/
REGISTERED OWNER INFO OWNEDBYDRIVER VEHICLE NO.2
SHADE IN DAMAGED AREA
2 3 4
LIABILITY
INSURANCE I Ri PORGY#E CO TRAVERSE 917080294IN 1GVE""LE
TOP,J� CITATION# CHARGE OTTOM
LEGALLY YES N`L J
25
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# 77P�1300
26
MAXWELL ATCHISON 13322
PART A PAGE 01 OF C7
3000-345-159 fR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EH02593
COLLISION REPORT III III III III III 111
1591972 CASE# 26-3667
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
POS. USE CLASS
NAME
'(LAST,FIRS 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.
MAXWELL ATCHISON 05-12-26 05:39 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
J.TRADER 4553 5/13/2026 1:43:19 PM
BADGE OR ID# 13322 OR]# WA0171300 TIME POLICE DISPATCHED 4:02 PM TIME POLICE ARRIVED',4:08 PM
PART PAGE IT]OF 4�
TIM
REPORT NO. EH02593 CASE# 26-3667 OFC LLI ION 05/12/26 16:00
OF COLLISION
NARRATIVE
CC 26-3667
On 5/12/2026 at 1602 hours I was dispatched to a motor vehicle collision at Maple Valey Hwy and I-
405 in the City of Renton, King County, Washington.
Pre-Collision
Driver 2 (Beth A. Willis, DOB: 02/01/1977) stated that she was
heading northbound in lane 3 towards the 1-405 underpass. Shortly before the underpass she had to
stop for traffic ahead of her.
Driver 1 (Sophia R. Grewell, DOB: 03/29/2006) stated that she was heading northbound in lane 3
towards the 1-405 underpass. While driving she was fixing her shoe and did not notice traffic stopping
ahead of her.
Collision
Driver 2 stated while stopped for the traffic ahead of her, in lane 3 she was hit in the rear by unit 1
one.
Driver 1 stated that she hit the rear end of unit 2 because she was fixing her shoe and she did not
notice traffic stop.
Injuries
Neither party complained of any injuries resulting from the collision.
Vehicle Disposition
Unit 2 (BSK6131) suffered moderate damage to the rear bumper, and the muffler was knocked loose
from its bracket and hanging under the car.
Unit 1 (CKF7522) suffered moderate damage to its front bumper. It was unclear what damage was
caused by this incident as driver 1 stated she had obtained previous damage from a previous
incident.
Neither vehicle needed a tow, both drove away from the scene.
Proximate Cause
The proximate cause of the accident was driver 1 not observing the vehicle in front of her stop for
traffic.
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 Officer M. Atchison #13322 at 1722 hours on 5/12/2026 in the City of Renton,
King County, Washington.
PAGE 3 OF 4
REPORT NO. EH02593 CASE# 26-3667 DATE AND TIME 05/12/2616:00
OF COLLISION
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PAGE 4 OF 4