HomeMy WebLinkAbout26-3173 TFF' NoucERA II I !�� I III I III I IIII III II I O 6 27c .
COLLISION REP FIT 1591971
CASE 26-3173 z
INTERSTATE ❑ CITY STREET FIRE ❑RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHIC;I F ❑ LOCAL AGENC 4200 3
HIT&RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 1 TOTAL#pF OBJECT 1 F
1 8 28
TRIBAL UNITS 03
RESERVATION STRUCK
z
3❑ DATE of M M D D Y Y Y Y TIME(2400) COUNTY# MILES N E IN CITY# ❑
cowsloN 04 - 1-- 2026 1839 17 ❑.= S 8 IN e 1070 3
4 4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓
NE 4TH ST BLOCK NO. e✓ Y900
4a 3❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ 150 FMILES EET e S ❑ E e JEFFERSON AVE NE
0 1 29
R PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE ❑ YES NO D:2538201791 1 4 30
6� LAST NAME DELMONTE FIRSTNAME MICHAEL MIDDLE D 1 1 2 31
INITIAL
STREET 01 12213 221 ST AVENUE CT E CITY
BONNEY LAKE ST WA ZIP 98391 z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
1/ I iNTERLOCKYEs NO NTERLOCKYEs NO�/ YES R No�/
8❑ LRIIVER #
ON DUTY❑ STATUS AIRBAG 3 RESTR 4 EJECT 1 HELMET USE 2 CLASS 1 NATURE OF INJURIES 2❑
3
10❑ PI aT�Stt C71961 T sTArI WAvIN#' 1 FTBR3X81 LKA27924
TRAILER STATE TRAILER STATE
11 3 5 PLATE# PLATE# FROM TO
TRLR. TRLR 3 7 33
12 0 0 VIN#' VIN#
9
OM TO
13 INFO VEH.YEAR 2020 MAKE ODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE 34
FORD TRANSI VN DAMAGE YES NO YESYES[:] NO✓
REGISTERED OWNER FO STATE DELIVERY 2170429TH STE LAKE TAPPS WA 98391 D:2538201791 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
4
14 LIABILITY INSURANCE Z NPOLICY E CO SEQUEL INSURANCE SERVICES ICAU10000002.01
LI EFFECTISUR N# TOPv-A LE CHARGE 36
LEGALLY YEs No clTAnoN# 6A0276387,6A0276387 DRIVING WITH WHEELS OFF <1�3
orroM
15❑ �UNIT
G 'j a2 VE IMOTOOR Z CYCLE ❑ PEDESTRIAN ❑ OWNER RTY ❑ DES 1/ H OLDMET PHONE
16❑
LAST NAME UNKNOWN FIRST NAME MIDDLE
INITIAL
STREET CITY RENTON ST ZIP 4
17❑ NEW ADDRESS❑ ❑ 37
18❑ CDL IGNITION REQUIRED IGNITION PtR-E-S1ENT MEDICAL-T�RANSPORTED � 38
INTERLOCK YES�NO� INTERLOCK YES I I NOF YEs t l NOF,/
19 LLIICENS RIVERS# STATE SEX U MMODYY 39
WELMET INJURY NATURE OF INJURIES 40
20❑ ON DUTY� STATUS' AIRBAG,2 RESTR g EJECT '1 USE 9 CLASS 1 ❑
❑ 41
21❑ PLATE# CUT9001 TAre WA VIN# USE
1
42
22❑ PLATE# STATE PLATE# STATE
23❑ 43
TRLR RLR
VIN#. IN#.
VEH YEAR 2010 MAKE HOND MODEL CIVIC STYLE SD VEHICLETOWED TO BLIN TOWEDBY GOV HI 44
L4❑ DAMAGE YES NO YES NO
REGISTERED OWNER INFO FILLYADEM2914NE4THST RENTONWA98056 D:4252746821 VEHICLE NO.2
SHADEDAMAGEbAREA
s Cd
LIABILITY
INSURANCE &POINSURGY#E CO GEIC04101-88-43-53IN 9TOP
vEwCLe ❑ ,J� CITATION# CHARGE
25 io BOTTOM
LEGALLY YES N J
'
=TURNER
NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
J
26 12650 WA0171300
PAGE 01 OF
PART A
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO.
COLLISION REPORT III III III III III 111
1591972 CASE# 26-3173
ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY)
NAME MIDDLE INITIAL) EDD/NGS SILAS C
(LAST FIRST,
ADDRESS&PHONE#
14700 SE PETROVITSKY RD APT C301 RENTON WA 98058 2067245703 SEXi F MMDOYyry 07 - 07 - 2000
PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT ' HELMET INJURY NATURE OF INJURIES
�✓ PQS. USE CLASS
NAME
(LAST,FIRST,MIDDLE INITIAL)
ADDRESS&PHONE# D Q 8
SEX MMDDYVYY
PASSENGER ❑WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET NJURY NATURE OF INJURIES
POS. USE CLASS
NAME
(LAST FIRST MIDDLE INITIAL)
AppRESS&PHONE#
SEX D.Q.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.
JASON TURNER 05-01-26 11:04 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
QUINT TIBEAU 7691 1 51712026 9:16:17 PM
BADGE OR ID# ( 12650 ORI#' WA0171300 TIME POLICE DISPATCHED', 6:39 PM TIME POLICE ARRIVED',6:50 PM
FART I PAGE IT]OF 5�
REPORT NO. CASE# 26-3173 OF COLLISION
04/23/26 18:39
OF CbLLI510N
NARRATIVE
Unit 1 was traveling westbound on NE 3rd ST approaching Jefferson Ave NE in the right lane. Unit 1
failed to negotiate the curve and ended up driving through a large grass patch just west of the
intersection. This grass patch was occupied by a construction crew working on a billboard. Unit 1
came within a few feet of striking the construction crew. Unit 1 drove through the grass and was now
traveling westbound in the 2900 block of NE 4th ST in the eastbound lane. Unit 1 collided with Unit 2
which was parked on the southern side of NE 4th ST; Unit 1 struck Unit 2 head on. Unit 3 was parked
directly behind Unit 2, the force of the collision caused Unit 2 to collide with Unit 3. Unit 3 was pushed
approximately 200 feet down the roadway ending up in a nearby parking lot. This set of events was
verified by multiple witnesses on scene.
Unit 2 and 3 were not occupied and parked legally. Unit 1 had significant damage to the front bumper
of their vehicle with airbag deployment. Unit 1 was not operable and required a tow. Unit 2 had
significant damage to the front bumper and rear bumper, the vehicle was not operable and required a
tow. Unit 3 had significant damage to the front bumper of the vehicle, the vehicle was not operable
and required a tow.
Unit 1 reported that the collision occurred because the sun was in his eyes and he could not see the
roadway. He reported that he had no injuries.
Silas C. Edgings (DOB: 07/07/2000) was a witness to the incident and confirmed how the collision
occurred. Officer Easterling spoke with the construction workers on scene and they reported the
same state of events, noting that Unit 1 had almost hit them.
At this time I find that the proximate cause of the collision was Unit 1's failure to negotiate the curve,
causing them to drive off the roadway, drive into the opposing lanes of travel, and collide with two
parked vehicles.
I declare under penalty of perjury under the laws of the State of Washington that the foregoing is
TRUE and correct. Electronically signed by J. Turner 12650 on 05/01/2026 at 2254 hours
PAGE 3 OF 5
SUPPLEMENTAL REPORT NO.
r`) POLICE TRAFFIC 1 1 8 27
COLLISION REPORT CASE# 26-3173
1 COMMERCIAL MOTOR CARRIER INTERSTATE INTRASTATE G
UNIT'# USDOT ICC# VEHICLE TYPE CARGO BODY
;TYPE
2 ❑ 1 28
CARRIER
NAME
3 CARRIER
ADDRESS `
CITY ST ZIP—1 I '
4 ❑ NAME # PLACARD: :❑
GI PLACARD IF NO NUMBER
SOURCE AXLES +
4a ADDITIONAL UNITS
MOTOR PEDAL-
PROPERTY DAMAGETHRESHOLD MET PHONE
5 ❑ UNIT# 3 VEHICLE t_"J � PEDESTRIAN YES� IN
1 4 29
LAST NAME : UNKNOWN FIRST NAME MIDDLE
INITIAL
STREET 30
NEW AnDRFS CITY RENTON ST ZIP
6
CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TANSPORTED 1 31
INTERLOCK YES NO NTERLOCK YES❑N0� YEs N
DRIVER'S STATE I SEX U M��DVSYv' -� 2
LICENSE
7
ON DUTY STATUS AIRBAG 2 RESTR. 9 EJECT 1 HELMET 9 INJURY 1 NATURE OF INJURIES
F�
USE CLASS
8 ❑ 1 32
LICENSE CHM6573 TAr WA VIN# 2HGFC2F58JH559813
PLATE#
9 TRAILER TRAILER
PLATE# STATE PLATE# STATE
10 ❑ TRLR TRLR
VIN.#. VIN.#.
11 0 0 VEH.YEAR2018 MAKE HOND MODEL CIVIC STYLE SD I VEHICLE TOWS ET SABLIN TOWED BY anvi vEH1CP FROM TO
DAMAGE YES NO YES NO
REGISTERED OWNER INFO SULTAN NURU 1820 SE 21ST PL RENTONWA 98055 D:2067245701 33
12 � SHADE IN DAMAGED AREA
4 FROM TO
((ABILITY INSURANCE[] INSURANCE CO
IN EFFECT &POLICY# R 701x
VEHICLE 10 6QTTUM 34
13 ❑ LEGALLY YES❑ NO❑ CITATION# CHARGE gg�@
STANDING S} l:9 7 6
14 ❑ UNIT Tr Vd 1RE O CYDCLE 1:1OWNER YE
YES AGE NOHRESHOLD MET PHONE ❑ 35
PEDESTRIAN
15 LAST NAME FIRST NAME INITIALMDDLE 36
F� IITIAL
❑
STRE
16 NEW ETETnnR"� CITY ST ZIP
CDL IGNITION REdUiREE7 IGNITtGN PRESENT MEDICALTANSPORTED
NTERLOCK YES No NTERLOCK YEs NO YEs NO ❑
17 4 37
LICENSE# STATE SEX MMDDDYBYY
18 ❑ ON DUTY� STATUS AIRBAG RESTR. ; EJECT HELMET INJURY NATURE of INJURIES 38
USE (CLASS
19 ❑ 39
LICENSE rnr VIN#
PLATE#
20 ❑ TRAILER' TRAILER El40
PLATE#< STATE PLATE# STATE
21 ❑ ❑ 41
TRLR TRLR
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 '
VEHICLE
EFFECT &POLICY# I 970P - 4 44
24 LERICLE YES❑ NO❑ CITATION# CHARGE iq 60TiOM
LEGALLv
E:l
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.
JASON TURNER 05-01-26 11:04 PM
25 INVESTIGATING OFFICER'S SIGNATURE OFFICER'S PHONE UNIT OR DIST DET DATED: PLACE SIGNED
APPROVED BY DATE
26 ORID# 12650 O#I',WA0171300 TIBEAU 51712026 PAGE F OF 5
3000-345-013(R 11118)
REPORT NO. CASE# + 26-3173 DATE AND TIME 04/23/26 18:39
OF COLLISION
1
t Cy
� r c
�h
ui4k 4 tl .'.
r �
l k
t
�F
�r� t
! mr d
}z
r
)1
8
� i u
lz 14
2Z�t
r
Y4
1
v
4i
S
s4J ti...
Z c
3�
i
PAGE 5 OF 5