HomeMy WebLinkAbout26-4059 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 0 27c
COLLISION REP FIT 1591971
SASE 26-4059 z
INTERSTATE ❑ CITY STREET FIRE ❑
RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHICI F ❑ LOCAL AOENC 4900 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' 05 - 1-- 2026 1514 17 ❑-= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
SUNSET BLVD N BLOCK NO. e✓ ❑
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ �,❑ FEET e S ❑ W e I405 N
0 4 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
✓NO D:2068525976 0 11
30
6� LAST NAME DEREBIE FIRSTNAME EFRATA MIDDLE T 1 1 2 31
INITIAL
STREET ❑ 7930 RAINIER AVE S APT 416 CITY SEATTLE ST WA 2jp, 981184419 z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
iNTERLOCKYEs NO INTERLOCKYEs NO YES NO
8❑ LRIIVERS STATE WA SEXI F MM DAY' 10 1— 01 — 2005 2 32
CENSE 9 ON DUTY❑ STATUS AIRBAG 3 RESTR 4 EJECT 1 HELMET USE 2 1 CLASS NATURE OF INJURIES z❑
3
10 9❑ P1 AT 14 CTE4273 STATE WA VIN# JHMFB4F34CS001544
TRAILER STATE TRAILER STATE
11 3 5 PLATE# PLATE# FROM TO
TRLR. TRLR $ 7 33
12 3 5 VIN#' VIN#
>; FROM TO
❑ VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN T Y GOVT.VEHICLE 1 $ 34
13 2 2012 HOND CIVIC YES 0NO agW�MEYERS TOWING ves❑ No
DAMAGE
REGISTERED OWNER INFO EFRATA DEREBIE 7930 RAINIER AVE S UNITA416 SEATTLE WA 98118 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
14 LIABILI V INSURANCE INSURANCE CO AMERICAN FAMILYINSURANCE BX13691543 3 4
IN EFFECT &POLICY# 9TOP
VEHICLE CHARGE 5 36
LEGALLY YES❑NO❑ CITATION# 6A0281373 FAIL YIELD LEFT TURN MOTOR )o sorrow
15❑ STANDING 7 6
1.' MOTOR PEDAL- PROPERTY DAM THR OLD MET PHONE
UNIT 02 VEHICLE CYCLE ❑ PEDESTRIAN ❑ PROPOWNER ❑ YES NO HO 2535396623
16 a
LAST NAME VARGAS ORTIZ FIRST NAME NICOLE MIDDLE I,I
INITIAL
17❑ STREET ❑', 5831 S 152ND ST APT B203 CITY TUKWILA ST WA ZIP 981885701 37
NEW ADDRESS ❑
18� CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED ❑ 38
INTERLOCK YEs❑NOR INTERLOCK YEs It I NOF YES t t— l NO❑
19 DRIVER'S STATE WA ]SEX IF D.C... 02 _ 17 2003 39
LICENSE# MMDDYY
WELMET {NJURY NATURE OF INJURIES 40
20❑ ON DUTY STATUS AIRBAG 6 RESTR 4 EJECT 1 USE 2 CLASS 7 PAIN TO LEFT ARM ❑
21❑ LICENSE I CVU7638 TATe WA YIN# KNADM4A36C6084328
❑ 41
PLATE#
42
22❑ PLATE# STATE PLATE# STATE
TRLR
23❑ UIN#. IN#.
43
RLR
'
TOWED BV Gov HI 44
VEH YEAR 2012 MAKE KJA MODEL RIO STYLE SD DAMAGE TOWED✓ NOO BLIN GENE MEYERS TOWING YES NO�/
24❑ REGISTERED OWNER INFO OWNED SY DRIVER VEHICLE N0.2
SHADEDAMAGEDAREA
3 4
LIABILITY INSURANCE❑ INSURANCE CO
IN EFFECT &POLICY# 9TOP 5
VFHICLE YES N(� CITATION# 6A0281375 CHARGE OP MOT VEH W/OUT INSURANCE ,o BOTTOM
LEGALLY
25 ' e
7CATALAN
NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
26 12007 WA0171300
PART A PAGE 01 OF
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EH06111
COLLISION REPORT III III III III III 111
1591972 CASE# 26-4059
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.CATALAN 05-26-26 05:23 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY E
DAT
C.JACOBS 1953 512712026 7:40:25 AM
BADGE OR ID# 1Y007 ORI# WA0171300 TIME POLICE DISPATCHED 3:14 PM TIME POLICE ARRIVED]3:14 PM
PART I PAGE IT]OF 4�
REPORT NO. EH06111 CASE# 26-4059 OF COLLISION
05/26/26 15:14
OF CbLLI510N
NARRATIVE
On May 26, 2026, at approximately 1514 hours, I was dispatched to a vehicle collision at the
intersection of Sunset Blvd NE and 1405, within the City Limits of Renton, County of King, State of
Washington.
Upon my arrival, I observed heavy mechanism to the involved vehicles with airbag deployment as
well as both of the involved parties complaining of pain. The Renton Regional Fire Authority (RRFA)
responded to the scene for evaluation. While on scene, I collected each of the involved party's driving
information and their independent recollection of the events leading up to the collision.
The driver of Unit#1, identified as Efrata Derebie, stated that she was the sole occupant of her
vehicle and that prior to the collision she was traveling eastbound on Sunset Blvd NE and
approaching the on ramp to i405. Efrata pulled into the left-turn lane and slowed to yield to traffic.
While attempting to complete her left turn, she noticed Unit#1 traveling southbound on Sunset Blvd
NE. Efrata believed she had enough time to cross the roadway, so she proceeded forward. After she
crossed the roadway, both vehicles collided in the southbound lane causing significant damage to the
front passenger side quarter panel and front bumper of Unit#1.
The driver of Unit#2, identified as Nicole Vargas Ortiz, said she was the sole occupant of her vehicle
and was traveling southbound on Sunset Blvd NE and approaching the entrance to 1405. Nicole
intended on continuing south past the onramp, but as she neared the intersection, Unit#1 struck her
vehicle. Nicole was unable to avoid the collision and both vehicles collided causing significant
damage to the front of Unit#2. The driver of Unit#2's said his left arm was in pain but was treated
and released at the scene.
Based on the above statements, I determined that the Driver of Unit#1 (Efrata) is the proximate
cause for the collision due to not granting the right of way during a left turn causing a collision. She
violated RCW 46.61.185(1) by being the driver of a vehicle intending to turn to the left within an
intersection and not yielding the right-of-way to any vehicle approaching from the opposite direction
which is within the intersection or so close thereto as to constitute an immediate hazard.
Nicole was operating a motor vehicle without insurance, so she was issued a Sector citation for that
traffic infraction.
Efrata was cited for failing to yield while making a left turn.
Both involved vehicles had to be towed due to extensive damage cause. An exchange of information
was provided to all involved parties.
I certify (or 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. Catalan 05/26/2026 Renton, King County, WA.
PAGE 3 OF 4
REPORT NO. EH06111 CASE# ' 26-4059 DATE AND TIME 05/26/26 15:14
OF COLLISION
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PAGE 4 OF 4