HomeMy WebLinkAbout26-3866 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 2 27c
COLLISION REP FIT 1591971
CASE 26-3866 z
INTERSTATE ❑ CITY STREET FIRE ❑RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHIr.I F ❑ LOCAL AOENC 4200 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 CITY#
COLLISION'. 05 - 19 - 2026 2217 17 . N E IN� S 8 W H OF e 1070 3
4❑ oN (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
BENSON RD S BLOCK NO. e✓ 2000 ❑
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ �.❑ FEET e S ❑ W e S PUGET DR
0 5 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
,/No D:4252727863 0 11
30
6❑ LAST NAME VASQUEZ FIRSTNAME ANDY MIDDLE A 1 1 2 31
INITIAL
STREET ❑ 11900 SE 161 ST ST CITY RENTON ST WA Zlp' 98058 z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION : PRESENT MEDICAL TRANSPORTED 3
1/ I INTERLOCK YES[:]NO NTERLOCKYEs NO Z/ YES R No�/
8❑ LDRIVER # STATE WA SEX'M MID
-O B 05 1— O6 — 1995 2 32
9 ON DUTY❑ STATUS' AIRBAG 6 RESTR 3 EJECT 1 HELMETU E 2 1 INJURY CLASS 6 [NATURE OF HEAD ANDNWRISTS JURIES z❑
3
10 1❑ P1 ATE 14 AVE4063 STATE WAa VIN# 4T18E46K67U694122
TRAILER STATE TRAILER STATE
11 0 0 PLATE# PLATE# ROM ro
TRLR. TRLR $ 5 33
12 0 0 VIN#' VIN#
>;. FROM TO
❑ VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN T GOVT.VEHICLE 1 $ 34
13 8 2007 TOYT CAMRY SD DAMAGE vE6 0NO f �LAWkkRS TOWING vEs❑ No
REGISTERED OWNER INFO OWNEDBYDRIVER VEHICLE NO. 1
SHADE IN DAMAGED AREA ❑ 35
14 LIABILI INSURANCE INSURANCE CO STATE FARM 529-5567-FO5-47 3 4
IN EFFECT &POLICY# 9TOP
❑ LEGA LE CHARGE 5 36
15 2 VEHsT" N YEs No clTAnoN# PROHIBITED U TURN o sorrow
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT VEHICLE ❑ CYCLE ❑ ❑ : OWNER ❑ YES 1/ No I D:2066943543
16 2
LAST NAME PHOMMAHAXAY FIRST NAME ELI MIDDLE
INITIAL
17 STREET NEW ADOREs7 22042 102ND PL SE CITY KENT ST WA ZIP 98031 4❑ 37
18� CDL IGNITION REQUIRED IGNITION PR—E-1SENT MEDICAL TRANSPORTED 38
INTERLOCK YEs❑No� INTERLOCK vEs It I NOF YES
t l NOF,/
19 LICENSE# STATE WA SEX M M .C... 11 � 05 _ 1975 0 39
WELMET {NJURY 7 NATURE OF INJURIES 40
20❑ ON DUTY STATUS AIRBAG,3 RESTR 3 EJECT 1 USE 2 CLASS RIGHT SHOULDER
❑LICENSE I 21❑ PLA E# C08150E TATe WA VIN 1t 3GTU2VECXFG272359 41
1
42
22❑ PLATE# STATE PLATE# STATE
23❑ VIN#. 43
TRLR RLR
'IN#.
TOWED ev Gov HI 44
VEH YEAR 2015 MAKE GMC MODEL SIERRA STYLE 4C DAMAGE TOWED✓ NOO BLIN BANKERS TOWING YES NOn
24❑ REGISTERED OWNER INFO OWNED SY DRIVER VEHICLE N0.2
SHADEDAMAGEDAREA
3 4
LIABILITY
INSURANCE INSU&PORGY#ECO STATE FARM 0772336-CO1-47EIN STOP 5
VE—LE ❑ ,J� CITATION# CHARGE
25 io BOTTOM
LEGALLY YES N J
' a
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# JAGENCY
26
JORDAN WILSON 13310 WA0171300
PART A PAGE 01 OF
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EH06851
COLLISION REPORT III III III III III 111
1591972 CASE# 26-3866
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,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.
JORDAN WILSON 05-20-26 04:58 AM
NVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
TIMOTHY NGUYEN 13182 512812026 6:45:40 PM
BADGE OR ID# 13310 OR]# WA0171300 TIME POLICE DISPATCHED 10:17 PM TIME POLICE ARRIVED',10:23 PM
PART I PAGE IT]OF 4]
REPORT NO. EH06851 CASE# 26-3866 OF COLLISION
05/19/26 22:17
OF CbLLI510N
NARRATIVE
26-3866
On 05/19/2026 approximately at 2218 hours, I was working as a uniformed patrol officer and driving a
marked patrol vehicle for the City of Renton. My FTO, Officer Ediger and I were dispatched to a report
of a 2-vehicle, possible-injury, collision near the intersection of Benson RD S and S Puget DR
Renton/King/WA.
I arrived on scene and located the 2 vehicles and Renton Fire Department near the intersection listed
above. Renton Fire Department evaluated the two parties and confirmed only minor injuries.
The driver of the black GMC, Sierra WA/AXB288 (unit#2) was identified by his WADL as ELI
PHOMMAHAXAY DOB: 11/05/1975. Eli said he was traveling southbound on Benson Rd S heading
towards the intersection. Eli said by the time he crossed the intersection of Benson RD S and S Puget
DR, Unit#1 tried making an improper U-turn. Eli said he tried avoiding unit#1 by swerving to the left
but didn't have enough time. Eli was cleared by Renton Fire but received minor injuries.
The driver of the 2007 Toyota Camry WA/AVE4063 (unit#1) was identified by his WADL as ANDY
ALEXIS VASQUEZ DOB: 05/06/1995. Andy was traveling east on S Puget DR, Andy came to the
intersection listed above and turned right onto Benson RD S heading southbound. Once Andy was on
Benson RD S, Andy tried making a U-turn to head back northbound on Benson RD S. When making
the U-turn Andy was struck by Unit#2 on his driver's side door. Andy was cleared by Renton Fire but
received minor injuries.
Both parties involved received each other's information and the vehicles were towed by Bankers
Towing.
I cited ANDY ALEXIS VASQUEZ for Improper U-Turn RCW (46.61.295) and sector citation number
#6A0288170.
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 J. Wilson #13310 02:45 AM 05/28/2026 Renton, King County, WA.
PAGE 3 OF 4
REPORT NO. EH06851 CASE# 26-3866 DATE AND TIME 05/19/26 22:17
OF COLLISION
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PAGE 4 OF 4