HomeMy WebLinkAbout26-4002 ITFF' "POLCERA II I !�� I III I III I IIII III II I . $ 27c
COLLISION REP FIT 1591971
SASE 26-4002 2
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 N E IN CITY# ❑
cowsloN 05 - 1-- 2026 2258 17 ❑.= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓
480 SUNSET BLVD N
BLOCK NO. e✓ --- ----�
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ ❑ FEET e S ❑ W e 0 $ 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
No ,/ I D:4252214241 0 11
30
LAST NAME PETERSON-PHILLIPS FIRST NAME DELANEY MIDDLE A
6 INITIAL 1 2 31
STREET ❑ 12611 SE 75TH ST CITY NEWCASTLE ST WA 21p 980561308 z
'NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
INTERLOCK YES[:]NO,/ INTERLOCKYEs NO�/ YES R No�/
8❑ LRIIVER #
ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 HELMETU E 2 CLASS 1 NATURE OF INJURIES z❑
3
10 9❑ Pi aT�S� BDJ3090 sTArI WAurN# 1FM5K8F86GGC24592
TRAILER STATE TRAILER STATE
11 3 0 PLATE# PLATE# FROM TO
TRLR. TRLR. $ 5 33
12 3 0 VIN#' VIN#
>; FROM TO
VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE 1 $ 34
13 3 2016 FORD EXPLOR DAMAGE YES NO YES[:] No
✓
REGISTERED OWNER INFO LAURA PETERSON 12611 SE 75TH ST NEWCASTLE WA 98056 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
14 LIABILI INSURANCE INSURANCE CO PROGRESSIVE 868175005 3 4
IN EFFECT &POLICY# 9TOP
36
VEHICLe CHARGE 1 5
YES❑NO CITATION# 6A0048853 FAIL YIELD AT YIELD o eorrom
15❑ STANDING 8 7 6
MOTOR PROPERTY'.PEDESTRIAN DAM,/ THR OLD MET PHONE
UN�T PEDAL-VEHICLE ❑ CYCLE: ❑ ❑ OWNER ❑ YES NO D:2064309201
16 a
LAST NAME PRAM FIRST NAME NGUYEN MIDDLE I T
INITIAL
17❑ STREET Is❑' 20490 137TH AVE SE CITY KENT ST WA ZIP 980423001 4❑ 37
NEW ADOREs
18❑ CDL IGNITION REQUIRED IGNITION PtR—E—S1ENT MEDICAL—T�RANSPORTED � 38
INTERLOCKYES�NO� INTERLOCK YEs I I NOF YEs t l NOF,/
19 DRIVER #
❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 H U EET 2 NJAURSY 1 NATURE OF INJURIES 40
❑ 41
21❑ ILICENSE PLA E# ASA8733 TArE WA VIN# 2HGF62F51EH536379 1
42
22❑ PLATE# STATE PLATE# STATE
23❑ UIN#. 43
TRLR RLR
'IN#.
VEH YEAR 2014 MAKE HOND MODEL CIVIC STYLE VEHICLE TOWED TO BLIN TOWEDBY GOV HI 44
L4❑ DAMAGE YES,/ NO YES NO
REGISTERED OWNER INFO THUYLE20490137THAVESE KENTWA98042 VEHICLE NO.2
SHADE IN DAMAGEbAREA
2 3 Cd
LIABILITY
INSURANCE &POINSURGY#E CO FARMERS 190427776IN I STOP
VE""LE ❑ N`L J
,J� CITATION# CHARGE
LEG
25 i o BOTTOM
ALLY YES $
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
J
26
JAKE GALL 12617 WA0171300
PART A PAGE 01 OF C7
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EH06637
COLLISION REPORT III III III III III 111
1591972 CASE# 26-4002
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.
JAKE GALL 05-24-26 12:36 AM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
NICOLAS SANGDER 11350 1 512812026 1:54:04 AM
BADGE OR ID# 12617 OR]# ': WA0171300 TIME POLICE DISPATCHED! 10:58 PM TIME POLICE ARRIVED 11:03 PM
PART I PAGE IT]OF 4�
REPORT NO. EH06637 CASE# 26-4002 OF COLLISION
05/23/26 22:58
OF CbLLI510N
NARRATIVE
*This incident was captured on my body worn video camera. This report is a summary of events that
occurred and is not an exact sequencing of events. Statements have been paraphrased and
summarized. *
The following occurred within the City of Renton, King County WA and was recorded on my body
worn camera.
On 05/23/2026 at around 2258 hours, I was dispatched to a blocking two vehicle collision located
near the Southbound 1-405 Offramp on Sunset Blvd N (480 Sunset Blvd N). I arrived on scene and
located both vehicles blocking the Southbound lane of travel on Sunset Blvd N. One vehicle was
facing North bound in the single South bound lane.
I spoke with driver 1 who provided all the necessary information. Driver 1 stated that she was stopped
at the turnaround on Sunset Blvd N, attempting to turn South onto Sunset Blvd N. Driver 1 inched
forward attempting to merge, but did not see vehicle 2 traveling South on Sunset Blvd in lane 1 of 1.
Vehicle 1 was drivable and there was only a small amount of damage to the front passenger quarter
panel, which impacted vehicle 2's rear driver side door and ripped off the rear bumper. Passenger 1
confirmed the same story.
I spoke with driver 2, who was uninjured. Driver 2 showed me in car video footage of the collision.
Driver 2 was driving the speed limit Southbound on Sunset Blvd N. The video shows vehicle 1
protrude out of the turn around point as driver 2 was passing by. The nose of vehicle 1 impacted the
rear driver side door/bumper of vehicle 2. Vehicle 2 was not drivable, so Gene Meyers towing was
called to the scene.
I provided both drivers with an exchange of insurance form, as well as the case number.
Driver 1 was cited for RCW 46.61.190.3 Failure to yield at intersection (6A0048853).
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 J. Gall/12617
05/24/2026 at 0026 hours, Renton, Washington
PAGE 3 OF 4
REPORT NO. EH06637 CASE# 26-4002 DATE AND TIME 05/23/26 22:58
OF COLLISION
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