HomeMy WebLinkAbout26-4066 (2) ITFF' "POLCERA II I !�� I III I III I IIII III II I . 1 27c
COLLISION REP FIT 1591971
SASE 26-4066 2
INTERSTATE ❑ CITY STREET FIRE ❑
RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHIr.I F ❑ LOCAL AOENC 4Y00 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#
COLLISION'. 05 - 1-- 2026 1843 17 ❑-= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
WILLIAMS AVE N BLOCK NO. e✓ 300 ❑
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ ❑ FEET e S ❑ VV e N 3RD ST
0 1 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
NO D:2536008677 0 11
30
6❑ LAST NAME CARRENO GUALDRON FIRST NAME JHON MIDDLE F 1 2 31
INITIAL
STREET ❑ 500 S 321ST ST APT 2B CITY FEDERAL WAY ST WA 2jp, 98003 z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
iNTERLOCKYEs NO 1/ INTERLOCKYEs NO�/ YES R No�/
8❑ LDRIVER # STATE WA SEX'M MID
-O B 01 1- 08 - 1998 2 32
9 ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 HELMET U E 2 1 CLASS NATURE OF INJURIES 2❑
3
10[1P1 ATNES# CTX9805 sTAr WAv N# 19XFA1F52BE012953
5 TRAILER STATE TRAILER STATE
11 3 5 PLATE# PLATE# FROM TO
TRLR. YRLR. 5 1 33
12 3 5 VIN#' VIN#
FROM TO
VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED By GOVT.VEHICLE 7 $ 34
13 1 2011 HOND CIVIC SD DAMAGE YES NO ves❑ No
REGISTEREDOWNERINFO OWNEDBYDRIVER VEHICLE NO. 1
SHADE IN DAMAGED AREA ❑ 35
14 ABILI V INSURANCE❑ NSURANCE CO <53 4
IN EFFECT &POLICY# Q
LENICLE CHARGE 36
LE ALLY res No clTAnoN# 6AO091521 OP MOT VEH W/OUT INSURANCE
15❑ STANDING
El
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM NO OLD MET PHONE
UNIT 02 VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES 1/ NO D:2533807126
16 a
LAST NAME TAISEY FIRST NAME JAMES MIDDLE J
INITIAL
17 STREET I❑ S❑' 27629 195TH AVE SE CITY KENT ST WA ZIP 98042 4❑ 37
NEW ADDREs
18❑ CDL IGNITION REQUIRED IGNITION PR-E-1SENT MEDICAL-T�RANSPORTED � 38
INTERLOCKYES�NO� INTERLOCK vEs It I NOF YES
t l NoF,/
19 LDICENS STATE WA SEX M M D.C.B. 05 _ 16 _ 2003 39
20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 H U EET 2 NJAURSY 1 NATURE OF INJURIES ❑ 40
LICENSE I ❑21❑ PLA E# BXU4338 TArE 41
WA vIN# 1FAHP3E23CL279575 1
42
22❑ PLATE# STATE PLATE# STATE
23❑ 43
TRLR RLR
VIN#. IN#.
I
VEH YEAR 2012 MAKE FORD MODEL FOCUS STYLE $D jVEHl DAMAGE TO WED NOO✓ BLIN TOWED By Gov 44
Yr
H YES
NO 1/
24❑ REGISTERED OWNER INFO OWNED SY DRIVER VEHICLE N0.2
SHADE DA GEbAREA
LIABILITY
INSURANCE INSURANCE
#E CO STATEFARM 5900105C2647IN I STOP 5
'E""LE ❑ ,J� CITATION# CHARGE to BOTTOM
LEGALLY YES N J
25 s e
7JAAA
'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
26L KEARSE 12994 WA0171300
PART A PAGE 01 OF
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EH06871
COLLISION REPORT III III III III III 111
1591972 CASE# 26-4066
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.
JAMAAL KEARSE 05-27-26 02:37 AM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
CASEY PROCTER 12123 512812026 9:18:29 PM
BADGE OR ID# 12994 ORI# WA0171300 TIME POLICE DISPATCHED 6:56 PM TIME POLICE ARRIVED',6:57 PM
PART I PAGE IT]OF 4�
REPORT NO. EH06871 CASE# 26-4066 OF COLLISION
05/26/26 18:43
OF CbLLI510N
NARRATIVE
Unless otherwise noted, all events took place in the City of Renton, in the County of King, in the State
of Washington.
This incident was captured on my body worn video camera and in-car cameras. This report is a
summary of events that occurred and is not an exact sequencing of events.
On 5/26/2026, at approximately 1856 hours I was dispatched to a report of a collision at the
intersection of N 3rd St and Williams Ave N. Dispatch advised 2 vehicle collision.
At approximately 1857 hours I arrived on scene. Unit 1 was located on Williams Ave N just south of
the intersection. Unit 2 was pulled off the road in a parking lot just east of the intersection. Unit 1 had
significant front-end damage. Unit 2 had significant damage to the passenger side of the car. Unit 1
had two occupants and Unit 2 had just one occupant. I contacted all parties involved and asked if
anyone was injured. They all stated they were uninjured and declined any medical aid. The driver of
Unit 1 handed me his driver's license and registration but advised he did not have insurance. Driver of
Unit 2 handed me his driver's license, registration and insurance.
The driver of Unit 1 relayed the following information. He was driving Northbound on Williams Ave N,
which is a one-way road that travels southbound. He stated he was following the directions on his
phone and didn't realize it was a one-way road. He was approaching the intersection of N 3rd St and
entered the intersection as there were no traffic control devices. He didn't see Unit 2 driving
eastbound on N 3rd St and struck the passenger side of Unit 2 with the front of his car.
The driver of Unit 2 advised the following. He was driving eastbound in lane 3 of 3 approaching the
intersection of Willams Ave N. He had a green light and entered the intersection. Unit 1 traveling
northbound on Williams Ave N entered the intersection at the same time, striking the passenger side
of his car with the front bumper of Unit 1.
I issued the driver of Unit 1 a notice of infraction for operating a motor vehicle without insurance.
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 J. Kearse #12994 9/9/2025 2050 Hours Renton, King County,
Washington
PAGE 3 OF 4
REPORT NO. EH06871 CASE# ' 26-4066 DATE AND TIME 05/26/26 18:43
OF COLLISION
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