HomeMy WebLinkAbout26-4198 ITFF' "POLCERA II I !�� I III I III I IIII III II I . 0 27c
COLLISION REP FIT 1591971
❑ ❑ FIRE ❑ CASE# 26-4198 2 5 0
INTERSTATE CITY STREET RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHIC;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 RESERVATION STRUCK
2
3❑ DATE of M M D D Y Y Y Y TIME(2400) COUNTY# MILES N E IN CITY#
CowsloN 05 - 1-- 2026 1415 17 ❑-= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
TALBOT RD S BLOCK NO. e ❑
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ �,❑ FEET e S ❑ W e S RENTON VILLAGE PL
Fill
1 29
MOTOR PEDAL- DAM THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El YEs NO ,/ D:5095995694 0 7 30
6� LAST NAME MARTINEZ FIRSTNAME J MIDDLE A 1 1 2 31
INITIAL
STREET ❑ 17643 196TH AVE SE CITY RENTON ST WA 7jp, 98058 2
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
INTERLOCK YES[:]NO 1/ INTERLOCKYEs NO�/ YES R No�/
8❑ LRIIVER #
ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 H USEET ICNLJAUSSY 1 NATURE OF INJURIES 2❑
3
10❑ Pi aTES� CWX5240 sTATe WAurN# 5N1AR18U96C659611
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 2006 NISS PATHFIN MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED By GOVT.VEHICLE 5 9 34
13 4 DAMAGE YES NO YES[:] No
✓
REGISTERED OWNER INFO OWNEDBYDRIVER VEHICLE NO. 1
❑
SHADE IN DAMAGED AREA ❑ 35
14 ❑ INSURANCE CO 3 4
LIABILITY INSURANCE
IN EFFECT &POLICY# 9TOP
vewCLE CHARGE 10BOTTOM 5 36
YES No CITATION# 6A0091766,6A0091766, INATTENTIVE DRIVING,NO VALID
15❑ STANDING 8 7 6
MOTOR PEDAL- PEDESTRIAN : PROPERTY DAM THR OLD MET PHONE
UNIT VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES 1/ NO D:4257365820
16 a
LAST NAME HOUSTON FIRST NAME CLIFFORD MIDDLE
INITIAL
17❑ STREET Is❑' 23624 1 01ST PL SE,APT J204 CITY' KENT ST WA ZIP 98031 37
NEW ADDREs
18❑ CDL IGNITION REQUIRED IGNITION PR-E-1SENT MEDICAL-T�RANSPORTED � 38
INTERLOCK YES❑No� INTERLOCK YEs It I NOF YES
t l NoF,/
19 DRIVERIS
❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 H U EET NJAURSY 1 NATURE OF INJURIES ❑ 40
❑21❑ PLATE# BXE4969 TATE 41
WA VIN# KL4MMBS24L8129555 1
42
22❑ PLATE# STATE PLATE# STATE
TRLR
23❑ UIN#. N#.
43
RLR
'I
Gov HI
VEH YEAR 2020 MAKE BUIC MODEL ENCORE STYLE DAMAGE TOWED NOO✓ BLIN TOWED BY 44
ES YES
NO 1/
24❑ REGISTERED OWNER INFO OWNED SY DRIVER VEHICLE N0.2
SHADE IN DAMAGED AREA
2 3 4
LIABILITY
INSURANCE &POINSURGY#E CO STATE FARM 523 1778-006-47IN 1GVEHICLE
TOP
CITATION# CHARGE OTTOM
LEGALLY YES[Z N(E
25❑ s a
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
26
P.LANTAGNE 12575 WA0171300
PAGE 01 OF
PART A
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EH07448
COLLISION REPORT III III III III III 111
1591972 CASE# 26-4198
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.
P.LANTAGNE 05-31-26 04:22 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
D.SKELTON 9139 5/31/2026 4:28:23 PM
BADGE OR ID# 12575 OR]# ! WA0171300 TIME POLICE DISPATCHED 2:97 Pry] TIME POLICE ARRIVED',2:17 PM
PART I PAGE IT]OF 4�
TIME
REPORT NO. EH07448 CASE# 26-4198 OF COLLISION05/31/26 14:15
NARRATIVE
26-4198
On 05/31/2026 at approximately 1415 hours, I, Officer Lantagne, observed a blocking, non-injury
collision which occurred at the intersection of Talbot RD S and S Renton Village PL, which is located
in the City of Renton, County of King, and the State of Washington. I was in my fully marked police
vehicle, wearing my patrol uniform and body worn vehicle.
I observed Unit#1, a 2006 Nissan Pathfinder with license plates CWX5240 issued out of Washington
State, and Unit#2, a 2020 Buick Encore with license plates BXE4969 issued out of Washington
State, blocking the northbound inside lane of Talbot RD S to the south of the intersection at S Renton
Village PL.
The driver of Unit#1, J A Martinez (DOB 05/25/1975), spoke primarily in Spanish and Officer Catalan
(Spanish speaking officer) responded to the scene to speak with him. I conducted a Department of
licensing check using Martinez's Washington State issued identification card which returned as
suspended in the third degree. Martinez advised he did not have insurance for the vehicle. Martinez
advised he knew his license was suspended.
I contacted the driver of Unit#2, Clifford Houston (DOB 11/11/1948), who told me the following:
Houston was stopped for traffic at a red light and had been waiting for a while. As Houston was
waiting for the light to turn green, the rear of his vehicle was struck by Unit#1.
I observed the damage to the vehicles and other physical evidence was consistent with the
statements made by Houston. Unit#1 had fresh minor damage to the front bumper and hood. Unit# 1
also had significant damage to the front end from a previous collision. Unit#2 had minor dents and
scrapes to the rear lift gate.
The collision diagram is an accurate illustration of the events leading up to the collision.
I provided an exchange of information to Houston. 1 issued an infraction to Martinez for inattentive
driving, operating a motor vehicle without proof of insurance, and operating a motor vehicle without a
valid driver's license with a valid ID to be mailed through the court.
Martinez was advised he could not legally drive the vehicle which was towed by Banker's Towing due
to it blocking traffic.
I, Officer P. Lantagne #12575, certify (or declare) under penalty of perjury, under the laws of the State
of Washington, the foregoing is true and correct.
Electronically signed by Officer P. Lantagne #12575 at 1544 hours on 05/31/2026 at Renton, WA.
PAGE 3 OF 4
REPORT NO. EH07448 CASE# ' 26-4198 DATE AND TIME 05/31/26 14:15
OF COLLISION
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