HomeMy WebLinkAbout26-4145 TFFiNouCERA II I III 1 III I III I IIII III II I . 0 27c
COLLISION REP FIT 1591971
CASE 26-4145 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 3 TOTAL#OF OBJECT 1 1 8 28
TRIBAL UNITS 03 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 1211 17 ❑-= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
HARDIE AVE SW BLOCK NO. e✓ 700 ❑
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ ❑ FEET e S ❑ VV e SW 7TH ST
0 3 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
✓NO D:8083938888 0 81
30
6� LAST NAME MATHINAY FIRSTNAME NADEGE MIDDLE 1 2 31
INITIAL
STREET ❑, 8518 S 123RD PL CITY SEATTLE ST WA 2jp, 98178 z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
iNTERLOCKYEs NO 1/ INTERLOCKYEs NO�/ YES R No�/
8❑ LRIIVER #
ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 H U SE
ICNLJAUSSY 1 NATURE OF INJURIES z❑
3
LICENSE CTB4898 sTArI WAvIN#' JT3HN86R9W0179659
10❑ PI ATE 94
TRAILER STATE TRAILER STATE
11 3 0 PLATE# PLATE# FROM TO
TRLR. RLR 1 7 33
12 3 0 VIN#' VIN#
FROM TO
VEH.YEAR 1998 MAKE TOYT MODEL 4 STYLE UT VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE 9 9 34
13 2 DAMAGE YES NO YES[:] NO✓
REGISTERED OWNER INFO OWNEDBYDRIVER VEHICLE NO. 1
SHADE IN DAMAGED AREA ❑ 35
14 LIABILI INSURANCE INSURANCE CO ALLSTATE 2030808699 3
IN EFFECT &POLICY# 9TOP
vEGALLv Hla.e 5 36
YES No CITATION# 6A0264000 CHARGE SPEED TOO FAST FOR CONDITIONS o eorrom
15❑ LE STANDING 8 7 6
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM -PHONE
THR OLD MET
UNIT U2 VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES NO ,/ D:2064983760
16 a
LAST NAME VENTURA FIRST NAME JORDAN MIDDLE Y
INITIAL
17❑ STREET ❑', 16618 125TH AVE SE CITY RENTON ST WA ZIP 98058 37
NEW ADDRESS ❑
18� CDL IGNITION REQUIRED IGNITION PtR—E—S1ENT MEDICAL TRANSPORTED ❑ 38
INTERLOCK YEs❑No� INTERLOCK YEs I I NOF YEs t l NOF,/
19 DRIVER'S STATE WA SEX F D.C.B. 02 _ 16 _ 1996 39
LICENSE# MMDDYY
WELMET INJURY1 NATURE OF INJURIES 40
20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 USE CLASS ❑
21❑ LICENSE ATM4996 TAre I WA VIN# 2HGFG3B59EH506916
❑ 41
PLATE#
42
22❑ PLATE# STATE PLATE# STATE
23❑ VIN#. 43
TRLR RLR
'IN#.
VEH YEAR 2014 MAKE HOND MODEL CIVIC STYLE SD VEHICLETOWED TO BLIN TOWEDBY GOV HI 44
L4❑ DAMAGE YES NO YES NO
REGISTERED OWNER INFO CLAYTON VENTURA 16618125TH AVE SE RENTONWA98058 VEHICLE NO.2
SHADE IN DAMAGEbAREA
2 3 Cd
LIABILITY
INSURANCE INSU&PORGY#E CO ALLSTATE 907031175IN I 5
VE""LE CITATION# CHARGE LEGAL
25 GQ
LY YES N�
❑ s a
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
J
26
R.ON/SHl 5738 WA0171300
PART A PAGE 01 OF C7
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EH10065
COLLISION REPORT III III III III III 111
1591972 CASE# 26-4145
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'
Units 2 and 3 in left turn lane from eastbound SW 7th St to northbound Hardie Ave SW. Unit 1
accelerating from stop signal, turning from southbound Hardie Ave SW to westbound SW 7th St.
Driver 1 Maghinay told me that as she drove through the turn, her car lost traction on wet roadway.
Maghinay said that she tried to drive the car as it slid, which only caused it to spin the other way.
Passenger side of Unit 1 struck front left corner of Unit 3. Unit 1 continued to spin, with left front of
Unit 1 hitting right rear of Unit 2. Maghinay issued NOI for speed too fast for conditions.
I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT.
R.ONISHI 05-29-26 01:35 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
D.SKELTON 9139 1 6/9/2026 4:03:40 AM
BADGE OR ID# 5738 ORI# WA0171300 TIME POLICE DISPATCHED; ?Y:19 PM TIME POLICE ARRIVED',12:22 pM
PART I PAGE IT]OF 4]
SUPPLEMENTAL REPORT NO. EH10065
r`) POLICE TRAFFIC 1 1 8 27
COLLISION REPORT CASE# 26-4145
1 COMMERCIAL MOTOR CARRIER INTERSTATE INTRASTATE G
UNIT'# USDOT ICC# VEHICLE TYPE CARGO BODY
;TYPE
2 ❑ 1 28
CARRIER
NAME
3 CARRIER
ADDRESS `
CITY ST ZIP—1 I '
4 ❑ NAME # PLACARD: :❑
GI PLACARD IF NO NUMBER
SOURCE AXLES +
4a ❑ ADDITIONAL UNITS
MOTOR PEDAL- PROPERTY DAMAGETHRESHOLD MET PHONE
UNIT# 3 �✓ � PEDESTRIAN YES NO
5 VEHICLE CYCLE OWNER ✓ D:2062295771
0 8 29
LAST NAME KELELEW FIRST NAME KIROS MIDDLE' ',, W
INITIAL
STREET 30
NEW AnDRFSP' 14031 33RD PL S CITY TUKWILA ST WA ZIP 98168
6 ❑ 1 1 2 31
CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TANSPORTED
INTERLOCK YEs NO✓ zERLOCK YES�NOf YEs N ✓
DRIVER'S
LICENSE STATE I WA SEX M MMDDYYv 02 - O6 - 1979
7
ON DUTY� STATUS AIRBAG' 2 RESTR. Q EJECT 1 HELMET I INJURY 1 1 NATURE OF INJURIES
USE CLASS
8 ❑ 1 32
LICENSE BJB7712 TAr WA VIN# JTDKN3DUXF1899316
PLATE#
9 TRAILER TRAILER
PLATE# STATE PLATE# STATE
10 ❑ TRLR TRLR
VIN.It VIN.#.
11 3 0 VEH.YEAR2015 MAKE TOYT I MODELPRIUS STYLE LIB VEHICLE TOWS E T SABLIN TOWED BY anvi vEH11' P FROM TO
DAMAGE YES NO ✓ YES NO ✓
33
REGISTERED OWNER INFO OWNED BY DRIVER J 9
12 SHADE IN DAMAGED AREA
7 j 4 FROM TO
LIABILITY INSURANCE INSURANCE CO SAFECO H2594271 gTOp
IN EFFECT &POLICY# 1
SHILLS 34
13 ❑ LEGALLY YES NO❑ CITATION# CHARGE 0 BOTTOM
STANDING S} 7 6
14 ❑ UNIT Tr Vd IRE O CYDCLE OWNER
RTY YES[—]AGE NOHRESHOLD MET PHONE ❑ 35
PEDESTRIAN
15 LAST NAME FIRST NAME NII7 aL
❑ 36
STREET"[-]
16 NEW nnR CITY ST ZIP
CDL IGNITION REdUiRED IGNITtGN PRESENT MEDICALTANSPORTED
INTERLOCK YES No INTERLOCK YEs NO YEs NO El
17 37
LICENSE# STATE SEX MMDDDYBYY
18 ❑ ON DUTY� STATUS AIRBAG RESTR. ; EJECT HELMET INJURY NATURE of INJURIES 38
USE (CLASS
19 ❑ 39
LICENSE rnr vIN#
PLATE#
20 ❑ TRAILER' TRAILER El40
PLATE#< STATE PLATE# STATE
21 ❑ TRLR TRLR 41
VIN# YIN#i
42
22 VEH.YEAR MAKE I MODEL STYLE I VEHICLE TO DUET SABLIN TOWED BY GOVT.VEHICLE
DAMAGE YES NO YES NO
23 REGISTERED OWNER INFO_ SHADE IN DAMAGED AREA 43
3 4 71
LIABILITY INSURANCE INSURANCE CO '
VINE
EFFECT &POLICY# i 970P - 4 E:l
44
24 LEHIcLE YES❑ NO❑ CITATION# CHARGE iq 60TiOM
LEGALLv
STANDING 8 7 6
1 CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT.
R.ONISHI 05-29-26 01:35 PM
25 INVESTIGATING OFFICER'S SIGNATURE OFFICER'S PHONE UNIT OR DIST DET DATED: PLACE SIGNED
APPROVED BY DATE
26 ORID# 5738 O#I,WA0171300 SKELTON 6/9/2026 PAGE F OF 4
3000-345-013(R 11118)
REPORTNO.! EH10065 CASE# 26-4145 DATE AND TIME 05/29/2612:11
OF COLLISION
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