HomeMy WebLinkAbout26-4150 TFFiNouCERA II I III 1 III I III I IIII III II I . 0 27c
COLLISION REP FIT 1591971
SASE 26-4150 2
INTERSTATE ❑ CITY STREET FIRE ❑
RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHIr.I F ❑ LOCAL AOENC 4Y00 3
HIT 8 RUN CODING
COUNTY RD PRIVATE WAY INVOLVED
2 2 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 1527 17 ❑-= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
SOUTH PORT DR BLOCK NO. e✓ ❑
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ �,❑ FEET e S ❑ W e HWY405 OFF RAMP
0 1 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
No ,/ I D:2063557428 0 11
30
6� LAST NAME BULEJE FIRSTNAME MARIA MIDDLE I R 1 1 2 31
INITIAL
STREET ❑ 2503 NE 4TH ST APT 414 CITY RENTON ST WA ZIP' 980564062 z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED I IGNITION PRESENT MEDICAL TRANSPORTED 3
iNTERLOCKYEs ,/ I NO NTERLOCKYEs NO Z YEs No�/
8❑ LRIIVER #
ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 HELMETU E 2 CLASS 1 NATURE OF INJURIES z❑
3
10❑ P1 aT�S� BQJ4295 sTArI WAurN# JA4A23A34GZ017162
TRAILER STATE TRAILER STATE
11 3 5 PLATE# PLATE# FROM To
TRLR. TRLR 7 3 33
12 3 5 VIN#' VIN#
>; FROM TO
❑ VEH.YEAR 2016 MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE 7 3 34
13 4 MITS OUTLAN 5D DAMAGE YES NO YES[:] No✓
REGISTERED OWNER INFO JOSHDEMPSE12503NE4THSTAPT414 RENTONWA98056 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
14 LIABILITY INSURANCE INSURANCE CO PROGRESSIVE 867138387 4
LI EFFECT I SUR N# TOPVEHICLE CHARGE 36
LEGALLYYES NO CITATION# 6A0002182 SPEED TOO FAST FOR CONDITIONS <1�3
orrom
15❑ STANDING 7 6
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES NO ,/ D:2064725492
16 a
LAST NAME PERKINS FIRST NAME DIONNE MIDDLE I C
INITIAL
17❑ STREET NEW ADDREss❑' 4004 NE 4TH ST STE 107 CITY RENTON ST WA ZIP 980564102 4❑ 37
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 LICENSE# STATE WA SEX F MMDDW 09 _ 20 _ 1970 39
20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 H U EET 2 NJAURSY 1 NATURE OF INJURIES ❑ 40
❑LICENSE 21❑ PLA E# CSX2564 TArE 41
WA vIN# W1NKJ4HBOSF344228 1
42
22❑ PLATE# STATE PLATE# STATE
23❑ UIN#. 43
TRLR RLR
'IN#.
Gov HI
VEH YEAR 2025 MAKE MERZ MODEL GLC STYLE 5D DAMAGE TOWED NOO✓ BLIN TOWED BY 44
ES YES NO,/
24❑ REGISTERED OWNER INFO OWNED SY DRIVER VEHICLE N0.2
SHADE IN DAMAGED AREA
2 3 4
LIABILITY
INSURANCE 8 POINSURGY#E CO STATE FARM 5795984DO347IN IGVEHICLE
TOP
❑ C—I CITATION# CHARGE OTTOM
LEGALLY YES N`LJ
25
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# JAGENCY
26
E.CHANG 10065 WA0171300
PART A PAGE 01 OF C7
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT No. EH10339
COLLISION REPORT III III III III III 111
1591972 CASE# 26-4150
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'
On 05-29-2026 at about 1527 hours, I was sent to a collision which occurred at the intersection of N
Southport Drive and the 405 Hwy Off Ramp, within the City of Renton, King County, Washington.
Upon arrival I saw both vehicles blocking traffic in lane 3 eastbound N Southport Drive. The driver of
unit 1 did not want to move her vehicle to the side to allow traffic to flow normally. I later found out
that her husband who is a "tow truck driver" told her not to move her vehicle. He arrived later and told
me he said he wanted to inspect the scene.
I spoke with both drivers and they had the same account of the incident. They were identified via
their valid WADL.
Unit 2 was stopped on a red light with unit 1 behind. When the light turned green a preceding vehicle
in front of unit 2 moved, unit 2 slowly started moving when unit 1 rearended unit 2.
The driver of unit 1 said the light was green when she went and collided with unit 2.
Unit 1 was traveling too fast and collided with unit 2.
No person shall drive a vehicle on a highway at a speed greater than is reasonable and prudent
under the conditions and having regard to the actual and potential hazards then existing. In every
event speed shall be so controlled as may be necessary to avoid colliding with any person, vehicle or
other conveyance on or entering the highway in compliance with legal requirements and the duty of
all persons to use due care.
The driver of unit 1 drove too fast and did not control her speed to prevent a collision.
I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT.
E.CHANG 05-29-26 06:19 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
J.TRADER 4553 1 6/9/2026 3:37.30 PM
BADGE OR ID# 10065 ORI#' WA0171300 TIME POLICE DISPATCHED 3:27 Pry TIME POLICE ARRIVED 3:28 PM
PART I PAGE IT]OF 3�
REPORTNO.! EH10339 CASE# 26-4150 DATE AND TIME 05/29/2615:27
OF COLLISION
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