HomeMy WebLinkAbout26-4434 STATE OF II I III 1 IIIllI111IN II II I REPORT NO. EH10342 170
27
COLLISION REP FIT 1591971
CASE 26-4434 z
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 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 CITY# ❑
cowsloN 06 - 08 - 2026 1039 17 ❑.❑ N E IN S 8 W H OF e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑ NON INTERSECTION ❑✓
NE 3RD ST BLOCK NO. e✓ 1800
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ 200 00 FMILES EET e S ❑ W e SUNSET EILVD N
2 0 29
MOTOR PEDAL- DAM THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El YES
No ,/ D:4252746330 0 11
30
6� LAST NAME LY FIRSTNAME DANNY MIDDLE 1 2 31
INITIAL
STREET ❑ 323 FERNDALE AVE NE CITY RENTON ST WA Zjp, 98056 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 HELMET
2 CLASS 1 NATURE OF INJURIES z❑
3
LICENSE C000370 sTArI WAurN# 7SAYGDEE7PA109898
10 F91 PI ATE#
TRAILER STATE TRAILER STATE
11 3 5 PLATE# PLATE# FROM To
TRLR. TRLR 3 7 33
12 3 5 VIN#' VIN#
FROM TO
VEH.YEAR 2023 MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE 3 7 34
13 4 TESL MODEL 5D DAMAGE YES NO YES[:] No
✓
REGISTERED OWNER INFO OWNEDBYDRIVER VEHICLE NO. 1
❑
SHADE IN DAMAGED AREA ❑ 35
14 LIABILITY INSURANCE INSURANCE CO ALLSTATE 947862743 3 4
IN EFFECT &POLICY# 9TOP
VEHICe CHARGE 1 5 36
LEGALLY YES❑NO❑ CITATION# 6A0002185 IMPROPER LANE USAGE I o eorrom
15❑ STANDING 7 6
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD M PHONE
UNIT 02 VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑LIES NO ET NO D:2067753814
16 a
LAST NAME MAHORO FIRST NAME OLIVIER MIDDLE
INITIAL
17❑ NEW STREETRE--- 511 QUEEN AVE NE CITY RENTON ST WA ZIP 98056 4❑ 37
18❑ CDL IGNITION REQUIRED IGNITION PR—E-1SENT MEDICAL—T�RANSPORTED � 38
INTERLOCKYES�NO� INTERLOCK YEs It I NOF YES
t l NOF,/
19 LICENSE# STATE WA SEX M M D.C.B. 10 _ 25 _ 1989 39
20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 H U EET 2 NJAURSY 1 NATURE OF INJURIES 40
❑21❑ PLATE# CJZ7519 TArE 41
WA VIN# JTDKBRFUOJ3083706 1
42
22❑ PLATE# STATE PLATE# STATE
TRLR
23❑ VIN#. IN#. 43
RLR
'
VEH YEAR 2018 MAKE TOYT MODEL PRIUS STYLE SD VEHICLE TOWED TO BLIN TOWEDBY GOV HI 44
L4❑ DAMAGE YESfj
NO,/ YES NO
REGISTERED OWNER INFO OLIVIER MAHORO 511 QUEEN AVE NE RENTON WA 98056 D:2067753814 VEHICLE NO.2
SHADEDAMAGEDAREA
3 4
LIABILITY
INSURANCE &POINSURGY#E CO STATE FARM 5360705C2147IN STOP 5
VEHICLE ❑ C[ CITATION# CHARGE to BOTTOM
LEGALLY YES N
25 s a
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# JAGENCY
26
E.CHANG 10065 WA0171300
PAGE 01 OF
PART A
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EH10342
COLLISION REPORT III III III III III 111
1591972 CASE# 26-4434
ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY)
NAME MIDDLE INITIAL) NGUYEN VAN M
(LAST FIRST,
ADDRESS&PHONE#
323 FERNDALE AVE NE RENTON WA 98056 4252746333 SEXi F MMDDYyvv 07 - 02 - 1968
PASSENGER L�WITNESS❑ UNIT# 1 PEAT OS 3 AIRBAG j 2 RESTR. 4 EJECT ? 1 HELMET NATURE OF INJURIES
USE 2 CLASS
'1
NAME
(LAST,FIRST,MIDDLE INITIAL) SOURIY STEPHEN S
ADDRESS&PHONE# D O B
119 GLENNWOOD AVE SE RENTON WA 98056 4255470042 SEXI M MMDDvvvv13 _ 1991
SEAT HELMET INJURY NATURE OF INJURIES
PASSENGER P]WITNESS UNIT# 2 PCS 6 AIRBAG 2 RESTR. 4 EJECT 1 USE 2 CLASS 1
NAME
(LAST FIRST MIDDLE INITIAL)
AppRESS&PHONE#
SEX D.O.B.
MMDDYYYY. -
PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET NJURY NATURE OF INJURIES
❑ ❑ POS. USE CLASS ----�
NARRATIVE'
On 06-09-2026 at about 1039 hours, I located a collision in the 1800 block of NE 3rd St, within the
City of Renton, King County, Washington.
Upon arrival I saw unit 1 and 2 were in lane 4 westbound.
There were no injuries in the collision.
Driver of unit 1 informed me he was merging into lane 4 to go onto Hwy 405 and collided with unit 2.
He said unit 2 was behind him. I saw he had damage on the front driver tire.
Driver of unit 2 said he was in lane 4 westbound when unit 1 merged into him from lane 3. The
passenger of unit 2 said unit 1 merged into them. There was damage on the front passenger side
bumper and fluids were leaking from unit 2.
Driver of unit 1 was not able to show me video of what occurred on his vehicle cameras.
I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT.
E.CHANG 06-09-26 01:31 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
J.TRADER 4553 1 6/9/2026 3:28:20 PM
BADGE OR ID# 10065 OR]#' WA0171300 TIME POLICE DISPATCHED' 10:39 AM TIME POLICE ARRIVED 10:39 AM
PART I PAGE IT]OF 3�
REPORTNO.! EH10342 CASE# 26-4434 DATE AND TIME 06/08/2610:39
OF COLLISION
*> . ......
ss
�t
$�rt�
s
x tSi t;54£i
i
41� it
tt
t v
v
k � tilt
;fill£ tS .k S
S) S
ASS
SSSh, �ss `�S"s7,,
3
S:a
PAGE 3 OF 3