HomeMy WebLinkAbout26-4703 TFFiNouCERA II I III 1 III I III I IIII III II I . 5 27c
COLLISION REP FIT 1591971
CASE 26-4703 z
INTERSTATE ❑ CITY STREET FIRE ❑RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHICI F ❑ LOCAL AGENC 4100 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'. 06 - 1-— 2026 1853 17 ❑-= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
BLOCK NO. e✓ --- ----� ❑
NE 4TH ST MILEPOST
4a❑
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ ❑ FEET e S ❑ VV e HOQU/AM AVE NE
0 5 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
,/No D:3105053100 0 11
30
6� LAST NAME LAZORE FIRSTNAME ARLYN MIDDLE V 1 2 31
INITIAL
STREET ❑✓ 18211 SE 121 ST CITY RENTON ST WA ZIP 98059 z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
iNTERLOCKYEs NO 1/ INTERLOCKYEs NO�/ YEs No�/
❑ DRIVER'S' STATE CA SEX'M MI MIT Y 02 - 27 - 1934 1 2 32
8 LICENSE#
9 1 ON DUTY❑ STATUS AIRBAG 4 RESTR 4 EJECT 1 HELMET U E 2 INJ gY 1 NATURE OF INJURIES z❑
❑ 3
10❑ P1 ATNES# 9MRN502 STATE CA v N# 19XF62F50DE245929
5 TRAILER STATE TRAILER STATE
11
3-LATE# PLATE# FROM TO
TRLR. TRLR 7 7 33
12 3 5 VIN#' VIN#
FROM TO
❑ VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN T v GOVT.VEHICLE 7 ] 34
13 3 2013 HOND CIVIC DAMAGE vE8 0NO agW�MEYERS ves❑ No
REGISTERED OWNER INFO OWNEDBYDRIVER VEHICLE NO. 1
SHADE IN DAMAGED AREA ❑
14 LIABILITY INSURANCE INSURANCE CO STATE FARM 5678854-D02.47A 35
4
IN EFFECT &POLICY# STOP
15❑ LE
vEGALLY Hla.e 5 36
res�No D CITATION# 6A0048857 CHARGE FAIL YIELD LEFT TURN MOTOR )o sorroM
STANDING 8 7 6
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT 02 VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES 1/ NO D:4257616810
16 a
LAST NAME SANABRIA-TAFOLLA FIRST NAME CITLALLI MIDDLE N
INITIAL
17❑ STREET NEW ADOREss❑' 401 TAYLOR AVE NW APT 10 CITY RENTON ST WA ZIP 980573470 4❑ 37
18❑ CDL IGNITION REQUIRED IGNITION PR-E-1SENT MEDICAL-T�RANSPORTED � 38
INTERLOCKYES�NO� INTERLOCK vEs It I NOF YES
t l NOF,/
19 DRIVER # STATE WA SEX F M D.C.B. 07 31 2000 39
20❑ ON DUTY STATUS AIRBAG,6 RESTR 4 EJECT 1 HE 2 INJURY 7 NATURE of INJURIES ❑ 40
USE CLASS BLOODYNOSE
❑21 PLA E# CUV2037 TATE 41
WA VINE 1N4AL21E58C132835 1
42
22❑ PILER LATE# STATE PLATE# STATE
23❑ VIN#. 43
TRLR RLR
'IN#.
TOWED BV Gov HI 44
VEH YEAR 2008 MAKE jy/$$ MODEL SQL)-/Nj�Q STYLE -TEHICLE
TOWED✓ NOO BLIN GENE MEYERS YES NO�/
24❑ REGISTERED OWNER INFO OWNED SY DRIVER VEHICLE N0.2
SHADEDAMAGED AREA
3 4
INAEFFITY ECTNSURANCE❑ &POINSULICY#E CO STOP 5
'E""LE ❑ ,J� CITATION# CHARGE to BOTTOM
LEGALLY YES N J
25 e
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
26
JAKE GALL 12617 WA0171300
PART A PAGE 01 OF C7
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EH12825
COLLISION REPORT III III III III III 111
1591972 CASE# 26-4703
ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY)
NAME MIDDLE INITIAL) MARRIOTT REBEKAH E
(/AST FIRST,
ADDRESS&PHONE#
18820 SE 134TH ST RENTON WA 98059 2069920158 SEXi F MMDOYyry 07 - 23 - 1986
PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT ' HELMET INJURY NATURE OF INJURIES
❑ ❑✓ POS. USE CLASS
NAME
(LAST,FIRST,MIDDLE INITIAL) MEADOWS BRENDA L
ADDRESS&PHONE# DOB
410 S 50TH PL UNIT B RENTON WA 98055 2084131606 SEX: F MMDDYvvv 01771
- 17 - 1964
PASSENGER UNIT# SEAT AIRBAG RESTR. EJECT HELMET INJURY NATURE OF INJURIES
[]WITNESS POS. USE CLASS
NAME
(LAST FIR57 MIDDLE INITIAL)
AppRESS R PHONE#
SEX D.O.B.MMDD -❑
YYYY.
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.
JAKE GALL 06-16-26 08:28 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
NfCOLAS SANGDER 11350 6/17/2026 12:57:40 AM
BADGE OR ID# 12617 OR]# ': WA0171300 TIME POLICE DISPATCHED! 6:54 PM TIME POLICE ARRIVED',6:55 PM
PART I PAGE IT]OF 4�
REPORT NO. EH12825 CASE# 26-4703 OF COLLISION
06/16/26 18:53
OF CbLLI510N
NARRATIVE
*This incident was captured on my body worn video camera. This report is a summary of events that
occurred and is not an exact sequencing of events. Statements have been paraphrased and
summarized. *
The following occurred within the City of Renton, King County WA and was recorded on my body
worn camera.
On 06/16/2026 at around 1854 hours, I was dispatched to an injury accident located at the
intersection of NE 4th St and Hoquiam Ave NE. I arrived on scene at 1855 hours and observed
vehicle 1 perpendicular to NE 4th ST, blocking both East and West lanes. Vehicle 2 was parked off
the north side of the road, with heavy front-end damage.
I contacted driver 1 who was still sitting inside his car. Driver 1 was able to provide me with his
license and insurance. Driver 1 stated that he was in the center turn lane, facing East on Ne 4th ST.
Driver 1 had the green light and attempted to navigate a U-turn to head back West on NE 4th ST.
Driver 1 did not see vehicle 2 driving West on NE 4th ST, which impacted vehicle 1's passenger's
side front door. Driver 1 was not injured but was elderly and had a failing memory. I had to ask him
multiple times for his vehicle insurance. He also could not remember his home address. Driver 1 was
checked out by aid as a precaution.
Vehicle 1 was not drivable, so Gene Meyers was called to the scene.
I contacted driver 2. Driver 2 was checked out by Renton Fire due to a bloody nose and bruising on
her arms. Driver 2 did not have insurance, but provided me with all her information. Driver 2 was
driving the speed limit west on NE 4th ST in lane 2 of 2. She observed vehicle 1 turn in front of her.
She was unable to slow down and impacted the passenger side of vehicle 2. Two witnesses also
provided the same story.
Vehicle 2 was also towed by Gene Meyers.
I provided both drivers with the case number.
I informed driver 1 that he will be receiving an infraction in the mail for failing to yield (6A0048857),
and that he would need to respond to the infraction within 33 days.
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 J. Gall/12617
06/18/2026 at 2016 hours, Renton, Washington
PAGE 3 OF 4
REPORTNO.! EH12825 CASE# 26-4703 DATE AND TIME 06/16/2618:53
OF COLLISION
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