HomeMy WebLinkAbout26-3153 TFFiNouCERA II I III 1 III I III I IIII III II I . 5 27c
COLLISION REP FIT 1591971
CASE 26-3153 z
INTERSTATE ❑ CITY STREET FIRE ❑RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHIr.I F ❑ LOCAL AOENC 4200 3
HIT 8 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#
cowsloN 04 - 1-- 2026 0855 17 ❑-= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
S.GRADY WAY BLOCK NO. e✓ 500 ❑
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ ❑ FEET e S ❑ W e SHATTUCKAVES
0 1 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
,/No D:2533257447 0 81
30
6� LAST NAME CHAUSSEE FIRSTNAME CHRISTIAN MIDDLE A 1 1 2 31
INITIAL
STREET ❑✓ 1600 BENSON DR#109 CITY RENTON ST WA 21p 98055 z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
INTERLOCK YES[:]NO INTERLOCKYEs NO YES NO
LRIIVER # STATE WA SEXI M MI MIT Y
8❑ ' 04 - 22 - 2006 1 2 32
9 ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 HELMET USE 2 CLASS 1 NATURE OF INJURIES z❑
3
10❑ Pi aTES� CTE6523 sTArI WAurN# W04G15GV8B1128133
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 2011 BUIC REGAL 4D MAKE M ✓
ODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE J 9 34
13 4 DAMAGE YES NO YESYES[:] NO
REGISTERED OWNER INFO CHRISTIAN C.IJSSEE 226 ALBERT ST WILKESON WA 98396 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
14 LIABILITY INSURANCE INSURANCE CO PROGRESSIVE 860108590 <1�3 4
LI EFFECT I SUR N# TOPVEHICLE CHARGE 36
E�ALLv YES❑NO❑ CITATION# 6AO170117 INATTENTIVE DRIVINGorrom
15❑ STANDING 7 6
MOTOR PEDAL- PROPERTY DAM THR OLD MET PHONE
UNIT 02 ❑✓ ❑ PEDESTRIAN ❑ ❑ DD 2966985440
VEHICLE CYCLE OWNER YES�/ NO
16 a
LAST NAME MALEH MIR FIRST NAME ASHKAN MIDDLE N
INITIAL
17❑ NEW STREETR 11604 S
7 E 236TH ST CITY KENT ST WA ZIP 980313684 4❑ 37
18❑ CDL IGNITION REQUIRED IGNITION PR-E-1SENT MEDICAL-T�RANSPORTED � 38
INTERLOCKYES�NOR INTERLOCK YEs It I NOF YES
t l NO❑
19 DRIVER'S STATE WA SEX M D.C... 04 07 1996 39
LICENSE# MMDDYY
20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 H U EET 2 NJAURSY 1 NATURE OF INJURIES ❑ 40
❑21❑ PLATE# CMP0625 TArE 41
WA VIN# JTJKGCEZ3R2016513 1
42
22❑ PLATE# STATE PLATE# STATE
TRLR
23❑ UIN#. IN#.
43
RLR
'
VEH YEAR 2024 MAKE LEXS MODEL NX STYLE UT VEHICLETOWED TO BLIN TOWEDBY GOV HI 44
L4❑ DAMAGE YES NO YES NO
REGISTERED OWNER INFO SHIRIN DAMIRCHEL11133 EAGLE LN S APT IO RENTON WA 98055 VEHICLE NO.2
SHADE IN DAMAGEbAREA
2 3 Cd
LIABILITY
INSURANCE 8 POINSURGY#E CO PROGRESSIVE 981753728IN 1 STOP
'E""LE CITATION# CHARGE
LEG
25 i o BOTTOM
ALLY YES NEI
❑ s
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
J
26
C.JACOBS 1953 WA0171300
PAGE 01 OF
PART A
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT NO. EH12995
COLLISION REPORT III III III III III 111
1591972 CASE# 26-3153
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 4-23-26 at about 0855 1 arrived in the 400 block of S Grady way for a 2-vehicle collision. Both
vehicles were stopped in lane 2 of westbound South Grady Way. Both drivers were out of their
respective vehicles standing in the roadway. Both drivers identified themselves via WADL.
Driver 1, Christian Chaussee told me;
He was westbound in lane 2. He believed that traffic in front of unit 2 had started to move, but did not
realize unit 2 was still stopped and struck unit 2 from the rear.
He was not injured.
Driver 2 told me;
He was stopped due to the traffic being stopped at the red light when unit 1 struck his vehicle from the
rear.
He does not think he was injured.
Both vehicles were driven from the roadway.
I issued Chaussee an infraction for drivers inattention including collision via complaint.
This collision occurred in the city of Renton, County of King.
I declare under penalty of perjury under the laws of Washington state that the foregoing is true and
correct.
C. Jacobs/1953
I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT.
C.JACOBS O4-23-26 11:38 AM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
X LANE 1000E 1 5/22/2026 11:23:21 PM
BADGE OR ID# 1953 OR]# WA0171300 TIME POLICE DISPATCHED 8:55 AM TIME POLICE ARRIVED',8:55 AM
PART I PAGE IT]OF
REPORT NO.! EH12995 CASE# 26-3153 DATE AND TIME 04/23/26 08:55
OF COLLISION
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