HomeMy WebLinkAbout26-4305 TFFiNouCERA II I III 1 III I III I IIII III II I . 1 27c
COLLISION REP FIT 1591971
CASE 26-4305 z
INTERSTATE ❑ CITY STREET FIRE ❑RESULTED
1 STOLEN
STATE ROUTE ❑ OTHER ❑ VFHIC;I F ❑ LOCAL AOENC 4200 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 1714 17 ❑-= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
S GRADY WAY BLOCK NO. e✓ ----� ❑
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ �.❑ FEET e S ❑ W e SHATTUCKAVES
0 4 29
MOTOR PEDAL- DAMAGE THRESHOLDHONE
UNIT 01 VEHICLE ❑ CYCLE El MET P
YES
�/No D:4252467603 0 11
30
6� LAST NAME LING FIRSTNAME ERICA MIDDLE N 1 1 2 31
INITIAL
STREET ❑ 2407 MEADOW AVE N CITy RENTON ST WA 2jp, 980562530 z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
1/ I INTERLOCK YES[:]NO NTERLOCKYEs NO�/ YES R No�/
8❑ LRIIVER #
ON DUTY❑ STATUS AIRBAG 6 RESTR 4 EJECT 1 HELMET 2 INJURY 7 NATURE OF INJURIES z❑
USE CLASS NECK PAIN AND RIGHT LEG PAIN
3
10❑ Pl QTNFS# CUA2742 STATE WA VIN If 5TDZSKFCXSS208479
TRAILER STATE TRAILED STATE
11 3 5 PLATE# PLATE# FROM To
TRLR. TRLR $ 5 33
vIN#
12 3 5 ' VIN#
>;. FROM TO
❑ VEH.YEAR 2025 MAKE MODEL STYLE VEHICLE TOWED TO BLIN 7 3 TOWED BY GOVT.VEHICLE 34
13 4 TOYT SIENNA VN DAMAGE YES NO YES❑ No✓
REGISTERED OWNER INFO ERICA(JIG 2407 MEADOWAVE N RENTON WA 98056 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
14 LIABILITY INSURANCE z INSURANCE CO ALLSTATE 820595012 <�3 4LI EFFECT I POLICY#vE—LE CHARGE 36
LEGALLv res❑NO❑ CITATION# TTOM
15❑ STANDING 6
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT 02 VEHICLE ❑ CYCLE ❑ ❑ OWNER ❑ YES 1/ NO D:2069451007
16 a
LAST NAME PRATT FIRST NAME ELI MIDDLE
INITIAL
17 STREET❑ NEW ADOREss❑' 3059 ISLAND CREST WAYAPT 13 CITY MERCER ISLAND ST WA ZIP 98040 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 M M D.O.B. 11 14 1990 39
20❑ ON DUTY STATUS I
AIRBAG 6 RESTR 4 EJECT 1 H U EET 2 NJAURSY 1 NATURE OF INJURIES ❑ 40
❑ILICENSE 21❑ PLA E# BVL1133 TATE 41
WA vIN1i 2T3RWRFV1LW093687 1
42
22❑ PLATE# STATE PLATE# STATE
23❑ UIN#. 43
TRLR RLR
'IN#.
VEH YEAR 2020 MAKE TOYT MODEL RAV4 STYLE SD VEHICLE TOWED TO BLIN TOWEDBY GOV 44
24❑ DAMAGE YES NO GENE MEYERS YES NOHI
REGISTERED OWNER INFO ELI PRATT 3059 ISLAND CREST WAYAPT 13 MERCER ISLAND WA 98040 D:2069451007 VEHICLE NO.2
SHADEDAMAGEDAREA
3 4
LIABILITY
INSURANCE INSU8 PORGY#E CO PROGRESSIVE 990929279IN STOP 5
VEHICLE ❑ ,.I—I CITATION# CHARGE io BOTTOM
LEGALLY YES N J 6
25 OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# JAGENCY
26
KEV/N PETERSON 12808 WA0171300
PART A PAGE 01 OF C7
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT No. EH13031
COLLISION REPORT III III III III III 111
1591972 CASE# 26-4305
ADDITIONAL PERSONS INVOLVED PASSENGERS AND/OR WITNESSES ONLY)
NAME MIDDLE INITIAL) SHUC REED M
(LAST FIRST,
ADDRESS&PHONE#
2407 MEADOW AVE N RENTON WA 98056 SEX M MMDDYyry 10 - 25 - 2020
PASSENGER WITNESS UNIT# SEAT AIRBAG' RESTR. EJECT ' HELMET INJURY NATURE OF INJURIES
✓� ❑ 1 POS. 9 6 4 1 USE 2 CLASS 1
NAME
(LAST,FIRST,MIDDLE INITIAL)
ADDRESS&PHONE# DOB
E MMDDYYYY
PASSENGER [:]WITNESSO UNIT# SEAT I AIRBAG RESTR. EJECT HELMET NJURY NATURE OF INJURIES
POS. USE CLASS
NAME
(LAST FIR57 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'
I was dispatched to a vehicle collision on 06/03/26 at the intersection of Shattuck Ave S and S Grady
Way, in city Renton, King County WA.
Unit 1 CUA2742 Driver: Erica Ung (DOB 10/02/1987)
Unit 1 BVL1133 Driver: Eli J. Pratt (DOB 11/14/1990)
Upon arriving I saw two vehicles that collided in the intersection and Trilled was on scene evaluating
the occupants of the crash. I spoke to Unit 1 who told me that she was in the left turn lane facing
West on S Grady Way of the intersection on Shattuck Ave S. She said that the light turned yellow and
she went to make the turn. As she turned into the intersection Unit 2 collided with her and she stated
he was going fast.
I spoke with Unit 2 who told me that he was traveling East in lane 1 the far-right straight lane on S
Grady Way approaching the intersection of Shattuck Ave S. He said that the light turned yellow and
that's when he collided with Unit 2 in the intersection.
I gave both parties involved a case number and information exchange as a reference.
Both parties saw and talked to Tri Med and claimed no injuries but soreness.
I certify (declare) under penalty of perjury under the laws of the State of Washington that the
foregoing is true and correct.
Electronically signed: Officer Kevin L. Peterson Date and Place: 06/03/2026, 2109 hours at Renton,
WA
I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT.
KEVIN PETERSON 06-03-26 09:11 PM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY DATE
X LANE 10008 1 6/17/2026 1:25:34 PM
BADGE OR ID# ( 9Y808 OR]# WA0171300 TIME POLICE DISPATCHED 5:14 PM TIME POLICE ARRIVED 5:22 PM
PART I PAGE IT]OF
REPORTNO.! EH13031 CASE# 26-4305 DATE AND TIME 06/03/2617:14
OF COLLISION
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