HomeMy WebLinkAbout26-4292 a ITFFi "OLCERA II IfI) 1 IlfII ('II (Illf If( fI I . 5 27c
COLLISION REP FIT 1591971
SASE 26-4292 2
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 N E IN CITY#
cawsloN 06 - 1-- 2026 1119 17 ❑-= S 8 IN e 1070 3
4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION ❑✓ NON INTERSECTION ❑
AIRPORT WAY S
BLOCK NO. e✓ --- ----� ❑
4a❑ MILEPOST
DISTANCE OF(REFERENCE OR CROSS STREET)
5❑ ❑ FEET e S ❑ VV a RAINIER AVE S
0 1 29
MOTOR PEDAL- DAMAGE THRESHOLD MET PHONE
UNIT 01 VEHICLE ❑ CYCLE El
NO F,/ I D:2532008839 0 81
30
6� LAST NAME RANGEL FIRSTNAME DIEGO MIDDLE N 1 1 2 31
INITIAL
STREET ❑ 28884 213TH CT SE CITY KENT ST WA ZIP 980426858 z
NEW ADDRESS
7❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED 3
iNTERLOCKYEs NO INTERLOCKYEs NO YES R NO
8❑ LRIIVER #
ON DUTY❑ STATUS AIRBAG 2 RESTR 4 EJECT 1 H U SE
ICNLJAUSSY 1 NATURE OF INJURIES z❑
3
10❑ P1 aT�S� D40176H sTArI WAvIN# 1FTNS24t84HA33223
TRAILER STATE TRAILER STATE
11 3 5 PLATE# PLATE# FROM TO
TRLR. YRLR. 3 5 33
12 0 0 VIN#' VIN#
>; FROM TO
VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN TOWED BY GOVT.VEHICLE J 9 34
13 r 2004 FORD ECONO DAMAGE YES NO YES[:] NO✓
REGISTERED OWNER INFO NESTOR RANGEL..111025 SE 272ND STAPT H2O4 KENT WA 98042 VEHICLE NO. 1 ❑
SHADE IN DAMAGED AREA 35
14 LIABILI INSURANCE INSURANCE CO SAME. 3 4
IN EFFECT &POLICY# 9TOP
VEHICLE 5 36
Yes❑NO❑ CITATION# CHARGE 10 BOTTOM
15❑ LEGALLY STANDING 8 7 6
MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE
UNIT VEHICLE ❑ CYCLE ❑ ❑
16 a OWNER ❑ YES 1/ NO D:4252827986
LAST NAME LEE FIRST NAME NORA MIDDLE I P
INITIAL
17❑ STREET ❑', 4008 LAKE WASHINGTON BLVD N A CITY RENTON ST WA ZIP 980561580 37
NEW ADDRESS ❑
18� CDL IGNITION REQUIRED IGNITION PR—E-1SENT MEDICAL TRANSPORTED ❑ 38
INTERLOCKYES�NOR INTERLOCK YEs It I NOF YES t t— l NO❑
19 LDI IVER # STATE WA SEX F M .C.B. 11 10 _ 1954 0 39
WELMET INJURY1 NATURE OF INJURIES 40
20❑ ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 USE CLASS ❑
21❑ LICENSE 479YZI TAre WA VIN1 1HGCG6699YA064420
❑ 41
PLATE#
42
22❑ PILER LATE# STATE PLATE# STATE
23❑ UIN#. 43
TRLR RLR
'IN#.
VEH YEAR 2000 MAKE HOND MODEL ACD4D STYLE VEHICLETOWED TO BLIN TOWEDBY GOV HI 44
L4❑ DAMAGE YES NO YES NO
REGISTERED OWNER INFO NORA LEE 4008 LAKE WASHINGTON BLVD N A RENTON WA 980561580 D:4252827986 VEHICLE NO.2
SHADE IN DAMAGEbAREA
2 3 Cd
LIABILITY
INSURANCE &POLICY#E CO PEMCO CA0597750IN 1 9TOP
vE""LE CITATION# CHARGE
LEG
25 i o BOTTOM
ALLY YES NEI
❑ s
OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY
J
26
M.LEVERTON 2517 WA0171300
PAGE 01 OF
PART A
3000-345-159 OR 11/181
STATE OF
POLICETRAFFICN CORRECTION REPORT No. EH13033
COLLISION REPORT III III III III III 111
1591972 CASE# 26-4292
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'
unit 2/gold stopped outside left turn airport unit 1 behind saw wb green and went on red
RTF
Within the city limits of Renton/King/Wa I responded to a 2 vehicle crash at the intersection of Rainer
Ave S at Airport Way. I contacted both drives in the parking lot of a nearby McDonald's.
Unit 2 told me she was stopped in the outside left turn lane westbound to southbound when she was
hit from behind by unit 1. She did not complain of injury and damages did not require a tow truck.
I contacted the driver of unit 1 who told me he was behind unit 2 stopped and noticed the light change
from green to red and he proceeded. However, this green light was not west bound to west bound
and not the turn lane. He did not complain of injury and damages did not require a tow truck.
Information/insurance only
I certify (declare) under penalty of perjury under the laws of the State of Washington that the
foregoing is true and correct.
M.Leverton/2517 City of Renton/King/Wa 6/5/2026
I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT.
M.LEVERTON 06-05-26 11:08 AM
INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST DET DATED PLACE SIGNED
APPROVED BY E
DAT
K.LANE 10008 6/17/2026 1:27:55 PM
BADGE OR ID# 2517 OR]# WA0171300 TIME POLICE DISPATCHED 11:20 AM TIME POLICE ARRIVED';11:34 AM
PART I PAGE IT]OF
REPORTNO.! EH13033 CASE# 26-4292 DATE AND TIME 06/03/2611:19
OF COLLISION
Wl l t
t ,V .
c f �
s atsstt���rsz. .,
t
r...
,¢�
JJ
r
1 L s ;rr iy
5
4
C 1
yr
a
PAGE 3 OF 3